RAND Hospital Data
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Below is a comprehensive list of notes for RAND Hospital Data updates throughout the years.
  1. Updated raw hospital cost report source data to most recent (uploaded by CMS on April 17, 2025), the Provider of Services file to incorporate the 2025 1st quarter update, and added the FY 2026 Preliminary IPPS Impact File.
  2. This update contains 6,064 hospitals reporting and 5,953.1 hospital-years in calendar year 2023, for 98.1% completion. It also contains partial year data for 2024: 3,506 hospitals reporting 1,912.6 hospital-years.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on January 14, 2025), the Provider of Services file to incorporate the 2024 4th quarter update, and added the 2023 AHRQ Compendium of US Health Systems.
  2. This update contains 6,031 hospitals reporting and 5,975.6 hospital-years in calendar year 2022, for 99.1% completion. It also contains partial year data for 2023: 6,048 hospitals reporting 5,554.4 hospital-years for 91.8% completion.
  3. We have added 22 variables to the paid dataset. Eight variables capture information used by Medicare in the formula to calculate the uncompensated care payment received by qualifying disproportionate share hospitals. The remaining 14 capture information on length of stays and number of discharges from inpatient psychiatric and inpatient rehabilitation facilities by payer: Medicare fee-for-service, Medicare HMO, Medicaid fee-for-service, and Medicaid HMO.
  4. Lastly, we have made two fixes to the data: 1) updated the formula for 'covid19_phe_funding' to pull in all reported values from cost reporting periods that overlap with the COVID-19 public health emergency (March 2020 - May 2023); and 2) updated code to pull in the new worksheet with hospital uncompensated, charity, and indigent care variables for Federal fiscal year 2023.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on October 17, 2024), the Provider of Services file to incorporate the 2024 3rd quarter update, and the IPPS impact file to reflect the FY 2025 Final Rule.
  2. This update contains 6,031 hospitals reporting and 5,975.4 hospital-years in calendar year 2022, for 99% completion. It also contains partial year data for 2023: 6,028 hospitals reporting 4,595.3 hospital-years.
  3. We have added 14 variables to the paid dataset, capturing information on beds and bed days available for inpatient psychiatric facilities, inpatient rehabilitation facilities, and other subproviders, as well as skilled nursing, nursing, long-term care, and hospice facilities.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on July 10, 2024) and the Provider of Services file to incorporate the 2024 2nd quarter update.
  2. This update contains 6,029 hospitals reporting and 5,967.8 hospital-years in calendar year 2022, for 99.0% completion. It also contains partial year data for 2023: 5,672 hospitals reporting 4,069.6 hospital-years for 71.7% completion.
  3. We have added 18 variables to the paid dataset to disaggregate information for inpatient psychiatric facilities (IPF), inpatient rehabilitation facilities (IRF), and other inpatient sub-providers (that is, inpatient departments not subject to the Acute Inpatient Prospective Payment System, or IPPS) where possible. For example, prior to this, one variable, costs_subprov, captured Medicare allowed costs for all inpatient sub-providers for all years. Now, the variable has been split into three variables for all years in which a hospital completes Form 2552-10: costs_ipf_only10, costs_irf_only10, and costs_subprov_oth_only10. To clarify the years in which the disaggregation is not available, we have also renamed costs_subprov to cost_subprov_only96.
  4. We have also added 6 variable to the paid dataset to capture information on gross patient revenue (i.e., charges) for IPF, IRF, other sub-providers, skilled nursing facility swing beds, nursing facility swing beds, and skilled nursing facilities.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on April 11, 2024), the Provider of Services file to incorporate the 2024 1st quarter update, and the IPPS impact file to reflect the FY 2025 Preliminary Rule.
  2. This update contains 6,023 hospitals reporting 5,944.9 hospital-years in calendar year 2022, for 98.7% completion. It also contains partial year data for 2023: 3,460 hospitals reporting 1,875.8 hospital-years.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on January 17, 2024), the Provider of Services file to incorporate the 2023 4th quarter update, the Area Health Resource File to incorporate the 2022-2023 update, and added the 2022 AHRQ Compendium of US Health Systems.
