# Medicare cost report: how to read a hospital's cost report for sales and account research Where to download hospital cost reports, which worksheet, line and column holds beds, days, payer mix, revenue and contract labor, and the traps that catch first-time readers. By Supreet Gupta, Co-founder and Chief Product Officer, Dmand AI · Published 2026-10-19 Read on the web: https://dmand.ai/blog/medicare-cost-report **Short answer** A Medicare cost report is the annual financial and statistical report every Medicare-certified hospital files on Form CMS-2552-10. It is public. Sales teams use it to size and qualify accounts: Worksheet S-3 holds beds, patient days and discharges, S-10 holds uncompensated care, G-2 and G-3 hold revenue, expenses and net income, and S-3 also shows contract labor. Most guides to the Medicare cost report are written for the people who prepare it. This one is for the people who read it from the outside: sales and research teams that want to know how big a hospital is, who pays it, how it is doing financially and what it spends on contract labor and IT. Every line reference below comes from the CMS Provider Reimbursement Manual, the HCRIS documentation or the CMS cost report data dictionary. ## What a Medicare cost report is, and why every hospital's report is public Medicare-certified institutional providers file an annual cost report with their Medicare Administrative Contractor (MAC), and CMS keeps the data in its Healthcare Cost Report Information System (HCRIS).[1] Hospitals use Form CMS-2552-10 for periods beginning on or after May 1, 2010.[2] The report covers facility characteristics, utilization, costs and charges by department, Medicare settlement data and financial statements.[1] It is a heavy lift for the hospital: CMS estimates 685 hours on average to complete one.[2] Filing is mandatory, and the report is public. The Provider Reimbursement Manual says cost reports are public record under the Freedom of Information Act.[2] ## Where to download Medicare cost reports: HCRIS files and the CMS cost report CSV There are two ways in, depending on how comfortable you are with data. 1. **The Hospital Provider Cost Report file on data.cms.gov.** One row per hospital report with a subset of the most-used fields, already flattened into a CSV.[3] Our count of the 2023 file found 6,109 rows, one per report, and 117 columns. Start here. 2. **The full HCRIS files on cms.gov.** One zip per fiscal year, from 2010 to 2026, each with a Report file, a Numeric file and an Alphanumeric file.[1] The numeric files are too large for Excel: one fiscal year holds about 19 million numeric records.[4] You need a database or statistics software. ## How HCRIS cost report data is organized by worksheet, line and column Every number in HCRIS is addressed by three codes: the worksheet, the line and the column. The HCRIS documentation's own example is the bed count on Worksheet S-3, Part I, line 14, column 2, stored as worksheet code S300001, line 01400 and column 00200.[5] Lines and columns are five digits, and many lines are subscripted, so a hospital can add lines between the standard ones. Always match on the full code, not on the position in a printed form. ## Which Medicare cost report worksheets matter for hospital sales research The form has dozens of worksheets. These are the ones that answer a seller's questions.[2][6] | Question | Worksheet | Where | | --- | --- | --- | | How many beds? | S-3, Part I | Line 14, column 2 | | How many inpatient days, in total and by payer? | S-3, Part I | Line 14, columns 6 (Medicare), 7 (Medicaid) and 8 (total) | | How many discharges? | S-3, Part I | Line 14, column 15 | | How many employees? | S-3, Part I | Line 14, column 10 (FTEs on payroll) | | Is it a teaching hospital? | S-3, Part I | Line 27, column 9 (intern and resident FTEs) | | How much does it spend on contract labor? | S-3, Parts II and V | Part II line 11; Part V lines 1 and 2 | | How much uncompensated care? | S-10 | Lines 20, 23, 26, 30 and 31 | | What are its patient revenues? | G-2, Part I | Line 28 | | What are its operating expenses? | G-2, Part II; A | G-2 line 43; Worksheet A line 200 | | What is its net income? | G-3 | Lines 3, 5 and 29 | | How much has it put aside for health IT? | G | Line 27 | | Who controls it, and what chain is it in? | S-2, Part I | Line 21; lines 140 to 143 | *Where each sales research question lives in Form CMS-2552-10. Line and column numbers from CMS sources.* Source: CMS Provider Reimbursement Manual Part 2, Chapter 40, and the CMS Hospital Provider Cost Report data dictionary ## How to find beds, patient days and discharges on Worksheet S-3 Worksheet S-3, Part I is the hospital's statistics page. Line 14 is the hospital total, and its columns hold the numbers most sellers want first.[6] - **Column 2: beds.** Beds available at the end of the period. - **Column 3: bed days available.