The CHNAudit: Evaluating hospital Community Health Needs Assessments
To improve transparency and accountability in the hospital Community Health Needs Assessment (CHNA) process, the Lown Institute created the CHNAudit.
What is the CHNAudit?
In collaboration with experts from hospitals, academia, policy, and community advocacy, we developed the CHNAudit as a tool to assess hospital alignment with IRS requirements and with best practices identified by specialty organizations, peer-reviewed literature, and members of the CHNAudit working group.
Hospitals are evaluated on 52 criteria across four main categories:
- Transparency: How well does the hospital make CHNA and community benefit information available and accessible?
- Community Engagement: To what extent does the hospital involve their community in the development of the CHNA/IS?
- Prioritization of Health Needs: Do the hospital’s identified health needs align with those identified by community members and public health experts?
- Accountability: Does the hospital include targets intended to measure program success? How many of these targets are fulfilled?
We believe stakeholders can use this tool to improve the CHNA/IS process. Community groups can identify opportunities for partnership and advocacy, hospitals can see how they stack up against their peers and discover ways to improve the CHNA/IS process for greater impact, and policymakers can gain insights into their local hospital’s performance and identify areas for potential oversight or regulation.
This project is supported by Arnold Ventures.
What is a Community Health Needs Assessment (CHNA)?
An IRS code created as part of the Affordable Care Act requires all nonprofit hospitals to conduct CHNAs every three years as a condition of their tax exempt status. They are also required to create an Implementation Strategy (IS) that explains how they will take action to address those needs and improve the health of their community.
Why CHNAs are important
CHNAs represent regulatory infrastructure that can have real community impact when done well. But studies show many hospitals fail to meet even basic requirements, such as posting their CHNA and implementation strategy online or soliciting and responding to written public comments. Deeper problems go beyond compliance: data collection often fails to reflect the community’s diversity, and hospitals track program outcomes inconsistently. The result is assessments and strategies that fall short of addressing what communities actually need.
CHNAudit Working Group
- Ariel Childs, MPH, Vital CxNs
- Ashlyn Burns, PhD, Indiana University School of Medicine
- Cory E. Cronin, PhD, College of Health Sciences and Professions, Ohio University
- Emma Clippinger, JD, NYC Office of Healthcare Accountability, Department of Health and Mental Hygiene
- Lauren Espy, MPH, MLK Community Healthcare
- Liz Coyle, BA, Georgia Watch
- Melissa Gutierrez Kapheim, PhD, Sinai Urban Health Institute
- Michelle Burton, PhD, Rising Communities
- Paul Hattis, MD, Lown Institute
- Rajika Reed, PhD, MPH, MEd, St. Luke’s University Health Network
- Sarah Grabe, MPH, Oregon Health Authority
- Tatiane Santos, PhD, MPH, Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine
For more information on the CHNAudit, contact jgarber@lowninstitute.org.
For media requests, contact atoleos@iowninstitute.org.