Disclosure management through off-balance sheet activities, its association with performance and contributions in the nonprofit hospital setting

This research consists of three essays that examine disclosures of off-balance sheet activities among non-profit (NP) hospitals. Essay I documents the existence of unconsolidated off-balance sheet activities among NP hospitals. Essay II analyzes the association and importance of off-balance sheet activities with NP hospital contributions. Essay III seeks to determine the incentives for and association of off-balance sheet activities with NP hospital financial performance. Overall, these research essays are the first to analyze the association of unconsolidated off-balance sheet activities among NP hospitals and seek to increase understanding of this phenomenon as well as provide regulatory guidance.