HCCIS
Reporting Entities - Forms and Instructions

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 16, 2025 at 10:30 am
  • Feb. 1, 2025 - First and Second Quarter FYE hospitals' 2024 annual reports due to MHA.
  • April 1, 2025 - Third Quarter FYE hospitals' 2024 annual reports due to MHA.
  • July 1, 2025 - Fourth Quarter FYE hospitals' 2024 annual reports due to MHA.
• Freestanding Outpatient Surgical Centers (FOSC)
  • March 1, 2025 - 2024 annual reports due to MDH.
• Diagnostic Imaging Facilities
  • March 1, 2025 - 2024 annual reports due to MDH.
• Health Care System Capital Expenditure Commitment
  • March 1, 2025 - 2024 annual reports due to MDH.

Hospitals

Hospital Annual Report (HAR)

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.

2024 Hospital Annual Report (HAR)

• 2024 HAR Formset (Excel)
• 2024 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

• 2024 HAR Training and Information - PDF
• 2024 HAR Training and Information Recording

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.

2024 FOSC Financial, Utilization and Services Report

• 2024 FOSC Formset (Excel)
• 2024 FOSC Instructions (PDF)
• 2024 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:
  Minnesota Department of Health
  Financial Management
  P.O. Box 64975
  St. Paul, MN 55164-0975
  Please include your HCCIS ID on your remittance.

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.

2024 Diagnostic Imaging Facility Utilization Report

• 2024 Diagnostic Formset (Excel)
• 2024 Diagnostic Instructions (PDF)
• 2024 Diagnostic Notification Letter (PDF)

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. 

2024 Health Care System or Other Provider Capital Expenditure Commitment Report 

• 2024 Capital Expenditure Formset (Excel)