My study examines the effect of regulatory pressures on the earnings management behavior of nonprofit (i.e., tax-exempt) hospitals. Prior research provides evidence that managers of nonprofit hospitals manage reported earnings to a range just above zero profit in order to conform to regulator low or zero profit expectations. I extend this research by investigating how reported performance on another accounting measure important to regulators, (i.e., charity care), further explains the earnings management behavior of nonprofit hospitals. Specifically, I develop theory to predict that nonprofit hospitals use discretionary accruals to manage positive earnings toward regulator low profit expectations less aggressively when reported performance on charity care is higher than regulator expectations. The intuition behind this prediction is that nonprofit hospital managers can benefit from reporting higher earnings (from profit-based compensation and/or enhanced reputations for operational efficiency), however, they must balance this against the costs of regulatory scrutiny. Results are consistent with my prediction. Further, I validate that my results are not alternatively explained by the mechanical relationship of my test variables, the general hospital economic environment, and/or the specific reporting environment of my sample firms. I do so by comparing the earnings management behavior of nonprofit hospitals to that of for-profit hospitals. Overall, results suggest that nonprofit managers strategically manage earnings higher when their firms are less vulnerable to regulator scrutiny of their reported chairy care. As such, my study contributes to the earnings management literature and has policy implications important to regulators, especially given the current U.S. healthcare environment.

The diploma thesis "Comparison of the pastoral and charitable care for the elderly in the Archdiocese of Prague" enquires into the relation between the pastoral and charitable care for the elderly in the Archdiocese of Prague and the quality of accessible local services. It seeks to define the meaning of being old in the 21st century, deals with the questions of ageing and old age and the perception of these phenomenons in the broad social context. The thesis underlines the dignity of old men as well as their specific psychological and spiritual needs. The second part of the paper inquires into the principles of the charitable and pastoral care and it tries to sort out the accessible services. The last, empirical part contains the methodology and interpretation of the research among the charitable and pastoral institutions and parishes. The Conclusion summarizes informations from the previous chapters. Keywords elderly, pastoral care, charity care, the Catholic Church, Archdiocese of Prague

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Provider incentives are a commonly used policy tool to mold provider behaviors.1 However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program. Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic surveys to member experience with care in order to evaluate characteristics key to patient-centered medical homes. I find that patient-perceived patient-centeredness of a practice is not related to the number of PCMH attributes a practice reports. However, some characteristics do play specific and significant roles in patient perception and outcomes. For instance, case management is not only associated with increased patient perception of after-hours access to care, but overall costs were reduced. Interestingly, having after hours clinic hours was more common with practices highly consistent with PCMH criteria, but these hours did not result in decreased emergency department use or cost of care. Chapter 2: The second provider incentive studied is the Medicare Hospital Value-Based Purchasing Program (HVBP). This program assigns payment adjustments based on performance on a series of rotating quality metrics. To date, changes in patient outcomes cannot be attributed to the program; however, it should not be concluded that hospitals are not responding at all. I identify changes in staffing by provider type as an early indicator of hospital response to payment incentives. Data come from the Virginia Health Information (VHI) Hospital Cost Report, 2010-2017. Using a generalized linear model, I find that when receiving a penalty, hospitals reduce staffing among the most and least expensive personnel (physicians and nursing aides). Hospitals increase nursing and administrative staff following a bonus. These findings are consistent with hospitals responding to incentives both by aiming to improve efficient use of resources and maintain or improve quality of care. Chapter 3: Finally, I assess potential unintended consequences of the HVBP program, specifically the provision of charity care. Using the VHI cost reports for year 2013 to 2017 with a regression discontinuity model, I find that hospitals receiving a bonus decrease their charity care among the lowest income patients (under 100% federal poverty level (FPL)). Hospitals receiving a penalty tend to reduce charity care among higher income patients (100%-200% FPL). These findings are consistent with two separate responses to the incentives. Hospitals receiving bonuses appear to be cream-skimming healthier, wealthier individuals while hospitals receiving penalties appear to be shifting the focus of their charity care to the most needy, likely in an effort to reduce cost of care levels overall while maintaining their community benefit programs, potentially as a result of goal gradient cognitive bias.

The thesis deals with the history of charity work among Seventh day Adventists in the Czech lands. It presents basic information about the origins, progress and theological emphasis of Seventh day Adventists concerning the charity work. It shortly describes the history of Adventism in the Czech lands. The second part is focused on each form of social, charitable and humanitarian care that was provided by the Seventh day Adventists in the Czech Republic. In addition, it describes poverty reduction as well as work in the Tabita social groups. Information is also provided about the medical missionary ministry, work of the summer children health camps and the Association for health care. The last part of the thesis is aimed at basic information about the Czech office of the Adventist development and relief agency and pastoral care among the Adventists.

The master thesis focuses on caring facilities and service, specifically the Charity care service of the regional charity of Klatovy. The Master thesis points out how necessary and at the same time demanding is the work of caregivers. The Master thesis also includes the characteristics of the clientele with whom Caritas care facility most often cooperates - seniors. It also contains an analysis of ethical dilemmas and problems which arose from semi-structured interviews with respondents,who are employees of specific centers of Caritas care service. The thesis also contains improvement suggestions and coments of the ethical dilemmas and problems which are made using 4 ethical theories - utilitarianism, deontology, ethic of care and situational ethic.