HCRIS (Medicare Hospital Cost Reports, CMS)

HCRIS (the Healthcare Cost Report Information System) holds the annual cost reports that Medicare-certified institutional providers file with the Centers for Medicare & Medicaid Services (CMS). The hospital report (Form CMS-2552) is the most-used: facility-level financials, charges, costs, beds, discharges, uncompensated and charity care, and Medicare utilization, for nearly every US hospital. The data is free and public. Used in, for example, Lewellen, where the 2011-2018 hospital reports supply Charity Care and Uninsured Discounts spending.

• Cost: free, public.
• API key: none required for the bulk files.
• Coverage: institutional Medicare cost reports; the hospital form (CMS-2552) for essentially all US hospitals, by provider fiscal year.
• Home: https://www.cms.gov/data-research/statistics-trends-and-reports/cost-reports

Access

CMS publishes the data as bulk archives, one per provider type and fiscal year, under downloads.cms.gov/Files/hcris/. The hospital form (CMS-2552-10) files are named HOSP10FY<year>.zip:

# Hospital cost reports (CMS-2552-10), FY2021 archive, no key
curl -sL -o HOSP10FY2021.zip \
  "https://downloads.cms.gov/Files/hcris/HOSP10FY2021.zip"
unzip HOSP10FY2021.zip

Each archive holds the standard HCRIS flat files for that year:

• *_RPT.CSV - report-level records (one row per cost report: provider number, fiscal-year begin/end dates, status, the report record number that joins the others).
• *_NMRC.CSV - the numeric data lines (worksheet, line, column, numeric value).
• *_ALPHA.CSV - the alphanumeric data lines (text-valued cells).
• Plus roster and supporting files.

A single reported figure (say, charity care) is a cell located by worksheet + line + column in the numeric file, joined to the report record in RPT. There is no wide “one row per hospital” table; you pivot the long worksheet cells yourself using the cost-report form layout.

Load in Python

import pandas as pd

rpt = pd.read_csv("HOSP10_2021_RPT.CSV", header=None, dtype=str)
nmrc = pd.read_csv("HOSP10_2021_NMRC.CSV", header=None, dtype=str)
# NMRC columns: record number, worksheet code, line, column, value.
# Locate a cell by (worksheet, line, column) from the CMS-2552-10 form,
# then join to RPT on the report record number to get provider + fiscal year.

Confirm the column order against the HCRIS documentation for the vintage you pulled; the flat files ship without header rows.

Gotchas (the ones that bite pipelines)

• Two form versions coexist: CMS-2552-96 and CMS-2552-10. Hospitals moved to the -10 form for cost-reporting periods beginning on or after 1 May 2010. Worksheet, line, and column coordinates differ between the two forms; a line number is meaningless without knowing which form produced it. The HOSP10 files are the -10 form; older years use the -96 layout.
• Data lives in long worksheet cells, not columns. A variable is a (worksheet, line, column) triple in the numeric file. Build an explicit mapping from the form before extracting; the wrong line silently returns a different concept.
• Provider fiscal years are not calendar years and vary in length. Each report covers that hospital’s own fiscal year, and short or long periods occur (mergers, fiscal-year changes). Align on the begin/end dates in RPT, not on a calendar-year label.
• One provider can have multiple reports for a period. Amended, reopened, or superseded reports appear; use the report status and dates in RPT to keep the right one rather than summing duplicates.
• The most recent fiscal years are incomplete. Reports arrive and settle with a lag, so the latest year’s archive keeps growing and is partial when first posted. Treat recent vintages as not-yet-final.
• Alphanumeric versus numeric files hold different cells. Text-valued fields are in ALPHA, numeric in NMRC. A field you cannot find in one is often in the other.

Provider types

File prefix	Form	Provider type
HOSP10	CMS-2552-10	Hospitals (2010 form onward)
HOSP	CMS-2552-96	Hospitals (1996 form)
SNF10	CMS-2540-10	Skilled nursing facilities
HHA10	CMS-1728-94/-20	Home health agencies
HOSPICE	CMS-1984-14	Hospices

Match the file prefix and form version before pulling line numbers; layouts are form-specific.

Citation

Cite CMS, HCRIS, the form and provider type, the fiscal years, the URL, and the access date, for example: Centers for Medicare & Medicaid Services, Healthcare Cost Report Information System, Hospital Form CMS-2552-10, FY2021, retrieved from https://downloads.cms.gov/Files/hcris/, accessed YYYY-MM-DD. Record the form version and the worksheet/line/column coordinates used so the extract is reproducible.