2000 AHA Annual Survey

2016 AHA Annual Survey Health Forum, Please return to: HOSPITAL NAME: _____ AHA Annual Survey 155 N Wacker Drive Suite 400. CITY, STATE: _____ Chicago IL 60606. A. REPORTING PERIOD (please refer to the instructions and definitions at the end of this questionnaire ). Report data for a full 12-month period, preferably your last completed fiscal year (366 days). Be consistent in using the same reporting period for responses throughout various sections of this Survey . 1. Reporting Period used (beginning and ending date) __ __ / __ __ / __ __ __ __ to __ __ / __ __ / __ __ __ __. Month Day Year Month Day Year 2. a. Were you in operation 12 full months b. Number of days open at the end of your reporting period? .. YES NO during reporting period . 3. Indicate the beginning of your current fiscal year __ __ / __ __ / __ __ __ __. Month Day Year B. ORGANIZATIONAL STRUCTURE. 1. CONTROL. Indicate the type of organization that is responsible for establishing policy for overall operation of your hospital.

1 2018 AHA Annual Survey American Hospital Association A. REPORTING PERIOD (please refer to the instructions and definitions at the end of this questionnaire)

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