Program Information - WA State Dept. of Health

Actual Fiscal Year End Reports by Hospital - The year end reports by year and then by hospital that can be selected on the far left are the exact duplication of the files submitted to the Dept. of Health. The various forms can be viewed and printed by pressing the appropriate tab. All files are Excel files and Require Excel or free Excel Viewer
The forms provided are:

	data	all the current reporting year data in spreadsheet format
	Transmittal	cover page for the paper transmittal
	Info_Pg1	Admissions, Patient Days, Births, Available Beds
	Info_Pg2	Admissions, Patient Days, Visits, and Revenue By Payor
	SS2_3_5_6	Employee Benefits, Rent Lease Expense, Insurance, License and Taxes Exp
	SS4	Depreciation Tables for Property, Plant, Equipment,
	SS8	Deductions From Revenue Table
	FS	Balance Sheet, Income Statement
	CC's Cost Center	Unit of Measure, Fte's, Salaries, Employee Benefits, Pro Fees, Supplies, Purch. Srv., Depreciation, Lease/Rent, Revenues, Cost Allocation Statistics
	Prior Year	all the prior reporting year data in spreadsheet format


	Fiscal Year End Reports
	2007
	2006
	2005
	2004
	2003
	2002
	2001
	2000
	1999
	1998
	1997

Hospital Financial BLANK Reporting Forms
(Use for Reporting to DOH/HPDS)
Blank forms for use in reporting hospital
aggregate financial and utilization data
Year End Form Budget Form

If you have any questions please contact Randy Huyck at (360) 236-4210

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CHS/Hospital and Patient Data System
Washington State Department of Health
1102 SE Quince Street, P.O. Box 47811
Olympia, Washington, 98504-7811

Last Update : 12/20/2007 10:44 AM
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