Community health needs assessments for tax-exempt hospitals

Every tax-exempt hospital facility must complete a community health needs assessment every three years and adopt a strategy to act on it. The rule is specific about whose voices must be in it. Gathering those voices well is qualitative work, and it is what we do.

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What section 501(r)(3) requires

A CHNA in the current tax year or one of the two before it: a three-year cycle (IRS overview; 26 CFR 1.501(r)-3).
Input from at least one governmental public health department; from members of medically underserved, low-income and minority populations or those who represent them; and from written comments on the hospital’s previous CHNA and implementation strategy.
A written report that defines the community, describes the methods, shows how input was gathered and used, sets out the significant health needs in priority order, lists the resources available to address them, and evaluates the impact of actions taken since the last CHNA.
Adoption of the report by an authorized body of the hospital, and publication so that it is widely available.
An implementation strategy adopted by the fifteenth day of the fifth month after the end of the tax year in which the CHNA was completed.
A $50,000 excise tax, per facility, for a year in which the requirements are not met (IRS, section 4959).

Facts on this page were checked against the official sources on September 20, 2026. Rules change; rely on the official announcement or regulation linked here, not on this summary.

Where we fit

We can run the whole assessment or the parts your team is not staffed for.

Focus groups and interviews with the people the rule says you must hear from
Surveys of all kinds: community, client, staff and partner
Quantitative analysis of the public and internal data the assessment has to cite
Data management, so every figure in the report can be traced to its source
Expert data visualization, and a written report your board can adopt
Final reporting in multiple formats: full report, executive summary, slide deck, one-page brief or dashboard
The impact evaluation of your last implementation strategy, which the rule requires and many reports treat as an afterthought

Mixed methods is our default design: qualitative and quantitative data, collected together and reported as one story.

Timing

Work backwards from the end of the tax year in which the CHNA is due. Community input takes months to do properly, and the board needs time to adopt the report. We recommend starting nine to twelve months ahead.

Is your CHNA due in the next eighteen months?

Tell us the facility, the tax year end and what you did last cycle. You will hear back within one business day.

Every inquiry is confidential. We never sell or share your information. Privacy policy.