WASHINGTON – The chairman of the powerful Senate Finance Committee is targeting a number of tax-exempt hospitals, including New York-Presbyterian, as part of an ongoing review of tax abuses in the charitable sector.

Senator Grassley, a Republican of Iowa, has asked 10 of the nation’s largest tax-exempt hospitals, including the largest hospital in New York City, to provide a detailed accounting of their charitable services, financial practices, and spending down to staff travel and country club memberships.

“It’s my job to make sure charities are earning their generous tax breaks,”

Mr. Grassley said. “By gathering information from nonprofit hospitals, I hope to learn whether the benefits they provide to the needy justify the tax breaks they receive.”

Tax exemptions for charitable hospitals amount to benefits of billions of dollars annually.

Mr. Grassley said the inquiry is part of a review of the nonprofit sector in advance of legislation he plans on introducing to prevent abuse of tax exemptions and encourage charitable giving in the wake of financial scandals that have tarnished the reputation of several high-profile charities in recent years.

Mr. Grassley’s letter is part of a broader movement in Congress that is questioning hospital tax breaks. The House Ways and Means Committee is holding a hearing today on tax-exempt hospitals as part of an ongoing investigation into whether the tax benefits given to hospitals should be curtailed. In some states, such concerns have led to requirements that hospitals pay back some taxes.

The House panel, headed by Rep. Bill Thomas, a Republican of California, will probe whether hospitals have become “increasingly commercial” in their operations, whether they compete with for-profit hospitals, and whether the current rationale for their tax-exempt status is adequate. The congressmen will hear from several witnesses, including advocates of tougher accountability measures for hospitals.

“Congress needs a better understanding of the subsidy for tax-exempt hospitals,” Mr. Thomas said. “Congress has a responsibility to assure the American taxpayer that the tax-exempt hospital sector is living up to its community responsibilities.”

New York-Presbyterian is the largest hospital in the city, treating one of out every five patients here. It is also the city’s largest private-sector employer, with 13,800 on the payroll. The 2,400-bed institution is the result of a merger between Presbyterian Hospital and New York Hospital.

According to tax records filed by New York-Presbyterian for 2003, the hospital’s president and CEO, Herbert Pardes, was paid more than $2.3 million in salary and over $1.1 million in benefits. Its executive vice president, Michael Berman, was paid over $1.7 million in salary and $1.4 million in benefits in 2003. The hospital had revenues of $2.2 billion.

The hospital’s vice president of public affairs, Myrna Manners, declined to comment on Mr. Grassley’s letter, the House Ways and Means hearing, the value of the tax exemption to the hospital, or congressional concerns about potential tax exemption abuses by hospitals.

“I can tell you that New York-Presbyterian has a long tradition of providing care to patients of all walks of life, and we are very proud of our commitment to providing the highest-quality care to all our patients,” Ms. Manners said.

A spokeswoman for Mr. Grassley, Jill Gerber, said she was unaware of any specific concerns relating to New York-Presbyterian.

Senator Schumer, a member of the Finance Committee, said he would “keep a close eye on this process” to make sure that New York’s not-for-profit hospitals “are treated in a fair and balanced way and recognized for their substantial commitment to our city and state.”

“New York hospitals provide a great service for New Yorkers, especially those in under served communities around the city. Beyond the care they provide to the uninsured, New York hospitals have a commitment to their communities to provide an array of educational and preventative services that are vital to their communities,” he said.

But members will hear some contrary accounts today. Among the witnesses scheduled to appear at today’s House hearing is a professor at the Harvard School of Public Health, Nancy Kane, who has called for greater accountability by hospitals, and who authored a study finding that the free care provided by tax-exempt hospitals often does not make up for what society forgoes in unpaid taxes.

Another witness, a tax law professor at the University of Illinois, John Colombo, has written that tax-exempt hospitals do not appear to provide any more charitable care than for-profit hospitals.

The committee will also hear from the commissioner of the Internal Revenue Service, Mark Everson; the head of the Government Accountability Office, David Walker; and the administrator of the Centers for Medicare and Medicaid Services, Mark McClellan.

On the Senate front, Mr. Grassley’s letter asks 46 detailed questions and requests answers by July 11.

He asks how the hospitals define charitable care and whether they would provide the same services were it not for the tax exemption. He also requests detailed information about joint ventures with other for-profit physicians or investors.

Mr. Grassley asks the hospitals to respond to the assertion that, “Many nonprofit, tax-exempt hospitals engage in joint ventures that shift the most profitable and valuable procedures, practices, and income streams to the joint ventures so that the greater profits and value may be shared with physicians and other for-profit persons.”

The senator asks the 10 hospitals to explain how they set fees charged to uninsured patients, and how they inform poor patients that charitable care is available to them.

He also wants to know how many lawsuits the hospitals have launched to collect bills from uninsured patients.

Mr. Grassley is also seeking a detailed breakdown of salaries and travel over the past three years of the hospitals’ five top salaried employees, as well as details on payments or reimbursements made to employees for country clubs.

Hospitals Under The Microscope

The following 10 nonprofit hospitals received letters from Senator Grassley seeking information about their tax-exempt status:

* New York-Presbyterian Hospital System, New York

* The Cleveland Clinic, Cleveland, Ohio

* Advocate Health Care Network and Advocate Health and Hospitals Corporation, Oak Brook, Ill.

* Resurrection Medical Center and Resurrection Health Care, Chicago.

* Phoebe Putney Health Systems, Inc., Phoebe Putney Memorial Hospital, Inc., Albany, Ga.

* William Beaumont Hospital and Beaumont Properties, Royal Oak, Mich.

* North Mississippi Health Services, Inc., North Mississippi Medical Center, Tupelo, Miss.

* Sutter Health, Sacramento, Calif.

* Fairview Health Systems, Minneapolis

* Banner Health, Phoenix