Medicare Fee-For-Service (FFS) Hospital Readmissions: Q3 2015 Q2 2016 State of Please contact Michelle Pastrano via email at MPastrano@hsag.com or by phone at 818.265.4648 for additional information This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. CA-11SOW-C.3-04122017-01
Overview Table 1: 30-Day All-Cause Readmission Rates Q3 2015 Q2 2016 1 Baseline Current (CY 2013) Q3 2015 Q4 2015 Q1 2016 Q2 2016 Q3 2015 to Q2 2016 138,632/747,457 33,131/177,025 32,950/179,489 35,444/192,221 33,325/180,300 134,850/729,035 18.5% 18.7% 18.4% 18.4% 18.5% 18.5% Nation 1 18.5% Table 2: Number of Emergency Department (ED) Visits Q3 2015 Q2 2016 Q3 2015 Q4 2015 Q1 2016 Q2 2016 291,906 286,717 298,591 290,459 Table 3: Number of Observation Stays Q3 2015 Q2 2016 Q3 2015 Q4 2015 Q1 2016 Q2 2016 29,500 29,586 30,178 29,660 1 National data are obtained from the Integrated Care for Populations and Communities (ICPC) Quarterly Scorecard and the most recent data available are through March 31, 2016. January 2017 (Q3 2015 Q2 2016) Page 1
Table 4: All-Cause Average Readmissions Rates by Region Region Average Rate Region 4 21.4% Region 19 19.1% Region 12 19.0% Region 2 19.0% Region 10 18.9% Region 8 18.7% Region 1 18.1% Region 15 18.1% Region 17 18.1% Region 5 18.0% Region 13 17.3% Region 3 17.3% Region 16 17.2% Region 18 16.4% Region 11 14.7% Region 20 14.6% Region 21 14.5% Region 14 14.4% Region 6 13.7% Region 7 13.0% Region 9 12.3% January 2017 (Q3 2015 Q2 2016) Page 2
Figure 1: and National Outpatient ED Visits, Observation Stays, and Inpatient Admissions 2,3 2 ED visits and observation stays resulting in an inpatient stay are not included in this calculation. 3 National data are obtained from the ICPC Quarterly Scorecard and the most recent data available are through March 31, 2016. January 2017 (Q3 2015 Q2 2016) Page 3
Table 5: Discharge Distribution after Inpatient Hospitalization for All Causes Q3 2015 Q2 2016 4 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 17.1% 350,722 59,979 40,657 67.8% 19,322 32.2% 10,675 17.8% 11,801 19.7% 14,869 24.8% 11,330 18.9% 11,304 18.8% SNF 21.4% 174,164 37,281 25,316 67.9% 11,965 32.1% 5,405 14.5% 6,807 18.3% 9,608 25.8% 7,598 20.4% 7,863 21.1% HHA 19.2% 136,804 26,249 19,874 75.7% 6,375 24.3% 4,419 16.8% 5,043 19.2% 6,674 25.4% 5,197 19.8% 4,916 18.7% Hospice 3.4% 18,065 609 388 63.7% 221 36.3% 131 21.5% 114 18.7% 137 22.5% 122 20.0% 105 17.2% Other 21.8% 49,280 10,732 5,752 53.6% 4,980 46.4% 2,809 26.2% 1,792 16.7% 2,332 21.7% 1,772 16.5% 2,027 18.9% Total 18.5% 729,035 134,850 91,987 68.2% 42,863 31.8% 23,439 17.4% 25,557 19.0% 33,620 24.9% 26,019 19.3% 26,215 19.4% *Skilled Nursing Facility (SNF) **Home Health Agency (HHA) Figure 2: 30-Day All-Cause Readmission Rates 5 4 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 5 National data are obtained from the ICPC Quarterly Scorecard and the most recent data available are through March 31, 2016. January 2017 (Q3 2015 Q2 2016) Page 4
