A new National Academy for State Health Policy’s (NASHP) tool helps states gather detailed information from hospitals about their community benefit expenditures and activities during the pandemic.
In exchange for their tax exemptions, the federal government requires hospitals to conduct community health needs assessments (CHNAs) and develop implementation plans to address the identified needs and report their community benefit spending to the Internal Revenue Services each year. However, there are currently no federal requirements that require community benefit spending to be tied to hospitals’ CHNAs or their implementation plans.
States can go beyond the federal requirements and require or encourage more detailed reporting of hospitals’ community benefit expenditures and their impacts. However, additional details may be necessary to assess how hospitals are identifying shifting community needs during COVID-19 and how community benefit spending is shifting to meet those needs.
The need for additional or renewed focus on racial and ethnic health inequities has been highlighted by the pandemic, and this new NASHP tool will help states collect detailed data that will show whether hospital community benefit programs and spending are addressing disparities and promoting equity.
This template can be used to complement NASHP’s two other reporting templates that synthesized several state community benefit reporting tools to help states collect data on hospital expenditures and community benefit program outcomes.
This tool is designed to capture more granular and actionable information than is currently required by the IRS Form 990 Schedule H, which allows some hospital systems with multiple facilities to report in aggregate and does not require hospitals to tie their reported spending back to needs identified by their CHNAs or other sources. If a state requests any hospital or hospital system’s Form 990 Schedule H worksheet, the information gathered with this NASHP tool can be compared with any reported activities listed there.
NASHP’s tool requires:
- Each hospital in a health system to report individually, and
- Hospitals to include program and activity information that the IRS considers to be a community benefit, community-building, or community health improvement activity on Parts I and II of IRS Form 990, Schedule H.
Instructions are included with the tool, and states are encouraged to tailor the instructions, or the form itself, to match their needs.
Support for this work was provided by the New England States Consortium Systems Organization (NESCSO) and the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the foundation or NESCSO.