The purpose of this community health needs assessment (CHNA) was to identify and prioritize significant health needs of the Sierra Nevada Memorial Hospital (SNMH) service area. The priorities identified in this report help to guide SNMH community health improvement programs and community benefit activities as well as their collaborative efforts with other organizations that share a mission to improve health. This CHNA report meets the requirements of the Patient Protection and Affordable Care Act (and in California, Senate Bill 697) that nonprofit hospitals conduct a community health needs assessment at least once every three years. The CHNA was conducted by Community Health Insights (www.communityhealthinsights.com).