Hospitals are required to provide a social safety-net through charity care to indigent populations. This study aims to build upon previous research by examining the provision of charity care by hospitals using national, longitudinal data. We found no significant difference in the provision of charity care. However, we did find that hospital charity care ratio may be influenced by type of care, location, and market conditions. Policymakers need to determine the appropriate level of charity care to be provided by non-profit hospitals. Managers need to determine the appropriate cost management strategy to support their hospitals' financial sustainability.