What Counts as Community Benefit

Definition of Community Benefit

Community benefit is a well-defined set of activities articulated by the Internal Revenue Service in its instructions to its Form 990 Schedule H. Community benefits are programs and services designed to improve health in communities and increase access to health care. Community benefit activities respond to a demonstrated health-related community need and seek to achieve at least one community benefit objective:

  • Improve access to health services,
  • Enhance public health,
  • Advance generalizable knowledge and
  • Relieve or reduce the burden of government burden or other community efforts to improve health.

Community Benefit Categories Includes:

  • Financial Assistance
  • Government-sponsored means-tested programs — unpaid costs of public programs
  • Other Community Benefit Services
    • Community Health Improvement Services
    • Health Professions Education
    • Subsidized Health Services
    • Research
    • Cash and In-Kind Contributions
    • Community-Building Activities
    • Community Benefit Operations

Community Benefit Categories
Quick Reference Guide

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Principles for Determining What Programs and Activities are Community Benefit

  • Community benefits are reported in terms of cost and in compliance with Schedule H instructions. Community benefit expenses are the expenses actually borne by the hospital organization, NOT charges, market value, or opportunity costs.
  • Financial assistance does not include bad debt, contractual allowances or quick pay discounts.
  • Activities or programs cannot be reported if they are more beneficial to the organization than to the community.
  • Do Not Count activities:
    • Provided for marketing purposes,
    • Restricted to hospital employees and physicians only,
    • Required of all health care providers by rules or standards,
    • Unrelated to health or the mission of the organization, and
    • The value of time provided by volunteers or employees on their own time.

What Counts as Community Benefit Q&A Search

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CHA's A Guide for Planning and Reporting Community Benefit, Chapter 2 and the Appendices and Resources sections, provide guidance and principles on what counts and what does not count as community benefit. The following tools are referenced:

The following resources address reporting questions that have been raised around specific issues.

To learn more about accounting and reporting community benefit, please visit Accounting for Community Benefit on CHA’s website.

What Counts Hotline

Do you have a question about whether a program should count as community benefit?

The following What Counts Q&A and Community Benefit Categories and Definitions, and Is It Community Benefit? are resources that can help you determine whether to report a program or activity as community benefit. If you still have questions: How to submit a What Counts Question to CHA.