Submit Financial Data (SIERA)

Financial data reporting includes:

Hospital Financial Reporting

Annual Financial Reporting

Each Hospital is required to submit a Hospital Disclosure Report within four months of the hospital’s fiscal year end. The report contains detailed financial and utilization information about the facility such as:

  • Type of ownership and inventory of provided services;
  • Number of beds and corresponding patient utilization statistics by payer;
  • Balance sheet, income statement, and statement of cash flows;
  • 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.

For reporting forms and instructions, see the Accounting and Reporting Manual for California Hospitals.

Annual Disclosure Reporting Forms

The following blank reporting forms are for hospital report periods ending on or after June 30th of the year listed. Forms are provided in MS Excel (.xlsx) format. Instructions and technical letters are provided in PDF format.

View reporting forms (2019-Current)
Submit Hospital Annual Financial Reports

Quarterly Financial and Utilization Reporting

Each Hospital is required to file the Quarterly Financial and Utilization report 45 days after the end of each calendar quarter.  Some data that the report contains are:

  • Number of beds
  • Discharges, patient days, and outpatient visits by payer;
  • Inpatient and Outpatient revenue by payer;
  • Deductions from revenue by component;
  • Net patient revenue by payer;
  • Operating expenses;
  • Non-operating revenue net of non-operating expenses; and
  • Highlighted balance sheet data.

For reporting forms and instructions, see the Accounting and Reporting Manual for California Hospitals.

Submit Hospital Quarterly Financial and Utilization Reports

Accounting and Reporting Manual for California Hospitals, Second Edition

This manual provides the uniform accounting and reporting system required to be implemented by all California hospitals. In order to improve access to the Hospital accounting and reporting requirements, the following files contain various parts of the Hospital Manual. The files are current and include amendments incorporated by reference into the California Code of Regulations, Title 22, Section 97018, effective October 1, 2019.

Supplemental Information

Hospital Technical Letters

HCAI’s Accounting and Reporting Systems Section has developed a series of technical letters regarding the uniform accounting and reporting system requirements for California hospitals. The purpose of these letters is to provide timely information to assist hospital financial officers and consultants in meeting these requirements. Please keep in mind that the older technical letters may contain instructions that relate to older annual and quarterly reporting periods, and may no longer be valid. We have elected to include them here to provide a record of all technical letters.

#36: AB 112 Distressed Hospital Loan Program; SB 525 Minimum Wages Health Care Workers – April 2024

#35: COVID-19 Worker Retention Pay; Quality Incentive Program (QIP) – October 2022

#34: Charity Care; Reporting Outpatient Visits by Payer; Cross-over Patients; Program of All-Inclusive Care for the Elderly (PACE) – November 2021

#33: Medicare Accelerated Payments REVISED, CARES Act Provider Relief Fund, Families First Coronavirus Response Act – Testing, Uninsured Relief Fund Payments, Paycheck Protection Program, FEMA Public Assistance Funds, Disaster Response, Quarterly Reporting Deductions from revenue, net patient revenue – REVISED – April 2021

#32: SIERA regulations; California Medication Assisted Treatment (MAT) Expansion Project; AIDS Drug Assistance Programs (ADAP) – October 2019

#31:  Splitting Medi-Cal DSH payments; completing prior year data; elimination of extraordinary items; penalty appeals – November 2018

#30:  PRIME payments; Observation Care; Staffed Beds – November 2017

#29:  Whole Person Care; cashing out employee paid time off; reporting negative utilization data, patient revenue – December 2016

#28:  SB 239 QAF; Other Operating Revenue – other line descriptions – October 2015

#27:  340B Pharmacy Program; LIHP; severance pay; employee bonuses; wound care; patient service with no charge rendered – January 2015

#26:  CCS; DSRIP; EHR; policy discounts; administrative adjustment; DSH payment – public and private; IGT; Covered California – REVISED – January 2014

