• No results found

Medicare Fee-For-Service (FFS) Hospital Readmissions: Q Q3 2014

N/A
N/A
Protected

Academic year: 2021

Share "Medicare Fee-For-Service (FFS) Hospital Readmissions: Q Q3 2014"

Copied!
18
0
0

Loading.... (view fulltext now)

Full text

(1)

Medicare Fee-For-Service (FFS)

Hospital Readmissions:

Q4 2013–Q3 2014

State of California

Please contact Michelle Pastrano-Bower via email at mpastrano@hsag.com

or by phone at 818.265.4648 for additional information.

(2)

Statewide Overview

Table 1: 30-Day All-Cause Readmission Rates—Q4 2013–Q3 2014

Q4 13 Q1 14 Q2 14 Q3 14 18.6% 18.4% 18.3% 18.3% 18.3% 138,758/747,069 33,131/180,312 34,380/188,245 32,672/178,916 31,352/171,423 Nation1 C alifornia Baseline (CY 2013) Current 18.0%

Table 2: Number of Emergency Department (ED) Visits—Q4 2013–Q3 2014

Q4 2013 Q1 2014 Q2 2014 Q3 2014

California 266,441 271,714 273,935 275,208

Table 3: Number of Observation Stays—Q4 2013–Q3 2014

Q4 2013 Q1 2014 Q2 2014 Q3 2014

California 28,804 27,456 27,649 27,875

1

Table 4: All-Cause Average Readmissions Rates by Region

[state_img]

Region Average

Rate Re gion 9 8.5% Re gion 7 12.6% Re gion 20 14.2% Re gion 11 14.2% Re gion 6 14.4% Re gion 21 14.6% Re gion 14 14.8% Re gion 5 16.5% Re gion 13 16.9% Re gion 18 17.1% Re gion 17 17.2% Re gion 3 17.3% Re gion 16 17.5% Re gion 10 17.9% Re gion 1 18.2% Re gion 2 18.2% Re gion 12 18.2% Re gion 15 18.4% Re gion 19 19.5% Re gion 8 20.0% Re gion 4 21.0% 1

(3)

Figure 1: California and National Outpatient ED Visits, Observation Stays, and Inpatient Admissions

2,3 0 50 100 150 200 250 300 Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 En co un te rs b y Th ou sa nd s

California ED Visits California Observation Stays California Admissions

0.5 1 1.5 2 2.5 3 3.5 4 En co un te rs b y M illio ns

(4)

Table 5: Discharge Distribution after Inpatient Hospitalization for All Causes—Q4 2013–Q3 2014

N % N % N % N % N % Home 17.2% 353,622 60,757 43,259 71.2% 17,498 28.8% 10,439 17.2% 11,622 19.1% 15,235 25.1% 11,703 19.3% 11,758 19.4% SNF 20.8% 170,745 35,519 25,347 71.4% 10,172 28.6% 4,993 14.1% 6,458 18.2% 9,232 26.0% 7,316 20.6% 7,520 21.2% HHA 19.2% 126,002 24,209 18,811 77.7% 5,398 22.3% 3,908 16.1% 4,771 19.7% 6,256 25.8% 4,694 19.4% 4,580 18.9% Hospice 3.5% 16,384 572 385 67.3% 187 32.7% 111 19.4% 112 19.6% 138 24.1% 106 18.5% 105 18.4% O the r 20.1% 52,143 10,478 6,008 57.3% 4,470 42.7% 2,599 24.8% 1,711 16.3% 2,201 21.0% 1,797 17.2% 2,170 20.7% Total 18.3% 718,896 131,535 93,810 71.3% 37,725 28.7% 22,050 16.8% 24,674 18.8% 33,062 25.1% 25,616 19.5% 26,133 19.9% 22-30 Days C alifornia 30-Day Readmits to

Different Hospital Days to Readmission

N % N % 0-3 Days 4-7 Days 8-14 Days 15-21 Days Group Discharged ToSetting Readmit Rate30-Day Discharges within 30 DaysReadmits

30-Day Readmits to Same Hospital

Figure 2: 30-Day All-Cause Readmission Rates

4

15.5% 16.0% 16.5% 17.0% 17.5% 18.0% 18.5% 19.0% 19.5% 20.0% Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 All -C au se Rea dm issi on Ra te State Nation 4

