Forms and Instructions

Forms and Instructions

Acute Care Hospitals
Psych/Specialty Hospitals
Freestanding Outpatient Surgical Centers (FOSC)
Diagnostic Imaging Facilities
Dental CBCT Facilities
Health Care System Capital Expenditure Report

Process for Amending Hospital Data (PDF)

Events and Deadlines

  • Acute and Psych/Specialty Hospitals
    • Hospital Formset Training
         HAR Webinar Training
            Wednesday January 22, 2020 - 10:00 am - 12:00 pm
            Contact Jenny Sanislo at jsanislo@mnhospitals.org or 651-659-1440 to pre-register.
    • Feb. 3, 2020 - First and Second Quarter FYE hospitals' 2019 annual reports due to MHA.
    • April 1, 2020 - Third Quarter FYE hospitals' 2019 annual reports due to MHA.
    • July 1, 2020 - Fourth Quarter FYE hospitals' 2019 annual reports due to MHA.

  • Freestanding Outpatient Surgical Centers (FOSC)
    • March 1, 2020 - 2019 annual reports due to MDH.

  • Diagnostic Imaging Facilities
    • March 1, 2020 - 2019 annual reports due to MDH.

  • Dental CBCT Facilities
    • March 1, 2020 - 2019 annual reports due to MDH.

  • Health Care System Capital Expenditure Commitment
    • March 1, 2020 - 2019 annual reports due to MDH.

Acute Care Hospitals

2019 Hospital Annual Report (HAR)

2019 HAR Training Materials
  • Available Soon

2018 Hospital Annual Report (HAR) 2018 HAR Training Materials

2017 Hospital Annual Report (HAR)
2016 Hospital Annual Report (HAR)
2015 Hospital Annual Report (HAR)

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Psych/Specialty Hospitals

2019 Psych/Specialty
This is included with the Hospital formset. There are specific instructions and coding built into the formset that will guide the Psychiatric and Specialty hospitals through the completion of the report.


2018 Psych/Specialty
2017 Psych/Specialty
2016 Psych/Specialty
2015 Psych/Specialty

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Freestanding Outpatient Surgical Center (FOSC)

2019 FOSC Financial, Utilization and Services Report


2018 FOSC Financial, Utilization and Services Report
2017 FOSC Financial, Utilization and Services Report
2016 FOSC Financial, Utilization and Services Report
2015 FOSC Financial, Utilization and Services Report

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Diagnostic Imaging Facility

2019 Diagnostic Imaging Facility Utilization Report
(see Minnesota Statutes, section 144.565)


2018 Diagnostic Imaging Facility Utilization Report
2017 Diagnostic Imaging Facility Utilization Report
2016 Diagnostic Imaging Facility Utilization Report 2015 Diagnostic Imaging Facility Utilization Report

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Dental CBCT Facility

2019 Dental CBCT Facility Utilization Report
(see Minnesota Statutes, section 144.565)


2018 Dental CBCT Facility Utilization Report
2017 Dental CBCT Facility Utilization Report
2016 Dental CBCT Facility Utilization Report
2015 Dental CBCT Facility Utilization Report

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Capital Expenditure Commitments

2019 Health Care System or Other Provider Capital Expenditure Commitment Report


2018 Health Care System or Other Provider Capital Expenditure Commitment Report
2017 Health Care System or Other Provider Capital Expenditure Commitment Report
2016 Health Care System or Other Provider Capital Expenditure Commitment Report 2015 Health Care System or Other Provider Capital Expenditure Commitment Report

More information about Capital Expenditure Reporting

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Updated Tuesday, December 03, 2019 at 11:46AM