Does mission still matter? A hospital may forfeit its future by forgetting its community.

The public finds it increasingly difficult to distinguish voluntary, not-for-profit health care organizations from their for-profit competitors. One result of this trend is challenges to not-for-profits' tax-exempt status. In 1987, this article's author, with Bruce Vladeck, published a book called Mission Matters: A Report on the Future of Voluntary Health Care Institutions. That book warned not-for-profit hospitals that, if they were to survive, they must maintain a close relationship with their communities. They urged such hospitals to nurture five traditional characteristics: Values that reflect community commitment. Accountability to patients and communities. Long-term commitment in the face of short-term trends and opportunities. A physician-hospital relationship that fosters a symbiosis of service. Institutional voluntarism that allows institutions to be both provider and beneficiary of community service. In this article, the author seeks to remind leaders of voluntary, not-for-profit institutions, including Catholic institutions, that they neglect community service at their own peril.