(5)

Table 6: Discharge Distribution after Inpatient Hospitalization for Acute Myocardial Infarction (AMI)—Q4 2013–Q3 2014

N % N % N % N % N % Home 16.2% 8,593 1,395 940 67.4% 455 32.6% 315 22.6% 280 20.1% 318 22.8% 233 16.7% 249 17.8% SNF 24.3% 2,371 575 383 66.6% 192 33.4% 93 16.2% 129 22.4% 153 26.6% 87 15.1% 113 19.7% HHA 23.0% 2,213 509 376 73.9% 133 26.1% 91 17.9% 89 17.5% 154 30.3% 91 17.9% 84 16.5% Hospice 4.1% 341 14 10 71.4% 4 28.6% 2 14.3% 3 21.4% 3 21.4% 2 14.3% 4 28.6% O the r 27.7% 1,044 289 156 54.0% 133 46.0% 111 38.4% 49 17.0% 43 14.9% 41 14.2% 45 15.6% Total 19.1% 14,562 2,782 1,865 67.0% 917 33.0% 612 22.0% 550 19.8% 671 24.1% 454 16.3% 495 17.8% 22-30 Days C alifornia 30-Day Readmits to

Different Hospital Days to Readmission

N % N % 0-3 Days 4-7 Days 8-14 Days 15-21 Days Group Discharged ToSetting Readmit Rate30-Day Discharges within 30 DaysReadmits

30-Day Readmits to Same Hospital

Figure 3: 30-Day AMI Readmission Rates

5

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 AM I Rea dm issi on Ra te State Nation

(6)

Table 7: Discharge Distribution after Inpatient Hospitalization for Heart Failure (HF)—Q4 2013–Q3 2014

N % N % N % N % N % Home 24.0% 17,043 4,094 3,089 75.5% 1,005 24.5% 607 14.8% 719 17.6% 1,010 24.7% 880 21.5% 878 21.4% SNF 27.3% 6,580 1,794 1,323 73.7% 471 26.3% 242 13.5% 297 16.6% 474 26.4% 375 20.9% 406 22.6% HHA 25.4% 7,704 1,954 1,536 78.6% 418 21.4% 276 14.1% 352 18.0% 498 25.5% 428 21.9% 400 20.5% Hospice 4.7% 1,049 49 38 77.6% 11 22.4% 9 18.4% 11 22.4% 13 26.5% 9 18.4% 7 14.3% O the r 29.5% 1,723 509 299 58.7% 210 41.3% 126 24.8% 88 17.3% 110 21.6% 83 16.3% 102 20.0% Total 24.6% 34,099 8,400 6,285 74.8% 2,115 25.2% 1,260 15.0% 1,467 17.5% 2,105 25.1% 1,775 21.1% 1,793 21.3% 22-30 Days C alifornia 30-Day Readmits to

Different Hospital Days to Readmission

N % N % 0-3 Days 4-7 Days 8-14 Days 15-21 Days Group Discharged ToSetting Readmit Rate30-Day Discharges within 30 DaysReadmits

30-Day Readmits to Same Hospital

Figure 4: 30-Day HF Readmission Rates

6

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 HF Rea dm issi on Ra te State Nation 6

National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are from July 1, 2010, through June 30, 2013.

(7)

Table 8: Discharge Distribution after Inpatient Hospitalization for Pneumonia (PNE)—Q4 2013–Q3 2014

N % N % N % N % N % Home 15.9% 12,254 1,949 1,500 77.0% 449 23.0% 358 18.4% 331 17.0% 488 25.0% 379 19.4% 393 20.2% SNF 22.4% 6,345 1,419 1,053 74.2% 366 25.8% 174 12.3% 250 17.6% 375 26.4% 303 21.4% 317 22.3% HHA 20.4% 4,682 955 772 80.8% 183 19.2% 151 15.8% 200 20.9% 255 26.7% 178 18.6% 171 17.9% Hospice 3.0% 735 22 15 68.2% 7 31.8% 2 9.1% 5 22.7% 5 22.7% 7 31.8% 3 13.6% O the r 19.4% 1,695 329 177 53.8% 152 46.2% 90 27.4% 51 15.5% 72 21.9% 44 13.4% 72 21.9% Total 18.2% 25,711 4,674 3,517 75.2% 1,157 24.8% 775 16.6% 837 17.9% 1,195 25.6% 911 19.5% 956 20.5% 22-30 Days C alifornia 30-Day Readmits to