** Beds times days in the period. - **Columns 5 to 8: inpatient days** for Title V, Medicare, Medicaid and all patients. - **Columns 9 to 11: FTEs** for interns and residents, employees on payroll and nonpaid workers. - **Columns 12 to 15: discharges** by program and in total. > **Available beds are not staffed beds** > > The cost report counts beds available for use, which is not the same as the staffed beds some surveys report. Label the number you use, and do not compare it with a staffed-bed figure from another source. ## How to calculate hospital payer mix from the Medicare cost report Payer mix tells you how much of a hospital's inpatient care Medicare and Medicaid pay for, which shapes its margins and priorities. You can estimate it from inpatient days on Worksheet S-3, Part I. - **Medicare share of days** = line 14, column 6 divided by line 14, column 8. - **Medicaid share of days** = line 14, column 7 divided by line 14, column 8. One trap: line 14, column 6 counts traditional Medicare only. Medicare Advantage days are reported separately on line 2, column 6, and kept out of the payer columns on the other lines.[6] Add them if you want every Medicare beneficiary. ## How to find hospital revenue, operating expenses and net income on Worksheets G-2 and G-3 Worksheets G-2 and G-3 are the hospital's income statement.[6] - **G-2, Part I, line 28:** total patient revenues, split into inpatient (column 1), outpatient (column 2) and total (column 3). - **G-2, Part II, line 43:** total operating expenses. - **G-3, line 3:** net patient revenues, after contractual allowances and discounts on line 2. - **G-3, line 5:** net income from service to patients. - **G-3, line 29:** net income, including other income. A quick operating margin is G-3 line 5 divided by G-3 line 3. A hospital with a negative margin will ask harder questions about your return on investment. ## How to find charity care, bad debt and uncompensated care on Worksheet S-10 Worksheet S-10 shows how much care a hospital provides without full payment.[6] - **Line 1:** cost-to-charge ratio. - **Line 2:** net revenue from Medicaid. - **Line 20:** charity care charges. - **Line 23:** cost of charity care. - **Line 26:** bad debt. - **Line 30:** cost of uncompensated care. - **Line 31:** total unreimbursed and uncompensated care cost. High uncompensated care usually means a safety-net hospital with thin margins, where savings and staff time carry more weight than new features. ## How to find a hospital's contract labor spending in the cost report For staffing firms, this is the most useful number in the report. Worksheet S-3, Part II, line 11 reports contract labor for direct patient care, such as nursing, diagnostic, therapeutic and rehab services, and line 12 reports contracted management and administrative services. Part II is completed by hospitals paid under the inpatient prospective payment system.[6] Worksheet S-3, Part V reports contract labor and benefit cost by component, and all hospitals complete it, including critical access, psychiatric, rehab, long-term care and children's hospitals.[6] Line 1 is the total facility and line 2 is the hospital. A rising contract labor line is a direct signal that a hospital is short-staffed. Pair it with [how hospitals buy staffing through MSPs and VMS platforms](https://dmand.ai/blog/msp-vs-vms-healthcare-staffing). ## How Worksheet S-2 shows type of control, components and the chain home office Worksheet S-2, Part I identifies the hospital.[6] - **Lines 3 to 18** list each component, such as the hospital, subproviders, a skilled nursing facility, home health agency, rural health clinic or FQHC, with its name and CCN. - **Line 21** records the type of control in 13 codes, grouped into nonprofit, proprietary and governmental. - **Lines 140 to 143** name the chain home office, if the hospital claims home office costs. That makes S-2 the bridge to the hospital's parent. See [how to find out who owns a hospital](https://dmand.ai/blog/who-owns-a-hospital) for the full lookup. ## When Medicare cost reports are due, and how current HCRIS data is Cost reports are due by the last day of the fifth month after the cost reporting period ends, or 150 days after a period that ends mid-month.[7] Because each hospital picks its own fiscal year, reports arrive all year round. That makes the data lag. In the HCRIS files dated October 2, 2026, there were 6,113 hospital reports for fiscal 2024, of which 3,593 were still as-submitted, and 3,805 for fiscal 2025 so far.[4] Status matters too. The HCRIS files keep only the highest status of each report: a settled report replaces the as-submitted one, and a reopened report replaces the settled one.[8] ## Mistakes to avoid when using Medicare cost report data The data is free and rich, and easy to misread. - **Treating available beds as staffed beds.** They measure different things. - **Missing Medicare Advantage days.** They sit on line 2, not in line 14, column 6. - **Matching on position, not code.** Subscripted lines move rows around; match on worksheet, line and column codes. - **Counting a hospital twice.** A hospital can file two reports in one year after a fiscal year change or a change of ownership.