title: Nonprofit hospitals' approach to community health needs assessment.
abstract: OBJECTIVE
  We sought a better understanding of how nonprofit hospitals are fulfilling the community health needs assessment (CHNA) provision of the 2010 Patient Protection and Affordable Care Act to conduct CHNAs and develop CHNA and implementation strategies reports.
  
  
  METHODS
  Through an Internet search of an estimated 179 nonprofit hospitals in Texas conducted between December 1, 2013, and January 5, 2014, we identified and reviewed 95 CHNA and implementation strategies reports. We evaluated and scored reports with specific criteria. We analyzed hospital-related and other report characteristics to understand relationships with report quality.
  
  
  RESULTS
  There was wide-ranging diversity in CHNA approaches and report quality. Consultant-led CHNA processes and collaboration with local health departments were associated with higher-quality reports.
  
  
  CONCLUSIONS
  At the time of this study, the Internal Revenue Service had not yet issued the final regulations for the CHNA requirement. This provides an opportunity to strengthen the CHNA guidance for the final regulations, clarify the purpose of the assessment and planning process and reports, and better align assessment and planning activities through a public health framework.
authors.affiliation: At the time of the study, Cara L. Pennel, Kenneth R. McLeroy, and James N. Burdine were with the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station. David Matarrita-Cascante was with the Department of Recreation, Parks and Tourism Sciences, Texas A&M University, College Station.
authors.forename: Cara L
authors.initials: CL
authors.lastname: Pennel
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: McLeroy
authors.forename: James N
authors.initials: JN
authors.lastname: Burdine
authors.forename: David
authors.initials: D
authors.lastname: Matarrita-Cascante
mesh_terms: D000704:Analysis of Variance; D018672:Community Health Planning / Q000331:legislation & jurisprudence* / Q000379:methods / Q000458:organization & administration; D003153:Community Health Services / Q000331:legislation & jurisprudence* / Q000379:methods / Q000458:organization & administration; D003159:Community-Institutional Relations / Q000331:legislation & jurisprudence; D003299:Cooperative Behavior; D006284:Health Plan Implementation / Q000379:methods / Q000458:organization & administration; D006292:Health Priorities / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006788:Hospitals, Voluntary / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006801:Humans; D020380:Needs Assessment / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D058991:Patient Protection and Affordable Care Act / Q000592:standards*; D015397:Program Evaluation; D013781:Texas; D014481:United States