Highland Park Hospital v. Department of Revenue , 155 Ill. App. 3d 272 ( 1987 )

JUSTICE REINHARD

delivered the opinion of the court:

Plaintiff, Highland Park Hospital (hospital), is an Illinois not-for-profit corporation providing hospital and health services. In December 1979, the hospital took title to the subject property, which was later developed into the Grove Professional Center (Professional Center), a medical center located in Long Grove, Illinois. The hospital transferred the property in November 1982 to plaintiff, Groveland Properties, Inc., a not-for-profit corporation set up to manage other property acquisitions of the hospital and its parent corporation, Lakeland Health Services. On December 30, 1982, the hospital filed a petition for exemption from taxation for the Professional Center for 1982 and subsequent years with the board of review of Lake County, Illinois (board). The petition claimed that the property was exclusively used for charitable purposes and was exempt under section 19.7 of the Revenue Act of 1939 (Ill. Rev. Stat. 1981, ch. 120, par. 500.7). After a hearing, the board allowed a 50% exemption for the part of the Professional Center used by the hospital, pending confirmation by the Illinois Department of Revenue.

The Department of Revenue initially disapproved the exemption, finding that the property was not an exempt use. Following a hearing which was held February 2, 1984, the Department again denied the exemption on second review. Plaintiffs filed an action for administrative review in the circuit court of Lake County. The circuit court affirmed the decision of the Department of Revenue, and plaintiffs appeal.

The property in question is a three-story brick building with a total of 29,601 square feet. The building, along with service roads and parking areas, is situated on approximately eight acres in the village of Long Grove in Lake County, Illinois. The Professional Center is owned and managed by plaintiff Groveland Properties, Inc., for the hospital. Both Groveland Properties, Inc., and the hospital are not-for-profit subsidiaries of Lakeland Health Services, Inc. Any funds acquired by Groveland Properties, Inc., in excess of operating expenses are turned over to the Highland Park Hospital Foundation, the fund-raising and development subsidiary of the group.

In 1980, due to decreasing patient admissions, the hospital conducted a feasibility study prior to construction of the Professional Center. The study concluded that the area around the Professional Center needed more than 20 additional physicians and that patient referrals from those physicians would meet the hospital’s admissions goal. To assure the community of quality medical care and to increase hospital admissions, physicians renting space at the Professional Center are required to be members of the hospital staff and are required to refer patients to the hospital when safely possible.

Construction on the Professional Center began in late 1980, and the first tenants moved in in late 1981. The first floor houses an Immediate Care Center, a laboratory, a pharmacy, a radiology facility, and two physicians’ offices. There is also a mail room, a lobby and waiting area, and mechanical spaces for the heating, air conditioning, and ventilation equipment of the building.

The Immediate Care Center is a walk-in clinic open seven days a week, 12 hours a day (8 a.m. to 8 p.m.). It is owned and operated by the hospital and is maintained by physicians on the staff of the hospital. The physicians renting space at the Professional Center, however, are not required to serve in the Immediate Care Center. The Immediate Care Center is equipped to treat minor ailments and emergencies, but is not set up for life-threatening emergencies such as myocardial infarctions. In 1982, approximately 5,000 patients were treated in the Immediate Care Center.

The laboratory provides some of the basic testing for patients of the Professional Center’s physicians and for patients of the Immediate Care Center. The laboratory also conducts some of the testing for patients at the hospital. The laboratory is characterized as a satellite of the hospital laboratory, and, although the complaint for administrative review states that the laboratory is rented, the evidence presented before the board of review indicated that no rent is received from the laboratory.

The pharmacy and radiology unit are both rental units, as are the physicians’ suites. While the board of review’s initial grant of exemption included the radiology unit, plaintiffs now concede that neither the pharmacy nor the radiology unit are entitled to exemption.

The second floor contains more physicians’ offices, a community room, and an exercise room. The community room accommodates 40 to 50 people and is available to residents of the community at no charge for programs and meetings. The hospital also conducts a series of health education programs in the community room which are open to the public. The community room produces no income.

