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Accounting

When Education Meets Medicine: What the Mayo Clinic Case Means for Nonprofit Tax Exemptions

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The Mayo Clinic is famous both for its medical care and patient education. In fact, its website is often cited by news organizations and others when reporting on medical stories; it is known for its accuracy and excellence. When the IRS determined that the Mayo Clinic was not entitled to its refund claim for substantial Unrelated Business Income Tax (UBIT), which the Mayo Clinic claimed based on its educational activities, the Clinic took action. Here’s the whole story, and what it means for nonprofits.

What Is Unrelated Business Income Tax (UBIT?)

Financial/tax concept about Unrelated Business Taxable Income UBTI with phrase on piece of paper

UBIT stands for Unrelated Business Income Tax. It’s a tax imposed on income that tax-exempt organizations such as nonprofits earn from activities not substantially related to their core exempt purpose. The Mayo Clinic claimed education as an activity substantially related to its core purpose.

The IRS Said No

The IRS felt differently, however. They assessed $11,501,621 in unpaid acquisition indebtedness UBIT for tax years 2003, 2005-2007, and 2010-2012. This amount was based on the acquisition indebtedness of property held by the Mayo Clinic. The property produced income. While the Mayo Clinic paid the debt, they initiated the request for a refund in 2016, which brings us to the current ruling.

Why did the IRS question the Mayo Clinic’s report? The IRS concluded that for the years in question, the Mayo Clinic did not meet the definition of a § 170(b)(1)(A)(ii) qualified organization as defined in Treasury Regulation § 1.170A-9(c)(1). To sum up the regulation, if the Mayo Clinic claimed education, it must be formal instructional activities, not merely incidental educational activities. Given that the clinic’s primary purpose is to provide medical services, at first, this seemed reasonable.

The Case Winds Its Way Through the Courts

The Mayo Clinic contested these findings, and as the case wound its way through the court system, various courts interpreted the IRS rulings differently. At issue was whether the Mayo Clinic’s educational activities were in addition to or inexorably intertwined with its medical services.

After much debate, the final district court found that “primary” purpose in this case means “substantial” and that the Mayo Clinic did meet the definition of education in the context of a substantial portion of its activities. Equally as important, its educational context was not “non-essential” but deemed an essential part of its primary mission. Given this, the court ruled that the Mayo Clinic was entitled to a full refund. The government is appealing this decision.

Context for Nonprofits

This case highlights several nuances in assessing a nonprofit’s educational purpose. To government entities such as the IRS, it means that education must be the primary purpose of the nonprofit, such as the activities of a college, school, or other institution of learning. However, many nonprofits, such as the Mayo Clinic, engage in significant educational activities with their constituents, but primarily engage in other services, such as medical care.

At issue in the case is whether or not such activities count as “substantial” enough to justify the requested refunds, or whether the organization’s primary purpose must be education in order to qualify under the IRS ruling.

Why This Matters

This ruling sets a powerful precedent for nonprofit organizations with hybrid missions. It signals that substantial commercial activities do not automatically disqualify an institution from being considered educational, as long as those activities are integrated with and serve the educational purpose.

For CPAs, nonprofit advisors, and academic institutions, the case offers a roadmap for navigating UBIT exemptions. It emphasizes the importance of demonstrating how various functions support a unified, exempt purpose.

Final Thoughts

The Mayo Clinic case is more than a tax dispute. It’s a reaffirmation of how education can be effectively integrated into complex, real-world operations. It challenges narrow definitions and opens the door for more nuanced evaluations of nonprofit missions. For organizations walking the line between service and instruction, this decision offers clarity with context.

Welter Consulting

Welter Consulting bridges people and technology together for effective solutions for nonprofit organizations. We offer software and services that can help you with your accounting needs. Please contact us for more information.

Accounting Excellence: What Nonprofits Can Learn from Accounting Firms

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How can you measure accounting excellence? And what tools, systems, and processes support excellence?

A recent report from Karbon, a software company specializing in practice management, examined the changes in performance of accounting firms before and after the COVID-19 pandemic. Their findings indicated that organizations that focused on several areas improved practice excellence. These areas included business processes, talent management, and the right software to support operations. Here, we take a look at these three areas and provide recommendations for nonprofits to adopt these lessons for their own accounting departments.

Two financial accountants analyzing business spreadsheets on laptop computer.

Measuring Practice Excellence

Before looking at the results, it’s important to understand how Karbon conducted their study. They measured practice excellence across “four pillars”: strategy, efficiency, growth, and management. The four pillars are then further subdivided into a total of 12 areas that the firm explored in 20-minute telephone surveys with participants. The resulting interviews were distilled into the findings of the report.

Efficiency Drives Success

The main finding throughout the entire study was that improving efficiency drives success for accounting firms. Firms that prioritized efficiency were also the most successful. These companies embraced new technologies, and by doing so, improved operations. The resulting improvements carried over well beyond the pandemic.

