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At least three local nonprofit hospitals are among more than 500 across the country that have been quizzed by the IRS about whether they comply with federal requirements for tax exemption.

The local hospitals -- Allegheny General Hospital, Mercy Jeannette Hospital and the University of Pittsburgh Medical Center -- were chosen randomly to complete the seven-page questionnaire, said Gregg J. Semanick, spokesman for the IRS. The government will use responses to determine, among other things, whether hospitals are complying with rules governing how they provide community benefits and the salaries they pay top executives.

The compliance check, which IRS initiated in May, is part of a broader effort by the government to increase scrutiny of nonprofit hospitals. Although there are about 7,000 nonprofit health-care organizations in the country, the IRS audited only about 350 between 1995 and 2005.

"We at the IRS are now faced with a health-care industry in which it is increasingly difficult to differentiate for-profit from nonprofit health-care providers," said Mark W. Everson, the commissioner of internal revenue, during congressional testimony in May. "There are increasing indicators that the twin cancers of technical manipulation and outright abuse that we saw develop in the profit-making segments of the economy are now spreading to pockets of the nonprofit sector."

The IRS questionnaire includes several questions about executive pay, including whether hospitals have formal written compensation policies and the process they use in determining salaries for top officials. Hospitals are asked to list the names of all officers, directors, trustees and key employees with which the hospital has a business relationship, and to describe that relationship.

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More broadly, the hospitals being surveyed are asked how much uncompensated care they provide and how they bill patients for services.

The IRS alerted hospitals late last year that this year it would be targeting compensation issues at nonprofit hospitals and the so-called "community benefit standard" that health-care organizations must satisfy to be exempt from taxes. The standard was created in 1969 in lieu of an outright requirement that nonprofits provide a specific level of care to the poor.

The 1969 standard called on hospitals seeking tax exemption to demonstrate that they provide benefits to a broad section of the community and that the hospital is operated to serve a public rather than a private interest. The standard recognized promotion of general community health as a charitable purpose.

But in the years since the standard was adopted, hospitals have debated which expenses can be included when tabulating the dollars they put toward their social mission. Some hospitals argue that their "bad debt" -- bills that can't be collected -- should be counted, as should the difference between what Medicare pays for services and what hospitals say is the true cost.

"I think that the IRS is trying to define 'community benefit' a little better, so that it wouldn't be open to interpretation," said Tina Latin-True, vice president and controller for the Hospital & Healthsystem Association of Pennsylvania.

Although the questionnaire was due June 15, many hospitals sought and received deadline extensions due to the length of the form, said Ms. Latin-True.

The IRS compliance check was welcomed by Sen. Chuck Grassley, R-Iowa, the chairman of the Senate Finance Committee. Mr. Grassley's committee has been raising questions for several years about the behavior of nonprofit hospitals on executive compensation matters, as well as the amount of charity care they provide.

Still, IRS should be doing more than just asking questions, Mr. Grassley said.

"With millions of low-income families and individuals facing spiraling health-care costs, the IRS and Treasury need to make sure that charitable hospitals that have received billions of dollars in tax breaks are making a difference," he said in a released statement. "It's clear that charitable hospitals are all over the map when it comes to providing charitable care and community benefits."