regulatory · verified
A CHNA/implementation-strategy failure triggers a $50,000 excise tax per noncompliant facility, per year, under IRC §4959; broader failure risks revocation of §501(c)(3) status
Audience
CFOs, VPs Finance, Compliance Officers, and Tax Directors of standalone/rural nonprofit community hospitals and mid-size nonprofit health systems (5-20 facilities), no in-house tax-exempt counsel
Problem
Every nonprofit hospital facility must independently satisfy six §501(r) requirements (CHNA, FAP, EMCP, AGB, billing/collection, Schedule H reporting) — miss the CHNA and it's a $50,000 excise tax per facility, per year; miss enough of the rest and the facility's income is taxed and the exemption can be revoked. Most standalone hospitals have no in-house tax-exempt counsel and rebuild the FAP or CHNA from a stale prior-year template each cycle.
Offer
Free Facility Readiness Scan -> §501(r) Facility Compliance Audit & Correction File ($14,000-$28,000 one-time, per facility) + Annual Compliance File subscription ($12,000-$24,000/yr) -> optional Triennial CHNA + Implementation Strategy Package ($22,000-$45,000/cycle) -> optional Remediation & Defense ($18,000-$60,000/matter) -> optional System Portfolio bundle (25-40% volume discount, 5+ facilities).
Operating process
[
{
"body": "Upload your current FAP/EMCP/billing policy, prior CHNA, most recent Schedule H, and 12 months of remittance data; every field is checked against the intake completeness checklist.",
"title": "Intake & normalize"
},
{
"body": "Each of the six §501(r) requirements is scored against the current 26 CFR 1.501(r) checklist, with a CFR citation on every finding.",
"title": "Requirement Diff"
},
{
"body": "AI drafts the corrected FAP/EMCP, AGB Workpaper, and Schedule H Narrative; a Compliance Analyst approves completeness before anything reaches a licensed signer.",
"title": "Draft and approve"
},
{
"body": "A TEO Attorney signs the compliance determination; a Healthcare CPA signs the AGB Workpaper and Schedule H representation.",
"title": "Dual sign-off"
},
{
"body": "The signed Compliance File is delivered, and CHNA clocks and AGB recalculation dates are tracked ahead of your next cycle.",
"title": "Deliver & renew"
}
]Evidence status
regulatory · verified
The IRS opened a hospital examination wave; roughly 35 organizations were under active §501(r) examination by late 2024, on top of the statutory triennial community-benefit review
market · inferred
Roughly 2,900 nonprofit 501(c)(3) community hospitals operate in the U.S.
regulatory · verified
A September 2025 House Ways & Means hearing and bipartisan Senate probes questioned the ~$37.4B annual value of the nonprofit-hospital tax exemption; research cited finds ~80% of tax-exempt hospitals spend less on community benefit than the value of their tax break
pricing · inferred
CHNA consultancies, healthcare CPA advisory lines, and health-law firms each sell a fragment of §501(r) compliance work at professional-services rates; no incumbent found delivers a single continuously-maintained, signed file across all six requirements
regulatory · verified
Roughly 20 states now mandate their own minimum free/discounted charity-care income limits, layered on top of the federal §501(r) baseline; Oregon adds a minimum community-benefit-spending requirement
pain · verified
The AGB percentage must be recalculated at least annually from allowed-claims data, with the FAP updated whenever the AGB method changes
Domain-design coverage
Passed: 17; total: 17; coverage: 100.