Different Hospital Days to Readmission

N % N % 0-3 Days 4-7 Days 8-14 Days 15-21 Days Group Discharged ToSetting Readmit Rate30-Day Discharges within 30 DaysReadmits

30-Day Readmits to Same Hospital

Figure 5: 30-Day PNE Readmission Rates

7

15.5% 16.0% 16.5% 17.0% 17.5% 18.0% 18.5% 19.0% 19.5% 20.0% 20.5% Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 PN E Rea dm issi on Ra te State Nation

(8)

Table 9: Discharge Distribution after Inpatient Hospitalization for Chronic Obstructive Pulmonary Disease (COPD)—Q4 2013–Q3 2014

N % N % N % N % N % Home 20.8% 12,496 2,597 2,001 77.1% 596 22.9% 412 15.9% 386 14.9% 677 26.1% 554 21.3% 568 21.9% SNF 24.9% 3,987 991 725 73.2% 266 26.8% 133 13.4% 158 15.9% 276 27.9% 220 22.2% 204 20.6% HHA 24.6% 3,963 973 796 81.8% 177 18.2% 130 13.4% 180 18.5% 259 26.6% 206 21.2% 198 20.3% Hospice 6.7% 345 23 15 65.2% 8 34.8% 3 13.0% 5 21.7% 6 26.1% 3 13.0% 6 26.1% O the r 26.4% 1,510 398 242 60.8% 156 39.2% 102 25.6% 68 17.1% 89 22.4% 65 16.3% 74 18.6% Total 22.3% 22,301 4,982 3,779 75.9% 1,203 24.1% 780 15.7% 797 16.0% 1,307 26.2% 1,048 21.0% 1,050 21.1% 22-30 Days C alifornia 30-Day Readmits to

Different Hospital Days to Readmission

N % N % 0-3 Days 4-7 Days 8-14 Days 15-21 Days Group Discharged ToSetting Readmit Rate30-Day Discharges within 30 DaysReadmits

30-Day Readmits to Same Hospital

Figure 6: 30-Day COPD Readmission Rates

8

18.0% 19.0% 20.0% 21.0% 22.0% 23.0% 24.0% 25.0% Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 CO PD Rea dm issi on Ra te State Nation 8

National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are from July 1, 2010, through June 30, 2013.

(9)

Table 10: Discharge Distribution after Inpatient Hospitalization for Total Hip/Knee Replacement (THA/TKA)—Q4 2013–Q3 2014

N % N % N % N % N % Home 3.6% 5,999 218 133 61.0% 85 39.0% 49 22.5% 42 19.3% 46 21.1% 41 18.8% 40 18.3% SNF 5.7% 8,662 490 351 71.6% 139 28.4% 90 18.4% 75 15.3% 120 24.5% 100 20.4% 105 21.4% HHA 3.2% 14,476 456 310 68.0% 146 32.0% 97 21.3% 87 19.1% 113 24.8% 82 18.0% 77 16.9% Hospice 28.6% 7 2 1 50.0% 1 50.0% 1 50.0% 1 50.0% 0 0.0% 0 0.0% 0 0.0% O the r 6.0% 1,829 110 75 68.2% 35 31.8% 21 19.1% 15 13.6% 35 31.8% 23 20.9% 16 14.5% Total 4.1% 30,973 1,276 870 68.2% 406 31.8% 258 20.2% 220 17.2% 314 24.6% 246 19.3% 238 18.7% 22-30 Days C alifornia 30-Day Readmits to

Different Hospital Days to Readmission

N % N % 0-3 Days 4-7 Days 8-14 Days 15-21 Days Group Discharged ToSetting Readmit Rate30-Day Discharges within 30 DaysReadmits

