The purpose of this project was to measure the community benefit and impact performance of CAHs nationally and by state using data from the American Hospital Association Annual Survey. This project was based on continuing work that has been ongoing under the previous cooperative agreement. This project built upon previous Flex Monitoring Team and University of Southern Maine activities related understanding the community impact and benefit activities of CAHs and the development and field-testing of appropriate community impact and performance measures. The data was used to prepare national and state-level reports on for CAH activity in this area.