Rural Health Grant Reporting & Performance Measures

The FORHP Reporting Framework

FORHP grantees submit reports through the HRSA Electronic Handbooks (EHBs) system. Reporting requirements include both programmatic performance reports and financial reports, each with specific content, format, and timeline requirements. Late or incomplete reports can trigger conditions on your award and, in severe cases, delay or suspend future funding.

Unlike some federal programs that use a single standardized report form, FORHP reporting requirements vary by program type. Network Development grants have different performance measures than SHIP, which differ from RCORP or Telehealth grants. Understanding the specific requirements for your program is essential. Your Notice of Award (NoA) and the NOFO specify exactly which reports are required and when.

HRSA EHBs Performance Reporting

All FORHP performance reports are submitted through the HRSA EHBs system. The primary performance report for most FORHP grantees is the Bureau Performance Report (BPR), though some programs use additional or alternative reporting instruments.

Bureau Performance Report (BPR)

The BPR is the standard performance report for FORHP grants. It captures quantitative performance data, narrative progress descriptions, and self-assessment information. The BPR typically includes these sections:

• Performance measures: Quantitative data on required program measures, typically comparing actuals to the targets established in your application. Measures are program-specific but generally cover service delivery outputs, health outcomes, and process indicators.
• Work plan progress: Status updates on each milestone in your approved work plan, including explanation of any delays or modifications
• Narrative summary: Overall description of project progress, significant accomplishments, challenges encountered, and lessons learned
• Quality improvement: Description of how performance data has been used to improve service delivery or project implementation during the reporting period

Reporting Schedule

Most FORHP grants require annual performance reports, due within 90 days of the end of each budget year. Multi-year grants also require a final performance report at the end of the project period. Some programs require semi-annual or quarterly reporting — check your NoA for the specific schedule.

Program-Specific Performance Measures

Each FORHP program has its own set of required performance measures. These measures are established in the NOFO and finalized in your approved EHBs work plan. While the specific measures vary by program, they generally fall into several categories.

Network Development Measures

• Number and type of consortium/network members actively participating
• Number of collaborative activities conducted by the network
• Population reached through network activities
• Evidence of systems integration or service coordination improvements
• Health outcome measures specific to the network's focus area

SHIP Measures

• Number of hospitals participating in the state SHIP program
• Value-based purchasing participation rates and outcomes
• Quality measure reporting rates and performance improvement
• Health information technology adoption or enhancement milestones

Telehealth Measures

• Number of telehealth encounters by modality (video, store-and-forward, remote monitoring)
• Number of unique patients served through telehealth
• Provider satisfaction and patient satisfaction with telehealth services
• Clinical outcomes for conditions managed through telehealth
• Cost savings or avoided costs attributable to telehealth (e.g., avoided patient transfers)

RCORP Measures

• Number of individuals screened for substance use disorders
• Number of individuals receiving MAT (Medication-Assisted Treatment)
• Number receiving prevention, treatment, and recovery services (tracked separately across three buckets)
• Naloxone distribution and overdose reversal data
• Opioid-related overdose mortality rates in the service area (population-level outcome)

Network and Consortium Activity Documentation

For network-based grants, performance reporting extends beyond individual service delivery to consortium-level activities. Document and report:

• Governance meetings: Number of consortium meetings held, attendance by member organization, and key decisions made
• Member contributions: How each consortium member contributed to project activities during the reporting period (services delivered, resources provided, data shared)
• Collaboration outcomes: Specific outcomes that resulted from collaborative activity, not just individual member activity. What did the network accomplish that individual members could not have accomplished alone?
• Changes in consortium: Any changes in membership, governance, or partnership scope, and how those changes affected project implementation

SF-425 Financial Reporting

The SF-425 (Federal Financial Report) is the standard financial report for all HRSA grants, submitted through the HRSA EHBs Payment Management System. The SF-425 reports federal cash receipts, federal expenditures, and the unliquidated federal balance for the reporting period.

Key SF-425 Data Points

Your SF-425 data must be consistent with your organization's general ledger and financial records. HRSA and auditors will compare SF-425 reports to your accounting system. Discrepancies raise compliance concerns. For additional context on financial management, see the Budget & Financial Management guide.

No-Cost Extension Reporting

If you receive a no-cost extension (NCE) to extend your project period without additional funding, reporting requirements continue through the extended period. Key considerations:

• NCE justification: Document the specific reason for the extension request, the remaining activities to be completed, and a revised timeline showing completion within the extension period (typically up to 12 months)
• Continuing reports: Performance and financial reports remain due during the NCE period per the same schedule as the original grant
• Final reports: Final performance and financial reports are due 90 days after the end of the extended project period, not the original end date

Reporting Best Practices

Strong reporting demonstrates not just compliance but effective program management. These practices strengthen your relationship with your HRSA Project Officer and position you well for continuation funding:

Maintain Real-Time Data Systems

Do not wait until reporting season to begin collecting performance data. Implement data collection systems at the start of your project period that capture required measures as services are delivered. This enables quarterly internal review of performance against targets and early identification of problems.

Explain Variances

When actual performance differs significantly from targets — either above or below — explain why. A target of 200 patients served with an actual of 50 requires explanation. But so does an actual of 500 against a target of 200, which may signal that your original targets were poorly calibrated or that your service model has evolved.

Connect Activities to Outcomes

Report not just what you did (outputs) but what changed as a result (outcomes). "Conducted 12 telehealth clinic sessions serving 180 patients" is an output. Adding "resulting in 85% of patients with controlled A1C levels compared to 68% at baseline" connects the activity to a health outcome. This distinction directly affects how HRSA evaluates your program effectiveness.

Communicate with Your Project Officer

Your HRSA Project Officer (PO) is your primary federal contact. Do not wait for a site visit or report submission to communicate significant issues. If you are falling behind on your work plan, experiencing consortium challenges, or encountering compliance questions, contact your PO proactively. HRSA POs can provide technical assistance, approve scope modifications, and help you navigate challenges — but only if they know about them.