Reporting
RHT reporting requirements for states and subrecipients
Each state reports to CMS on a fixed schedule. Subrecipients report to their state. This page covers both levels and links to the CMS sources.
What state RHT offices report to CMS
Each state sends CMS three quarterly reports and one annual report each year. The annual report takes the place of the fourth quarterly report. CMS uses it to set the state's workload funding for the next budget period.
Next due dates
| Report | Period covered | Due date | Source |
|---|---|---|---|
| Quarterly Report #1 | Aug 1 – Oct 30, 2026 | Nov 29, 2026 (Sunday; moves to Mon Nov 30) | CMS-10949 Supporting Statement A v9, Table 2 |
| Quarterly Report #2 | Oct 31, 2026 – Jan 30, 2027 | Mar 1, 2027 | CMS-10949 Supporting Statement A v9, Table 2 |
| Quarterly Report #3 | Jan 31 – Apr 30, 2027 | May 30, 2027 (Sunday; moves to the next business day) | CMS-10949 Supporting Statement A v9, Table 2 |
| Annual Report #2 | Aug 1, 2026 – Jul 31, 2027 | Aug 30, 2027 | CMS-10949 Supporting Statement A v9, Table 1 |
States submit in GrantSolutions. Subrecipients report to their state on the state's schedule.
Reporting schedule
| Report | Period covered | Due |
|---|---|---|
| Annual Report #1 | Dec 29, 2025 – Jul 31, 2026 | Aug 31, 2026 |
| Quarterly Report #1 | Aug 1 – Oct 30, 2026 | Nov 29, 2026 |
| Quarterly Report #2 | Oct 31, 2026 – Jan 30, 2027 | Mar 1, 2027 |
| Quarterly Report #3 | Jan 31 – Apr 30, 2027 | May 30, 2027 |
| Annual Report #2 | Aug 1, 2026 – Jul 31, 2027 | Aug 30, 2027 |
| Annual Reports #3 to #5 | Aug 1 – Jul 31 of each year | Aug 30 of 2028, 2029 and 2030 |
| Quarterly Reports #4 to #13 | Aug 1 – Oct 30, Oct 31 – Jan 30, Jan 31 – Apr 30 | Nov 29, Mar 1, May 30 (Feb 29 in 2028) |
| Final Report | Dec 29, 2025 – Oct 30, 2030 | Feb 27, 2031 |
There is no quarterly report for May 1 to Jul 31. The annual report covers that period.
A due date on a weekend moves to the next business day. For this reason, Annual Report #1 moved from Sunday, Aug 30, 2026, to Monday, Aug 31, 2026. Nov 29, 2026 and May 30, 2027 also fall on a Sunday.
Each annual report goes in with the state's non-competing continuation (NCC) application. The NCC is due about 60 days before the budget period ends.
How states submit
States submit in GrantSolutions. GrantSolutions is the official system of record for the program.
The first annual report used a CMS Excel template. Later reports start in a CMS web tool, MDCT RHTP. The state exports each report from the tool and uploads it to GrantSolutions.
Each completed checkpoint needs evidence. CMS examples include a project plan, a go-live memo, an executed contract and a utilization report.
What each report contains
| Element | Annual report | Quarterly report | Scored by CMS |
|---|---|---|---|
| Initiative progress narrative | Required | Optional | No |
| Number of people served | Required | Not collected | No |
| Initiative metrics, with value and as-of date | Required | Optional | No |
| Initiative checkpoints, with evidence | Required | Required | Yes |
| State policy action commitments | Required | Required | Yes |
| Obligated and spent funds | Required | Required | No |
| Success stories | Required | Optional | No |
| Sustainability planning | Required | Not collected | No |
| Definition of "rural area" | First annual report only | Not collected | No |
The quarterly report is a subset of the annual report. Quarterly data rolls up into the annual report.
For people served, CMS asks for an exact count of the people who benefited during the period. A reasonable estimate is allowed when there is no exact count. Future projections do not count.
Metric rules
- Each initiative needs at least four quantifiable metrics.
- At least one of the four must show results at county or community level.
- Each metric value goes in with the date it was measured.
- CMS must approve any metric a state adds or removes.
- CMS expects states to start reporting outcome progress by 2028 at the latest.
What rides on the annual report
CMS recalculates each state's technical score from the annual report. The new score sets the state's workload funding for the next budget period.