There’s also a strong correlation between focusing on business process improvements and overall practice excellence. The study found a 71% correlation between Business Process Excellence and Practice Excellence scores. Accounting firms that spent time examining and improving business processes made improvements across their entire company, resulting in higher scores in Practice Excellence.

Closing the Talent Gap

We’ve written many times about the talent shortage in the accounting profession and how companies, as well as the AICPA, are addressing this gap. Another important finding from the Karbon report is that accounting firms that were intentional about closing the talent gap were more successful than their peers who did not take steps to find, recruit, train, and manage talented people. Factors that improved talent management and retention among successful accounting firms included a thorough onboarding process, searching for candidates with higher emotional intelligence scores and attributes, effective meeting management, and 360-degree performance reviews. It is worth noting that managing meetings effectively is an integral part of the overall talent management cycle. It may be inferred that “meeting creep” (i.e., too many meetings, unfocused meetings, unproductive meetings) exhausts talented people. Or at least that’s what we think!

Adopting the Right Technology Is Critical for Efficiency

Among the many findings in the report, one thing stands out: adopting the right technology is crucial to support efficiency and practice excellence.

The “right” technology differs among firms, of course. A large accounting firm with multiple offices needs a different system than a nonprofit or a government accounting department. Matching accounting software with an organization’s needs is a crucial factor in driving success.

The study found three types of software supported practice success:

  • Business intelligence 
  • Practice management 
  • Communication 

Each type of software supports excellence in different ways:

  • Business intelligence software enables companies to measure performance through visualizations that are often easier to read than standard reports.
  • Practice management software helps accounting firms centralize workflows and streamline operations.
  • Communication tools enable secure real-time messaging.

Key Takeaways for Nonprofits

At Welter Consulting, we help nonprofits find solutions that work for their unique needs. Our key takeaways for clients, based on the Karbon report, are that the right software, matched with the right client, does wonders to improve performance and drive excellence.

Nonprofit accounting software can help nonprofits transition from spreadsheets or general-purpose small business software to nonprofit-specific platforms that support their unique accounting needs. Such software enables program-specific metrics tracking, can integrate with donor and grant software, and supports many of the efficiencies cited in the paper as drivers of practice excellence. Talent management software also supports recruiting and training talented individuals, a challenge that nonprofits often face.

As the Karbon report indicates, accounting firms that not only survived the pandemic but thrived afterwards focused on improving efficiencies. They did this by examining and enhancing business practices, improving talent management, and adopting the right software. Nonprofits can learn from this example and adopt these ideas to further improve their own operations and accounting groups.

Welter Consulting

Welter Consulting bridges people and technology together for effective solutions for nonprofit organizations. We offer software and services that can help you with your accounting needs. Please contact us for more information.

The Right Nonprofit Accounting System for Your Evolving Organization

By | Accounting, Nonprofit | No Comments

Organizations grow and change over time just like people do. They start small and grow in new and interesting ways. As a nonprofit grows, its accounting needs change, too. Often, organizations begin with simple spreadsheets or out-of-the-box small business accounting software. There comes a time, however, when spreadsheets take more time than you have in your day to update, or when your software is sluggish, overburdened, or simply not flexible enough to meet your current requirements.

In this article, we’ll explore what to do next if you’re unhappy with your current system. We’ll discuss the steps to evaluate your needs and select a flexible nonprofit accounting system that supports your current growth and future needs.

person using a tablet for accounting

Symptoms of Accounting System Growth Pains

Doctors ask patients about the symptoms of their maladies. What are the symptoms of accounting system growth pains?

  • A system that makes it difficult to get the reports you need – you find yourself exporting data into spreadsheets, then manipulating spreadsheets to generate the charts, graphs, and reports you need.
  • After typing data into your accounting system, you need to key the exact same information into another system because the systems don’t ‘talk’ to each other.
  • Duplicate data is rampant because everyone must type information into multiple systems. Even something as simple as typing “Rd” instead of “Road” leads to duplicate information and problems.
  • Month-end closing takes hours, even days, when you feel like it should be much easier.
  • It’s almost impossible.


Sounds familiar? If any of this sounds like your situation, you may be experiencing accounting system growing pains. It’s like a pair of shoes that no longer fit – they pinch because your feet have grown. It’s time to get the right size.

Imagine the Possibilities with a New Nonprofit Accounting System

Now imagine the possibilities with a new nonprofit accounting system. Cloud systems provide a comprehensive solution that includes accounting, finance, operations, human resources, and other systems all in one interconnected platform. Information entered into one part of the system flows naturally into other parts, providing unmatched real-time visibility. Preparing for audits, sharing information, and even simple monthly reconciliations are all much easier with a modern cloud-based accounting platform.

Searching for a New Accounting System

How do you begin the search for a new nonprofit accounting system?