The exercise room has a dual purpose. It is open to patients of the Professional Center’s physicians. Also, the hospital conducts exercise programs, weight control programs, and aerobics classes, all of which are open to the public. It produces no income, although a fee is charged to pay an outside instructor. The third floor consists entirely of physicians’ suites.

All patients of the Immediate Care Center are initially billed for their treatment. Bills are sent out every 15 to 30 days, and patients are contacted by telephone if no payment is made after 90 days. At this point, if patients can prove an inability to pay, the collection process will stop, and the hospital will write off that particular charge. Otherwise, formal collection efforts begin. The Immediate Care Center generated $106,885 in patient revenues in 1982. Of that amount, $6,000, or approximately 6%, was uncollectible and written off as free care.

Several advertisements for the Immediate Care Center were utilized by plaintiffs to promote the center. Essentially, these advertisements stated the hours that the facility was open, the availability of care without an appointment, the nature of the services provided, and the relative low cost of the services compared to other medical facilities. It is further stated that private health insurance will probably cover the cost, or a Visa or Master Card may be used. No mention is made of free care for those unable to pay.

The circuit court in this case found that the Department of Revenue’s denial of exemption was “not against the manifest weight of the evidence.”

Defendants first urge that this court also defer to the Department of Revenue’s decision unless it is against the manifest weight of the evidence. Hearings in this matter were held before both the Lake County board of review and the Illinois Department of Revenue. No disputed testimony or documentary evidence was presented at either hearing. The only witness, other than those from the hospital, was an employee of the Department of Revenue who testified as to the criteria he employed in determining that the property in question was not primarily used for charitable purposes. The evidence presented by plaintiffs was not challenged for truthfulness or accuracy.

Because the relevant facts are uncontradicted, “[t]he issue before us is not whether the Department’s [of Revenue’s] decision was against the manifest weight of the evidence. When the facts upon which a decision of tax exempt status rests are undisputed, whether property is exempt is a question of law.” (Cook County Masonic Temple Association v. Department of Revenue (1982), 104 Ill. App. 3d 658, 660, 432 N.E.2d 1240; see also Caterpillar Tractor Co. v. Department of Revenue (1963), 29 Ill. 2d 564, 566, 194 N.E.2d 257.) Thus, the decision as to whether the property is exempt “depends solely upon an application of the appropriate legal standard to the undisputed facts.” Illinois Central Gulf R.R. Co. v. Department of Local Government Affairs (1983), 95 Ill. 2d 111, 129, 447 N.E.2d 315.

The Lake County board of review has taken an interesting position in this appeal. When plaintiffs requested an exemption for the Professional Center, the board granted a 50% exemption. This percentage was determined by comparing the amount of floor space used to generate rental income with the amount of floor space used by the hospital itself. The board now takes the position that a proportionate exemption is inappropriate, even if portions of the property otherwise meet the requirements for exemption, relying on Illinois Institute of Technology v. Skinner (1971), 49 Ill. 2d 59, 273 N.E.2d 371.

The board, however, has misinterpreted the holding of Skinner. The Skinner court noted that while the primary use of property determines tax-exemption status, there are two distinct situations to which this principle applies. One is where the property as a whole is used for both exempting and nonexempting purposes. In that case, an exemption is appropriate only if the exempting use is primary and the nonexempting use is incidental. (49 Ill. 2d 59, 66, 273 N.E.2d 371.) The second situation is where distinct portions of the property are used for exempting purposes while the remainder is used for nonexempting purposes. In such a case, the remainder alone would be taxable if it is a substantial portion of the property. (49 Ill. 2d 59, 66, 273 N.E.2d 372.) The Skinner court concluded:

“Thus, ‘there may be separate assessments by separating uses, as in the case of First M.E. Church v. City of Chicago, 26 Ill. 482, where the court held that the first story of the church building, occupied for stores, banking business and the like, and the second story, used for lawyers’ and doctors’ offices and other business purposes, were not exempt from taxation, but the main body of the third and fourth stories, used for religious purposes, was exempt.’ ” Illinois Institute of Technology v. Skinner (1971), 49 Ill. 2d 59, 66, 273 N.E.2d 371, quoting People ex rel. Carr. v. Sanitary District of Chicago (1923), 307 Ill. 24, 27-28, 138 N.E. 209.

