Frequently Asked Questions

Below you will find answers to the questions most frequently asked. If you do not find the information you need, please contact us at info@alegent.com.

1. Question: Why does the Alegent Health organization receive tax exempt status from the federal government?

   Answer: The federal government recognizes the "promotion of health" as a charitable purpose. An entity organized for charitable purposes qualifies for tax-exempt status under Section 501(c)(3) of the Internal Revenue Code. Tax-exempt status is essential to assisting healthcare organizations in achieving their charitable purpose of offering a broad array of activities and services that promote the health of the community.

2. Question: Why is not-for profit healthcare an important model?

   Answer: Not-for-profit healthcare organizations provide 85% of the healthcare in the United States. These not-for-profit healthcare organizations are devoted to the charitable purpose of promoting community health and care for patients regardless of their ability to pay. Without the not-for-profit healthcare system, many underinsured and uninsured patients would not receive the care they need.

3. Question: What does Alegent Health need to do to maintain its tax-exempt status?

   Answer: In order to maintain tax-exempt status, an entity must demonstrate it is organized and operated for charitable purposes such as the promotion of health. This is accomplished by providing services that promote the health of the community , providing emergency room care without regard to ability to pay, devoting available funds to enhance healthcare services in the community and offering a charitable care program for those in need. Without shareholders that require dividends, not-for-profit healthcare organizations devote their resources entirely to providing and improving healthcare.

4. Question: Does Alegent Health meet its obligations to provide charitable care in exchange for its tax-exempt status?

   Answer: Alegent Health exceeds its obligation to provide charitable care as it provides emergency room care without regard to ability to pay; offers a generous financial assistance plan for patients who cannot afford to pay; and it strives to provide services that promote the health of its entire community. In the last year, over 6,500 uninsured patients obtained treatment at Alegent Health. Over the last five years, Alegent Health has provided nearly $17 million in charity care.

5. Question: What is the difference between the internal audit and external audit and why are both needed?

   Answer: The external audit is an independent review to obtain reasonable assurance as to whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation.
   
   Conversely, an internal audit is an independent assessment function established within an organization to examine and evaluate its activities as a service to the organization. Audits include operational, compliance and financial focus. Internal audit measures the degree to which various functions of the organization adhere to such areas as managerial policies and regulatory directives.
   
   Why both? Well, in addition to the assurance provided to the reader of its financial statements, an external audit meets an obligatory requirement because of Alegent Health's publicly held debt.
   
   Although an Internal Audit program is not required, having one enhances the Board of Directors' ability to discharge its fiduciary responsibility in the oversight of internal controls. Senior Leadership obtains a greater understanding of the organization's strengths and opportunities. Management benefits from the identified audit recommendations.

6. Question: How is the external auditor chosen? How often do they change?

   Answer: Engagements with external audit firms are evaluated every three years.

   External auditors are evaluated on the following criteria:

   • Industry knowledge - Strong healthcare background and client base
   • Staff - Highly seasoned, well trained audit professionals with a consultant's perspective and strong business acumen
   • Service - Consistent, exceptional, partnering with Alegent Health management
   • Technology - Leading edge audit methodologies and tools
   • Systems/information technology - audit experience and credentials
   • Fees - Exceptional value
   • RFP process (explained below)

   Written RFP responses are evaluated and scored by Alegent Health Accounting & Finance management. RFP finalists are interviewed by a selection committee composed of membership from the Alegent Health Finance & Audit Committee and Alegent Health Executive and Accounting & Finance management. The Selection Committee then recommends an external audit firm to the Alegent Health Finance & Audit Committee. Finally, the Alegent Health Finance & Audit Committee recommends an external audit firm to Alegent Health.

7. Question: What is the difference between the Corporate Governance Committee and the Corporate Integrity Program?

   Answer: The charter of the Corporate Governance Committee establishes the following duties and responsibilities: Monitor and evaluate governance guidelines; review and assess charter; annual self-examination; establish and evaluate recruitment criteria for Board members and committee appointments; establish the ethical framework for the Corporate Integrity Program; and monitor and enforce the Conflicts of Interest policy. Members of the Board of Directors are appointed to serve on the Corporate Governance Committee.

   The Alegent Health Corporate Integrity Program is a voluntary compliance program developed using the framework established by the Department of Health and Human Services (DHHS) Office of Inspector General (OIG). Compliance efforts help establish a culture within Alegent Health that promotes prevention, detection and early and prompt resolution of issues that may not be in compliance with Federal and State laws; Federal, State and private payor healthcare program requirements; as well as Alegent Health’s ethical and business practices.

8. Question: How are members of the Finance & Audit Committee (FAC) of the Board of Directors selected?

   Answer: Members of the FAC are appointed by the Chair of the Board. All FAC members are independent of Alegent Health and its management and must be financially literate.