Community Health Needs Assessments

Every community is different.
Every CHNA should be too.

That is the conviction behind every CHNA we conduct. It is also, in our experience, the difference between an assessment a hospital actually uses and one that sits on a shelf until it’s dusted off again in three years.

We have been in this work long enough to know what a good CHNA looks like and what it takes to get there. Public Goods Group has been doing this work since before it was required, helping shape the federal regulations that made community health needs assessments a standard part of nonprofit hospital operations, and conducting approximately 85 assessments for hospitals and health systems since then. We co-authored publications with Community Catalyst on the role of health equity in CHNA methodology, and we bring that same depth to every assessment we conduct.

We design every assessment around the hospital and the community it serves, starting with how a hospital defines its community and ending with a board-approved implementation strategy that departments across the organization can actually execute over the three-year cycle.

How we go about CHNAs

We can lead the full process or step into any part of it. Some hospitals need a partner from day one. Others have strong internal teams and need targeted support on data analysis, community voice, or board materials. We work in whatever way works best for the hospital and its community.

Process Design and Community Definition

We start by helping hospitals define their community and develop a methodology that will withstand scrutiny. That means making deliberate decisions about which populations to include, how data will be gathered and weighted, and how community voice will be built into the process from day one. This is the foundation everything else rests on.

Data Gathering, Analysis, and Visualization

We gather and analyze secondary data from public health, census, and community-specific sources, identifying patterns, disparities, and gaps that a surface-level read would miss. We then translate that analysis into clear visualizations and a community health profile that tells the story of what the data actually shows.

Capturing the Community's Voice

We design and conduct stakeholder engagement that brings in the perspectives of community leaders, patients, nonprofit representatives, elected officials, and those with direct knowledge of vulnerable populations. This includes community surveys, stakeholder interviews, and targeted focus groups.

Prioritization, Report Authorship, Board Approval

We help hospitals evaluate findings from data sources and community input, score priority health needs, and build the case for each. We can then author the actual CHNA, using your style and brand colors. Once that’s ready, we can prepare presentations, executive summaries, and the documentation hospital leadership and boards need to review and approve with confidence and authority.

Implementation Plan Development and Board Approval

We work across hospital departments to develop implementation strategies for each priority, including specific actions, planned partnerships, resources, and anticipated impact, and support the board approval process for those strategies. We will also help you establish metrics along the way, as well as the process for capturing relevant work.

Implementation Tracking and Reporting

We help hospitals track progress against their implementation strategies across the full three-year cycle, keeping the work accountable between assessment periods. That includes supporting the reporting requirements that keep hospitals accountable to their boards, their communities, and the IRS. We can prepare any sort of documentation needed to support this work.

What hospitals often ask

Most hospitals come to us with similar questions about process, scope, and what working together actually looks like. These are the ones we hear most often. If yours is not here, reach out.

What is a CHNA?

A community health needs assessment is a structured process that nonprofit hospitals are required to complete every three years under the Affordable Care Act. It involves gathering and analyzing data on community health, collecting input from community members and stakeholders, identifying and prioritizing health needs, and developing an implementation strategy to address them. Done well, it is one of the most useful planning tools a hospital has. Done poorly, it satisfies a requirement and not much else.

Federal law requires that hospitals solicit input from persons who represent the broad interests of the community, including those with special knowledge of or expertise in public health. In practice that means public health departments must be part of the process. Beyond that, a well-designed CHNA should include community leaders, nonprofit representatives, elected officials, patients, and people with direct knowledge of vulnerable and underserved populations. The broader and more representative the input, the stronger the assessment.

Yes. Nonprofit hospitals that fail to conduct a CHNA and adopt an implementation strategy every three years risk losing their tax-exempt status under the Affordable Care Act. That is not a small thing. But the requirement is almost beside the point. A well-conducted CHNA tells a hospital things about its community that it genuinely could not know otherwise. It surfaces needs that do not show up in patient data, brings in voices that rarely make it to the boardroom, and creates a roadmap for community investment that holds up over three years. Hospitals that treat it as a planning tool end up with a clear case for the work they are already doing and a clear path for what comes next.

A full CHNA typically takes 12 to 15 months from process design through board approval of the implementation strategy, depending on the size of the hospital, the complexity of the community, and how much internal capacity the hospital brings to the process. Implementation tracking then continues across the full three year cycle. The IRS has strong parameters around timing, so we’ll always make sure you are within compliance.

More people than you might expect, and that is a good thing. A CHNA that lives only in the community benefit office tends to produce implementation strategies that also live only in the community benefit office. The assessments that drive real change involve hospital leadership, clinical leadership, finance, and the board at key points in the process. We help hospitals figure out who needs to be in the room and when, so the process does not become a burden but does produce something the whole organization can act on.

Yes. We work with hospitals that need a full process partner from day one and with hospitals that have strong internal teams and need targeted support in a specific phase. Some clients bring us in only for data analysis and visualization. Others need help with stakeholder engagement or board materials. We are built to work either way.

Health equity is not a box we check at the end of a CHNA. It is built into our methodology from the beginning, starting with how we define the community and which populations we prioritize, through how we design stakeholder engagement to reach people who are rarely in the room, to how we frame findings and recommendations. We co-authored publications with Community Catalyst on the role of health equity in CHNA methodology and bring that same rigor to every assessment we conduct.

Carefully and honestly. Findings that reflect badly on a hospital are rarely a surprise to the community, and trying to minimize or obscure them tends to damage trust more than the findings themselves. We help hospitals think through how to present difficult findings in a way that acknowledges reality, demonstrates accountability, and focuses attention on what comes next. A hospital that is honest about hard findings and has a credible plan to address them is in a much stronger position than one that produces a CHNA that reads like a press release.

Then your CHNA is even more important. Hostility toward a hospital is almost always rooted in something real, a history of closures, a perception of indifference, unresolved community harm, or simply a feeling that the hospital serves some people better than others. A well-conducted CHNA, one that genuinely listens and takes community input seriously, is one of the most powerful tools a hospital has for beginning to repair that relationship. We have worked in communities where the hospital was not well regarded and we know how to design a process that creates space for honest conversation without making things worse.

It probably will. That is not a failure of the process, it is the process working. A CHNA is not a promise to solve every problem it surfaces. It is a commitment to understand your community honestly and prioritize where you can have the most impact. We help hospitals navigate the gap between what the community needs and what the hospital can realistically do, and we help frame that gap in a way that is honest without being defensive.

Implementation plans come in many formats, but the core is always the same: each one outlines how a hospital will address every priority health need identified in the CHNA. It details specific actions, planned partnerships with community organizations, resources to be committed, and anticipated impact over the three year cycle. It is designed to be actionable across multiple hospital departments, not just the community benefit office, and it requires board approval. We help hospitals build plans that are realistic, specific, defensible, and in line with existing hospital strategies.

It depends on where in the process you are engaging us. For process design engagements we need a basic understanding of your service area, your internal team, and your timeline. For later phase engagements we will need access to whatever data and community input has already been gathered. We are used to stepping into processes at any stage and getting up to speed quickly.”

Let’s get started.

If you want to start a new project, we invite you to get in touch with us. 

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