The 2025 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. 

The following documents are not fully ADA compliant.  

2025 ASCBS form for Nonprofit Hospitals

• Texas Nonprofit Hospitals Form I 
• Texas Nonprofit Hospitals Form II 

2025 ASCBS form for Public Hospitals and For-Profit Disproportionate Share Hospitals 

• Public and For-Profit Dispro Part I 

Hospitals required & exempt from reporting 2025 charity care and community benefits information:  

• Required Report 2025 
• Exempt Report 2025 

For more information, please contact us for assistance.