2021 Annual Statements of Community Benefits Standard

The 2021 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. 

Community Benefits Survey Forms

The following documents are not fully ADA compliant.  

2021 ASCBS form for Nonprofit Hospitals 


2021 ASCBS form for Public Hospitals and For-Profit Disproportionate Share Hospitals 


Hospitals required & exempt from reporting 2021 charity care and community benefits information:  


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