AN OPERATIONAL APPROACH TO THE EVALUATION OF LEASES BY HOSPITALS*

The evaluation of the lease versus purchase alternative by not-for-profit hospitals presents a problem that stems from the interaction between investment and financial decisions. This paper provides an analytical framework that resolves this issue by neutralizing the impact of the lease contract on the hospital's financial structure and debt capacity. The formulation incorporates the special operating characteristics of not-for-profit hospitals: namely, they are not subject to federal income tax, and part of their revenue is generated through cost-based reimbursement.