For decades, it has been almost an article of faith that not-for-profit hospitals, clinics, nursing homes and other institutions dedicated to serving the health care needs of the sick and elderly would be exempt from paying almost any type of taxation in recognition of their charitable purposes. The simple logic behind these exemptions was that these institutions should be able to devote 100% of their resources to fulfilling their charitable mission of serving their communities without the burden of paying levies to federal, state or local governments.