Table 6: Discharge Distribution after Inpatient Hospitalization for Acute Myocardial Infarction (AMI) Q3 2015 Q2 2016 6 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 15.2% 9,159 1,396 938 67.2% 458 32.8% 316 22.6% 275 19.7% 343 24.6% 220 15.8% 242 17.3% SNF 23.2% 2,539 590 379 64.2% 211 35.8% 101 17.1% 105 17.8% 134 22.7% 126 21.4% 124 21.0% HHA 21.6% 2,536 549 397 72.3% 152 27.7% 124 22.6% 106 19.3% 129 23.5% 109 19.9% 81 14.8% Hospice 1.9% 372 7 5 71.4% 2 28.6% 3 42.9% 1 14.3% 2 28.6% 0 0.0% 1 14.3% Other 23.0% 1,049 241 114 47.3% 127 52.7% 83 34.4% 44 18.3% 41 17.0% 38 15.8% 35 14.5% Total 17.8% 15,655 2,783 1,833 65.9% 950 34.1% 627 22.5% 531 19.1% 649 23.3% 493 17.7% 483 17.4% Figure 3: 30-Day AMI Readmission Rates 7 6 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 7 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 through June 30, 2015. January 2017 (Q3 2015 Q2 2016) Page 5
Table 7: Discharge Distribution after Inpatient Hospitalization for Heart Failure (HF) Q3 2015 Q2 2016 8 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 24.3% 17,756 4,319 3,124 72.3% 1,195 27.7% 585 13.5% 729 16.9% 1,138 26.3% 984 22.8% 883 20.4% SNF 27.8% 7,180 1,995 1,431 71.7% 564 28.3% 263 13.2% 331 16.6% 549 27.5% 433 21.7% 419 21.0% HHA 26.4% 8,982 2,370 1,829 77.2% 541 22.8% 348 14.7% 434 18.3% 598 25.2% 467 19.7% 523 22.1% Hospice 3.6% 1,162 42 29 69.0% 13 31.0% 6 14.3% 10 23.8% 8 19.0% 6 14.3% 12 28.6% Other 34.5% 1,790 617 343 55.6% 274 44.4% 148 24.0% 126 20.4% 145 23.5% 106 17.2% 92 14.9% Total 25.3% 36,870 9,343 6,756 72.3% 2,587 27.7% 1,350 14.4% 1,630 17.4% 2,438 26.1% 1,996 21.4% 1,929 20.6% Figure 4: 30-Day HF Readmission Rates 9 8 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 9 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 through June 30, 2015. January 2017 (Q3 2015 Q2 2016) Page 6
Table 8: Discharge Distribution after Inpatient Hospitalization for Coronary Artery Bypass Graft (CABG) Q3 2015 Q2 2016 10 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 11.5% 985 113 82 72.6% 31 27.4% 12 10.6% 30 26.5% 40 35.4% 18 15.9% 13 11.5% SNF 19.9% 779 155 103 66.5% 52 33.5% 25 16.1% 35 22.6% 39 25.2% 22 14.2% 34 21.9% HHA 12.0% 1,428 171 131 76.6% 40 23.4% 38 22.2% 41 24.0% 46 26.9% 27 15.8% 19 11.1% Hospice 0.0% 6 0 0 ND 0 ND 0 ND 0 ND 0 ND 0 ND 0 ND Other 20.8% 342 71 45 63.4% 26 36.6% 8 11.3% 8 11.3% 16 22.5% 20 28.2% 19 26.8% Total 14.4% 3,540 510 361 70.8% 149 29.2% 83 16.3% 114 22.4% 141 27.6% 87 17.1% 85 16.7% Figure 5: 30-Day CABG Readmission Rates 11 10 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 11 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 through June 30, 2015. January 2017 (Q3 2015 Q2 2016) Page 7
