The Internal Revenue Service has issued proposed regulations on the requirement that charitable hospitals conduct community health needs assessments and adopt implementation strategies at least once every three years.

The proposed regulations, which will be formally published on Friday after they were issued Wednesday, also discuss the related excise tax and reporting requirements for charitable hospitals and the consequences for failure to satisfy the requirements.

Under the Affordable Care Act, a charitable hospital needs to conduct a community health needs assessment at least once every three years and adopt an implementation strategy to meet the community health needs identified. The CHNA must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health. The CHNA must also be made widely available to the public. A hospital organization that fails to meet the CHNA requirements for any taxable year is subject to a $50,000 excise tax on.

The hospital must also report the amount of any excise tax imposed on its annual Form 990 information return. Hospitals also need to report on the Form 990 how the organization is addressing the needs identified in each CHNA, and describe any needs that are not being addressed, along with the reasons why the needs are not being addressed.

Hospital organizations whose 2012 tax years began after March 23, 2012 are required to complete all of the questions on their 2012 Form 990, Schedule H, the IRS noted. Hospital organizations whose 2012 tax years began on or before March 23, 2012 are required to complete all parts and sections of Schedule H for tax year 2012, with the exception of Part V, Section B, lines 1-8 regarding community health needs assessments.

For the text of the proposed regulations, see the Affordable Care Act Tax Provisions or the New Requirements for 501(c)(3) Hospitals under the Affordable Care Act pages on

The IRS said it continues to welcome public input on the new requirements for charitable hospitals under the Affordable Care Act. Comments and requests for a public hearing must be received by July 5, 2013.

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