  2. We have added specialty hospitals to all premium datasets, and this update contains 6,015 hospitals reporting and 5,586.4 hospital-years in calendar year 2022, for 92.9% completion. The variable 'provider_type' can be used to distinguish newly incorporated specialty hospitals (="SPHO") from previously available short-term, acute care and critical access hospitals (="HOSP"). Additional information on hospital type can be found in 'prvdr_ctgry_sbtyp_cd' and 'prvdr_ctgry_sbtyp_cd_formatted'.
  3. Lastly, we have simplified the geographic summary datasets to focus on capacity, utilization, and limited financial variables. If there is a variable that you previously used in a geographic summary dataset that has been removed and you would like it restored, please reach out to us at hospitaldata@rand.org.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on October 17, 2023), the Provider of Services file to incorporate the 2023 3rd quarter update, and the IPPS impact file to reflect the FY 2024 Final Rule. This update contains 4,601 hospitals reporting 4,572.8 hospital-years (99.4% completion) for calendar year 2021. It also contains partial data for calendar year 2022: 4,582 hospitals reporting and 3,498.9 hospital-years, for 76.4% completion.
  2. We have added 10 variables to the paid dataset. They capture the value of fixed assets from 10 categories: land, land improvements, buildings, lease improvements, fixed equipment, major movable equipment, health information technology designated assets, and minor equipment that is and is not depreciable.
  3. Lastly, we now incorporate information from all available years of the AHRQ Compendium of US Health Systems into the health system variables (in_compendium, health_sys_id, health_sys_name, health_sys_city, and health_sys_state). We use information from 2021 compendium to populate the health systems variables for 2021 and 2022; we use information from the 2020 compendium for 2020; information for 2018 and 2019 is sourced from the 2018 compendium; and information for 2016 and 2017 is sourced from the 2016 compendium. For years prior to 2016, we no longer populate values of the health system variables.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on July 17, 2023), the Provider of Services file to incorporate the 2023 2nd quarter update, and the IPPS impact file to reflect the FY 2024 Preliminary Rule. This update contains 4,600 hospitals reporting 4,567.6 hospital-years (99.3% completion) for calendar year 2021. It also contains partial data for calendar year 2022: 4,064 hospitals reporting and 2,861.8 hospital-years, for 70.4% completion.
  2. We have added 260 variables to the paid dataset. Seven capture information on a new cost center added to Form 2552-10 for cost reports ending on or after January 1, 2022, to record costs associated with providing treatment for opioid use disorder through Medicare-enrolled programs. Thirty-one variables capture information about full-time equivalents for paid employees, interns and residents, and volunteers who work across different units of the hospital and associated facilities. The remainder (222) capture information needed for CMS to calculate the wage index: salaries and wage related costs, the number of paid hours, and the average wages for provision of specific services.
  3. Based on feedback from users, we have improved the formula to estimate 'covid19_phe_funding'.
  4. Four variables have been renamed so that they better reflect the information they capture. Additional information is available in RAND_hospital_data_contents_2023_08_01.xlsx, which is included in our documentation zip package.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on April 19, 2023). This update contains 98.4% complete data for calendar year 2021: 4,596 hospitals reporting and 4,521.4 hospital-years.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on January 19, 2023), the Provider of Services file to incorporate the 2022 4th quarter update, and the Area Health Resource File (AHRF) to reflect 2021-2022 data. This update contains partial data for calendar year 2021: 4,586 hospitals reporting and 4,152.7 hospital-years, for 90.6% completion.
