Community Health Needs Assessment
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What is a CHNA?

Read more about HPSA Acumen's work with Yuma County and CHNA here

Community Health Needs Assessments (CHNA) are part strategic plan and part grounding rod.  The Patient Protection and Affordable Care Act of 2010 (ACA) requires tax-exempt hospitals to create a hospital community health needs assessment every three years.  This hospital CHNA is developed alongside community stakeholders.  The community health needs assessment requirements include:

  • Demographic Assessment identifying the community the hospital serves
  • A community health needs assessment survey of perceived healthcare issues
  • Quantitative analysis of actual health care issues
  • Appraisal of current efforts to address the healthcare issues
  • Formulate a 3-year plan - the community comes together to address those remaining issues collectively, ultimately working towards growing a healthier community

More on the Regulations

This portion of the ACA will be enforced by the Internal Revenue Service (IRS) based on regulations the agency develops and will eventually publish in the Federal Register. Hospitals that fail to meet the IRS requirements or ignore the new mandate risk losing their exempt status under Section 501 of the tax code and being penalized with up to $50,000 in fines for each year a given hospital is out of compliance.

For large organizations that operate multiple hospitals, the CHNA requirement pertains to every separate hospital location, not simply the incorporated structure. The ACA also requires that tax-exempt hospitals develop action plans to address any healthcare deficiencies or inefficiencies revealed during the CHNA research. For rural hospitals, collaboration with the local health department and interested stakeholders to accomplish some tasks of a CHNA will be less complicated. Large multi-hospital or multi-specialty hospital networks, meanwhile, will have to thoughtfully define their communities and balance compliance requirements with the compelling desire to maintain operational confidences and strategic plans.

Once the hospital organization completes the required triennial CHNA, the IRS expects hospital executives to use it as a benchmark for progress with action plans on their annual filing (with the IRS) on the non-profit Form 990 informational return. Specifically, the Treasury and Health and Human Services departments can use data on the 990, Schedule H, to report to Congress and the President on a hospital's level of charity care, bad debt expense, and the unreimbursed costs of means and non-means tested government programs. To ensure compliance, they'll also use the information to conduct both random and targeted audits of tax-exempt hospitals.


HPSA Acumen can meet your organization's CHNA needs from start to finish. Contact us today. 




HPSA Acumen Inc.  -  PO Box 274,  201 East 4th Street - 3rd Floor,  Jamestown, NY 14701

Phone: (716) 483-0888  -  Fax: (716) 487-0085