Brown ArrowCommunity Benefit / Community Health Needs Assessment

Not-for-profit hospitals, in order to maintain their tax-exempt, or "charitable," status, under section 501(c)(3) of Federal Internal Revenue Code, have long been required to provide benefit to the community that they serve. Recent changes in legislation now require that such hospitals explicitly and publicly demonstrate community benefit by conducting a community health needs assessment (CHNA) and adopting an implementation strategy to meet the identified community health needs. (IRS).

Section 9007 of the Patient Protection and Affordable Care Act, Public Law 111-148 (the "Affordable Care Act"), created section 501(r) of the Code adding new requirements effective beginning with the first tax year on or after March 23, 2012, that 501(c)(3) hospitals must conduct a CHNA at least once every three years in order to assess community need and annually file information (by means of Schedule H (Form 990)) regarding progress toward addressing identified needs. (IRS). This can involve partnerships with other clinical, public health, and population health focused organizations. Section 9007 furthermore established tax penalties for hospitals that do not comply, as well as reporting requirements regarding national compliance on the IRS. (IRS).
The IRS has provided initial guidance concerning the CHNA requirement (see legislative and tax information); this guidance has been further augmented by individual states to accommodate their state-specific requirements for tax-exempt status (Hilltop). A growing set of tools, examples, and analyses are provided below to assist both those tasked with preparing a CHNA, as well as those interested in reviewing national progress.


    State and Special Population Resources

  • A Resource Center for Implementing CDC's 6|18 Initiative Details

    Resource Center is designed to advance implementation of CDC's 6|18 Initiative by Medicaid, state and local health departments, and other payers and purchasers. It offers practical resources and state examples to guide stakeholders in spending smarter for healthier populations.

  • AHRQ Health Care Innovations Exchange Details

    The Innovations Exchange offers health professionals and researchers the opportunity to share, learn about, and ultimately adopt evidence-based innovations and tools suitable for a range of health care settings and populations.

  • CARES Engagement Network CHNA Tool Details

    Assess the health of your community with this easy-to-use Community Health Needs Assessment (CHNA) tool.

  • CDC Community Health Improvement Navigator Details

    This website is aimed at those who participate in CHI work within hospitals and health systems, public health agencies, and other community organizations. It provides vetted tools and resources for community health improvement.

  • CHNA and CHA Tools: Community Assessment Starts Here Details

    This toolkit includes a series of webinars to assist in the CHNA development, an instructional video on creating a report with this tool, and a map creation tool (or use an existing map).

  • Community Benefit (CHA) Details

    This website features a selection of tools, reports and forms to assist organizations in fulfilling the community benefit requirements. News feeds alert users to new data, relevant to the area.

  • Community Benefit Insight Details

    A comprehensive, searchable tool for community benefit data, enabling local organizations to assess how hospital resources are allocated. The tool includes community benefit expenditures as reported by tax-exempt hospitals from all fifty states and the District of Columbia.

  • Community Benefit Resource Index Details

    Resources to assist hospitals in planning and implementing community benefit programs and services, including community health needs assessment, implementation strategies, and evaluation.

  • Community Health Assessment & Health Improvement Planning Details

    This site helps state, tribal, local, and territorial (STLT) health departments as they develop community health assessments and health improvement plans, whether for accreditation preparation, nonprofit hospital collaboration, or other reasons.

  • Community Health Assessment Clearinghouse Details

    Intended as a resource for community health planners, practitioners, and policy developers both in counties and hospitals in New York State but relevant to other states and settings, this website contains health data, local health planning, and examples of Community Health Assessments and Hospital Community Service Plans (CHNAs).

  • Community Health Assessment Toolkit Details

    The Association for Community Health Improvement's Community Health Assessment Toolkit offers a nine-step pathway for conducting a CHA and developing implementation strategies. It is designed to assist in planning, leading and using community health needs assessments to understand and improve health of communities.

  • Community Health Assessment and Improvement Planning Details

    This website provides access to resources in support of both assessment of community benefit and accreditation, from from the perspective of Local Health Departments. Included are sections on community benefit, the Community Health Status Indicators Project, and accreditation prerequisites: CHAs and CHIPs.

  • Community Health Maps Tutorial Details

    This self-paced online course from the National Library of Medicine® (NLM) will help you gain the skills needed to use Community Health Maps to: empower communities, collect health data, and create maps. CE credit is available.

  • Community Health Needs Assessment Data Platform Details

    This web-based resource was designed to assist KP hospitals with conducting CHNAs; free registration is required to use the platform.

  • Community Need Index (CNI) Details

    Index assists in the process of gathering vital socio-economic factors in the community. The CNI is strongly linked to variations in community healthcare needs and is a strong indicator of a community's demand for various healthcare services.