The rural facility and population score does not change. CMS calculated it once, from data available at application time in late 2025.
A missed required report is a violation of the award. The state has 90 days after CMS gives notice to fix it. If the state does not fix it, CMS may recover past payments and withhold further baseline and workload funding.
What states report about subrecipients and vendors
Each RHT dollar a state pays out goes against an obligation to a first-tier entity. A first-tier entity holds a direct agreement with the state. It can be a subrecipient or a contractor.
From Quarterly Report #1, states also report downstream entities. A downstream entity receives RHT funds from a first-tier entity. A subcontractor that receives at least $30,000 of RHT funds goes on the Downstream Reporting tab. CMS names SaaS IT vendors as one example of a contractor.
Federal award terms flow down to subrecipients, and that includes annual and quarterly reporting. No subrecipient can opt out of reporting and checkpoint requirements.
Standard federal reports
The NOFO also lists the standard post-award reports:
- Progress reports
- Federal Financial Report (FFR)
- FFATA subaward reporting, now filed in SAM.gov
- SAM.gov responsibility and qualification records
- Payment Management System (PMS) reports
- Audit reporting through the Federal Audit Clearinghouse
- Workplan updates
- Debarment, suspension, ineligibility and voluntary exclusion certification
- The annual non-competing continuation (NCC) application
Administrative costs can use no more than 10% of a state's allotment for each budget period. The cap covers direct and indirect administrative costs.
How do states prepare RHT Quarterly Report #1?
Quarterly Report #1 is the first RHT report in the CMS web tool, MDCT RHTP. It is also the first report with downstream entities. The steps below follow the CMS guides.
What period does Quarterly Report #1 cover, and when is it due?
Quarterly Report #1 covers Aug 1 to Oct 30, 2026.
CMS lists the due date as Nov 29, 2026. That date is a Sunday. CMS-10949 Supporting Statement A v9, Table 2, says a deadline on a weekend reverts to the next business day. The report is therefore due Monday, Nov 30, 2026.
All later dates are in the Next due dates table above.
What goes in a quarterly report?
A quarterly report is a subset of the annual report. The State Reporting Expectations Guide, Section IV, sets these quarterly elements:
- Required: initiative checkpoints, state policy action commitments, and obligated and spent funds.
- Optional: the initiative progress narrative, metrics and success stories.
CMS scores two of these elements: initiative checkpoints and state policy action commitments. Each checkpoint update needs evidence. Each status change on a policy action needs a document or a direct URL.
People served is not in the quarterly report. CMS collects it only in the annual report. The full element list is in What each report contains.
What is new in Quarterly Report #1: downstream entities
The first annual report needed only first-tier entities. From Quarterly Report #1, states also complete the Downstream Reporting tab. A subcontractor that receives at least $30,000 of RHT funds goes on that tab.
The financial tabs also change. From Quarterly Report #1, states have Budget Period 1 and Budget Period 2 funds, with a separate Excel workbook for each budget period. The state uploads the workbooks to the web tool. The rules for who counts as a downstream entity are in What states report about subrecipients and vendors. For budget lines, see the budget kit.
A six-week prep plan for Nov 30
This is our suggested schedule. CMS does not set these weekly steps. Each step maps to a CMS requirement, which is named in brackets.
| Week | Dates (2026) | Step |
|---|---|---|
| 1 | Oct 19–23 | List each first-tier entity. Under each one, list its downstream entities, including each subcontractor at $30,000 or more. [Obligated and Spent Funds Guide] |
| 2 | Oct 26–30 | Ask each first-tier entity for checkpoint status and evidence through Oct 30, the last day of the period. [Guide, evidentiary documentation] |
| 3 | Nov 2–6 | Collect obligated, spent and downstream amounts as of Oct 30. Use one workbook for each budget period. [Obligated and Spent Funds Guide] |
| 4 | Nov 9–13 | Update the status of each state policy action commitment. Attach a document or a direct URL for each change. Name evidence files by state, initiative and checkpoint. [Guide, evidentiary documentation] |
| 5 | Nov 16–20 | Decide whether to send the optional narrative, metrics and success stories. Enter the report in MDCT RHTP. You can use "Submit for Review" to send a draft to your Project Officer. [Guide, Sections IV and VIII] |
| 6 | Nov 23–30 | Select "Submit Report" before the deadline. Then export the package and upload it to GrantSolutions. [Guide, Section VIII] |
The MDCT Help Desk works 9 am to 5 pm ET, Monday to Friday, and closes on holidays. Thanksgiving is Nov 26. Its address is MDCT_help@cms.hhs.gov.
