A recent trial court decision could have significant, long-term consequences for the financial models of Pennsylvania nonprofit health care providers. Ruling that three nonprofit Chester County hospitals of the Reading, Pennsylvania-based nonprofit Tower Health system are not tax exempt "charities," a judge has ordered them to begin paying millions in annual local property taxes that fund local school districts. The Tower Health decision has led local municipalities and school districts across the commonwealth to consider tendering property tax notices to nonprofit health care entities that have long been deemed exempt from such expenses.