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The following opinion is presented on-line for informational use only and does not replace the official version. (Mich Dept of Attorney General Web Site - www.ag.state.mi.us)



STATE OF MICHIGAN

FRANK J. KELLEY, ATTORNEY GENERAL


Opinion No. 6497

February 22, 1988

HOSPITAL FINANCE AUTHORITY ACT:

Loans to hospital service corporations

A nonprofit cooperative hospital service organization is not a hospital and, therefore, is ineligible to borrow money from the State Hospital Finance Authority.

Honorable David C. Hollister

State Representative

The Capitol

Lansing, Michigan 48913

You have requested my opinion on the following question:

Is a nonprofit cooperative hospital service organization described in Section 501(e) of the Internal Revenue Code (the 'Code') which is exempt from federal taxation pursuant to Section 501(a) of the Code, and which provides supporting services to hospitals, eligible to borrow money from the Michigan State Hospital Finance Authority?

Your letter of request provides the following background of the cooperative hospital service organization in question:

'Detroit Medical Center Cooperative Services (DMCCS) is a cooperative hospital service organization which was incorporated in 1970 as a Michigan nonprofit corporation. DMCCS is organized on a membership basis; the members of DMCCS are:

--Children's Hospital of Michigan

--Detroit Receiving Hospital and University Health Center

--Grace Hospital Division and Harper Hospital Division of Harper-Grace Hospitals

--Hutzel Hospital

--Rehabilitation Institute, Inc.

'All of the members are Michigan nonprofit corporations licensed as hospitals under Article 17, Part 215 of the Public Health Code (Act No. 368 of the Michigan Public Acts of 1978, as amended). They are also all tax exempt, charitable organizations as described in Section 501(c)(3) of the Code.

'Since its incorporation, DMCCS has been operated as a cooperative hospital service organization as described in Section 501(e) of the Code. . . .

'. . . .

'The Articles of Incorporation of DMCCS set forth the sole purpose for which DMCCS was formed:

"To perform, on a centralized basis, for organizations described in Section 501(e)(1)(B) of the Internal Revenue Code, as it has been or may in the future be amended, any or all of the following services: data processing, purchasing, warehousing, billing and collection, food, industrial engineering, laboratory, printing, communications, record center, and personnel services (including selection, testing, training and education).'

"To perform and render such services, to the extent only that such services are required for and incident to the performance of the tax exempt functions of each such organizations.'

'DMCCS performs a number of the above-referenced services, including: the operation of a centralized telephone communications system, a transcription service for medical records, a telepaging system for paging doctors and other staff, the administration and coordination of a graduate medical education program, and the operation of a central computerized electrocardiogram system. The recipients of the services of DMCCS are its member hospitals and certain nonmember hospitals located in Michigan. All of the hospitals to which supporting services are provided by DMCCS are non-profit, non-public hospitals licensed by the Department of Public Health, and are tax exempt organizations as described in Section 501(c)(3) of the Internal Revenue Code.

'Correspondingly, the Internal Revenue Service has determined that DMCCS meets the requirements of Section 501(e), and therefore qualifies as an organization described in Section 501(c)(3).'

Your letter states that the members of Detroit Medical Center Cooperative Services (DMCCS) are all private, nonprofit corporations licensed as hospitals, each of which is served by DMCCS.

Section 501(e) of the Internal Revenue Code of 1954, 26 USC 501(e), describes a cooperative hospital service organization as follows:

'For purposes of this title, an organization shall be treated as an organization organized and operated exclusively for charitable purposes, if--

'(1) such organization is organized and operated solely--

'(A) to perform, on a centralized basis, one or more of the following services which, if performed in its own behalf by a hospital which is an organization described in subsection (c)(3) and exempt from taxation under subsection (a), would constitute activities in exercising or performing the purpose or function constituting the basis for its exemption: data processing, purchasing, warehousing, billing and collection, food, clinical, industrial engineering, laboratory, printing, communications, record center, and personnel (including selection, testing, training, and education of personnel) services; and

'(B) to perform such services solely for two or more hospitals each of which is

(i) an organization described in subsection (c)(3) which is exempt from taxation under subsection (a),

(ii) a constituent part of an organization described in subsection (c)(3) which is exempt from taxation under subsection (a) and which, if organized and operated as a separate entity, would constitute an organization described in subsection (c)(3), or

(iii) owned and operated by the United States, a State, the District of Columbia, or a possession of the United States, or a political subdivision or an agency or instrumentality of any of the foregoing;

'(2) such organization is organized and operated on a cooperative basis and allocates or pays, within 8-1/2 months after the close of its taxable year, all net earnings to patrons on the basis of services performed for them; and

'(3) if such organization has capital stock, all of such stock outstanding is owned by its patrons.'

The Hospital Finance Authority Act, MCL 331.31 et seq; MSA 14.1220(1) et seq, established the State Hospital Finance Authority, MCL 331.41; MSA 14.1220(11), and empowered it to lend money to hospitals for hospital facilities, MCL 331.43; MSA 14.1220(13).

