This study examines the relationship between institutional pressures to provide social benefits and the discretionary accrual behavior of nonprofit firms. I examine this issue within the context of U.S. nonprofit hospitals, an economically significant and politically rich setting where firms face considerable institutional pressure to provide an important social benefit: charity care. I argue that institutional pressures on nonprofits to provide higher levels of social benefits imply that lower profits should be reported. I develop theory and provide evidence which suggests that, due to competing private incentives to report higher profits, nonprofit managers strategically use discretionary accruals to increase accounting earnings when the social benefits their firms have provided in the current period exceed external stakeholders' normative expectations. The findings from this study inform the ongoing political debate regarding the appropriateness of tax exemptions for U.S. nonprofit hospitals and should therefore be of interest to both regulators and policymakers. In addition, this study provides timely insights for researchers regarding how institutional pressures can affect managers' reporting behaviors in other settings where similar competing reporting incentives exist between managers' private benefits and stakeholder expectations related to social benefits.

In this paper, we examine bad debt and charity care reporting by nonprofit hospitals around bond issuance. Given the tax advantages afforded to nonprofit hospitals, including the ability to issue tax-exempt debt, hospital managers encounter stakeholder pressure to provide community benefits. When nonprofits issue debt, they also face economic pressure to meet creditors’ financial performance expectations. We document a reporting strategy that allows nonprofit hospitals to reduce the cost of bond debt while simultaneously alleviating regulators’ and community members’ concerns about inadequate provision of charity care. Using data from public bond issues for California nonprofit hospitals, we find that hospital managers shift costs from bad debt expense to charity care in periods prior to a public bond issuance and that the strategy is associated with a lower cost of debt. Our results inform those relying on accounting measurements to infer nonprofit hospitals’ social good provisions and financial health.

ABSTRACT We conduct two experiments to examine whether and how the framing (bonus vs. penalty) of a target‐based incentive contract affects knowledge sharing and knowledge seeking. In the first experiment, we predict and find that penalty‐framed contracts increase employees' stress due to the fear of potential loss, which in turn reduces their willingness to share knowledge. Additionally, consistent with loss aversion, employees under penalty‐framed contracts are more likely to seek knowledge than those under bonus‐framed contracts. The second experiment corroborates our theoretical arguments by demonstrating the crucial role of stress in reducing knowledge‐sharing behavior. The results show that, when stress is alleviated through an informal control mechanism, penalty‐framed contracts no longer reduce knowledge sharing. The implications of our findings for research and practice are discussed.