How state offices get the grantee numbers
People-served counts and county-level metric values start with grantee data. A state office collects them from every subrecipient before each due date.
In DispatchCare, each grantee records each mission and its outcome in the same fields. A request can come from the hospital's EHR. Staff can also create a request in the DispatchCare web app or mobile app.
Each completed mission carries its timestamps and the patient's address. Your office can count missions and residents served by county across all grantees. The fields match in every county, so you do not chase a spreadsheet from each grantee before a due date.
DispatchCare does not file reports with CMS. It does not score checkpoints. Your office decides how mission counts feed each initiative's people-served figure and metrics.
DispatchCare is a VectorCare product. VectorCare is a vendor or subcontractor to subrecipients. It does not administer RHT funds.
What subrecipients report to the state
Your state sets your due dates and formats. The state must meet the CMS dates above. Plan for state data requests before each CMS due date.
Four obligations to plan for
Performance reporting
Progress against the measures in your state's approved plan, on the cadence the state sets, commonly quarterly, with an annual roll-up.
Uniform Guidance (2 CFR 200)
Allowability, internal controls, procurement standards, subrecipient monitoring and, where thresholds are met, single audit requirements.
FFATA / subaward transparency
Federal reporting of subawards above the applicable threshold, including entity identifiers and award details.
Record retention
Program records generally retained for at least three years after submission of the final expenditure report, longer if litigation or audit is open.
Design your data capture backwards
The single most common failure is a program that runs for two quarters and then tries to reconstruct its numbers. Decide the measures first, encode them as required fields on mission closure, and the report becomes an export.
Fields worth making mandatory from day one:
- Referral source, referral timestamp and first-contact timestamp.
- Protocol used and visit disposition, including exception reasons.
- Escalations to medical control and their outcome.
- Cohort identifier so utilization can be joined to hospital or claims data later.
- Geography at the level your state reports on: county, and rural classification.
Last reviewed:
Sources
- CMS Rural Health Transformation Program
- RHT Program NOFO, CMS-RHT-26-001
- CMS RHT Reporting and Rescoring Webinar, Feb 25, 2026
- CMS-10949 RHT Program Reporting (OMB 0938-1498)
- CMS-10949 State Reporting Expectations Guide, Aug 11, 2026
- CMS-10949 Obligated and Spent Funds Reporting Guide, Aug 13, 2026
- CMS RHT Program FAQs
- CMS RHT Post-Award FAQs, Sep 2026
- 2 CFR Part 200 (Uniform Guidance)
- 2 CFR 200.334, record retention
- FFATA subaward reporting (SAM.gov)
Questions buyers ask
States file three quarterly reports and one annual report each year. Annual reports are due Aug 30 from 2027 to 2030. Annual Report #1 was due Aug 31, 2026, because Aug 30 fell on a Sunday. Quarterly reports are due Nov 29, Mar 1 and May 30, and a weekend date moves to the next business day. The final report covers Dec 29, 2025 to Oct 30, 2030. It is due Feb 27, 2031.
CMS recalculates each state's technical score from the annual report. That score sets the state's workload funding for the next budget period. If a state misses a required report, it has 90 days after notice to fix it. After that, CMS may recover past payments and withhold further funding.
No. The state files each report with CMS and decides what goes in it. DispatchCare, powered by VectorCare, gives each grantee the same mission and outcome fields, so your office can count them across grantees.
2 CFR 200.334 sets the rule. Keep federal award records for three years from the date you submit your final financial report. Keep them longer if litigation, a claim or an audit starts before the three years end.
It depends on your state's approved RHT plan; the full answer and where to check are in the RHT budget kit at dispatchcare.com/rural-health-transformation/budget-kit.
The hospital's own ADT and registration data is joined to enrolled cohorts in the BI layer. No HIE feed is required for a single-hospital view.
See a mission go from the chart to the home and back.
A 15-minute walkthrough with a coordinator view, a CP program view and the dashboard your sponsor will read.