CQC Nonprofit Hospital Scorecards Reveal Disturbing Practices in Three More States

By Consumers for Quality Care, on January 9, 2024

CQC Nonprofit Hospital Scorecards Reveal Disturbing Practices in Three More States

For Immediate Release
January 9, 2024


CQC Nonprofit Hospital Scorecards Reveal Disturbing Practices in Three More States


Arkansas, North Dakota, and South Dakota Earn #HospitalFail Grade from Consumers for Quality Care


WASHINGTON, D.C. – Today, Consumers for Quality Care (CQC) released a new set of Nonprofit Hospital Scorecards, this time highlighting how nonprofit hospitals in Arkansas, North Dakota, and South Dakota are putting profits before patients. In these states, nonprofit hospitals are charging patients huge markups, devoting inadequate resources to charity care, and leaving working-class consumers with mountains of medical debt. This is despite the fact that, as nonprofits, these hospitals are incorporated as tax-exempt charitable organizations. But reports from respected and credible sources, such as CNNKFF Health NewsPatient Rights Advocate, the Lown Institute, the Leapfrog Group, and RAND Corporation indicate that nonprofit hospitals in these states operate more like big businesses hungry for profit.

In Arkansas, for example, nonprofit hospitals recorded a fair-share deficit of $105 million, meaning that the state’s nonprofit hospitals received, in aggregate, $105 million more in tax breaks than what they spent on charity care. On top of that, the University of Arkansas for Medical Sciences, a public nonprofit hospital, was found to have sued thousands of patients since 2019 to collect outstanding medical debts. As CNN reported, many of the patients sued by the university were its own employees.

In North Dakota, hospitals charged privately insured patients an average of 211 percent of what they charged Medicare patients for the same services. Yet these high hospital prices were no indication of high-quality care: North Dakota was ranked 47th in the nation for patient safety at its hospitals.

Finally, in South Dakota, when 34 of the state’s hospitals were reviewed by Patient Rights Advocate, none were found to be in compliance with federal price transparency rules. Crucially, these rules require very little of hospitals, only that they post their prices online in a standardized, searchable, easy-to-read format. By refusing to comply, hospitals in South Dakota are leaving patients in the dark, without the information that they need to make informed decisions about their care.

“The findings in these scorecards should serve as a wakeup call, but not just for policymakers in Arkansas, North Dakota, and South Dakota. Policymakers everywhere should know that nonprofit hospitals are not keeping their end of the bargain,” said CQC Board Member Jim Manley. “Although the situation in these states is troubling, it is part of larger pattern, a national trend in which nonprofit hospitals are failing to uphold their charitable missions.”

CQC’s Nonprofit Hospital Scorecards highlight the disturbing gap between what the public expects of nonprofit hospitals and how these hospitals really operate.

“Legally, these nonprofit hospitals are charitable organizations, but in reality, they are squeezing patients for every dollar of profit that they can get,” Manley said. “It’s a shame that rather than being part of the solution to America’s health care challenges, these hospitals are contributing to the problem, even as they pocket tens of millions of dollars in tax breaks each year.”

As more information comes to light about the predatory practices used by nonprofit hospitals, policymakers have fewer reasons to ignore the role that these institutions play in pushing health care costs higher in the United States. To this end, CQC calls on leaders in Congress, leaders in the Biden administration, and leaders in state capitals across the country to do everything within their power to improve health care access and protect consumers from harmful practices by nonprofit hospitals.

View all of CQC’s Nonprofit Hospital Scorecards here. In the months to come, CQC will cover more states in its Nonprofit #HospitalFail Campaign. Visit our website here to stay informed.


Consumers for Quality Care (CQC) a coalition of advocates and former policymakers working to provide a voice for patients in the health care debate as they demand better care. CQC is led by a board of directors that includes the Honorable Donna Christensen, physician and former Member of Congress; Jim Manley, former senior advisor to Senators Edward Kennedy and Harry Reid; Jason Resendez, community advocate and health care strategist; and Mary L. Smith, former head of Indian Health Service.