Table 9: Discharge Distribution after Inpatient Hospitalization for Pneumonia (PNE) Q3 2015 Q2 2016 12 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 16.6% 18,071 2,992 2,235 74.7% 757 25.3% 563 18.8% 528 17.6% 730 24.4% 584 19.5% 587 19.6% SNF 25.1% 14,932 3,748 2,657 70.9% 1,091 29.1% 541 14.4% 660 17.6% 1,013 27.0% 734 19.6% 800 21.3% HHA 21.6% 9,189 1,983 1,550 78.2% 433 21.8% 342 17.2% 370 18.7% 509 25.7% 408 20.6% 354 17.9% Hospice 2.6% 2,387 63 38 60.3% 25 39.7% 15 23.8% 15 23.8% 15 23.8% 8 12.7% 10 15.9% Other 19.9% 3,551 707 386 54.6% 321 45.4% 165 23.3% 99 14.0% 149 21.1% 115 16.3% 179 25.3% Total 19.7% 48,130 9,493 6,866 72.3% 2,627 27.7% 1,626 17.1% 1,672 17.6% 2,416 25.5% 1,849 19.5% 1,930 20.3% Figure 6: 30-Day PNE Readmission Rates 13 12 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 13 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 through June 30, 2015. January 2017 (Q3 2015 Q2 2016) Page 8
Table 10: Discharge Distribution after Inpatient Hospitalization for Chronic Obstructive Pulmonary Disease (COPD) Q3 2015 Q2 2016 14 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 21.7% 12,170 2,638 1,993 75.5% 645 24.5% 444 16.8% 420 15.9% 647 24.5% 562 21.3% 565 21.4% SNF 26.7% 4,233 1,130 778 68.8% 352 31.2% 160 14.2% 202 17.9% 291 25.8% 240 21.2% 237 21.0% HHA 25.0% 4,718 1,180 940 79.7% 240 20.3% 185 15.7% 195 16.5% 306 25.9% 251 21.3% 243 20.6% Hospice 5.0% 496 25 18 72.0% 7 28.0% 2 8.0% 3 12.0% 6 24.0% 6 24.0% 8 32.0% Other 25.2% 1,414 357 210 58.8% 147 41.2% 83 23.2% 56 15.7% 78 21.8% 56 15.7% 84 23.5% Total 23.1% 23,031 5,330 3,939 73.9% 1,391 26.1% 874 16.4% 876 16.4% 1,328 24.9% 1,115 20.9% 1,137 21.3% Figure 7: 30-Day COPD Readmission Rates 15 14 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 15 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 through June 30, 2015. January 2017 (Q3 2015 Q2 2016) Page 9
Table 11: Discharge Distribution after Inpatient Hospitalization for Total Hip/Knee Replacement (THA/TKA) Q3 2015 Q2 2016 16 Readmits Same Hospital Different Hospital Days to Readmission Setting 30-Day Within 0 3 Days 4 7 Days 8 14 Days 15 21 Days 22 30 Days Group Discharged To Readmit Rate Discharges 30 Days N % N % N % N % N % N % N % Home 2.8% 7,817 218 142 65.1% 76 34.9% 43 19.7% 41 18.8% 47 21.6% 40 18.3% 47 21.6% SNF 6.1% 7,162 440 319 72.5% 121 27.5% 79 18.0% 77 17.5% 102 23.2% 87 19.8% 95 21.6% HHA 3.2% 15,446 499 326 65.3% 173 34.7% 106 21.2% 105 21.0% 107 21.4% 104 20.8% 77 15.4% Hospice 0.0% 7 0 0 ND 0 ND 0 ND 0 ND 0 ND 0 ND 0 ND Other 6.4% 1,297 83 59 71.1% 24 28.9% 14 16.9% 14 16.9% 21 25.3% 17 20.5% 17 20.5% Total 3.9% 31,729 1,240 846 68.2% 394 31.8% 242 19.5% 237 19.1% 277 22.3% 248 20.0% 236 19.0% Figure 8: 30-Day THA/TKA Readmission Rates 17 16 An entry of ND, or missing data point, indicates that data were unavailable for the specified time period. 17 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 through June 30, 2015. January 2017 (Q3 2015 Q2 2016) Page 10
