Question: We have an on-site library. The library's primary "customers" are the medical students; however anyone is able to use the library as a resource. Many individuals who are not affiliated with the hospital (example: nursing students from a nearby college) will use the library as a resource.

Because it is a requirement of the Graduate Medical Education program, I would imagine that it falls under the community benefit of provision of Graduate Medical Education. However, the fact that other people use the library — including individuals from outside of the Hospital, who are unaffiliated with the hospital — raises the question of whether we are providing a community benefit.

Recommendation: Advancing knowledge by having a library available and used by hospital staff and medical students provides clear community benefit. To be counted, the library should be available to the public. It is recommended that the expense of the library be counted in its entirety as Category B3. Other Health Professions Education. You should be careful to follow Medicare Cost Reporting principles in the accounting of Graduate Medical Education costs, including the library. Also use caution not to double count library costs if such costs already have been included in one or more GME cost centers or overhead allocations.

(February 2011)

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