30-Day Readmits to Same Hospital

Figure 7: 30-Day THA/TKA Readmission Rates

9

0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% Q2 2011 Q3 2011 Q4 2011 Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 2014 Q3 2014 TH A/ TK A Rea dm issi on Ra te State Nation

(10)

Methodology and Data Source Information

The dashboard provides information regarding the state’s all-cause, acute myocardial infarction (AMI), heart failure (HF),

pneumonia (PNE), chronic obstructive pulmonary disease (COPD), and total hip/knee replacement (THA/TKA) 30-day

readmissions. Rates are calculated using hospital inpatient claims for Medicare Fee-For-Service (FFS) beneficiaries. Data

in this report are limited to Medicare FFS Part-A data for discharges from October 1, 2013, through September 30, 2014.

10

Readmission rates in this report are not calculated using the 30-day risk standardized methodology for the Centers for

Medicare & Medicaid Services (CMS) Hospital Readmission Reduction Program or found on hospitalcompare.hhs.gov.

Readmission rates are updated quarterly with the most current time period’s data. The time periods illustrated in this

document are examples only and may not reflect the most current data period.

Pages 1 and 2 contain the following information.

Summary table

Regional map

Emergency department (ED) visits and

observation stays tables

Outpatient ED visits, observation stays, and inpatient

admissions graphs

Example Dashboard (Pages 1 and 2)

10

The CSAT data file was used for this analysis. The CSAT data file is provided to HSAG by CMS. The CSAT data file includes Part A and Part B claims for FFS beneficiaries.

1

3

4

2

1

2

3

(11)

Example Outpatient ED Visits, Observation Stays, and Inpatient Admissions Dashboard

Summary Table

The summary table contains the state’s baseline and current 30-day readmission rates, including the numerator and

denominator for each quarter. All rates are calculated from Medicare inpatient claims for FFS beneficiaries. See page D

for measure definitions. The summary table also includes the national rate. Due to availability of the data, the national

rate may be calculated from a different time period.

ED Visits and Observation Stays Tables

The ED visits and observation stays tables provide the count of ED visits and observation stays, respectively, for each

quarter in the current report period. ED visits and observation stays resulting in an inpatient stay are not included in the

counts.

Regional Map

The state of California was divided into 21 regions, which are defined similarly to the regions established by the Hospital

Council of Northern and Central California, the Hospital Association of Southern California, and the Hospital Association

of San Diego and Imperial Counties. Aggregate readmission rates are calculated for each region using the hospitals

located in the region. The table shows regional readmission rates for each region.

Outpatient ED Visits, Observation Stays, and Inpatient Admissions

The two graphs depict the volume of outpatient ED visits, observation stays, and inpatient admissions for the state and the

nation. The purpose of each is to monitor acute care utilization at the state and national levels. The counts are calculated

1

2

3

4

4

(12)

Pages 3 through 8 provide the following data for all-cause and disease-specific 30-day readmissions:

Discharge distribution table

Line graph

Example Dashboard (discharge distribution and line graph)

Discharge Distribution Table

The discharge distribution table shows the 30-day readmission rates by discharge setting, the proportion of readmissions

that occurred back to the admitting hospital or another hospital, and the number of days from discharge to readmission.

Readmissions from home, skilled nursing facilities (SNFs), home health agencies (HHAs), and hospice are determined by

the patient discharge status on the index hospitalization claim. All other discharge status codes are bucketed into the

“Other” category.

Line Graph

The purpose of the readmission line graph is to track readmission rates over time. The line graph shows the state’s (green

line) improvement in relation to the nation (orange line). Rates are calculated quarterly.

5

6

5

6

5

6

(13)

Measure Definitions

All-Cause 30-Day Readmission Rates

All-cause readmission rates are calculated as the percentage of hospital admissions that occurred within 30 days of an

index admission for any condition. Each hospital admission within 30 days following an index admission is considered a

readmission (e.g., a beneficiary with four readmissions in the measurement period counts as four separate readmissions).

Any beneficiary who dies in the hospital or is transferred to another hospital on the same day is excluded from the

calculation. Readmissions from home, SNFs, HHAs, and hospice are determined by the patient discharge status on the

index hospitalization claim.