Methodology and Data Source Information The dashboard provides information regarding your state s all-cause, acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), 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. Planned readmissions are excluded from this analysis. Data in this report are limited to Medicare FFS Part-A data for discharges from July 1, 2015 to June 30, 2016. 18 International Classification of Diseases (ICD)-10 codes are used to calculate rates starting from October 2015. 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 through 3 contain the following information. 1 Summary table Emergency department (ED) visits and 2 observation stays tables 3 4 Regional map Outpatient ED visits, observation stays, and inpatient admissions graphs 1 Example Dashboard (Pages 1 through 3) 2 18 The Complete Standard Analytical Table (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. Please note that the results obtained from CSAT may vary from your own state s results. Page A
3 Example Outpatient ED Visits, Observation Stays, and Inpatient Admissions Dashboard 4 Page B
1 Summary Table The summary table contains your 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 E for measure definitions. The summary table also includes the national rate. Due to availability of the data, the national rates may be calculated from a different time period. 2 ED Visits and Observation Stays Tables The ED visits and observations stays tables provide the count of ED visits and observations 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. 3 Regional Map The state of was divided into 21 regions, which are defined similarly to the regions established by the Hospital Council of Northern and Central, the Hospital Association of Southern, 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. 4 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 for quarterly periods from Medicare acute care claims for FFS beneficiaries. Claims are classified based on hierarchy rules similar to Medicare bundled payment rules. Each encounter counts as only one of three types: (1) Inpatient admission, (2) Observation stay, or (3) ED visit. Therefore, ED visits and observation stays that result in an inpatient stay are counted as an inpatient stay. ED visits that result in an observation stay, but not an inpatient stay, are counted as an observation stay. Page C
Pages 4 through 10 provide the following data for all-cause and disease-specific 30-day readmissions: 5 Discharge distribution table 6 Line graph Example Dashboard (discharge distribution and line graph) 5 6 5 Discharge Distribution Table The discharge distribution table shows the 30-day readmission rates by discharge setting, the proportion of readmissions that occurred back to your 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. Results for the state and your hospital s region are provided for comparison. 6 Line graph The purpose of the readmission graph is to track readmission rates over time. The Line Graph shows your state s improvement in relation to nation. Rates are calculated quarterly. Page D
