• 12/18/15 – IRS Guidance on Reporting Housing Improvements on Schedule H — see December 18, 2015 Update
• 03/10/15 — Revenue Procedure — Guidance regarding correction and disclosure procedures for hospital organizations to follow so that certain failures to meet the requirements of § 501(r) of the Internal Revenue Code will be excused for purposes of § 501(r)(1) and 501(r)(2)(B).
• 12/31/14 — Final Regulations — Additional Requirements for Charitable Hospitals; Community Health Needs Assessments for Charitable Hospitals; Requirement of a Section 4959 Excise Tax Return and Time for Filing the Return
  
  • CHA Summary of CHNA and Implementation Strategy Requirements

CHA Resources

• Assessing and Addressing Community Health Needs: A Summary Of New Requirements and Recommended Practices — A concise overview of new federal requirements for tax-exempt hospitals to conduct community health needs assessments and adopt implementation strategies to address identified needs.
  
  Download a copy
  Order now

• Assessing and Addressing Community Health Needs — offers practical advice on how hospitals can work with community and public health partners to assess community health needs and develop effective strategies for improving health in our communities.

State Requirements

• Hilltop Institute, Community Benefit State Law Profiles — a compilation of each state's community benefit laws and regulations, analyzed in the context of the ACA's community benefit framework

CHA Resources

• Survey of State Laws/Oversight related to Community Health Needs Assessments and Implementation Strategies (as of August 2010)

Regulatory and Congressional Actions/Reports

• IRS issues extension to Dec. 31, 2020 for CHNAs and Implementation Strategies (July 14, 2020)
• Joint Letter to IRS on CHNA Extension (July 7, 2020)
• IRS extends due date for CHNAs and Implementation Strategies (April 9, 2020)
• CHA Requests Extension of Six Months to File 990 (March 31, 2020)
• Charles Rettig Letter to Finance Committee on IRS Section 501(r) (April 11, 2019)
• Report to Congress on Private Tax-Exempt, Taxable, and Government-Owned Hospitals (May 2018)
• Hatch, Grassley Press IRS for Answers on Nonprofit Hospitals, (Feb. 15, 2018)
• Chairman of Senate Judiciary Committee letter to IRS Commissioner calling for greater oversight of tax-exempt hospital billing and collection practices (June 6, 2016)
• Chairman’s letter to Senate Judiciary Committee regarding investigation into hospital billing and collection practices (May 24, 2016)
• New Guidance Recommends Schools Participate in Hospital CHNA Process (Jan. 15, 2016)
• IRS Report to Congress on Private Tax-Exempt, Taxable, and Government-Owned Hospitals (January 2015)
• CMS issues revised guidance on "free care" (Dec. 15, 2014) 

Other Reports/Research/Articles

• Community Catalyst releases report "Hospitals Investing in Health: Community Benefit in Massachusetts," October 2016  
• Ernst & Young Schedule H Benchmark Report for Tax Years 2009 & 2010, American Hospital Association, April 2013
• "Provision of Community Benefits by Tax-Exempt U.S. Hospitals." Gary J. Young, J.D., Ph.D., Chia-Hung Chou, Ph.D., Jeffrey Alexander, Ph.D., Shoou-Yih Daniel Lee, Ph.D., and Eli Raver. New England Journal of Medicine  2013; 368:1519-1527
• Beyond Charity Care: Mission Matters for Tax-Exempt Health Care, J. David Seay, Esquire, The Catholic Health Association, 2007
• Why Nonprofits Matter in American Medicine: A Policy Brief, Nonprofit Sector Research Fund: Working Paper Series, 2005 

Other Resources for Advocacy Leaders

• CHA's Advocacy website