The 2012 blank Annual Statement of Community Benefits Standard (ASCBS) form is used in collecting charity care and community benefits information from Texas nonprofit hospitals, public hospitals and for-profit hospitals participating in the Disproportionate Share Hospital Program.
2012 ASCBS form for Nonprofit Hospitals:
2012 ASCBS form for Public Hospitals and For-Profit Disproportionate Share Hospitals:
Lists of hospitals required to report and hospitals exempt from reporting charity care
and community benefits information for the 2012 reporting period: