Download Files for Financial Disclosure

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Download file for the FY 2009 Ambulatory Surgery Center Profile.
FY 2009 Ambulatory Surgery Center Profile Excel (2003 version)
Read instructions for completing and submitting on the first TAB of workbook.

 

Download Files for the Financial Disclosure Policy Statement 2000-1 (Effective: Beginning with the fiscal year 2000 reporting period) - to be used by all "covered facilities" and related organizations in complying with financial disclosure requirements.
Statement of charges, fees, and salaries for goods and services rendered in excess of $55,000.00
Statement of charges, fees, and other sums collected in excess of $55,000.00
55 Form Policy- Financial Disclosure Policy Statement 2000-1
55 Electronic - Policy Attachment
Form A (Excel Format) - Charges, Fees, and Salaries > $55,000.00 Paid to Employees
Form B (Excel Format) - Charges, Fees, and Salaries > $55,000.00 Paid for Executive or Management Services
Form C (Excel Format) - Charges, Fees, and Salaries > $55,000.00 Paid to Other Vendors
Form D (Excel Format) - Charges, fees, and Other Sums > $55,000.00 Collected

 

Downloadable Files for the Hospital Uniform Reporting System (Uniform Report) to be used by hospitals in complying with financial disclosure requirements.
- Memorandum of Changes in 2000 Template
- Uniform Report Instructions
- Uniform Report template revised 11/14/00
- Revenue summary by various departments
- Instructions for completing the revenue summary schedules

Financial Disclosure Power Point Presentation.