HCCIS Forms and Instructions
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 12, 2022 - 1:00 - 2:00 pm
Contact Jenny Sanislo at jsanislo@mnhospitals.org or 651-659-1440 to pre-register. - Feb. 1, 2022 - First and Second Quarter FYE hospitals' 2021 annual reports due to MHA.
- April 1, 2022 - Third Quarter FYE hospitals' 2021 annual reports due to MHA.
- July 1, 2022 - Fourth Quarter FYE hospitals' 2021 annual reports due to MHA.
- Freestanding Outpatient Surgical Centers (FOSC)
- March 1, 2022 - 2021 annual reports due to MDH.
- Diagnostic Imaging Facilities
- March 1, 2022 - 2021 annual reports due to MDH.
- Dental CBCT Facilities
- March 1, 2022 - 2021 annual reports due to MDH.
- Health Care System Capital Expenditure Commitment
- March 1, 2022 - 2021 annual reports due to MDH.
Hospitals
2021 Hospital Annual Report (HAR)
- Formset - Excel
- 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 Web site is secured and encrypted.
2020 Hospital Annual Report (HAR) 2020 HAR Training Materials
2019 Hospital Annual Report (HAR) 2018 Hospital Annual Report (HAR) 2017 Hospital Annual Report (HAR)
Freestanding Outpatient Surgical Center (FOSC)
2021 FOSC Financial, Utilization and Services Report
- Formset - Excel
- Instructions - PDF
- Notification Letter - PDF
- Note new filing fee submission requirement in the instructions.
You will be invoiced and 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.
2020 FOSC Financial, Utilization and Services Report
2019 FOSC Financial, Utilization and Services Report
2018 FOSC Financial, Utilization and Services Report
2017 FOSC Financial, Utilization and Services Report
Diagnostic Imaging Facility
2021 Diagnostic Imaging Facility Utilization Report
(see Minnesota Statutes, section 144.565 and Minnesota Statues, section 144.1225).
2020 Diagnostic Imaging Facility Utilization Report
2019 Diagnostic Imaging Facility Utilization Report
2018 Diagnostic Imaging Facility Utilization Report
2017 Diagnostic Imaging Facility Utilization Report
Dental CBCT Facility
2021 Dental CBCT Facility Utilization Report
(see Minnesota Statutes, section 144.565)
- CBCT Dental Facility Formset - Excel
- Instructions - PDF
- CBCT Dental Facility Notification Letter - PDF
2020 Dental CBCT Facility Utilization Report
2019 Dental CBCT Facility Utilization Report
2018 Dental CBCT Facility Utilization Report
2017 Dental CBCT Facility Utilization Report
Capital Expenditure Commitments
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
2018 Health Care System or Other Provider Capital Expenditure Commitment Report
2017 Health Care System or Other Provider Capital Expenditure Commitment Report
