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Annual Financial Data

Hospital Annual Financial Reporting Forms & Instructions

Hospitals are required to submit a Hospital Annual Disclosure Report within four months of the hospital's fiscal year end. The report contains: Type of ownership and inventory of provided services; Number of beds and corresponding utilization patient statistics by payer; Balance sheet and income statement; Revenues by payer and revenue center; Expenses by natural classification and cost center; and Productive hours and average hourly rates by employee classification and cost center.

The following information is available for Hospital Annual Financial Disclosure Reporting. Forms, instructions and technical letters are provided in PDF format. For assistance and information about downloading files, go to the "Help Tools"

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Manual/Instructions/Extension Requests

Hospital Annual Disclosure Report Forms

The following blank reporting forms are for hospital report periods ending on or after June 30th of the year listed. Forms are available for download as a complete set, with each report page being a separate Excel worksheet. For years 2004 and prior, each report page is available as a separate Excel spreadsheet file. The file name for these separate report pages is the page number. For example, P00.xls is report page 0 and P034.xls is report page 3.4.

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Individual Pages

0-4 | 5-10 | 12-19 | 20-22

Summary of Changes to Reporting Forms

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