Polsinelli is one of the nation’s leading providers of legal services to nonprofit organizations. We’ve built our team with nationally recognized nonprofit attorneys that hold business acumen and in-depth industry knowledge on state and federal tax and nonprofit issues. Our attorneys are well versed on the challenges facing tax-exempt organizations, which has enabled us to make significant contributions to nonprofit entities through our use of innovative approaches to meeting their legal and organizational needs.

Our team literally wrote the book on tax-exempt and nonprofit law. In fact, our attorneys have published more than 25 books in this area, reflecting their extensive practical experience in strategically and proactively serving nonprofit clients.

These publications include a recently released book about IRS Form 990, which was produced in a collaboration involving four of our attorneys. The redesigned Form 990 is one of the most significant developments nonprofit organizations have faced in many years. In addition, two of our other members authored a Tax Management Portfolio, which is a well-known tax treatise published by the Bureau of National Affairs.

As active industry contributors, we are better able to keep our clients abreast of important developments in this area of law as it relates specifically to their business. Meanwhile, our firm is equally committed to learning about our nonprofit clients’ operations, as well as their business objectives and challenges. This combined focus allows us to enhance our clients’ decision-making while also achieving desired outcomes and results.

Our team partners with a range of clients that include national health care organizations, hospitals and health systems, as well as universities, government organizations, research institutions, and a variety of state and national industry associations.

Nonprofit has a broad range of practice areas and services, including:
  • Academic Institutions
  • Charitable and Religious Organizations
  • Health Care
  • Private and Public Foundations


  • Negotiated on behalf of a large religious health care system with the IRS on the form and content of the new IRS Form 990. This included revising the draft schedules on governance, compensation, charity care, and related organizations to reduce the burden on religious health care systems and nonprofit systems generally.
  • Counseling executive teams, boards and board committees on Form 990 preparation; advised clients of the risks of disclosing certain activities on the 990 that have legal consequences; and educated organizations as to the importance of the Form 990.
  • Coordinated with the Senate Finance Committee Tax Staff regarding the American Recovery and Reinvestment Act of 2009 on drafting legislative history language for inclusion in the committee report encouraging the IRS to grant 501(c)(3) status to health care organizations engaged in health information exchange.
  • Guided a nonprofit 13-hospital health care system through one of the largest hospital sale transactions in United States history (the $1.3 billion sale of Health Midwest to HCA).
  • Spun off The University of Kansas Hospital Authority from The University of Kansas; drafted the legislation creating the hospital as a nonprofit instrumentality of the state; secured a private letter ruling from the IRS recognizing the hospital as tax-exempt instrumentality of the state; and negotiated and drafted a comprehensive affiliation agreement between the hospital and the state university.
  • Created several medical research organizations and foundations, including the Stowers Institute for Medical Research, operated in conjunction with hospitals to conduct medical research, as well as obtained recognition of tax-exempt status for the medical research organizations and structured the hospital affiliation agreements.
  • Structured research consortium of nonprofits and governmental organizations utilizing a supporting organization structure and a for-profit technology transfer and commercialization subsidiary, incorporating flexible governance rights of members, complex support allocation and intellectual property sharing rights, and successfully obtained the IRS blessing of the structure in Private Letter Ruling 200326035 dealing with 501(c)(3) status and UBI issues.
  • Regularly advise hospital and health system clients on unrelated business income consequences of clinical trials and clinical research; establish protocols for documenting files; and develop strategies for successfully arguing that such activities are not UBI despite long-standing IRS positions to the contrary.
  • Structured a joint operating agreement between Mountain States Health Alliance in Johnson City, Tenn., and an unrelated nonprofit community hospital and obtained one of the early IRS private letter rulings approving the joint operating agreement and granting 501(c)(3) status to the joint operating company.
  • Created numerous hospital-physician joint ventures to preserve hospital tax-exempt status; minimize unrelated business income risks to hospital; ensure charity care and community benefit commitments from the joint venture; and accommodate physician business and entrepreneurial objectives (e.g., created a syndicated specialty hospital for Mountain States Health Alliance in Johnson City Tennessee that included ownership by nonprofit hospital and numerous physicians).
  • Regularly assists hospitals and health systems with creation of template or form documents that comply with IRS rules and regulations, including physician recruitment agreements, physician employment agreements, template joint venture operating agreements, articles of incorporation and bylaws.
  • Obtained several of the early IRS determination letters issued to RHIOs and HIEs regarding exempt status and counseled such organizations on governance structure, obtaining ARRA funding, negotiating vendor contracts and HIPAA privacy and security compliance.
  • Utilized for-profit subsidiaries to effectively achieve strategic goals and minimize attribution of the for-profit activities to the nonprofit parent.
  • Counsel hospitals and health systems with MOB development and private activity use, unrelated business income, and acquisition indebtedness rules related to ownership and leasing of MOB space.
  • Represented Rockhurst University, a Catholic Jesuit University, in the creation of a tax-exempt corporation, followed by the acquisition of substantially all of the assets of the nation’s second largest seminar company.
Related News

Past Events