Rural Hospitals (Flex Program)


Community Impact and Benefit Activities of CAHs, Other Rural, and Urban Hospitals, 2018

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rural, hospitals, CAH, critical access hospital, data, benchmarking


Non-profit and publicly-owned hospitals, including Critical Access Hospitals (CAHs), have obligations to address the health needs of their communities. Non-profit hospitals are required to report their community benefit activities to the Internal Revenue Service using Form 990, Schedule H. Community benefit activities include programs and services that provide treatment and/or promote health in response to identified community needs. Publicly-owned hospitals are also held accountable to the needs of their communities through the oversight of their governing boards and local governments. To monitor the community impact and benefit activities of CAHs and to understand whether and how their community impact and benefit profiles differ from those of other hospitals, we compared CAHs to other rural and urban hospitals using a set of indicators developed by the FMT.

This report enables State Flex Programs and CAH administrators to compare the community impact and benefit profiles of CAHs nationally (Tables 1 and 2) to the performance of CAHs in their state (see links to state-specific tables on page 5). Table 1 provides data for select measures of community impact and benefit, including the provision of essential health care services that are typically difficult to access in rural communities. Table 2 provides data on hospital charity care, bad debt, and uncompensated care activities.

The Flex Monitoring Team also produces state-specific reports with more detailed results.


FMI: contact Zach Croll,

Funding Organization

Federal Office of Rural Health Policy

fmt-community-benefit-national-2018.pdf (542 kB)
Community Impact and Benefit Activities of Critical Access, Other Rural, and Urban Hospitals, 2018