A community health needs assessment (CHNA) provides an opportunity for non-profit hospitals to identify needs and resources within the community. The following report outlines the process undertaken by Orange City Area Health System (OCAHS) in Orange City, IA to fulfill these requirements. OCAHS conducted this Community Health Needs Assessment (CHNA) partly as a collaborative process with three other hospitals and the public health agency in Sioux County. This collaborative process included joint planning, identification of common data indicators and conducting a county-wide survey. Although the process was collaborative, OCAHS reviewed both community level and county level data and input and developed this community health needs assessment as an individual assessment. An implementation plan specific for OCAHS will be developed as well based on this assessment.