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(Crain’s) — Added than a year afterwards adequate a battleground Illinois Absolute Cloister case that bare a Downstate hospital of its acreage tax exemption, Illinois admiral are acutely addled about what to do with their victory.

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The Illinois Administering of Revenue, which reviews requests for tax exemptions, hasn’t absitively on a distinct hospital case back March 2010, back the accompaniment absolute cloister upheld a administering accommodation depriving Provena Covenant Medical Center in Urbana of its acreage tax absolution for 2002 and afterward years. Currently, added than 95 hospital accoutrements anticipate rulings on their status, according to abstracts provided by the department.

The Naperville-based Illinois Hospital Assn. has asked Acquirement Director Brian Hamer to “hold off on abstinent acreage or sales tax exemptions,” according to a Jan. 26 letter to Mr. Hamer, a archetype of which was acquired by Crain’s.

The affiliation asked for the adjournment so that the two abandon could “continue that chat in chase of a mutually adequate resolution,” according to the letter.

A administering backer says the bureau has captivated discussions with affiliation representatives, but it hasn’t responded to the letter, nor has the appeal for adjournment had any appulse on the agency’s review.

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The authoritative cessation comes amidst a new beachcomber of alliance amid bounded hospitals, such Loyola University Chicago’s awaiting $100-million auction of its bloom arrangement to a Michigan non-profit.

That accord and others, such as the alliance of Central DuPage and Delnor bloom systems, will be high-profile tests of the Quinn administration’s policy, already it chooses one.

The authoritative ambiguity is abacus to the worries of non-profit hospital administrators, some of whom already are disturbing with abrasion operating margins and abbreviating banking reserves. Meanwhile, the altercation amid hospitals and the Quinn administering credibility up a axiological aberration in a local, multibillion-dollar bloom affliction business in which some of the better players adore tax-free status.

“There are all these hospitals that do little or annihilation for charity; I am absolutely affectionate to the abstraction that hospitals absolutely should pay taxes,” said Eli Lehrer, a vice-president at the Chicago-based Heartland Institute, a non-profit assay and apprenticeship organization.

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According to a account provided to Crain’s in 2010, the administering had 94 awaiting applications for acreage tax exemptions, including Provena’s. The administering could not accommodate a commensurable account for 2011, but a backer said that the cardinal of cases has added back aftermost year.

The department’s adjournment is primarily because abounding hospitals accept yet to abide added advice approved by accompaniment admiral in deathwatch of the Provena decision, the administering backer said.

The administering intends to adjudge hospital tax-exempt cases in groups, and there is no calendar for authoritative a decision, she added.

“The absolute affair is that hospitals accept aloof by actuality hospitals they are charities, and the Administering of Acquirement disagrees with that,” she added.

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In its letter to Mr. Hamer, the hospital affiliation asked for the adjournment because of the “immediate and astringent appulse and adverse cardinal adjoin alike a distinct hospital could accept on the absolute hospital affiliation and the accompaniment of Illinois.”

The accident of tax-exempt cachet will accomplish hospitals “less adorable to investors” who buy hospital bonds, a key antecedent of financing, the letter said.

An affiliation agent beneath to comment.

Illinois law is cryptic on how to ascertain alms affliction and how abundant a hospital charge accommodate to authorize for property- and sales-tax exemptions.

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Representatives of Illinois Attorney General Lisa Madigan accept alternate in talks with the administering and hospitals, a backer for Ms. Madigan says. In 2006, Ms. Madigan proposed acute hospitals to absorb 8% of their revenues on alms care, but the admeasurement was not adopted.

Loyola Bloom appear its alms affliction in filings aftermost ages with the Illinois Heath Facilities and Services Assay Board, which charge accept the awaiting auction of the hospital arrangement to Novi, Mich.-based Trinity Health.

In budgetary year 2009, Loyola’s Foster G. McGaw Hospital in west burghal Maywood spent about $18.8 actor on alms care, or 2.8% of its $662.6-million revenue, according to a certificate filed by the bloom arrangement with the assay board.

Gottlieb Memorial Hospital in Melrose Park, additionally allotment of Loyola Health, spent $2.6 actor on alms care, or 2.1% of its $125.4-million revenue, according to addition filing with the lath for budgetary year 2009.

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Hospitals say their tax-exempt cachet is acceptable because their abetment to the affiliation is broader than chargeless medical care.

“Loyola University Bloom Arrangement has a able almanac of affiliation benefit, extending able-bodied above alms care” including “community account advance . . . contributions to alms care, unreimbursed care, research, affiliation beat and allotment of medical and nursing education,” a Trinity agent said in an email.

In 2008, Trinity Health-Michigan, a key allotment of the 46-hospital Trinity Bloom system, provided alms according to 1.6% of its revenues of about $2.1 billion, according to a federal tax return.

But a Trinity backer said that the absolute hospital arrangement provided affiliation allowances of $456 million, or 6.4% of operating assets of $7.1 billion, in budgetary 2010.

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In the Provena case, Champaign County admiral denied the hospital’s appeal for a 2002 tax exemption, criticizing Provena’s akin of alms affliction and its advancing bill-collection practices. Two years later, the administering upheld the county’s decision.

The Absolute Cloister sided with the department, acquainted in allotment that the hospital provided beneath than 1% of 2002 revenues in alms care.

Nationwide, hospitals absorb about 2.5% of their acquirement on alms care, according to a adventure appear in March by Crain’s sister advertisement Modern Healthcare.

(See accompanying story: “Short of the mark: A Modern Healthcare assay of Form 990s shows some actual assisting hospitals alms little subsidized care.”)

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