  • Select a team from within your organization to steer the search. The members don’t need to be IT experts. A cross-sample from across multiple departments is the best way to steer a software selection team.
  • Work with a consultant. A good consultant who understands the nonprofit world and its unique accounting and reporting needs will save you time and effort by steering you towards software that supports your organization’s growth.
  • Make a list of the current pain points with your existing system and the wish list of what you’d like to see in your new one.
  • Take your time. Your new nonprofit accounting system will be with your organization for many years to come. Take the time now to research, review, and select the best one to support your growth.

It can be challenging to know the next steps when your organization has outgrown spreadsheets and standard accounting programs. With the right partner by your side, you can step forward into the search for a new nonprofit accounting program with confidence.

Welter Consulting

Welter Consulting bridges people and technology together for effective solutions for nonprofit organizations. We offer software and services that can help you with your accounting needs. Please contact us for more information.

ACA Compliance for Nonprofits: New Penalties, New Priorities in 2026

By | Accounting, Government, Nonprofit, Tax | No Comments
clipboard with paper which says ACA affordable care act compliance for nonprofits 2026

The IRS recently released Rev. Proc. 2025-26, providing the indexing adjustments for the upcoming calendar year 2026. These indexing adjustments affect applicable large employers (ALEs) starting next year. ALEs are defined as entities having 50 or more employees. Such organizations must either offer minimum essential coverage that is affordable (i.e., provides minimum value to full-time employees and their dependents) or make an employer shared responsibility payment to the IRS, all part of the Affordable Care Act’s employer shared responsibility provisions.

Nonprofit status does not matter in the context of this law; it’s the number of full-time employees that counts. If your organization employs 50 or more full-time employees, it’s important to understand the indexing adjustments to ensure full compliance with the ACA and avoid potential penalties.

What Is an Employer Shared Responsibility Payment?

The Employer Shared Responsibility Payment is a financial penalty imposed by the IRS on ALEs who fail to meet specific health coverage obligations under the Affordable Care Act.

To avoid the ESRP, an ALE must offer its full-time employees and their dependents health insurance that:

  • Qualifies as minimum essential coverage
  • Is affordable based on IRS standards and
  • Provides minimum value, meaning it covers at least 60% of expected healthcare costs

If an ALE does not offer coverage to at least 95% of its full-time employees, or if the coverage offered is unaffordable or inadequate, and at least one employee receives a premium tax credit through the Health Insurance Marketplace, the employer may owe one of two types of ESRPs:

  • A penalty for not offering coverage to enough employees
  • A penalty for offering coverage that fails the affordability or value tests

These payments are calculated monthly and assessed annually, with amounts indexed for inflation. Importantly, ESRPs are non-deductible and apply regardless of an employer’s tax-exempt status.

IRS Implements Updated Penalty Amounts in 2026

Beginning in 2026, the IRS will implement updated penalty amounts under the Employer Shared Responsibility Provisions of the Affordable Care Act. Nonprofit organizations classified as Applicable Large Employers (ALEs) must be especially mindful of these changes. If an ALE does not offer minimum essential coverage to its full-time employees, it may face a penalty of $3,340 per employee annually. Alternatively, if coverage is offered but is deemed unaffordable or does not meet minimum value standards, the penalty rises to $5,010 for each affected employee. These penalties are indexed for inflation and apply to plan years starting after December 31, 2025.

ESRPs are non-deductible expenses, meaning nonprofits cannot offset them through tax savings. This can pose a significant financial strain, especially for organizations operating on tight budgets or relying heavily on grant funding and donations.

Avoid the Penalty and Stay in Compliance

To avoid the Employer Shared Responsibility Payment, companies must first determine whether they qualify as an Applicable Large Employer, which generally means having 50 or more full-time employees or full-time equivalents in the previous calendar year. If they meet this threshold, they are required to offer minimum essential health coverage to at least 95 percent of their full-time employees and their dependents. This coverage must be affordable according to IRS safe harbor standards. It must also provide minimum value, meaning it covers at least 60 percent of expected healthcare costs.

Employers should also accurately track employee hours to determine full-time status and use IRS-approved methods for measurement. In addition, they must report coverage information to both the IRS and employees using the appropriate forms, such as Form 1095-C and Form 1094-C. If contacted by the IRS regarding a potential penalty, employers have a 90-day window to respond and provide documentation. Monitoring and meeting these requirements can help your organization avoid steep penalties from the IRS.

Preparing Nonprofits for ACA Compliance: Why Early Action Matters

As the 2026 updates to the Employer Shared Responsibility Payment take effect, nonprofit organizations must recognize that compliance affects them too. These provisions apply equally to tax-exempt employers as well as for-profit companies. If you don’t follow the IRS rules, your organization will face a steep penalty.

By understanding the rules, evaluating coverage, and proactively preparing for the new thresholds, nonprofits can protect their budgets and continue focusing on their mission. Early planning and informed decision-making will ensure your organization remains compliant and avoids costly penalties in the years ahead.

Welter Consulting

Welter Consulting bridges people and technology together for effective solutions for nonprofit organizations. We offer software and services that can help you with your accounting needs. Please contact us for more information.