Condition-Specific 30-Day Readmission Rates

When calculating condition-specific readmission rates, an admission is included if the principal diagnosis/procedure code

for the admission specifies that disease (i.e., AMI, HF, PNE, COPD, and THA/TKA). Condition-specific readmissions

include all-cause admissions that occur within 30 days of an index admission for the specific condition (e.g., a beneficiary

with an index admission of AMI who is readmitted for a urinary tract infection [UTI] is considered an AMI readmission).

Any beneficiary who dies in the hospital or is transferred to another hospital on the same day is excluded from the

calculation. The following table lists the codes used to identify the discharges for AMI, HF, PNE, COPD, and THA/TKA.

Disease Diagnosis Codes

AMI11 410.00, 410.01, 410.10, 410.11, 410.20, 410.21, 410.30, 410.31, 410.40, 410.41, 410.50, 410.51, 410.60, 410.61, 410.70, 410.71, 410.80, 410.81, 410.90, 410.91 HF 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428 PNE 480.0, 480.1, 480.2, 480.3, 480.8, 480.9, 481.0, 482.0, 482.1, 482.2, 482.3, 482.31, 482.32, 482.39, 482.4, 482.41, 482.42, 482.49, 482.81, 482.82, 482.83, 482.84, 482.89, 482.9, 483.0, 483.1, 483.8, 485.0, 486.0, 487.0, 488.11 COPD 491.21, 491.22, 491.8, 491.9, 492.8, 493.20, 493.21, 493.22, 496, 518.81*, 518.82*, 518.84*, 799.1*

Procedure Procedural Codes

THA/TKA12 81.51, 81.54

* Principal diagnosis when combined with a secondary diagnosis of COPD (491.21, 491.22, 493.21, or 493.22)

ED Visits and Observation Stays

The following table lists the codes used to identify ED visits and observation stays.

Revenue Codes HCPCS

ED Visits 0450, 0451, 0452, 0456, 0459, 0981

(14)

California Hospitals by Region

Region 1: San Diego/Imperial

Alvarado Hospital Medical Center Palomar Health Downtown Campus Scripps Mercy Hospital

Alvarado Parkway Institute Behavioral Health

System Paradise Valley Hospital Sharp Chula Vista Medical Center

Aurora San Diego Pioneers Memorial Healthcare District Sharp Coronado Hospital And Healthcare Center

El Centro Regional Medical Center Pomerado Hospital Sharp Memorial Hospital

Fallbrook Hospital Scripps Green Hospital Sharp Mesa Vista Hospital

Grossmont Hospital Scripps Memorial Hospital - Encinitas Tri-City Medical Center

Kaiser Foundation Hospital - San Diego Scripps Memorial Hospital La Jolla University Of California San Diego Medical Center

Region 2: San Bernardino/Riverside

Arrowhead Regional Medical Center Hi-Desert Medical Center Parkview Community Hospital Medical Center

Barstow Community Hospital John F Kennedy Memorial Hospital, Inc. Redlands Community Hospital

Bear Valley Community Hospital Kaiser Foundation Hospital Fontana Riverside Community Hospital

Canyon Ridge Hospital Kaiser Foundation Hospital, Riverside Riverside County Regional Medical Center

Chino Valley Medical Center Kaiser Foundation Hospital-Moreno Valley San Antonio Community Hospital

Colorado River Medical Center Loma Linda Behavioral Med Ctr San Gorgonio Memorial Hospital

Community Hospital Of San Bernardino Loma Linda University Medical Center Southwest Healthcare System

Corona Regional Medical Center Loma Linda University Medical Center-Murrieta St. Bernardine Medical Center

Desert Regional Medical Center Menifee Valley Medical Center St Mary Medical Center

Desert Valley Hospital Montclair Hospital Medical Center Temecula Valley Hospital

Eisenhower Medical Center Mountains Community Hospital Victor Valley Community Hospital

Hemet Valley Medical Center Palo Verde Hospital Vista Behavioral Hospital

Region 3: Orange

AHMC Anaheim Regional Medical Center Hoag Orthopedic Institute Placentia Linda Hospital

Anaheim General Hospital Huntington Beach Hospital Saddleback Memorial Medical Center

