10 US hospitals that spend the least on community investment relative to tax breaks, per Lown ranking

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Seventy-two percent of the country's private nonprofit hospitals had a fair-share deficit in 2018, meaning they spent less on charity care and community investment than they received in tax exemptions, according to a report released July 12 by nonpartisan healthcare think tank the Lown Institute.

The Lown Institute calculated fair-share spending for 2,391 private nonprofit hospitals by comparing each hospital’s spending on charity care and community investment to the value of its tax breaks, using data from CMS' 2018 hospital costs reports.

Below are the 10 U.S. hospitals with the largest fair-share deficits:

1. Cleveland Clinic
-$261 million fair-share deficit
Community benefit spending makes up 1.4 percent of total expenses

2. NewYork-Presbyterian Hospital (New York City)
-$237 million fair-share deficit
Community benefit spending makes up 1.9 percent of total expenses

3. UCSF Medical Center (San Francisco)
-$208 million fair-share deficit
Community benefit spending makes up 0.9 percent of total expenses

4. Massachusetts General Hospital (Boston)
-$179 million fair-share deficit
Community benefit spending makes up 1.2 percent of total expenses

5. University of Michigan Health System (Ann Arbor)
-$169 million fair-share deficit
Community benefit spending makes up 1.1 percent of total expenses

 6. NYU Langone Medical Center (New York City)
-$163 million fair-share deficit
Community benefit spending makes up 2.5 percent of total expenses

7. Vanderbilt University Medical Center (Nashville, Tenn.)
-$157 million fair-share deficit
Community benefit spending makes up 2.3 percent of total expenses

8. Brigham and Women's Hospital (Boston)
-$142 million fair-share deficit
Community benefit spending makes up 1 percent of total expenses

9. Penn Medicine (Philadelphia)
-$142 million fair-share deficit
Community benefit spending makes up 0.5 percent of total expenses

10. Cedars-Sinai Medical Center (Los Angeles)
-$138 million fair-share deficit
Community benefit spending makes up 1.6 percent of total expenses

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