#25:  AB 102-20% IGT Fee; Hospital Value-Based Purchasing Program; Rural Floor Settlement; Charity Care reported in County Indigent; Hospitalist – September 2012

IMPORTANT CHANGES TO SB335/QUALITY ASSURANCE FEE REPORTING INSTRUCTIONS

#24:  Section 1115; GHPP; ADAP; uncompensated care pool; MAA; TCM; staffed beds vs. available beds – February 2012

#23:  Quarterly vs Annual Report Review – Outpatient Visits – August 2011

#22:  Comparison of Quarterly vs Annual Reports – New Comparisons – July 2011

#21:  Grants; Medi-Cal Short Doyle; Chargemaster – November 2010

#20:  Maternity Data – November 2009

#19:  AB 915; SyFHR – October 2008

#18:  AB 774 Fair Pricing – August 2007

#17:  AB 774 Fair Pricing – April 2007

#16:  Section 1011; Eligibility for low income programs; charity care; home office costs; chargeable vs non-chargeable supplies; other operating revenue vs non-operating revenue; – October 2006

#15:  Medicare Advantage Private Fee-for-Service (FFS) Plan – March 2006

#14:  County Medical Services Program (CMSP) Blue Cross Life – October 2005

#13:  Revised Standard Units of Measure (SUM); Live Birth Summary vs No. of Deliveries; Use Concise Label Descriptions; Charity Care Reported in Other Payers; partial charity care – May 2005

#12:  Charity Care: Payment Shortfalls; Emergency Department (ED): Trauma Center Designations vs ED License Levels – October 2004

#11:  SB 1255; SB 1732; SB 391; SB1179; Healthy Families; Clinical Teaching funds – April 2004

#10:  Medi-Cal Outpatient Lawsuit Settlement; Tobacco Settlement Funds; Community Benefit Services Reported as Charity Care; outpatient statistics; Other Indigent vs Other Payer – June 2003

#9:  Standard Units of Measure for Non-Revenue Producing Cost Centers; Cost reductions and Minor Cost recoveries – July 2002

#8:  Managed Care and New Payer Categories Defined; Capitation Premium Revenue; Purchased Inpatient Services and Purchased Outpatient Services – June 2001

#7:  Accounting and Reporting Requirements for Managed Care Payer Categories – December 1999

#6:  HQRS, Quarterly Reports – June 1999

#5:  Number of Personal Contacts; Average Number of Hospital Employees; Number of Admissions; Average Number of Nursing Personnel; Number of Hours of Nursing Inservice Education – October 1998

#4:  Square Feet – July 1998

#3:  Quarterly Reporting – October 1997

#2:  Quarterly Reporting, Hospital Annual Financial Data Diskette; Medicare and Medi-Cal Provider Numbers – March 1997

#1:  Quarterly Reporting, Changes to Annual Report – December 1996

Long-Term Care Facilities Annual Financial Reporting

Submit Long-Term Care Facility Annual Financial Reports

Each Long-Term Care (LTC) Facility, (skilled nursing, intermediate care, intermediate care/developmentally disabled, and congregate living health facilities) is required to submit a Long-Term Care Facility Integrated Disclosure and Medi-Cal Cost Report within four months of the facility’s fiscal year end. The report contains detailed financial and utilization information about the facility such as:

  • Type of ownership and inventory of provided services;
  • Number of beds and utilization statistics by payer;
  • Balance sheet and income statement;
  • Revenue by payer and by revenue center;
  • Expenses by natural classification and by cost center; and
  • Productive hours and hourly rates by employee classification and by cost center.

Accounting and Reporting Manual for Long-Term Care Facilities, Second Edition

This manual provides the uniform accounting and reporting system required to be implemented by all California skilled nursing and intermediate care facilities. In order to improve access to the LTC Facility accounting and reporting requirements, the following files contain all of the various parts of the LTC Facility Manual.

Supplemental Information

Integrated Disclosure and Medi-Cal Cost Report Forms

Forms are provided in MS Excel (.xlsx) format.

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