In this case, plaintiffs claim on appeal that only certain portions of the Professional Center, those used primarily for charitable purposes, are entitled to exemption. If plaintiffs were claiming that the entire Professional Center is exempt, then an analysis under the first example set forth in Skinner would be appropriate. Because plaintiffs only claim portions of the property are exempt, however, there is no requirement that the entire property be used primarily for charitable purposes. Plaintiffs are entitled to a proportionate exemption for any distinct portions of the property which meet the test for exemption. See Metropolitan Sanitary District v. Rosewell (1985), 133 Ill. App. 3d 153, 156, 478 N.E.2d 1100; Hopedale Medical Foundation v. Tazewell County Collector (1978), 59 Ill. App. 3d 816, 823, 375 N.E.2d 1376.

Having decided the appropriate standard of review and that a proportionate exemption is not prohibited, the inquiry now must focus on whether the property in question is used exclusively for charitable purposes. Article IX, section 6, of the 1970 Illinois Constitution allows the legislature to exempt from taxation property used exclusively for charitable purposes. (Ill. Const. 1970, art. IX, sec. 6.) Section 19.7 of the Revenue Act of 1939 allows exemptions for “[a]ll property of institutions of public charity, all property of beneficent and charitable organizations *** when such property is actually and exclusively used for such charitable or beneficent purposes, and not leased or otherwise used with a view to profit.” Ill. Rev. Stat. 1981, ch. 120, par. 500.7.

The criteria for determining whether an organization qualifies for this exemption is set out in Methodist Old Peoples Home v. Korzen (1968), 39 Ill. 2d 149, 233 N.E.2d 537. (Board of Certified Safety Professionals of the Americas, Inc. v. Johnson (1986), 112 Ill. 2d 542, 546, 494 N.E.2d 485.) Our supreme court established the following principles which constituted the frame of reference to determine whether or not a use was in fact exclusively for charitable purposes: (1) the use was for the benefit of an indefinite number of persons, persuading them to an educational or religious conviction, for their general welfare — or in some way reducing the burdens of government; (2) that the charitable institution has no capital, capital stock or shareholders, earns no profits or dividends, but rather derives its funds mainly from public and private charity and holds them in trust for the objects and purposes expressed in its charter; (3) that the institution dispenses charity to all who need and apply for it, does not provide gain or profit in a private sense to any person connected with it, and does not appear to place obstacles of any character in the way of those who need and would avail themselves of the charitable benefits it dispenses; (4) that the statements of the agents of an institution and the wording of its governing legal documents evidencing an intention to use its property exclusively for charitable purposes do not relieve such institution of the burden of proving that its property actually and factually is so used; (5) and that the term “exclusively used” means the primary purpose for which property is used and not any secondary or incidental purpose. (Methodist Old Peoples Home v. Korzen (1968), 39 Ill. 2d 149, 157, 233 N.E.2d 537.) The burden of proving the right to exemption is upon the party seeking it, and, in determining whether property is included within the scope of an exemption, all facts are to be construed and all debatable questions resolved in favor of taxation. (Board of Certified Safety Professionals of the Americas, Inc. v. Johnson (1986), 112 Ill. 2d 542, 547, 494 N.E.2d 485.) As the concept of property use which is exclusively charitable does not lend itself to easy definition, each individual claim for tax exemption must be determined from the facts presented. (Methodist Old Peoples Home v. Korzen (1968), 39 Ill. 2d 149, 156, 233 N.E.2d 537.) Although the courts do not have the power to create an exemption by judicial interpretation (People ex rel. Baldwin v. Jessamine Withers Home (1924), 312 Ill. 136, 139, 143 N.E. 414; Evangelical Hospital Association v. Novak (1984), 125 Ill. App. 3d 439, 442, 465 N.E.2d 986), the determination of whether the property use is exclusively charitable is a judicial function. Small v. Pangle (1975), 60 Ill. 2d 510, 516, 328 N.E.2d 285.