  • Community Tool Box Details

    The Community Tool Box is a global resource for free information on essential skills for building healthy communities. Its goal is to promote community health and development by connecting people, ideas and resources.

  • Comprehensive Community Needs Assessment (CCNA) Tool Details

    The Center for Applied Research and Environmental Systems (CARES) provides basic data on counties and states through an online data retrieval system and provides you with a downloadable, and editable, Microsoft Word document which can serve as a basis for conducting a more detailed CCNA. Free registration is required.

  • County Health Rankings & Roadmaps Details

    Provides county-by-county health rankings for each of the 50 states and Washington DC, explanations of each health factor, and actionable strategies to improve the health of communities across the nation.

  • HSRProject (HSRProj) Details

    Database of ongoing health services research projects. Search for studies relating to access, cost, and quality of health care, including patient outcomes, health services research methods, community needs assessments, etc.

  • HSRR (Health Services and Sciences Research Resources) Details

    HSRR is a searchable database of information about research datasets, instruments/indices and software employed in Health Services Research, the Behavioral and Social Sciences and Public Health. The database includes brief descriptions of research resources and links to PubMed.

  • Hospital-based Strategies for Creating a Culture of Health (2014) Details

    This report presents the results of an analysis of the community health needs assessments from 300 tax-exempt hospitals. It outlines the key drivers to community health needs, including: access to care, lack of health insurance, socioeconomic factors, limited preventive and screening services, limited care coordination, and inadequate chronic condition management.

  • Implementing Healthy People 2020: MAP-IT: A Guide to Using Healthy People 2020 in Your Community Details

    This framework was developed to help organizations create a community needs assessment in conjunction with the Healthy People 2020 goals.

  • Leading Health Indicators Details

    Healthy People 2020 provides a comprehensive set of 10-year, national goals and objectives for improving the health of all Americans. Healthy People 2020 contains 42 topic areas with more than 1,200 objectives. A smaller set of Healthy People 2020 objectives, called Leading Health Indicators (LHIs), have been selected to communicate high-priority health issues and actions that can be taken to address them.

  • Maps and Data Details

    This tool will allow you to browse maps created by Community Commons members, or build state specific reports for Community Health Needs Assessment and Vulnerable Populations Footprint.

  • MeasureUp Details

    The Building Health Places Network's website contains tools aimed at measuring programs' impact on families and communities and on factors related to health.

  • Neighborhood Atlas Details

    Tool allows for rankings of neighborhoods by socioeconomic status disadvantage in a region of interest (e.g. at the state or national level). It includes factors for the theoretical domains of income, education, employment, and housing quality. It can be used to inform health delivery and policy, especially for the most disadvantaged neighborhood groups.

  • Opportunity 360 Details

    Tool includes several online data and mapping applications, toolkits and how-to-guides, as well as innovative technologies for engaging community residents. It also offers a 360-degree view of any neighborhood, including housing, health, education, employment, transportation, and environment. Free registration is required for use.

  • Public Health Quality Improvement Exchange (PHQIX) Details

    Searchable site for public health professionals interested in learning and sharing information about quality improvement (QI) in public health.

  • ROI Calculator for Partnerships to Address the Social Determinants of Health Details

    This calculator is designed to assist community-based organizations and their medical partners in creating mutually advantageous financial arrangements for funding the delivery of social services to high-need, high-cost (HNHC) populations, by calculating the return on investment (ROI) from integrating social services with medical care.

  • Resources for Implementing the Community Health Needs Assessment Process Details

    CDC has compiled a selection of resources to assist hospitals in conducting a community needs assessement.

  • Tools for Community Action Details

    This website includes links to The Guide to Community Preventive Services, Community Health Resources Database, Community Health Assessment aNd Group Evaluation (CHANGE) Tool and Action Guide, several actions guides, and a series of reports focusing on health education


  • State and Special Population Resources
    • Assessing Your Community's Health: A Needs Assessment Toolkit for Health Care for the Homeless (HCH) Grantees (2014) - (National Health Care for the Homeless Council) Details

      Designed primarily for Health Center Program grantees, this toolkit explains the process and tools for conducting a CHNA.

    • City of Philadelphia Community Health Explorer - (Philadelphia Department of Public Health) Details

      The CHA is a systematic assessment of population health in Philadelphia, highlighting key public health challenges and assets and informing local public health programs, policies, and partnerships. The CHA includes indicators reflecting health behaviors, health conditions, health care factors, and social and environmental determinants of health.

    • Cottage Data2Go Details

      An online mapping and data tool that maps Cottage Health's 2016 Community Health Needs Assessment (CHNA) data, census data and other publicly available data for factors that influence health outcomes. The tool provides a view of the specific health needs by demographics, geography and health outcome or influencer. Data is specific to Santa Barbara County, CA. (Cottage Health)

    • Hennepin County Public Health Data Details

      A tool to monitor the health of children and adults who live in Hennepin County. Data includes indicators on chronic disease, mortality, infectious disease, nutrition, substance use, preventive care, child health, and more.