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 your facility s calculation. Readmissions from home, SNFs, HHAs, and hospice are determined by the patient discharge status on the index hospitalization claim. Planned Readmissions A planned readmission is a readmission within 30 days of discharge from a short-term acute care hospital that is a scheduled part of the patient s plan of care. Planned readmissions are excluded from this report. Condition-Specific 30-Day Readmission Rates When calculating disease-specific readmission rates, an admission is included if the principal diagnosis/procedure code for the admission specifies that disease (i.e., AMI, HF, CABG, 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 your facility s calculation. The following table lists the codes used to identify the discharges for AMI, HF, CABG, PNE, COPD, and THA/TKA. ED Visits and Observation Stays The following table lists the codes used to identify ED visits and observations stays. Revenue Codes ED Visits 0450, 0451, 0452, 0456, 0459, 0981 HCPCS Observation Stays 0762, 0760 AND G0378 Page E
Hospitals by Region ALVARADO HOSPITAL MEDICAL CENTER Region 1 ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTE AURORA SAN DIEGO EL CENTRO REGIONAL MEDICAL CENTER GROSSMONT HOSPITAL KAISER FOUNDATION HOSPITAL - SAN DIEGO PALOMAR HEALTH DOWNTOWN CAMPUS PARADISE VALLEY HOSPITAL PIONEERS MEMORIAL HEALTHCARE DISTRICT POMERADO HOSPITAL SCRIPPS GREEN HOSPITAL SCRIPPS MEMORIAL HOSPITAL - ENCINITAS SCRIPPS MEMORIAL HOSPITAL LA JOLLA SCRIPPS MERCY HOSPITAL SHARP CHULA VISTA MEDICAL CENTER SHARP CORONADO HOSPITAL AND HLTHCR CTR SHARP MEMORIAL HOSPITAL SHARP MESA VISTA HOSPITAL TRI-CITY MEDICAL CENTER UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Region 10 ADVENTIST MEDICAL CENTER ADVENTIST MEDICAL CENTER - REEDLEY CLOVIS COMMUNITY MEDICAL CENTER COALINGA REGIONAL MEDICAL CENTER COMMUNITY REGIONAL MEDICAL CENTER FRESNO HEART AND SURGICAL HOSPITAL FRESNO SURGICAL HOSPITAL KAISER FOUNDATION HOSPITAL - FRESNO KAWEAH DELTA MEDICAL CENTER MADERA COMMUNITY HOSPITAL PORTERVILLE DEVELOPMENTAL CENTER SAINT AGNES MEDICAL CENTER SIERRA VIEW MEDICAL CENTER TULARE REGIONAL MEDICAL CENTER Region 11 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA GEORGE L MEE MEMORIAL HOSPITAL HAZEL HAWKINS MEMORIAL HOSPITAL NATIVIDAD MEDICAL CENTER SALINAS VALLEY MEMORIAL HOSPITAL Region 12 DOCTORS MEDICAL CENTER EMANUEL MEDICAL CENTER JOHN C FREMONT HEALTHCARE DISTRICT MEMORIAL MEDICAL CENTER MEMORIAL HOSPITAL LOS BANOS MERCY MEDICAL CENTER OAK VALLEY HOSPITAL DISTRICT STANISLAUS SURGICAL HOSPITAL Region 13 EL CAMINO HOSPITAL GOOD SAMARITAN HOSPITAL KAISER FOUNDATION HOSPITAL-SAN JOSE KAISER FOUNDATION HOSPITAL-SANTA CLARA