Community Health Needs Assessment Requirements for Tax-Exempt Hospitals

November 2011

What Are The IRS Requirements?

Hospitals Required to Comply

All hospitals recognized as a 501(c)(3), including governmental hospitals.

MHA has requested a method for governmental hospitals

to submit the required information.

Multihospital Organizations

If more than one hospital is operated by an organization, each hospital is required to complete a CHNA and adopt an implementation strategy, including separate documentation.

MHA encouraged the IRS to allow a consolidated CHNA

to be submitted with separated CHNAs and strategies within.

Timing and Frequency of CHNAs

The CHNA must be conducted once every three years, beginning in the hospital’s first taxable year after March 23, 2012.

To be considered conducted, the written report must also be made widely available to the public.

8 Steps To Conducting A CHNA

Step One: Define the Community Step Two: Identify Partners Step Three: Gather Secondary Data Step Four: Develop and Conduct Primary Data

Assessment Step Five: Aggregate Primary and Secondary Data Step Six: Identify and Prioritize Community Health

Issues Step Seven: Develop and Implement a Strategy to

Address the Priority Health Issues Step Eight: Disseminate the CHNA Report

Using The CHNA Results – Implementation

Hospitals are required to: Identify, prioritize and address health

issues identified in the CHNA Explain why certain identified health

issues may not be addressed Implementation is step 7 in the CHNA

process – more information will follow

Dissemination of CHNA Results

Hospitals are required to: Post the written report on the hospital’s

website or another appropriate website Provide individuals with instructions on

how they may download or receive a printed copy

Dissemination is step 8 in the CHNA process – more information will follow

Documenting the CHNA Process

Documentation Components

Description of the: Community Process and methods used How broader interests were considered Prioritized community health needs List of existing health care resources List of identified gaps

Questions?

The Community Health Needs Assessment Process

Where to begin… What are the steps?

Population-based model for improving health outcomes

CHNA question

s and data

Categories for

analysis and

prioritiesImplementation Plan

Strategies and

process measures

Outcome

measures

Step One: Define the Community

The community definition must include Geographical service area Population served Specialty services provided At-risk populations Unique community characteristics Federal designation for medically

underserved Other hospitals in same “community”

Step One: Community (cont’d)

MHA encouraged the IRS to allow hospitals flexibility in the definition of community

while including the medically underserved, low-income and chronically ill populations.

The CHNA must include information from: Those with special

knowledge or public health expertise*

The broad community including low-income, minority, medically underserved, those with chronic disease, unique sub-groups

Step Two: Identify Partners

Do not conduct the CHNA alone, others need and want this information

* The IRS has not defined the qualifications of “persons with special knowledge of or expertise in public health. MHA has commented this should remain flexible.

Step Two: Partners (cont’d)

Consider the following CHNA partners: Local public health agency Health care consumer advocates Nonprofit organizations Academic institutions Government officials Business community, Chamber of

Commerce Ministerial alliances Support groups

Step Three: Gather Secondary Data

Hospitals are strongly encouraged to gather data from other reliable local, state and national resources.

These data should provide the foundation for the quantitative information.

What do the data indicate are the health care issues in your community?

Step Three: Secondary Sources Consider the following CHNA Sources

MHA preventive hospital and health behavior reports: www.mhanet.com

Missouri Department of Health and Senior Services – Missouri Information for Community Assessment: www.health.mo.gov

Federal government agencies– http://www.healthypeople.gov/2020/default.a

spx National Foundations– www.countyhealthrankings.org– http://www.statehealthfacts.kff.org/

Future CHNA Steps

Step Four: develop and conduct primary data assessment

Step Five: aggregate primary and secondary data

Step Six: identify and prioritize community health issues

Step Seven: develop and implement a strategy to address the priority health issues

Step Eight: disseminate the CHNA report

One Strategy: Commit to Three Stakeholders/partners Secondary data sources Formats for primary survey At-risk population groups Routes to disseminate findings Priorities to address Strategies for each priority Three indicators per priority Three year plan

Consequences and Benefits of Compliance

Benefits of Compliance

Strong communities need strong hospitals and strong health partnerships that work to address: the behaviors and prevalence of chronic

diseases obesity through good nutrition and

active lives community safety through increased

preparedness and resiliency deteriorating mental health

infrastructure the needs of vulnerable populations

Failure To Comply

A $50,000 excise tax will be imposed for each taxable year in any three-year period.

Multihospital systems will be subject to the excise tax if it does not meet the requirements for all of its hospitals separately.

Questions?

Future Webinars and Conference

Conducting and Documenting the CHNA 2:30 – 4 p.m., Wed., January 25 or 10:30 – noon, Thurs., February 9

Analyzing and Prioritizing CHNA Data 2:30 – 4 p.m., Wed., March 7 or 9 – 10:30 a.m., Thurs., March 8

Practical Strategies for Addressing Obesity 9 a.m. – 3:30 p.m., Tues., June 19, Lake of the

Ozarks

Leslie Porth, MPH, R.N.Vice President of Health

Planning573-893-3700 x 1305

lporth@mail.mhanet.com

Staff Contact

Mary BeckerSenior Vice President of

Strategic Initiatives573-893-3700 x 1303

mbecker@mail.mhanet.com