  2. We have added 9 variables to the paid dataset. Five capture facility characteristics; three identify whether the facility is or contains an inpatient psychiatric facility [ipf_only10], an inpatient rehabilitation facility [irf_only10], or a long-term care facility [long_term_care_hosp]. One identifies whether the facility is part of a multicampus hospital with locations in different CBSAs [multicampus_facility_only10] and the other identifies whether the facility provides inpatient services to Medicaid patients [mdcd_inpat_services]. The remaining four variables indicate whether a facility received a geographic reclassification from urban to rural as a result of OMB standards in either Federal fiscal year 2015 or Federal fiscal year 2021.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on October 18, 2022), the Provider of Services file to incorporate the 2022 3rd quarter update, and the Impact File to the FY2023 final rule. This brings the number of hospitals reporting in calendar year 2020 to 4,629 and the number of hospital-years up to 4,587.8, for 99% completion. This update also includes partial data for calendar year 2021: 4,578 hospitals reporting and 3,491.0 hospital-years, for 76.3% completion.
  2. We have added 33 variables to the paid dataset. Nine capture information about available bed days for intensive care and other specialty care units. The remaining 24 variables capture the individual components of capital-related expenses (depreciation, insurance, interest, leases, taxes, and other) for buildings and fixtures as well as movable equipment. We provide component expenses for the trial balance of accounts (i.e., cap_related_bldgs_fixtures and cap_related_movable_equip) as well as for net expenses that are input into the cost allocation process (i.e., net_expenses_cap_bldgs_fixtures and net_expenses_cap_movable_equip).
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on July 22, 2022), the Provider of Services file to incorporate the 2022 2nd quarter update, and the Impact File to the FY2023 proposed rule. This brings the number of hospitals reporting in calendar year 2020 to 4,627 and the number of hospital-years up to 4,580.8, for 99% completion. This update also includes partial data for calendar year 2021: 3,829 hospitals reporting and 2,620.8 hospital-years, for 68.4% completion.
  2. We have added three variables to the free data. Two of these variables, can be used to distinguish rural (=2) and urban (=1) facilities based on the standard geographic classification of hospitals; 'geo_class_beg' captures a facility's classification at the beginning of the reporting period, and 'geo_class_end' captures the classification at the end of the reporting period. We have also added 'transplant_center' to allow users to identify facilities that perform organ transplants.
  3. We have added 60 new variables to the paid dataset. Among the highlights: 'covid19_phe_funding,' which captures amounts hospitals received from Federal COVID-19 relief programs; four facility characteristics variables: 'all_inclusive_rate_hosp,' 'rural_referral_center,' 'pickle_amend_hosp_only10,' and 'employees_ftes_incl_subprov'; 18 quantity of services variables; and 18 variables with information on organ transplants. Lastly, we have added seven variables related to the cost allocation process, five variables capturing Medicare bad debts, and seven variables related to the calculation of DGME and IME payments.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on April 22, 2022) and the Provider of Services file to incorporate the 2022 1st quarter file. This brings the number of hospitals reporting in calendar 2020 up to 4,624 and number of hospital-years to 4,525.4.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on January 14, 2022) as well as the Provider of Services file to incorporate the 2021 4th quarter file, and the Area Health Resource File (AHRF) to reflect 2020-2021 data. This brings the number of hospitals reporting in calendar 2019 up to 4,658 and number of hospital-years to 4,606.0. This update also includes partial data for calendar 2020: 4,618 hospitals reporting and 4,124.8 hospital-years.
  2. We have added one variable to the free dataset: 'ownership_hcris_only10', which captures detailed information about a facility's ownership type, as captured in the cost report.
