Community Health Needs Assessment

As a not-for-profit hospital, you have the responsibility to support and improve healthcare in your community. The Patient Protection and Affordable Care Act (PPACA or ACA) established federal reporting requirements for maintaining 501(c)(3) status that include showing how your hospital is addressing the greatest needs in your area through a Community Health Needs Assessment (CHNA). This report must be filed every three years publicly and with the IRS.

While this document can be challenging to assemble, it can be widely beneficial for your hospital or facility in broadening and deepening community involvement while also informing strategic plans, improving stakeholder communications, and enhancing marketing efforts.

The risks of producing an inadequate CHNA can also be substantial for your facility. Failing to address core CHNA requirements can incur a $50,000 excise tax from the IRS in addition to other penalties. In a Quorum study of 139 not-for-profit hospital reports and websites, we discovered the following:*

  • Up to 40% had a deficiency in meeting core CHNA requirements
  • 38 to 45% had a deficiency in meeting core CHNA process steps
  • 68% confronted potential difficulty in measuring progress of CHNA implementation
  • Up to 78% had a deficiency in documenting at least one detail process step specified in IRS regulatory guidance**

Where Does Your Hospital Stand?

Quorum has developed a proprietary assessment framework that has helped over 60 hospitals evaluate existing CHNA reports for completeness or develop a report from the ground up. Based on each client’s unique needs and community characteristics, Quorum modifies the assessment methodology to produce a tailored assessment and plan. This assessment helps facilities meet federal requirements while also generating a useable, actionable report.


* Quorum examined a 5% sample (139 valid hospitals) of the 2,722 CMS listed not-for-profit U.S. hospitals for the existence of a Widely Available CHNA. Excluded hospitals: acquired not-for-profit status on a basis other than a 501(c)(3) exemption; converted status for various reasons; did not have a web­site; report was produced by Quorum Strategic Resources Group.

** Analysis did not evaluate quality (i.e., how well or poorly a CHNA complied with the regulation). Consideration was only for evidence that the report addressed the requirements in some fashion. No opinion was formed about whether the report was “conspicuously” posted on a website, as is required to meet the “Widely Available” IRS criteria.


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