KAISER PERMANENTE PSYCHIATRIC HEALTH FACILITY- SANT O'CONNOR HOSPITAL REGIONAL MEDICAL CENTER OF SAN JOSE SAINT LOUISE REGIONAL HOSPITAL SANTA CLARA VALLEY MEDICAL CENTER STANFORD HEALTH CARE DOMINICAN HOSPITAL San Jose Behavioral Health Region 14 KAISER FOUNDATION HOSPITAL - REDWOOD CITY KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO MENLO PARK SURGICAL HOSPITAL MILLS-PENINSULA MEDICAL CENTER SAN MATEO MEDICAL CENTER SANTA CRUZ COUNTY PSYCHIATRIC HEALTH FACILITY SEQUOIA HOSPITAL SETON MEDICAL CENTER SUTTER MATERNITY & SURGERY CENTER OF SANTA CRUZ CALIFORNIA PACIFIC MEDICAL CTR - ST. LUKE'S CAMPUS WATSONVILLE COMMUNITY HOSPITAL Region 15 CALIFORNIA PACIFIC MEDICAL CTR-DAVIES CAMPUS HOSP CALIFORNIA PACIFIC MEDICAL CTR-PACIFIC CAMPUS HOSP CHINESE HOSPITAL FREMONT HOSPITAL JEWISH HOME KAISER FOUNDATION HOSPITAL - SAN FRANCISCO LAGUNA HONDA HOSPITAL & REHABILITATION CENTER LANGLEY PORTER PSYCHIATRIC INSTITUTE SAINT FRANCIS MEMORIAL HOSPITAL SAN FRANCISCO GENERAL HOSPITAL ST MARY'S MEDICAL CENTER TELECARE HERITAGE PSYCHIATRIC HEALTH FACILITY ALAMEDA HOSPITAL UCSF MEDICAL CENTER Region 16 ALTA BATES SUMMIT MEDICAL CENTER ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMP CONTRA COSTA REGIONAL MEDICAL CENTER EDEN MEDICAL CENTER HIGHLAND HOSPITAL Page F
JOHN MUIR BEHAVIORAL HEALTH CENTER KAISER FOUNDATION HOSPITAL - ANTIOCH JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS KAISER FOUNDATION HOSPITAL - FREMONT JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND KAISER FOUNDATION HOSPITAL - SAN LEANDRO KAISER FOUNDATION HOSPITAL - VACAVILLE KAISER FOUNDATION HOSPITAL - WALNUT CREEK KAISER FOUNDATION HOSPITAL AND REHAB CENTER NORTHBAY MEDICAL CENTER SAN LEANDRO HOSPITAL SAN RAMON REGIONAL MEDICAL CTR ST ROSE HOSPITAL ST. HELENA HOSPITAL CENTER FOR BEHAVIORAL HEALTH SUTTER DELTA MEDICAL CENTER SUTTER SOLANO MEDICAL CENTER VALLEYCARE MEDICAL CENTER WASHINGTON HOSPITAL Region 17 DAMERON HOSPITAL DOCTORS HOSPITAL OF MANTECA KAISER FOUNDATION HOSPITAL MANTECA LODI MEMORIAL HOSPITAL MARK TWAIN MEDICAL CENTER SAN JOAQUIN GENERAL HOSPITAL SONORA REGIONAL MEDICAL CENTER ST JOSEPH'S BEHAVIORAL HEALTH CENTER ST JOSEPH'S MEDICAL CENTER OF STOCKTON SUTTER AMADOR HOSPITAL SUTTER TRACY COMMUNITY HOSPITAL Region 18 BARTON MEMORIAL HOSPITAL HERITAGE OAKS HOSPITAL KAISER FOUNDATION HOSP SO SACRAMENTO KAISER FOUNDATION HOSPITAL - ROSEVILLE KAISER FOUNDATION HOSPITAL - SACRAMENTO MARSHALL MEDICAL CENTER MERCY GENERAL HOSPITAL MERCY HOSPITAL OF FOLSOM MERCY SAN JUAN MEDICAL CENTER METHODIST HOSPITAL OF SACRAMENTO SIERRA NEVADA MEMORIAL HOSPITAL SIERRA VISTA HOSPITAL, INC SUTTER AUBURN FAITH HOSPITAL SUTTER CENTER FOR PSYCHIATRY SUTTER DAVIS HOSPITAL SUTTER MEDICAL CENTER, SACRAMENTO SUTTER ROSEVILLE MEDICAL CENTER TAHOE FOREST HOSPITAL UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER WOODLAND MEMORIAL HOSPITAL Region 19 AURORA BEHAVIORAL