Many hospitals (and other organizations) have conducted assessments of their communities health needs and responded to those needs. The Patient Protection and Affordable Care Act of 2010, requires that nonprofit (tax-exempt) hospitals must complete every three years a community health needs assessment (CHNA) and adoption of an implementation strategy to address identified needs (effective with the first taxable year after March 23, 2012). There is a $50,000.00 excise tax for failing to meet the CHNA requirements for any taxable year and noncompliance with the CHNA requirement may result in a loss of the exemption. Information from: Bilton, M. (2011). Community health needs assessment. Trustee: The Journal For Hospital Governing Boards, 64(9), 21-24.