Chapman Medical Center Kaiser Foundation Hospital Anaheim St Joseph Hospital

Coastal Communities Hospital La Palma Intercommunity Hospital St Jude Medical Center

College Hospital Costa Mesa Los Alamitos Medical Center University Of California Irvine Med Center

Fairview Developmental Center Mission Hospital Regional Med Center West Anaheim Medical Center

Fountain Valley Regional Hospital & Medical

Center Newport Bay Hospital Western Medical Center Hosp Anaheim

Garden Grove Hospital & Medical Center Orange Coast Memorial Medical Center Western Medical Center Santa Ana

(15)

Region 4: Los Angeles

Alhambra Hospital Medical Center Hollywood Community Hospital Of Hollywood Pacific Hospital Of Long Beach

Antelope Valley Hospital Med Center Hollywood Presbyterian Medical Center Pacifica Hospital Of The Valley

Aurora Charter Oak Huntington Memorial Hospital Palmdale Regional Medical Center

Aurora Las Encinas Hospital Joyce Eisenberg Keefer Medical Center Pomona Valley Hospital Medical Center

Bellflower Medical Center Kaiser Foundation Hospital - Baldwin Park Presbyterian Intercommunity Hospital

Beverly Hospital Kaiser Foundation Hospital - Downey Providence Holy Cross Medical Center

BHC Alhambra Hosp Kaiser Foundation Hospital - Los Angeles Providence Little Co Of Mary Med Ctr San Pedro

Brotman Medical Center Kaiser Foundation Hospital - Panorama City Providence Little Company Of Mary Med Ctr Torrance

California Hospital Medical Center La Kaiser Foundation Hospital - South Bay Providence Saint Joseph Medical Ctr

Catalina Island Medical Center Kaiser Foundation Hospital - West La Providence Tarzana Medical Center

Cedars-Sinai Medical Center Kaiser Foundation Hospital - Woodland Hills Resnick Neuropsychiatric Hospital At UCLA

Centinela Hospital Medical Center Keck Hospital Of USC Ronald Reagan UCLA Medical Center

Citrus Valley Medical Center-IC Campus Lac/Harbor-UCLA Med Center Saint Francis Medical Center

City Of Hope Helford Clinical Research Hospital Lac/Olive View-UCLA Medical Center Saint John's Health Center

Coast Plaza Hospital Lac/Rancho Los Amigos National Rehabilitation Ctr Saint Vincent Medical Center

College Hospital LAC+USC Medical Center San Dimas Community Hospital

College Medical Center Lakewood Regional Medical Center San Gabriel Valley Medical Center

Community And Mission Hospital Of

Huntington Park Lanterman Developmental Center Santa Monica - UCLA Med Ctr & Orthopaedic Hospital

Community Hospital Of Long Beach Long Beach Memorial Medical Center Sherman Oaks Hospital

Del Amo Hospital Los Angeles Community Hospital Silver Lake Medical Center

Doctors Hospital Of West Covina, Inc. Los Angeles Metropolitan Medical Ctr St Mary Medical Center

Downey Regional Medical Center Marina Del Rey Hospital Tarzana Treatment Center

East Los Angeles Doctors Hospital Memorial Hospital Of Gardena Temple Community Hospital

East Valley Hospital Medical Center Methodist Hospital Of Southern Ca Torrance Memorial Medical Center

Encino Hospital Medical Center Miracle Mile Medical Center Tri-City Regional Medical Center

Foothill Presbyterian Hospital Mission Community Hospital - Panorama USC Kenneth Norris Jr Cancer Hospital

Garfield Medical Center Monterey Park Hospital Valley Presbyterian Hospital

Glendale Adventist Medical Center Motion Picture & Television Hospital Verdugo Hills Hospital

Glendale Mem Hospital & Health Center Northridge Hospital Medical Center West Hills Hospital & Medical Center

Good Samaritan Hospital Olympia Medical Center White Memorial Medical Center

Greater El Monte Community Hospital Pacific Alliance Medical Center Whittier Hospital Medical Center

(16)

Region 5: Ventura

Aurora Vista Del Mar Hospital Ojai Valley Community Hospital St Johns Pleasant Valley Hospital

Community Memorial Hospital San

Buenaventura Santa Barbara County Psychiatric Health Facility St John’s Regional Medical Center

