Hospital Annual and 12-Month Filings and Instructions

hospital filing
Connecticut hospitals are required (Conn. Gen. Statute 19a-643-206) to report annually on their actual operating results for the previous fiscal year, October 1st to September 30th, to the Office of Health Strategy (OHS).

The annual filing reports include information such as audited financial statements, Medicare Cost Reports, hospital and parent corporation legal charts of corporate structure, hospital uncompensated care policies and procedures, hospital financial data, hospital utilization statistics, and the Hospital Reporting System (HRS) reports.

Important dates to remember:

• Fiscal Year filings are reported for the period October 1 – September 30.
• The Annual Reporting filing is due to OHS no later than the end of business day on February 28 of each year.
• Twelve Months Actual Filing are due to OHS no later than end of business day March 31 of each year.

Annual and 12-month reports

Annual and 12-month reports 

View annual and 12-month reports with the Hospital Reporting System (HRS).

Financial documents 

View hospital financial statements, Medicare Cost Reports, officers and directors, organization charts, and more in the Hospital Reporting System (HRS).

File annual and 12-month data 

Log into the OHS Hospital Reporting System (HRS) for acute care hospitals to file annual and 12-month reports.

Hospital Data Reporting 

Return to the Hospital Data Reporting program page.

Archived Hospital Annual Reporting 

View archived Annual Hospital Reporting Filings from 2016 and earlier. 

General Filing Information

Hospital Filings Cover Letter to hospitals 

FY 2023 Hospital Cost to Charge Ratios 

Filing Changes and Reminders document 

Hospital Financial Review Regulations 

HRS Reports and OHS Statute and Regulation references 

FY 2024 Annual Reporting Resources

Review the the instructions, affidavit and checklists to complete the FY 2024 annual reporting requirements.
icon

FY 2024 Annual Reporting General Instructions

ux icon

FY 2024 Annual Reporting Affidavit


FY 2024 Annual Reporting Submission Checklist

FY 2024 Twelve Months Actual Filing Instructions

Review the instructions, affidavit and checklists to complete the 12 month actual filing requirements.

icon

FY 2024 Twelve Months Actual Filing General Instructions

ux icon

FY 2024 Twelve Months Actual Filing Affidavit

icon

FY 2024 Twelve Months Actual Filing Submission Checklist

A complete listing and description of each of the Annual Reporting and 12-Month requirements can be found below:

Report 1 - Audited Financial Statements of the Hospital, the Hospital's parent corporation and the Hospital's affiliates
Report 2 - Medicare Cost Report
Report 3 - Most recent Legal Chart of Corporate Structure
Report 4 - Current Lists of Officers and Directors
Report 9 through Report 14 - CHIME Hospital Utilization Reports – currently not required.
Report 15 - The Hospital's Uncompensated Care Policies and Procedures
Report 24A – Trauma Activation Fee Policies and Procedures for the Hospital

Report 5 - Hospital, Affiliate and Related Corporation Net Assets
Report 6 - Transactions between the Hospital and Affiliates or Related Corporations
Report 6A - Transactions between Hospital Affiliates or Related Corporations
Report 7 - Expenditures by Affiliates/Related Corps. for the Benefit of the Hospital
Report 8 - Hospital Commitments/Endorsements for the Benefit of Affs./Rel. Corps.
Report 16 - Donations and Funds Restricted for Indigent Care and Free Beds
Report 17A - Hospital Bed Funds Held or Administered by the Hospital - Patient Activity
Report 17B - Hospital Bed Funds Held or Administered by the Hospital - Fund Activity
Report 18 - Hospital Collection Placement Policies and Collection Agent Information
Report 19A - Salaries and Fringe Benefits of the Ten Highest Paid Hospital Positions
Report 19B – Salaries and Fringe Benefits of the Ten Highest Paid Health System Positions
Report 19C – Financial Gains Realized from a Transfer of Ownership CON
Report 20 - Report of Each Joint Venture, Partnership and Corporation Related to the Hospital
Report 21 - Hospital Salaries & Fringe Benefits paid by Joint Ventures, Affiliates & Related Corp.
Report 22 - Transfer of Assets, Operations, Change of Control from the Hospital to a For Profit Entity
Report 23 - Charity Care and Reduced Cost Services Provided by the Hospital
Report 24B – Trauma Activation Fees Charged by the Hospital

Report 625 - Report of Independent Accountants on Applying Agreed-Upon Procedures-currently not required
Report 750 - Hospital's and Hospital Parent Corporation's IRS Form 990, Return of Organization Exempt From Income Tax
Report 100 - Hospital Balance Sheet Information
Report 125 – Hospital Statement of Cash Flows-currently not required
Report 150 - Hospital Statement of Operations Information
Report 175 - Hospital Operating Expenses by Expense Category and by Department
Report 185 - Hospital Financial and Statistical Data Analysis
Report 300 - Parent Corporation Consolidated Balance Sheet Information
Report 325 – Parent Corporation Consolidated Statement of Cash Flows
Report 350 - Parent Corporation Consolidated Statement of Operations Information
Report 385 - Parent Corporation Consolidated Financial Data Analysis
Report 400 - Hospital Inpatient Bed Utilization by Department
Report 450 - Hospital Inpatient & Outpatient Other Services Utilization & FTE Employees
Report 485 - Hospital Outpatient (OP) Surgical, OP Endoscopy & OP Emergency Room Services by Location
Report 550 – Summary of Charges Payments, Statistics and Uncompensated Care
Report 565 – Hospital Emergency Department Outpatient Charges and Payments
Report 600 – Report Summary for the Verification of Net Patient Revenue
Report 700 - Statistical Analysis of Hospital Revenue and Expense