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Reporting Entities - Forms and Instructions
HCCIS
On this page:
Events and Deadlines
Hospitals
Freestanding Outpatient Surgical Centers (FOSC)
Diagnostic Imaging Facilities
Capital Expenditure Commitments
Related:
Process for Amending Hospital Data (PDF)
Events and Deadlines
- Acute and Psych/Specialty Hospitals
- Hospital Formset Training
HAR Webinar Training
January 17, 2024 at 10:30 am - Feb. 1, 2024 - First and Second Quarter FYE hospitals' 2023 annual reports due to MHA.
- April 1, 2024 - Third Quarter FYE hospitals' 2023 annual reports due to MHA.
- July 1, 2024 - Fourth Quarter FYE hospitals' 2023 annual reports due to MHA.
- Hospital Formset Training
- Freestanding Outpatient Surgical Centers (FOSC)
- March 1, 2024 - 2023 annual reports due to MDH.
- Diagnostic Imaging Facilities
- March 1, 2024- 2023 annual reports due to MDH.
- Health Care System Capital Expenditure Commitment
- March 1, 2024 - 2023 annual reports due to MDH.
Hospitals
Hospital financial, utilization, and services data is collected through an annual report, the Hospital Annual Report (HAR). All hospitals (excluding federal hospitals) are required to complete the HAR.
2023 Hospital Annual Report (HAR)
- 2023 HAR Formset (Excel)
- 2023 HAR Instructions (PDF)
- Tip Sheet - included in the formset
- Note: Web transmission site available: https://portal.mnhospitals.org. Contact Jennifer Sanislo at (651) 659-1440 for your login and password. This website is secured and encrypted.
HAR Training Materials
2022 Hospital Annual Report (HAR)
2021 Hospital Annual Report (HAR)
2020 Hospital Annual Report (HAR)
2019 Hospital Annual Report (HAR)
Freestanding Outpatient Surgical Center (FOSC)
Freestanding Outpatient Surgical Center Report (FOSC)
Freestanding Outpatient Surgical Center (FOSC) financial, utilization, and services data is collected through an annual survey, the FOSC Annual Report. All licensed surgical centers are required to complete the FOSC report. All data, except that on administrative costs, is classified as public and reported on a facility-level.
2023 FOSC Financial, Utilization and Services Report
- 2023 FOSC Formset (Excel)
- 2023 FOSC Instructions (PDF)
- 2023 FOSC Notification Letter (PDF)
- Note new filing fee submission requirement in the instructions.
An invoice will be sent to your organization. Fees should be submitted to:
ATTN: Minnesota Department of Health
Health Economics Program/HCCIS
Financial Management
P.O. Box 64975
St. Paul, MN 55164-0975
Please include your HCCIS ID on your remittance.
2022 FOSC Financial, Utilization and Services Report
2021 FOSC Financial, Utilization and Services Report
2020 FOSC Financial, Utilization and Services Report
2019 FOSC Financial, Utilization and Services Report
Diagnostic Imaging Facility
Diagnostic Imaging Utilization Report (DI)
Data are collected from all clinics, imaging facilities, and mobile imaging providers that provide or bill for Diagnostic Imaging services such as MRI, PET, CT, and SPECT. All data is classified as public and reported on a facility-level.
2023 Diagnostic Imaging Facility Utilization Report
- 2023 Diagnostic Formset (Excel)
- 2023 Diagnostic Instructions (PDF)
- 2023 Diagnostic Notification Letter (PDF)
2022 Diagnostic Imaging Facility Utilization Report
2021 Diagnostic Imaging Facility Utilization Report
2020 Diagnostic Imaging Facility Utilization Report
2019 Diagnostic Imaging Facility Utilization Report
Capital Expenditure Commitments
Capital Expenditure Report (CER Information)
All health care providers must report major capital spending commitments over $1 million to the Minnesota Department of Health on an annual basis. Expenditure commitments for health care systems or clinics should be reported to the Capital Expenditure Retrospective Review Report. Expenditure commitments that are intended for a specific facility should be reported on the respective HAR, FOSC, or Diagnostic Imaging forms.
2023 Health Care System or Other Provider Capital Expenditure Commitment Report
2022 Health Care System or Other Provider Capital Expenditure Commitment Report
2021 Health Care System or Other Provider Capital Expenditure Commitment Report
2020 Health Care System or Other Provider Capital Expenditure Commitment Report
2019 Health Care System or Other Provider Capital Expenditure Commitment Report