Prioritizing Community Health Needs

Non-profit hospital facilities must complete a Community Health Needs Assessment (CHNA) every three years as required by Section 501(r)(3) of the Internal Revenue Code. The CHNA report must include:

“A prioritized description of the significant health needs of the community identified through the CHNA. This includes a description of the process and criteria used in identifying certain health needs as significant and prioritizing those significant health needs.”


The IRS guidelines describe a health need as something that influences the improvement or maintenance of health status in the community at large and in specific areas or populations. After the collection of primary and secondary data, hospital facilities must determine which issues, barriers, problems, or factors should be classified as community health needs. The guidelines do not mandate any specific frameworks or methodology for prioritizing needs, although the process and criteria utilized must be described within the CHNA report.

Prioritized needs are a crucial component of the CHNA because they can shape the development of internal programming, strategic planning, external partnerships, and the distribution of grants, funding, or program applications. The list of prioritized needs also serves as the foundation for the Implementation Strategy.


Hospital facilities may choose to present a list of needs to a patient advisory council, key internal stakeholders, or board members for prioritization. The IRS guidelines indicate that a facility should determine which needs are significant “based on all the facts and circumstances present in the community it serves.”

The list below includes recommended criteria that may be considered during the prioritization process.

  • Benchmarked secondary data
  • Coded and categorized primary data
  • Information related to the burden, scope, severity, or urgency of the health need
  • The feasibility and effectiveness of intervening
  • Health disparities
  • The hospital’s strategic priorities
  • Partner activity surrounding a given need
  • Existing county health improvement plan (CHIP) or state health improvement plan (SHIP)
  • State-specific CHNA requirements

To gather feedback during the prioritization process, Carnahan Group recommends utilizing an online survey tool or audience response system to input rankings into a decision matrix. An example is provided below:


In addition to tailored decision matrices, Carnahan Group’s team of strategic analysts also leverage business intelligence tools to develop customized quadrant charts that may be used to identify data patterns and visualize the most significant health needs. An example is provided below:


Carnahan Group excels in data management and aggregation and the community benefit team carefully manages the aggregation of primary and secondary data to elucidate key themes, intersecting health needs, and gaps in social, public health, and healthcare services.

Each of Carnahan Group’s CHNA reports includes a clear and concise documentation of the methodology utilized to prioritize significant community needs.


Discover the benefits of partnering with Carnahan Group on your next CHNA.

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