  3. We have added 75 variables to the paid dataset. With these additions, the dataset now contains information on non-salary expenses for all cost centers listed on Worksheet A. Lastly, we have renamed 16 variables sourced from Worksheet S-3, Part V to clarify that they capture information on the costs of employee benefits.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on October 22, 2021) as well as the Impact File to the 2022 final rule and the Provider of Services file to incorporate the 2021 3rd quarter file. This brings the number of hospitals reporting in calendar 2019 up to 4,657 and number of hospital-years in calendar 2019 up to 4,604.8. This update also includes partial data for calendar 2020: 4,602 hospitals reporting and 3,492.8 hospital-years.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on July 20, 2021) as well as the Impact File to the 2022 proposed rule and the Provider of Services file to incorporate the 2021 2nd quarter file. This brings the number of hospitals reporting in calendar 2019 up to 4,652 and number of hospital-years in calendar 2019 up to 4,596.2. This update also includes partial data for calendar 2020: 3,015 hospitals reporting and 1,789.6 hospital-years.
  2. Based on feedback from users, we have updated the formulas for four variables to improve estimates: 'commercial_charges_est,' 'commercial_rev_est,' 'commercial_rev_to_charges_est,' and 'commercial_to_mdcr_est'.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on April 15, 2021) as well as the Provider of Services file to incorporate the 2021 1st quarter file. This brings the number of hospitals reporting in calendar 2018 up to 4,696 and number of hospital-years in calendar 2018 up to 4,656.0. This update also includes partial data for calendar 2019: 4,648 hospitals reporting and 4,423.2 hospital-years.
  2. We have added 51 variables to the paid dataset. Thirty-six variables provide information on coinsurance, deductibles, other payments and sequestration adjustments received by facilities through various CMS payment systems. There are also eight variables with information on adjustments to expenses in the cost allocation process and four with information on cash reserves. Lastly, we have added two variables that indicate the amount of time in the cost reporting period that the facility was either a sole community hospital or a Medicare dependent hospital, and one status variable to capture if the hospital received a low volume adjustment.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on January 12, 2021) as well as the Area Health Resources File to incorporate the 2019-2020 and the Provider of Services file to incorporate the 2020 4th quarter file. This brings the number of hospitals reporting in calendar 2018 up to 4,694 and number of hospital-years in calendar 2018 up to 4,653.4. This update also includes partial data for calendar 2019: 4,639 hospitals reporting and 4,119.1 hospital-years.
  2. We have added 69 variables to the paid dataset. Twenty-nine variables, including 'costs_hosp_nf_cont_lbr_only10' and 'costs_hosp_nf_cont_benef_only10', provide information on the cost of labor and benefits for contract workers after 2010. The remaining forty variables contain information on other than salary expenses and total (salary plus other than salary) expenses for select cost centers.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on October 17, 2020) as well as the Impact File to the 2021 final rule and the Provider of Services file to incorporate the 2020 3rd quarter file. This brings the number of hospitals reporting in calendar 2018 up to 4,692 and number of hospital-years in calendar 2018 up to 4,649.9. This update also includes partial data for calendar 2019: 4,397 hospitals reporting and 3,235.4 hospital-years.
  2. We have added 9 variables to the paid dataset. Four are sourced from the Area Health Resource File: 'cbsa_ind' indicates whether a county is part of a metropolitan, micropolitan, or no core-based statistical area (CBSA); 'cbsa_cnty_status' indicates whether a county is central or outlying in a CBSA; 'rural_urban' is a continuum indicating the level of rurality for a given county, and 'rural_urban_desc' describes in words what each value of 'rural_urban' means. The five remaining variables are from the HCRIS data. Two provide information on Medicaid swingbed patient days ('mdcd_snf_swingbed_inpat_days' and 'mdcd_nf_swingbed_inpat_days'); two provide information on labor and delivery days ('mdcd_landd_days_only10' and 'all_landd_days_only10'); and the last is 'all_employee_disc_days_only10'.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on July 17, 2020) as well as the Impact File to the 2021 proposed rule and the Provider of Services file to incorporate both the 2019 4th quarter file as well as the 2020 2nd quarter file. This brings the number of hospitals reporting in calendar 2018 up to 4,688 and number of hospital-years in calendar 2018 up to 4,639.3. This update also includes partial data for calendar 2019: 3,102 hospitals reporting and 1,840.3 hospital-years.
