Fiscal Year End Reports by Hospital
The year end reports by year and then by hospital that can be selected below are the exact duplication of the files submitted to the Department of Health. The various forms can be viewed and printed by selecting the appropriate tab.The forms provided are:
- Data - All the current reporting year data in spreadsheet format
- Transmittal - Cover page for the paper transmittal
- Info Pg1 - Admissions, patient days, births, available beds
- Info Pg2 Admissions, patient days, visits, and revenue by payor
- SS2 3 5 6 Employee benefits, rent lease expense, insurance, license and taxes exp
- SS4 Depreciation tables for property, plant, equipment
- SS8 Deductions from revenue table
- FS Balance sheet, income statement
- CC's Cost Center: Unit of measure, full-time employees (FTEs), salaries, employee benefits, pro fees, supplies, purchase services, depreciation, lease/rent, revenues, cost allocation
- Prior Year All the prior reporting year data in spreadsheet format
Hospital Financial Blank Reporting Forms
Blank forms for use in reporting hospital aggregate financial and utilization data. Use these forms for reporting to the Department of Health.
If you have any questions contact our hospital finance specialist at 360-236-4210.