Los Robles Hospital & Medical Center Simi Valley Hospital & Health Care Services Ventura County Medical Center

Region 6: Santa Barbara

Goleta Valley Cottage Hospital Marian Regional Medical Center Santa Ynez Valley Cottage Hospital

Lompoc Valley Medical Center Santa Barbara Cottage Hospital

Region 7: San Luis Obispo

Arroyo Grande Community Hospital Ridgecrest Regional Hospital Twin Cities Community Hospital

French Hospital Medical Center Sierra Vista Regional Medical Center

Region 8: Kern

Bakersfield Heart Hospital Good Samaritan Hospital Mercy Hospital

Bakersfield Memorial Hospital Kern Medical Center San Joaquin Community Hospital

Delano Regional Medical Center Kern Valley Healthcare District Tehachapi Hospital

Region 9: Inyo/Mono

Mammoth Hospital Northern Inyo Hospital Southern Inyo Hospital

Region 10: Madera/Fresno/Kings/Tulare

Adventist Medical Center Corcoran District Hospital Madera Community Hospital

Adventist Medical Center - Reedley Fresno Heart And Surgical Hospital Porterville Developmental Center

Central Valley General Hospital Fresno Surgical Hospital Saint Agnes Medical Center

Clovis Community Medical Center Kaiser Foundation Hospital - Fresno Sierra View District Hospital

Coalinga Regional Medical Center Kaweah Delta Medical Center Tulare Regional Medical Center

Community Regional Medical Center

Region 11: Monterey/San Benito

Community Hospital Of The Monterey Peninsula Hazel Hawkins Memorial Hospital Salinas Valley Memorial Hospital

George L Mee Memorial Hospital Natividad Medical Center

Region 12: Stanislaus/Merced/Mariposa

Doctors Medical Center Kaiser Permanente Psychiatric Health Facility-Sant Mercy Medical Center

Emanuel Medical Center Inc. Memorial Medical Center Oak Valley District Hospital

(17)

Region 13: Santa Clara

El Camino Hospital Kaiser Foundation Hospital-Santa Clara Saint Louise Regional Hospital

Good Samaritan Hospital O'Connor Hospital Santa Clara Valley Medical Center

Kaiser Foundation Hospital-San Jose Regional Medical Center Of San Jose Stanford Hospital

Region 14: San Mateo/Santa Cruz

Dominican Hospital Langley Porter Psychiatric Institute Sequoia Hospital

Jewish Home Menlo Park Surgical Hospital Seton Medical Center

Kaiser Foundation Hospital - Redwood City Peninsula Medical Center Sutter Maternity & Surgery Center Of Santa Cruz

Kaiser Foundation Hospital - South San Francisco San Mateo Medical Center Watsonville Community Hospital

Region 15: San Francisco

California Pacific Medical Ctr - St. Luke's Campus John Muir Behavioral Health Center St Mary's Medical Center

California Pacific Medical Ctr-Davies Campus

Hosp Kaiser Foundation Hospital - San Francisco St. Helena Hospital Center For Behavioral Health

California Pacific Medical Ctr-Pacific Campus

Hosp Laguna Honda Hospital & Rehabilitation Center Telecare Heritage Psychiatric Health Facility

Chinese Hospital Saint Francis Memorial Hospital UCSF Medical Center

Fremont Hospital San Francisco General Hospital

Region 16: Solano/Contra Costa/Alameda

Alameda County Medical Center John Muir Medical Center - Walnut Creek Campus Northbay Vacavalley Hospital

Alameda Hospital Kaiser Foundation Hospital - Antioch San Leandro Hospital

Alta Bates Summit Medical Center Kaiser Foundation Hospital - Vacaville San Ramon Regional Medical Ctr

Alta Bates Summit Medical Center - Alta Bates

Camp Kaiser Foundation Hospital - Walnut Creek St Rose Hospital

Contra Costa Regional Medical Center Kaiser Foundation Hospital And Rehab Center Sutter Delta Medical Center

Doctors Medical Center-San Pablo Kaiser Foundation Hospital Fremont/Hayward Sutter Solano Medical Center

Eden Medical Center Kaiser Foundation Hospital Oakland/Richmond Valleycare Medical Center