  2. We added one variable from the Provider of Services file to the free dataset, 'ipps_hosp_pos' to more easily identify IPPS facilities. We also added one variable from HCRIS to identify facilities that receive disproportionate share (DSH) payments ('receives_dsh_only10').
  3. We have also added 36 variables to the paid dataset. Two are sourced from the Provider of Services File: chow_cnt and chow_dt, which identify the number of times a facility has changed ownership, and the effective date of the most recent change of ownership, respectively. The remainder are from the HCRIS data. Four variables relate to payer mix and cover Medicare and Medicaid (with and without HMO) as a share of all inpatient discharges: 'mdcr_inpat_discharge_share,' 'mdcd_inpat_discharge_share,' 'mdcrinclHMO_inpat_disch_share' and 'mdcdinclHMO_inpat_disch_share'. Eleven other variables relate to the facility’s balance sheet, including short-term notes payable and total accumulated depreciation, as well as nine depreciation component variables. The remaining variables cover inpatient days and patient revenues across different specialized care units, including the intensive care unit, surgical intensive care unit, burn intensive care unit, skilled nursing facility and nursery.
  4. Lastly, we have improved our methodology for calculating weighted sum variables for facilities that submit cost reports that cover less than one year of time. Overall, we found that around 5-10% of facilities submitted reports covering less than 12 months in each year, and the impact on the overall distribution of values was minimal. At the same time, we recognize that this may have a specific impact on values where the analysis is not on aggregate but instead examining individual facilities in very specific years. As always, current subscribers are strongly advised to use datasets from the most recentlyd. If you are a past subscriber and you believe your research may be impacted by our change in methodology, please reach out and we will provide a link to a one-time download of the premium dataset of your choice.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on April 15, 2020). This brings the number of hospitals reporting in calendar 2017 up to 4712 and number of hospital-years in calendar 2017 up to 4686.1. This update also includes partial data for calendar 2018: 4674 hospitals reporting and 3419.3 hospital-years.
  2. We added 8 variables to the subscriber-only data to provide information about hospital capacity: number of adult and pediatric beds ('adult_peds_beds' and 'tot_adult_peds_beds'), number of beds in the intensive care unit ('intensive_care_beds_only96' and 'intensive_care_beds_only10'), as well as number of beds in coronary care ('coronary_care_beds'), surgical intensive care ('surgical_ic_beds'), burn intensive care ('burn_ic_beds') and other specialty care areas ('ther_spec_care_beds').
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on January 17, 2020). This brings the number of hospitals reporting in calendar 2017 up to 4713 and number of hospital-years in calendar 2017 up to 4687.3. This update also includes partial data for calendar 2018: 4674 hospitals reporting and 3418.7 hospital-years.
  2. We incorporated geographic information (CBSA ID, CBSA name, county ID, county name) from the 2018-2019 Area Health Resources File.
  3. We added four variables to the subscriber-only data to provide information about hospital systems catalogued in the 2018 Compendium of US Health Systems.
  4. We added one variable to the free data, `in_compendium`, to indicate hospitals that appear in the Hospital Linkage File in the 2018 Compendium of US Health Systems.
  1. Updated raw HCRIS source data to most recent (uploaded by CMS on October 9, 2019) and updated the Impact File to the 2020 final rule. This brings the number of hospitals reporting in calendar 2017 up to 4709 and number of hospital-years in calendar 2017 up to 4684.8. This update also includes partial data for calendar 2018: 4646 hospitals reporting and 3391.5 hospital-years
  2. We added 118 variables to the subscriber-only data, including variables about uncompensated care costs, non-reimbursable costs, salary expenses, and inpatient Medicare costs and payments.
  3. We added one variable to the free data, `total_uncomp_expnsshr_only10`, i.e. total unreimbursed and uncompensated care cost as a share of operating expenses. This variable is the sum of costs of Medicaid/CHIP, charity care, and non-Medicare bad debt divided by operating expenses.