With legislative and regulatory scrutiny trained on not-for-profit hospitals, administrators should brace themselves for potential challenges to their tax-exempt status. Industry leaders recommend reviewing documents that outline a hospital's charitable purpose, setting a clear policy on providing care to persons unable to pay for it, placing a value on community services, and taking other steps. Whether changes in laws governing tax exemption come from national, state, or local efforts, hospitals should be ready to show proof of their charitable activities.