    • Iowa Community Indicators Program (ICIP) - (Iowa State University (ISU)) Details

      Iowa State University has created a resource that examines regional economic and demographic change.

    • New York State Community Health Indicator Reports (CHIRS) - (New York State Department of Health) Details

      Reports were developed initially in 2012 and are annually updated to consolidate and improve data linkage for the provided health indicators in the County Health Assessment Indicators (CHAI) for all communities in New York. The CHIRS provide data for over 300 health indicators, organized by 15 health topic and data tables with links to trend graphs and maps.

    • Oklahoma State of the State's Health - (Oklahoma State Department of Health) Details

      Interactive site provides data on health indicators at the county- and demographic-levels, graded in relation to national averages.

    • State and State/Local Resources - (National Library of Medicine (NLM), NIH) Details

      Website provides links to high quality resources and analyses from a broad set of sources, identified by the National Library of Medicine

    • Tri-State Community Wellness Indicators Details

      This website provides information on demographics, health, and societal risk factors for fourteen counties in southwestern Indiana, southeastern Illinois and northwestern Kentucky.

    • Vermont State Data Center - (University of Vermont) Details

      A searchable resource created by the University of Vermont. It is divided by Vermont cities, towns, and villages, with information on demographics, transportation, education, and health resources in Vermont.

    • Virginia Department of Health Data Portal - (Virginia Department of Health) Details

      This data portal was developed to provide a convenient access point for health-related data for Virginia. This portal is a comprehensive source for community health assessment, public, and population health data. Each data portal page provides interactive data at the most granular level available.

    • Wisconsin Data Atlas - (University of Wisconsin) Details

      An accessible web portal that connects community groups working to improve health to the local area data and information they need to inform and evaluate their work. They aim to provide a comprehensive picture of the multiple factors that impact health, including individual behaviors, policies, systems, and environments.

    • exploreMOhealth - (Missouri Foundation for Health) Details

      Tool allows community health improvement stakeholders and the public access to data to identify health factors and outcomes at the ZIP code level across Missouri.


  • American Hospital Association Details

    The primary organization for hospitals, AHA's website contains a number of reports, presentations, and case studies relevant to organizations seeking to comply with the community benefit requirement.

  • Association for Community Health Improvement Details

    ACHI is a national association for community health, community benefit, and healthy communities professionals.

  • Centers for Disease Control and Prevention (CDC) Details

    The Centers for Disease Prevention and Control (CDC) is one of the operating components of the U.S. Department of Health and Human Services. CDC's mission is to promote health and quality of life by preventing and controlling disease, injury, and disability.

  • Community Benefit Connect Details

    The purpose of Community Benefit Connect is to support nonprofit hospitals by building a learning community of practitioners who will translate into action community benefit planning, implementation, reporting and evaluation. Included on the website are suggested links, webinars, and a blog.

  • Community Health Assessment (CHA) and Community Health Improvement (CHIP) initiatives Details

    NNPHI has assembled a webinars and case studies aimed at assisting public health institutes in becoming familiar with specific community health improvement tools and techniques.

  • Community Indicators Consortium Details

    The Community Indicators Consortium advances and supports the development, availability and effective use of community indicators for making measurable and sustainable improvements in quality of community life.

  • Health Impact Project Details

    The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, is a national initiative designed to promote the use of health impact assessments (HIAs) as a decision-making tool for policymakers. Project site contains reports, articles, and an interactive map of HIAs in the US.

  • Hospital Accountability Project Details

    This website features news related to the CHNA regulations, as well as links to documents useful to organizations needing to comply with the regulations.

  • Hospital Community Benefit Program Details

    This website was developed to assist policymakers in locating the necessary resources to ensure continuation of their tax-exempt status.

  • National Center for Rural Health Works Details

    Funded through the Federal Office of Rural Health Policy (ORHP), the National Center for Rural Health Works provides tools and templates by which community residents can evaluate their health systems.

  • Public Health Accreditation Board Details

    Provides information about a national voluntary accreditation program for state, local, territorial and tribal public health departments. The goal of the accreditation program is to improve and protect the health of every community by advancing the quality and performance of public health departments.

  • Robert Wood Johnson Foundation Details

    RWJF's mission is to improve the health and health care of all Americans.

  • Tax Information for Charities & Other Non-Profits Details

    Includes a calendar of events, newsletter, and training information for non-profit organizations.

  • W.K. Kellogg Foundation Details

    The Foundation provides grant support for projects that concentrate on early childhood (prenatal to age 8), within the context of families and communities.