Healthcare Systems and Controversial Tax Breaks: Everything You Need to Know
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Just about everyone has an opinion on the healthcare system in the United States. What may Americans don’t realize, however, is that there’s another tangential battle going on when it comes to healthcare facilities themselves. Property tax breaks – specifically for non-profit hospitals and clinics – are common. In recent months and years, though, many have questioned whether or not these facilities are actually paying their fair share. As a matter of fact, one April 2023 government report notes that many hospitals that are currently tax-exempt have not met required standards for years. Specifically, Jessica Lucas-Judy, Director of Strategic Issues for the Government Accountability Office (GAO), wrote, “IRS officials told us that the agency had not revoked a hospital’s tax-exempt status for failing to provide sufficient community benefits in the previous 10 years.”Here, we tell you everything you need to know about this ongoing issue.The Disparity In Property TaxationEvery year, homeowners like Terry Taylor-Allen and her husband, William, dutifully pay property taxes. The Allens are proud of their bungalow in Charlotte, North Carolina’s Dilworth neighborhood. However, as North Carolina Healthcare News shared, a stark contrast unfolds next door, where houses owned by The Charlotte-Mecklenburg Hospital Authority (Atrium Health) enjoy a tax-free status, despite substantial revenue. This exemplifies a somewhat peculiar fiscal dynamic that exists from coast to coast.Tax Exemptions For Healthcare GiantsAtrium Health, a healthcare system that boasted $8.9 billion in revenue in 2021 alone, benefits from a property tax exemption due to its status as a hospital authority. It is not alone – this is a tax break given to healthcare facilities throughout the country. This exemption even extends to properties unrelated to medical purposes. As North Carolina Healthcare News pointed out, a tax-exempt Atrium property in Cornelius, NC houses a PDQ Tenders chicken restaurant. While patrons still pay sales tax on their meals, Atrium doesn’t pay any property taxes for the land the fast food shop sits on. This narrative is mirrored by Novant Health, a nonprofit hospital that receives tax breaks solely on properties deemed charitable. “If you think about the cumulative total of everything (the hospitals) have taken off the tax rolls over the years, that’s a Godzilla number,” Taylor-Allen, told the news outlet. “Think about all the school needs and how much that money could help low-income people who don’t have health care, housing or food.” Cumulative Financial ImpactIn 2020, non-profit hospitals received an estimated $28 billion in tax breaks. This was an average of $9.4 million per hospital. Many questions have arisen, however, about how much true “non-profit” work these facilities are doing. A report stemming from work done by Senator Bernie Sanders noted that the hospitals in question “spent only an estimated $16 billion on charity care” – that’s a glaring $12 billion difference.Per North Carolina Health News’s analysis of that state specifically, tax-exempt properties assessed at over $2.4 billion in Mecklenburg County alone. If fully taxed, Atrium and Novant would have ranked as the county's fourth- and fifth-largest property taxpayers in 2022, contributing an additional $23 million to the city and county tax base.
Tax and Financial Insights
by NR CPAs & Business Advisors


2026 IRS Mileage Rates: Key Updates and Insights
The IRS has rolled out the inflation-adjusted mileage rates for 2026, offering taxpayers an efficient way to claim deductions for vehicle-related expenses incurred for business, charity, medical, or moving purposes. These adjustments reflect the continued economic shifts impacting car operation costs.
Effective January 1, 2026, the new standard mileage rates are established as follows:
- Business Travel: Increased to 72.5 cents per mile, inclusive of a 35-cent-per-mile depreciation allocation. This marks a rise from the 70 cents per mile rate set for 2025
- Medical/Moving Purposes: Reduced slightly to 20.5 cents per mile, down from 21 cents in the previous year, reflecting the variable cost considerations.
- Charitable Contributions: Consistent at 14 cents per mile, a fixed rate unchanged for over a quarter-century.
As is typical, the business mileage rate considers the integral fixed and variable costs of automobile operation. Meanwhile, the medical and moving rates remain contingent on variable expenses as determined by the IRS study.

It is critical to note that the One Big Beautiful Bill Act (OBBBA) held firm on disallowing moving expense deductions except for specific cases within the Armed Forces and intelligence community, marking a substantial shift since 2017.
When engaging in charitable work, taxpayers might opt for a direct expense deduction over the per-mile method, covering gas and oil costs. However, comprehensive upkeep and insurance costs are non-deductible expenses.
Business Vehicle Use Considerations: Taxpayers can alternatively compute vehicle expenses using actual costs, which might benefit from shifting depreciation rules, particularly through bonuses and first-year advantages. Keep in mind, however, reverting from actual cost calculations to standard rates in subsequent years is restricted, particularly per vehicle protocol and when exceeding four vehicles in concurrent use.

Additionally, parking, tolls, and property taxes attributable to business can be deducted independently of the general rate, an often-overlooked advantage by many business owners.
Tax Strategies for Employers and Employees: Reimbursements based on the standard mileage framework, providing the right documentation is in place, remain tax-free for employees. Meanwhile, the elimination and continued prohibition of unreimbursed employee deductions continue, with particular exceptions offered to qualified personnel across specific occupations.
Opportunities for Self-employed Individuals: Entrepreneurs remain eligible for deductions on business-related vehicle use via Schedule C, with potential to account for business-use interest on auto loans.

Heavy SUVs and Deduction Advantages: Heavier vehicles exceeding 6,000 pounds but under 14,000 pounds open opportunities for substantial tax deductions through Section 179 and bonus depreciation avenues. The lifecycle of such a vehicle bears implications on recapturing initially claimed deductions, urging cautious tax planning.
For professional guidance on optimizing your vehicle-related tax deductions and understanding their implications on tax strategies, contact our office in Coral Gables, Florida, where expert advice and strategic insights are just a call away.


Educator's Deduction Reform: Key Changes Under OBBBA
The One Big Beautiful Bill Act (OBBBA) introduces significant enhancements for educators' tax deductions starting in 2026, offering both strategic opportunities and planning considerations for educators who qualify. With the reinstated itemized deduction for qualified unreimbursed expenses, educators have a broader spectrum of financial relief. This is complemented by the retention of the $350 above-the-line deduction, allowing educators to maximize their tax benefits by selectively allocating expenses between these avenues.
Understanding the nuances of these changes is crucial for educators and financial advisors alike. The dual-option deduction strategy can potentially enhance tax efficiency, thereby aligning with broader financial planning goals.

At NR CPAs & Business Advisors, based in Coral Gables, Florida, our expertise in tax preparation and planning provides invaluable support to educators navigating these changes. Our comprehensive approach, combined with personalized advice from our experienced team, ensures compliance and optimization in line with the latest tax legislations.
Given these updates, it is imperative to engage with seasoned professionals to fully leverage your deduction strategies. Contact us today to streamline your tax planning under OBBBA's new guidelines and maximize your deductions for upcoming tax years.


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