Healthcare fundraising is essential to sustaining hospitals and health systems, especially given the industry’s increasing financial challenges. 

Compliance with complex regulatory frameworks is central to this mission. These regulations protect patient information, maintain donor trust, and ensure ethical conduct. However, navigating them can be daunting for healthcare fundraising professionals and financial leaders. 

This guide outlines six actionable tips to help hospital CFOs and healthcare fundraising professionals stay compliant while driving revenue to meet pressing healthcare needs. 

1. Understand the healthcare fundraising regulatory landscape.

Successfully navigating regulations begins with understanding the legal and regulatory framework for healthcare fundraising. Key regulations to focus on include: 

• HIPAA (Health Insurance Portability and Accountability Act): HIPAA is central to healthcare fundraising compliance. Under HIPAA, using patient information for fundraising requires written patient authorization. For example, let’s say you’re interested in creating a series of patient testimonials for your healthcare organization’s website. After identifying patients with compelling stories, you must contact them to ask for their consent to use their names, images, and treatment information in robust testimonial stories. 
• State-specific fundraising laws: Many states have specific rules regulating solicitation practices through phone, mail, or email. For instance, 23 states require charitable registration and disclosure statements. Familiarize yourself with the regulations in the states where your organization operates or solicits funds. 
• IRS regulations: Nonprofit hospitals and organizations must adhere to IRS guidelines, such as providing proof that the hospital operates for the benefit of the community and offering transparency in how funds are used. 

Review your institution’s fundraising practices regularly with compliance experts to ensure they align with HIPAA and your state’s solicitation laws. By clearly understanding the requirements, CFOs and fundraising teams can mitigate risks and ensure smooth operations. 

2. Implement robust compliance policies and procedures.

Fundraising professionals often find themselves caught between donor intent and institutional policy. A clear, board-approved policy empowers you to make decisions that support ethical and financial integrity.

These guidelines should include internal checks and balances for campaign transparency and proper data use. Examples of specific measures to incorporate are: 

• Data access policies: Limit patient and donor information access to essential fundraising employees only.
• Gift acceptance policies: Ensure all donations, whether from individuals, corporations, or foundations, follow ethical guidelines and meet IRS standards. Examples of ethical guidelines include not accepting gifts that may lead to a conflict of interest or donations to endorse a commercial organization. 
• Alignment with IRS regulations around quid pro quo contributions: Fundraising policies should clarify how to calculate and disclose the fair market value of any benefits provided to donors to ensure proper tax reporting.
• Documentation standards: Maintain thorough documentation to allow for external or internal audits of your fundraising practices when required. 
• Legal review for donor-imposed restrictions: Any gift with conditions, such as designated use, naming rights, or time limits, should undergo legal review to confirm enforceability and alignment with organizational policy.
• Valuation procedures for non-cash gifts: Policies should outline how your organization appraises and records non-cash contributions to avoid compliance issues and ensure accurate financial reporting.
• Limits on certain types of support, such as gifts tied to specific medical outcomes: To protect ethical boundaries in healthcare fundraising, organizations must clearly prohibit gifts that imply influence over clinical decisions or patient care.

Conduct annual reviews of your compliance policies with your legal counsel or consultants to ensure they remain current and effective. 

3. Provide ongoing training for your fundraising team.

Your compliance protocols are only as effective as the people implementing them. Regular training and development ensure your fundraising and finance teams adhere to evolving regulations. Topics to include in team training sessions are: 

• Ethical fundraising practices: Reinforce patient and donor outreach guidelines, emphasizing practices that protect donor and patient trust. Honor donors’ and patients’ requests to remain anonymous if they wish. 
• HIPAA compliance in practice: Focus on how teams can securely use patient information for campaigns and honor patient communication preferences. For instance, let’s say you want to create a series of patient testimonials to support a social media fundraising campaign. Ask for patients’ written authorization to use their names alongside information about their medical histories or treatments. 
• Scenario-based workshops: Provide real-life examples of ethical dilemmas or compliance issues that teams may encounter and guide them to the correct resolution. Give team members feedback to ensure their responses align with your internal guidelines. 

Schedule semiannual training workshops, and make compliance-focused e-learning modules available for teams to access on demand. 

4. Collaborate with the finance department to accurately report fundraising revenue.

Fundraising professionals know that gifts come in many forms—annual gifts, pledges, bequests, donor-advised funds (DAFs), endowment contributions—but not all are treated equally in financial reporting. Coordination with your finance department is essential to appropriately recognize and use philanthropic dollars.

To avoid discrepancies between development and finance, you should:

• Establish clear definitions and timelines for pledge fulfillment. Define what constitutes a pledge and set realistic timelines for fulfillment to ensure accurate forecasting and donor follow-up.
• Align campaign counting standards with GAAP (Generally Accepted Accounting Principles). Ensure internal campaign reporting aligns with financial accounting standards to maintain transparency and credibility.
• Use consistent processes for restricted vs. unrestricted funds. Differentiate how you track and report restricted and unrestricted gifts to honor donor intent and support audit readiness.

With alignment between your fundraising and finance teams, your organization can more accurately forecast revenue, improve budgeting, and confidently share impact reporting with key stakeholders, especially board members and external funders.

5. Leverage technology to strengthen compliance.

Technology can be pivotal in ensuring your healthcare fundraising efforts remain compliant, efficient, and innovative. Consider implementing tools that integrate compliance into your workflows, such as: 

• Constituent relationship management (CRM) systems: Modern donor management systems like Blackbaud or Salesforce allow you to segment data securely, restrict access, and track donor preferences. Remember that your organization is responsible for ensuring that any CRM platforms you use align with HIPAA regulations. 
• AI-powered fundraising tools: As BWF’s guide to AI fundraising use cases states, “With the help of AI solutions, healthcare organizations can identify their top prospective donors quickly and reach out to them with personalized messages.” AI can streamline compliance while improving fundraising outcomes. For example, you can configure an AI prospect research tool to analyze donor data for trends without accessing sensitive patient information. 
• Fundraising automation platforms: Automate email campaigns and donation acknowledgment processes to ensure timely and compliant communication. 

Evaluate your current fundraising technology stack and identify gaps. Consider platforms that specialize in healthcare fundraising compliance and integrate seamlessly into hospital financial systems. 

6. Seek expert legal counsel.

Even with strong internal protocols, the complexities of healthcare regulations often require guidance from legal experts. Engaging with legal counsel experienced in nonprofit healthcare fundraising helps prevent potential compliance issues and protects your organization. These legal professionals can provide guidance in areas such as: 

• Audit support: An experienced legal partner can review fundraising practices and documentation to identify risks ahead of audits. 
• Strategic planning: Seek guidance on structuring endowment campaigns, naming rights agreements, or planned giving programs to meet fundraising and compliance goals. 
• Mitigating emerging risks: With healthcare regulations evolving, proactive consultation with legal advisors can keep your organization ahead of new compliance requirements. 

Build relationships with expert legal and compliance consultants specializing in healthcare and nonprofit regulations, ensuring you have a strong partner to lean on when challenges arise. 

The Critical Role of Compliance in Healthcare Fundraising 

Fundraising is not just about dollars; it’s about trust. By adhering to compliance regulations, hospitals and health systems can strengthen trust, sustain valuable donor relationships, and create programs aligned with organizational missions. 

For hospital CFOs, these compliance best practices are also directly linked to the organization’s financial health. A well-executed and compliant fundraising program supplements institutional revenue, supports endowments, and provides funding for research and innovation. 

Begin your compliance review with a strategic partner or evaluate whether your systems and policies meet financial and regulatory needs.