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January 7, 2013

The Patient Protection and Affordable Care Act (“the ACA) has undergone many changes since its original enactment in 2010. Section 9007 of the ACA specifically requires that in order for an organization to continue as a 501(c) (3) tax exempt provider and/or avoid imposition of excise taxes, it must conduct a Community Health Needs Assessment (“CHNA”) every three years and implement a strategy to meet the community health needs identified in the assessment.
The Internal Revenue Service (“IRS”) has adopted regulations to implement Section 9007 and impose a $50,000 excise tax and possible revocation of the tax exempt status if these requirements are not met. CHNA compliance with this provision of the ACA will be monitored by the IRS with a set of regulations to be issued, and will be an integral part of the process to evaluate the continuation of tax exempt status for hospitals.
The CHNA must be conducted by the end of the hospital's first fiscal year starting after March 23, 2012 and be completed for every facility operating as a hospital in a health system. The CHNA will describe how providers engage their communities in their service area in identifying, addressing, and prioritizing community health needs. 
The written report relative to the documentation of a CHNA, based on the IRS guidance, is to include a description of:
  •  The community served i.e., geographic area, target population served by the hospital and how it was determined;
  • A description of the process and methods used by the hospital to conduct the CHNA including sources of information and collaboration with other organizations;
  • The process used by the hospital to take into account input from persons who represent the broad interests of the community served by the hospital and the persons and organizations with which the hospital consulted with relative to conducting the CHNA;
  • The prioritized description of the community health needs identified by the CHNA;  and 
  • A description of the existing healthcare facilities and other resources within the community available to meet the community health needs identified in the CHNA.
An Implementation Strategy Report addressing each of the community health needs is also required and must be approved by an authority or governing body of the hospital.  Executive Resources, LLC (“EXEC”) has extensive experience in performing CHNAs and assisted many clients in preparing and implementing their CHNAs along with other ACA requirements such as:
  •  Financial Assistance policy emergency medical care policy, IRC Section 501(r)(4); 
  • Limitations on charges, IRC Section 501(r)(5); and 
  • Billing and collections, IRC Section 501(r)(6).

We would like to discuss our experience in assisting our many clients with this important CHNA process and other ACA requirements with you. Please contact us at 732-974-7200 and visit our website at to learn more about our firm and experience. Thank you and we look forward to speaking with you. 


Contact us, and we'll be happy to tell you exactly how we can address your particular institutional situation.