After this session, you will be able to: List the factors resulting in the reversal of the Provena decision denying charitable exemption. Discuss the arguments being made by local and state tax authorities against tax exemptions for "modern" hospitals and other healthcare facilities. Identify the triggers for exemption controversy as well as the practical measures that will assist in defeating regulatory challenges to exempt status. Describe the debate ongoing over the cortrect approach to the valuation of hospitals for tax purposes. Consider the use of valuation studies to respond to allegations that the organization is undeserving of tax subsidy and not charitable.