After carefully considering the record and the foregoing legal principles, we conclude, as did the Department of Revenue, that the Immediate Care Center does not qualify for a charitable exemption because it is not exclusively used for charitable purposes. All patients who utilize the Immediate Care Center are billed. None of the advertisements for the center disclose any charitable nature of the facility, and, in fact, the advertisements notify the public of the inexpensive cost of the services and of the alternative methods of payment by insurance, Visa, or Master Card. Free or charitable care is not mentioned. In 1982, only 6% of the total revenue of the Immediate Care Center was found to be uncollectible. Plaintiffs call this 6% free care, although there is no evidence in the record that the recipients of this “free care” were ever aware that they were receiving charity other than that the debts were not being collected. There is no evidence that the general public knows that free care is available at the center. It also appears that efforts are first made to collect unpaid bills, even from those later determined to be unable financially to pay them, thereby requesting and perhaps receiving some payment from those very persons whom the plaintiffs claim they serve as charity cases. These uncollectible amounts, in reality, are nothing more than bad debts. On these facts, we conclude that the small amount of uncollectible bills of some 6% of the revenue of the center, which are only classified as free care when ultimately determined to be uncollectible, does not entitle plaintiffs to a charitable exemption for the Immediate Care Center as property exclusively or primarily used for charitable purposes.

Plaintiffs contend, however, that in Sisters of Third Order of St. Francis v. Board of Review (1907), 231 Ill. 317, 83 N.E. 272, where only 5% of the total patients were charity patients, the court found the hospital to be a public charity actually and exclusively used for charitable purposes. We are not persuaded that the factual considerations in that case are similar to those presented here. It is apparent that the hospital in Sisters of St. Francis was clearly deemed to be an institution of public charity and the fact that the vast majority of patients paid for care was not a valid basis to remove that classification “so long as charity was dispensed to all those who needed it and who applied therefor, *** and so long as it does not appear that any obstacle, of any character, was *** placed in the way of those who might need charity of the kind dispensed by this institution, calculated to prevent such persons making application to or obtaining admission to the hospital.” 231 Ill. 317, 322, 83 N.E. 272.

In the case at bar, the Immediate Care Center does not dispense charity to all those who need it or apply for it. The fact is that the general public and those who ultimately do not pay for medical services are never made aware that free care may be available to those who need it. The only evidence is that the bills which the hospital ultimately determines are uncollectible are not pursued to collection. The facts here are not comparable to those in Sisters of St. Francis.

Nor do we believe that People ex rel. Cannon v. Southern Illinois Hospital Corp. (1949), 404 Ill. 66, 88 N.E.2d 20, supports plaintiffs’ position. Similar to Sisters of St. Francis, the court in Southern Illinois Hospital ruled that no obstacle was placed by the hospital that would hinder or prevent needy persons from seeking or receiving the charity the hospital dispenses. All emergency cases were immediately treated without question of ability to pay, and all elective cases were ultimately treated despite an inability to pay even though a waiting period was caused by the hospital’s investigation to see if the patient is available for relief. (404 Ill. 66, 73, 88 N.E.2d 20.) The court, however, was not confronted with a set of facts similar to these in the case at bar where there is no showing that the general public or the eventual patients were made aware that they could receive free care and that case is also not controlling. Both Sisters of St. Francis and Southern Illinois Hospital involved institutions set up primarily for a charitable purpose, while the operations and collection procedures of the Immediate Care Center demonstrate, at best, a charitable result as a secondary or incidental purpose.

