California Office of Statewide Health Planning & Development

Healthcare Information Division - 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"

Manual/Instructions/Extension Requests

• Accounting and Reporting Manual for California Hospitals, Second Edition
• Hospital Technical Letters
• Hospital Annual Disclosure Report Extension Request Form

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.

Complete Sets   2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2000-2003 | 1997-1999

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

• Page 0        2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 1        2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 2        2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 3.1     2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 3.2     2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 3.3     2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 3.4     2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 4        2004 | 2003 | 2002 | 2001 | 2000
• Page 4.1     2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 4.2     1999

• Page 5         2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 5.1      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 5.2      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 6         2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 7         2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 8         2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 9         2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 10       2004 | 2003 | 2002 | 2001 | 2000 | 1999

• Page 12      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 14      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 15      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 16      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 17      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 18      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 19      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 19a    2004 | 2003 | 2002 | 2001 | 2000 | 1999

• Page 20      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 20a    2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 21      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 21.1   2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 22      2004 | 2003 | 2002 | 2001 | 2000 | 1999
• Page 22.1   2004 | 2003 | 2002 | 2001 | 2000 | 1999

Summary of Changes to Reporting Forms

• Summary of Changes for 2005
• Summary of Changes for 2004
• Summary of Changes for 2003
• Summary of Changes for 2002
• Summary of Changes for 2001
• Summary of Changes for 2000
• Summary of Changes for 1999

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