Hospital reporting

• Definitional differences. Schedule H 7a excludes some categories that HCRIS S-10 may include — Medicaid shortfall handling, partial-payment netting, charity-vs.-uninsured-discount classification.
• Cost-to-charge ratio (CCR) handling. HCRIS S-10 applies a hospital-wide CCR; Schedule H allows different cost-step-down approaches.
• Charity care policy boundaries. Hospitals can categorize the same patient case as charity care, bad debt, or contractual allowance — moving cost between lines.
• Multi-facility aggregation. A single 990 EIN often covers several HCRIS-reporting facilities. Summing facility-level charity care up to the system level can smooth or amplify reporting differences across facilities.
• Non-Medicare hospitals. Children's hospitals, specialty cancer centers, and some teaching hospitals don't bill Medicare in volume, so HCRIS S-10 charity care can legitimately be near zero while Schedule H reports millions.

HCRIS uses the federal fiscal year as a reporting cycle, not as a fiscal period. The file labeled "FY2023" contains hospital reports submitted during federal fiscal year 2023 — but the periods those reports cover vary by hospital fiscal calendar:

• For July–June fiscal-year hospitals, "FY2023" mostly contains their report for the year that ended June 2024.
• For calendar-year hospitals, "FY2023" mostly contains their CY2023 report (ending Dec 2023).
• For October–September hospitals, "FY2023" mostly contains their report ending September 2023.

None of those periods perfectly aligns with 990 Tax Year 2022 (which itself varies by filer fiscal calendar). About 29% of the 1,295 computable matched systems are period-aligned within 1 month; about 65% are exactly 12 months off. When you look up a hospital, the detail card shows the period-alignment status as a per-row signal — an aligned hospital has the two filings covering the same fiscal year, and a misaligned hospital is comparing different years. Don't use a misaligned row to infer a direct like-period difference.

Note: "alignment" here is a heuristic based on the two filings' end dates, not a proof of period overlap. Hospitals occasionally report stub periods or change fiscal calendars; the end-date proxy is correct for the vast majority but isn't a substitute for reading the filings directly.

Coming in v2: per-hospital matching across HCRIS reporting cycles 2022/2023/2024 to find the report whose period actually matches each hospital's TY2022 990. This will substantially expand the well-aligned set.

Each detail card shows a Social Vulnerability Index value for the hospital's home county, sourced from CDC/ATSDR's 2022 SVI release. SVI is a composite of 16 census variables across four themes (socioeconomic status; household characteristics including age, disability, single-parent, English-language proficiency; racial & ethnic minority status; housing type & transportation). Higher percentile = more vulnerable.

What the page shows is the overall summary rank (RPL_THEMES) on a 0-100 scale, sourced from the county FIPS of the hospital's HCRIS-reporting facility. For multi-facility systems where the facilities are in different counties, we take the median across those home-county SVI values. This is a proxy, not a true service-area measure — actual catchment areas can extend well beyond the home county, and within-county variation is invisible at this resolution. It should not be used to infer hospital service-area need or adequacy of charity care.

Coverage: ~98% of matched systems. CDC's SVI is US-government work and public domain. Source: CDC/ATSDR SVI.

Other caveats: SVI is not the same thing as ADI. SVI weighs minority status and housing factors; ADI is built more around income/employment/education. The same county can land at very different points on the two indices. v2 may add tract-level resolution and a true catchment-area weighting.

• Crosswalk: 3,079 of 6,042 HCRIS hospitals appear in CBI's December 2024 crosswalk; the unmatched ~50% are mostly for-profit and government hospitals (no 990) plus hospitals not in CBI's frozen vintage. Of 1,481 unique TY2022 990 EINs ingested, 1,334 match the crosswalk.
• Time window: HCRIS Fiscal Year 2023 paired with 990 Tax Year 2022, ingested across IRS release years 2024, 2025, and 2026. TY2022 amendments filed after the 2026 quarterly cutoff aren't included.
• Validation: 6 spot-checked EINs match the IRS source XML exact-to-the-dollar; parser is verified clean. The specific EINs and the per-filing line-7a values from each are listed in the methodology artifact. Not a guarantee that every row is parsed correctly — bug reports welcome at the GitHub issues link.
• The page is a per-hospital lookup tool. Each hospital appears in its own detail card on user request. A nonzero difference in any given row does not by itself say whether either filing is wrong. The value is making the cross-form view computable at all, where previously every researcher had to reconstruct it from raw filings.

• Per-hospital HCRIS year matching (v2) to expand the well-aligned subset substantially.
• Earlier tax years (TY2018–TY2021) for trend analysis.
• BMF-based crosswalk reconciliation to close the ~20% unmatched-EIN remainder.
• FDA approval review documents as a Phase 2 dataset.