The next question is whether plaintiffs have met their burden of proving that the laboratory is primarily used for charitable purposes. The evidence regarding the use of the laboratory is minimal. A witness for the hospital characterized the laboratory as a “satellite” of the hospital laboratory. The witness testified that the laboratory provides some of the basic testing for patients of the Immediate Care Center and for patients of the physicians in the building as well as some of the testing for patients at the hospital. When asked if the laboratory, the radiology unit, or the Immediate Care Center produced income for plaintiffs, the witness responded that the radiology unit, a rental unit, produces income, but did not state whether the laboratory was rented or not.

The evidence set forth above is insufficient to carry plaintiffs’ burden of proving that the laboratory is primarily used for charitable purposes. Plaintiffs have not shown any figures regarding the percentage of laboratory work done for the various users. It could be that most of the work is done for the hospital, but it is even more likely that most of the testing is performed for the physicians in the building. If most of the testing is done for the building’s physicians, the primary use would be to generate profit. Also, plaintiffs have not proved that any free care is dispensed by the laboratory. Without more evidence as to the actual use of the laboratory, it is impossible to determine whether the primary use is charitable. Plaintiffs have not met their burden of proof and, thus, are not entitled to an exemption for the laboratory.

We consider next whether plaintiffs have met their burden of proving that the exercise and community rooms are primarily used for charitable purposes. The exercise room has a dual purpose. It is available to patients of the building’s physicians at no cost. The room is also used by the hospital to conduct exercise programs, weight control programs, and aerobics classes. These programs are open to the public and are free, except for a small fee to pay for an outside aerobics instructor. No income is generated for the hospital. One of the brochures advertising the Professional Center states that use of the exercise center is free to patients of the center’s physicians.

Plaintiffs state that the community room, which can accommodate 40 to 50 people, is available to residents of the community for various programs and meetings at no charge and for ongoing patient education programs. The physicians conduct a lecture series, and the community is invited to attend. An exhibit lists numerous medical-related programs in the community room over a four-month period put on by nurses or physicians. These include programs on first aid, blood pressure detection, back care, acne treatment, eye surgery, foot problems, parenting, and pregnancy.

The hearing officer determined that neither room qualified as charitable exemptions because neither room fulfilled a major criterion for charitable use: that a burden of government is relieved by the use of these rooms.

The law recognizes as charitable those purposes which will benefit an indefinite number of persons either by the influence of education or religion or by relieving their bodies from disease, suffering and constraint or by erecting or maintaining public buildings or works or by otherwise lessening the burden upon the State to care for and advance the interests of its citizens. (American College of Surgeons v. Korzen (1967), 36 Ill. 2d 340, 347, 224 N.E.2d 7.) The plaintiffs must also bear the burden of proving the right to the exemption by demonstrating that the primary purpose for which the property is used is for a charitable purpose. See Methodist Old Peoples Home v. Korzen (1968), 39 Ill. 2d 149, 157, 233 N.E.2d 537.

It is readily apparent that plaintiffs have failed to meet their burden that the exercise room is primarily used for charitable purpose. No data was given concerning the public’s use of the exercise room except general testimony that exercise, weight control, and aerobics classes are held there. On the other hand, the evidence shows that the exercise room is on the second floor of the center where private physicians and dentist offices are located. A brochure advertising the center states that the exercise room is free to patients of the Professional Center’s physicians. Thus, both easy access to and awareness of the exercise room for the general public is not obtained. In addition, both the exercise room and the community room, based on the limited evidence in this record of their use, do not lessen the burden of the State to care for and advance the interests of its citizens. Although plaintiffs claim that certain activities occur in the exercise room and the community room which in some ways may be perceived as relieving the burden of the State to advance the interest of its citizens, we conclude that the rooms are situated in a building primarily used by private physicians and dentists and appear to be more incidental to promoting these professionals’ private business than to lessen the burden of the State to care for and advance the interest of its citizens.

For the foregoing reasons, the judgment of the circuit court of Lake County is affirmed.

Affirmed.

NASH, J., concurs.