John Muir Medical Center - Concord Campus Northbay Medical Center Washington Hospital

Region 17: San Joaquin/Amador/Calaveras/Tuolumne/Alpine

Dameron Hospital Mark Twain St Joseph's Hospital St Josephs Med Center Of Stockton

Doctors Hospital Of Manteca San Joaquin General Hospital Sutter Amador Hospital

Heritage Oaks Hospital Sierra Vista Hospital, Inc. Sutter Center For Psychiatry

(18)

Region 18: Yolo/Sacramento/Nevada/Placer/El Dorado

Barton Memorial Hospital Mercy Hospital Of Folsom Sutter General Hospital

Kaiser Foundation Hosp So Sacramento Mercy San Juan Medical Center Sutter Roseville Medical Center

Kaiser Foundation Hospital - Roseville Methodist Hospital Of Sacramento Tahoe Forest Hospital

Kaiser Foundation Hospital - Sacramento Sierra Nevada Memorial Hospital University Of California Davis Medical Center

Marshall Medical Center (1-Rh) Sutter Auburn Faith Hospital Woodland Memorial Hospital

Mercy General Hospital Sutter Davis Hospital

Region 19: Sutter/Yuba/Sierra/Plumas/Tehama/Glenn/Colusa/Butte

Aurora Behavioral Healthcare-Santa Rosa, LLC. Feather River Hospital Sempervirens

Biggs Gridley Memorial Hospital Glenn Medical Center Seneca District Hospital

Colusa Regional Medical Center Oroville Hospital St Elizabeth Community Hospital

Eastern Plumas Hospital - Portola Campus Plumas District Hospital Sutter Surgical Hospital - North Valley

Enloe Medical Center Rideout Memorial Hospital

Region 20: Marin/Napa/Sonoma/Lake/Mendocino/Humboldt/Del Norte

Frank R Howard Memorial Hospital Novato Community Hospital Sonoma Valley Hospital

Healdsburg District Hospital Palm Drive Hospital St Helena Hospital

Jerold Phelps Community Hospital Petaluma Valley Hospital St Joseph Hospital

Kaiser Foundation Hospital Queen Of The Valley Medical Center Sutter Coast Hospital

Kaiser Foundation Hospital-Santa Rosa Redbud Community Hospital Sutter Lakeside Hospital

Mad River Community Hospital Redwood Memorial Hospital Sutter Medical Center Of Santa Rosa

Marin General Hospital Santa Rosa Memorial Hospital Ukiah Valley Medical Center/Hospital D

Mendocino Coast District Hospital Sonoma Developmental Center

Region 21: Siskiyou/Modoc/Trinity/Shasta/Lassen

Banner Lassen Medical Center Mercy Medical Center Redding Shasta Regional Medical Center

Fairchild Medical Center Modoc Medical Center Surprise Valley Community Hospital

Mayers Memorial Hospital Patients' Hospital Of Redding Trinity Hospital

References

Related documents

These include: an integrated analysis of the Historical Administrative Data Study (HADS) designed to provide data on signi fi cant administrative predictors of suicides among the

The extracorporeal techniques most frequently employed for the removal of toxins are hemodialysis, continuous hemofiltration techniques, hemoperfusion and the molecular

The budget contains the operating budgets for the General Fund; one enterprise funds (the Congregate Housing Fund); four special revenue funds (Personal Use Fishery Fund, Water and

Activities/Associations : Board Certified in Clinical Health Psychology, ABPP; Medical Advisory Board, Collaborative for Excellence in Occupational Medicine; Fellow, American

Regulatory authority for additional short form if they must be carefully before one of a complaint should always be, keep any other barrier film to.. Strategies for a c qur

This specification describes the performance requirements for needle free jet injectors that use a sterile, single-dose, auto-disabling, needle-free syringe* intended for

Graduate School of International Relations and Pacific Studies University of California, San Diego IR/PS, 9500 Gilman Drive. La Jolla, CA 92093-0519 Antonio Yúnez-Naude PRECESAM-CEE

polygyny are recurrent in their narratives, and because they are more likely than Senegalese men married to European women to be stigmatized for “marrying out.” Because the