The title to the Hospital Finance Authority Act states:

'AN ACT to create a state hospital finance authority to lend money to nonprofit hospitals for capital improvements or to refinance hospital indebtedness; to provide for the incorporation of local hospital authorities with power to lend money to nonprofit hospitals for hospital indebtedness or to refinance hospital indebtedness; to construct, acquire, reconstruct, remodel, improve, add to, enlarge, repair, own, lease, and sell hospital facilities, to finance outstanding hospital indebtedness; to authorize the authorities to borrow money and issue obligations to accomplish the purposes of this act, including the refunding or advance refunding of obligations issued by 1 or more authorities created or incorporated under this act; to permit the authorities to enter into loans, contracts, leases, mortgages, and security agreements which may include provisions for the appointment of receivers; to exempt obligations and property of the authorities from taxation; and to provide other rights, powers, and duties of the authorities.'

The title of the Hospital Finance Authority Act refers to the lending of money to nonprofit hospitals. 'Hospital' is defined in the Hospital Finance Authority Act as follows:

"Hospital' means a nonpublic corporation, association, institution, or establishment located within the state for the care of the sick or wounded or of those who require medical treatment, operated without profit to an individual corporation or association. It includes nonprofit corporations or other organizations engaged solely in some phase of hospital activity or in providing a supporting service to hospitals or public corporations which operate or own hospital facilities.' MCL 331.33(e); MSA 14.1220(3)(e). [Emphasis added.]

The Public Health Code, 1978 PA 368, as amended, MCL 333.1101 et seq; MSA 14.15(1101) et seq, Article 17, contains a number of definitions of a hospital. Part 201, which involves general provisions relating to health care facilities and agencies, at MCL 333.20106(5); MSA 14.15(20106)(5), contains the following definition:

"Hospital' means a facility offering inpatient, overnight care, and services for observation, diagnosis, and active treatment of an individual with a medical, surgical, obstetric, chronic, or rehabilitative condition requiring the daily direction or supervision of a physician. The term does not include a hospital licensed or operated by the department of mental health.'

Part 215 of the Public Health Code, at MCL 333.21511; MSA 14.15(21511), which involves the licensing of hospitals, contains the following provision:

'(1) A hospital shall be licensed under this article.

'(2) 'Hospital' shall not be used to describe or refer to a health facility unless the health facility is licensed as a hospital by the department under this article. This section does not apply to a hospital licensed or operated by the department of mental health or the federal government or to a veterinary hospital.'

The Mental Health Code, 1974 PA 258, as amended, MCL 330.1100 et seq; MSA 14.800(100) et seq, provides for the licensure of mental and psychiatric hospitals, and defines such hospitals at MCL 330.1135; MSA 14.800(135), in part, as follows:

'[A] mental hospital, psychiatric hospital, or psychiatric unit is an establishment offering inpatient services for observation, diagnosis, active treatment, and overnight care of persons with a mental disease, or with a chronic mental disease or condition requiring the daily direction or supervision of physicians licensed to practice in the state.'

Part 221, which involves the issuance of certificates of need, contains at MCL 333.22104(5), MSA 14.15(22104)(5), the following provision:

"Hospital', for purposes of sections 22156 to 22158 only, means a hospital as regulated under part 215, but shall not include a veterans facility operated by the state or federal government.'

OAG, 1979-1980, No 5510, p 205, 207-208 (June 28, 1979) concluded that a health maintenance organization was not eligible to obtain a loan from the Michigan State Hospital Finance Authority. OAG, 1979-1980, No 5510, stated:

'The intent of the Legislature in enacting 1969 PA 38, supra, must be ascertained by reading all of the provisions of the statute. Smalley v Ashland Brown-Stone Co, 114 Mich Commission v Fraternal Order of Eagles, Aerie No. 629, 286 Mich 32; 281 NW 427 (1938). From a reading of all of the cited statutory provisions, it must be concluded that the Legislature intended licensed private hospitals to be eligible for loans from the State Hospital Finance Authority for hospital facilities. The latter includes certain facilities incidental to and necessary for the efficient operation of licensed private hospitals, as well as the erection of an office building, 80 percent of whose space is to be leased to certain licensed or certified health professionals, to meet a demonstrated need as determined by the Department of Public Health and to be geographically or functionally related to one or more hospital facilities, as enumerated in 1969 PA 38, Sec. 3(e)(f)(i), supra. Non-licensed hospital entities are not eligible for such loans.' (Emphasis added.) OAG, 1979-1980, No 5510, supra, at 207-208.

DMCCS has not been, and is not, licensed as a hospital or a health facility by the Michigan Department of Public Health or by the Department of Mental Health. DMCCS is not 'offering inpatient, overnight care, and services for observation, diagnosis, and active treatment' of patients, MCL 333.20106(5); MSA 14.15(20106)(5), nor does it offer 'inpatient services for observation, diagnosis, active treatment, and overnight care of persons with a mental disease, or with a chronic mental disease or condition requiring the daily direction or supervision of physicians licensed to practice in the state.' MCL 330.1135; MSA 14.800(135). It is merely an administrative support organization of several hospitals, but it does not constitute a hospital, and is not a facility under the licensure provisions of the Public Health Code, Part 215, supra, or under the Mental Health Code, supra. A hospital service corporation does not constitute a hospital for purposes of review and issuance of a certificate of need, as it does not constitute either a hospital or any other health facility, as defined in the Public Health Code, Part 221, supra.

It is my opinion, therefore, that a nonprofit cooperative hospital service organization is not a hospital and is ineligible to borrow money from the State Hospital Finance Authority.

Frank J. Kelley

Attorney General


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