[5] - **Reading the hospital as the system.** Each report covers one hospital and its components, not the health system above it. - **Trusting type of control blindly.** CMS does not define the categories, so hospitals pick their own.[9] If you would rather not join HCRIS files yourself, Dmand AI site of care profiles show beds, staffing and financials next to the site's place in its health system's org tree and the executives who run it, so you can qualify an account and find the buyer in one view. **See beds, staffing and the buying committee for any US hospital** Search hospitals by size, state and system, open a site of care profile, and find the executives who run it. 30 days free, self-serve, no credit card. [Start free trial](https://app.dmand.ai/signup) · [Book a demo](https://dmand.ai/book-a-demo) ## Sources 1. [Cost Reports](https://www.cms.gov/data-research/statistics-trends-and-reports/cost-reports), Centers for Medicare & Medicaid Services 2. [Provider Reimbursement Manual, Part 2, Chapter 40, Hospital and Hospital Health Care Complex Cost Report, Form CMS-2552-10](https://www.cms.gov/regulations-and-guidance/guidance/manuals/paper-based-manuals-items/cms021935), Centers for Medicare & Medicaid Services 3. [Hospital Provider Cost Report](https://data.cms.gov/provider-compliance/cost-reports/hospital-provider-cost-report), Centers for Medicare & Medicaid Services 4. [HCRIS hospital 2552-10 reports and status counts](https://downloads.cms.gov/files/hcris/hosp10-reports.zip), Centers for Medicare & Medicaid Services, October 2026 5. [Hospital 2552-10 documentation and README](https://www.cms.gov/files/zip/hospital2010-documentation.zip), Centers for Medicare & Medicaid Services 6. [Cost report data dictionary](https://data.cms.gov/sites/default/files/2024-03/9756088d-5280-4090-80b9-449d31ef25a3/Cost%20Report%20Data%20Dictionary%20Update.pdf), Centers for Medicare & Medicaid Services, and Provider Reimbursement Manual, Part 2, Chapter 40 7. [42 CFR 413.24, Adequate cost data and cost finding](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-413/subpart-B/section-413.24), Electronic Code of Federal Regulations 8. [Hospital 2552-2010 form](https://www.cms.gov/data-research/statistics-trends-and-reports/cost-reports/hospital-2552-2010-form), Centers for Medicare & Medicaid Services 9. [Hospital Ownership: Medicare Sources of Information (IF12848)](https://www.congress.gov/crs-product/IF12848), Congressional Research Service, December 12, 2024 ## Questions people ask about Medicare cost reports ### What is a Medicare cost report? A Medicare cost report is the annual financial and statistical report every Medicare-certified hospital files with its Medicare Administrative Contractor. Hospitals use Form CMS-2552-10. It covers facility characteristics, beds and patient days, costs and charges by department, Medicare settlement data and financial statements. ### Are Medicare cost reports public? Yes. The Provider Reimbursement Manual says cost reports are public record under the Freedom of Information Act. CMS publishes the data in its Healthcare Cost Report Information System (HCRIS), and individual reports can be requested from the Medicare Administrative Contractor. ### Where can I download a hospital's Medicare cost report? CMS publishes hospital cost report data on its Cost Reports page as HCRIS files, one zip per fiscal year, from 2010 onward. For a simpler start, the Hospital Provider Cost Report file on data.cms.gov has one row per report with the most-used fields. ### When is the Medicare cost report due? By the last day of the fifth month after the cost reporting period ends, under 42 CFR 413.24(f)(2). If the period ends mid-month, the report is due 150 days after it ends. Extensions are allowed only for extraordinary events such as a flood or fire. ### Where is the bed count in the Medicare cost report? Worksheet S-3, Part I, line 14, column 2 holds the number of beds available at the end of the period. In HCRIS data it is coded as worksheet S300001, line 01400, column 00200. These are available beds, not the staffed beds some surveys report. ### What is Worksheet S-10 in the cost report? Worksheet S-10 reports a hospital's uncompensated and indigent care: Medicaid revenue and charges, charity care charges and cost, bad debt, and total uncompensated care cost. It shows how much care a hospital provides without full payment. ### What is the difference between an as-submitted and a settled cost report? An as-submitted report is what the hospital filed. A settled report has been reviewed by the Medicare Administrative Contractor, and a reopened report has been revised after settlement. CMS's HCRIS files keep only the highest status of each report, so a settled report replaces the as-submitted one. ### How current is HCRIS cost report data? It lags. Hospitals file five months after their fiscal year ends, and fiscal years differ by hospital. In the October 2026 HCRIS files, 6,113 hospital reports were in for fiscal 2024, of which 3,593 were still as-submitted, and fiscal 2025 was still coming in.