• The general characteristics of the hospital, including a copy of the hospital’s independently audited financial statements, if available, or other financial statements.
• Any direct ownership interest in the hospital by any person, any indirect ownership by an entity, and the percentage of ownership interest and type of stock held. In the case of an investing entity, the form must also identify each investor or owner of the entity and the percentage of his or her ownership in the entity. Any individual investor, either a direct or indirect owner, must be identified as a physician or physician’s immediate family member if applicable. A separate worksheet must be completed for each physician owner or immediate family member with his or her Social Security number or Medicare National Provider Identifier (NPI) and certain other information.
• Any payments made to the hospital by direct or indirect physician owners of the hospital, including without limitation initial investments, assessments, capital calls and loan guarantees, as well as the date, type and amount of payment. In cases of indirect ownership, the individuals who make up the investing entity must also be identified, as well as their status (such as a physician or an immediate family member). Any guarantee or other agreement that reduces or limits the physician’s risk of loss or liability must also be reported.
• The following compensation arrangements between a hospital and physicians must be reported: all rentals of office space or equipment to or from the hospital and the physician; personal service arrangements; physician recruitment payments; a copy of each such agreement must be produced (but only one copy of a uniform personal services agreement needs to be supplied); isolated transactions such as a physician’s sale of property or practice; any compensation to a physician unrelated to a designated health service under Stark; any other payments by a physician to the hospital for items or services; charitable donations by a physician; nonmonetary compensation to physicians in the form of items or services exceeding $300 per physician per calendar year; incidental benefits valued at $25 or more per occurrence granted to medical staff members; any higher return paid on a physician’s invested capital than is warranted by the amount invested; loans or loan guarantees made by either the hospital or physician on behalf of the other; and any initial investments, capital calls or other payments made by the hospital on behalf of a physician.
• Financial relationships permitted by Stark that apparently need not be reported on the DFRR are those relating to physician employment agreements, risk-sharing compensation agreements, compliance training, obstetrical malpractice insurance subsidies, professional courtesy, retention payments and community-wide health information systems.

 The DFRR represents a significant change in CMS’s enforcement policy under the Stark law and increases the risk of scrutiny for both hospitals and physicians. It creates potentially new liabilities based on a hospital’s late submission of the DFRR and incomplete or inaccurate statements. If a hospital has not yet done so, it should examine all contracts or investment arrangements with physicians and evaluate its contract management systems to ensure compliance with Stark II requirements. If a hospital’s compliance plan does not already require collecting and reviewing this information through a legal audit of its physician agreements, then the hospital is strongly urged to do so in anticipation of CMS’s future adoption of an industry-wide mandatory disclosure program for hospitals.