HEALTHCARE-SANTA ROSA, LLC COLUSA REGIONAL MEDICAL CENTER EASTERN PLUMAS HOSPITAL - PORTOLA CAMPUS ENLOE MEDICAL CENTER FEATHER RIVER HOSPITAL GLENN MEDICAL CENTER ORCHARD HOSPITAL OROVILLE HOSPITAL PLUMAS DISTRICT HOSPITAL RIDEOUT MEMORIAL HOSPITAL SEMPERVIRENS SENECA DISTRICT HOSPITAL ST ELIZABETH COMMUNITY HOSPITAL SUTTER SURGICAL HOSPITAL - NORTH VALLEY Region 2 ARROWHEAD REGIONAL MEDICAL CENTER BARSTOW COMMUNITY HOSPITAL BEAR VALLEY COMMUNITY HOSPITAL CANYON RIDGE HOSPITAL CHINO VALLEY MEDICAL CENTER COLORADO RIVER MEDICAL CENTER COMMUNITY HOSPITAL OF SAN BERNARDINO CORONA REGIONAL MEDICAL CENTER DESERT REGIONAL MEDICAL CENTER DESERT VALLEY HOSPITAL EISENHOWER MEDICAL CENTER HEMET VALLEY MEDICAL CENTER HI-DESERT MEDICAL CENTER JOHN F KENNEDY MEMORIAL HOSPITAL KAISER FOUNDATION HOSPITAL FONTANA KAISER FOUNDATION HOSPITAL, RIVERSIDE KAISER FOUNDATION HOSPITAL-MORENO VALLEY LOMA LINDA BEHAVIORAL MED CTR LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL LOMA LINDA UNIVERSITY MEDICAL CENTER LOMA LINDA UNIVERSITY MEDICAL CENTER-MURRIETA MENIFEE VALLEY MEDICAL CENTER MONTCLAIR HOSPITAL MEDICAL CENTER MOUNTAINS COMMUNITY HOSPITAL PACIFIC GROVE HOSPITAL PALO VERDE HOSPITAL PARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER REDLANDS COMMUNITY HOSPITAL RIVERSIDE COMMUNITY HOSPITAL RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER SAN ANTONIO REGIONAL HOSPITAL SAN GORGONIO MEMORIAL HOSPITAL SOUTHWEST HEALTHCARE SYSTEM ST BERNARDINE MEDICAL CENTER ST MARY MEDICAL CENTER TEMECULA VALLEY HOSPITAL VICTOR VALLEY GLOBAL MEDICAL CENTER Region 20 FRANK R HOWARD MEMORIAL HOSPITAL HEALDSBURG DISTRICT HOSPITAL JEROLD PHELPS COMMUNITY HOSPITAL KAISER FOUNDATION HOSPITAL KAISER FOUNDATION HOSPITAL-SANTA ROSA MAD RIVER COMMUNITY HOSPITAL MARIN GENERAL HOSPITAL MENDOCINO COAST DISTRICT HOSPITAL NOVATO COMMUNITY HOSPITAL PETALUMA VALLEY HOSPITAL QUEEN OF THE VALLEY MEDICAL CENTER REDWOOD MEMORIAL HOSPITAL SANTA ROSA MEMORIAL HOSPITAL SONOMA DEVELOPMENTAL CENTER SONOMA VALLEY HOSPITAL SONOMA WEST MEDICAL CENTER ST HELENA HOSPITAL ST HELENA HOSPITAL-CLEARLAKE Page G
ST JOSEPH HOSPITAL SUTTER COAST HOSPITAL SUTTER LAKESIDE HOSPITAL SUTTER SANTA ROSA REGIONAL HOSPITAL UKIAH VALLEY MEDICAL CENTER Region 21 BANNER LASSEN MEDICAL CENTER FAIRCHILD MEDICAL CENTER MAYERS MEMORIAL HOSPITAL MERCY MEDICAL CENTER MT SHASTA MERCY MEDICAL CENTER REDDING MODOC MEDICAL CENTER PATIENTS' HOSPITAL OF REDDING SHASTA REGIONAL MEDICAL CENTER SURPRISE VALLEY COMMUNITY HOSPITAL TRINITY HOSPITAL Region 3 AHMC ANAHEIM REGIONAL MEDICAL CENTER ANAHEIM GLOBAL MEDICAL CENTER CHAPMAN GLOBAL MEDICAL CENTER COLLEGE HOSPITAL COSTA MESA FAIRVIEW DEVELOPMENTAL CENTER FOOTHILL REGIONAL MEDICAL CENTER FOUNTAIN VALLEY REGIONAL HOSPITAL & MEDICAL CENTER HOAG ORTHOPEDIC INSTITUTE GARDEN GROVE HOSPITAL & MEDICAL CENTER HUNTINGTON BEACH HOSPITAL HOAG MEMORIAL HOSPITAL PRESBYTERIAN KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHE LA PALMA INTERCOMMUNITY HOSPITAL LOS ALAMITOS MEDICAL CENTER MISSION HOSPITAL REGIONAL MED CENTER NEWPORT BAY HOSPITAL ORANGE COAST MEMORIAL MEDICAL CENTER ORANGE COUNTY GLOBAL MEDICAL CENTER PLACENTIA LINDA HOSPITAL SADDLEBACK MEMORIAL MEDICAL CENTER SOUTH COAST GLOBAL MEDICAL CENTER ST JOSEPH HOSPITAL ST JUDE MEDICAL CENTER UNIVERSITY OF CALIFORNIA IRVINE MED CENTER WEST ANAHEIM MEDICAL CENTER Region 4 ALHAMBRA HOSPITAL MEDICAL CENTER ANTELOPE VALLEY HOSPITAL AURORA CHARTER OAK AURORA LAS ENCINAS HOSPITAL BEVERLY HOSPITAL BHC ALHAMBRA HOSP CALIFORNIA HOSPITAL MEDICAL CENTER LA CASA COLINA HOSPITAL CATALINA ISLAND MEDICAL CENTER CEDARS-SINAI MEDICAL CENTER CENTINELA HOSPITAL MEDICAL CENTER CITRUS VALLEY MEDICAL CENTER-IC CAMPUS CITY OF HOPE HELFORD CLINICAL RESEARCH HOSPITAL COAST PLAZA HOSPITAL COLLEGE HOSPITAL COLLEGE MEDICAL CENTER COMMUNITY HOSPITAL OF HUNTINGTON PARK COMMUNITY HOSPITAL OF LONG BEACH DEL AMO HOSPITAL EAST LOS ANGELES DOCTORS HOSPITAL ENCINO HOSPITAL MEDICAL CENTER FOOTHILL PRESBYTERIAN HOSPITAL GARDENS REGIONAL HOSPITAL AND MEDICAL CENTER GARFIELD MEDICAL CENTER GLENDALE ADVENTIST MEDICAL CENTER GLENDALE MEM HOSPITAL & HLTH CENTER GLENDORA COMMUNITY HOSPITAL GOOD SAMARITAN HOSPITAL GREATER EL MONTE COMMUNITY HOSPITAL HENRY MAYO NEWHALL HOSPITAL HOLLYWOOD PRESBYTERIAN MEDICAL CENTER HUNTINGTON MEMORIAL HOSPITAL JOYCE EISENBERG KEEFER MEDICAL CENTER KAISER FOUNDATION HOSPITAL - BALDWIN PARK KAISER FOUNDATION HOSPITAL - DOWNEY KAISER FOUNDATION HOSPITAL - LOS ANGELES KAISER FOUNDATION HOSPITAL - PANORAMA CITY KAISER FOUNDATION HOSPITAL - SOUTH BAY KAISER FOUNDATION HOSPITAL - WEST LA KAISER FOUNDATION HOSPITAL - WOODLAND HILLS KECK HOSPITAL OF USC LAC+USC MEDICAL CENTER LAC/HARBOR-UCLA MED CENTER LAC/OLIVE VIEW-UCLA MEDICAL CENTER LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR LAKEWOOD REGIONAL MEDICAL CENTER LONG BEACH MEMORIAL MEDICAL CENTER LOS ANGELES COMMUNITY HOSPITAL MARINA DEL REY HOSPITAL MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL MEMORIAL HOSPITAL OF GARDENA METHODIST HOSPITAL OF SOUTHERN CA MIRACLE MILE MEDICAL CENTER MISSION COMMUNITY HOSPITAL MONTEREY PARK HOSPITAL MOTION PICTURE & TELEVISION HOSPITAL NORTHRIDGE HOSPITAL MEDICAL CENTER OCEAN VIEW PSYCHIATRIC HEALTH FACILITY OLYMPIA MEDICAL CENTER PACIFIC ALLIANCE MEDICAL CENTER PACIFICA HOSPITAL OF THE VALLEY PALMDALE REGIONAL MEDICAL CENTER PIH HOSPITAL - DOWNEY POMONA VALLEY HOSPITAL MEDICAL CENTER PRESBYTERIAN INTERCOMMUNITY HOSPITAL PROVIDENCE HOLY CROSS MEDICAL CENTER PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE PROVIDENCE SAINT JOHN'S HEALTH CENTER PROVIDENCE SAINT JOSEPH MEDICAL CTR PROVIDENCE TARZANA MEDICAL CENTER RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA RONALD REAGAN U C L A MEDICAL CENTER SAINT FRANCIS MEDICAL CENTER SAINT VINCENT MEDICAL CENTER SAN DIMAS COMMUNITY HOSPITAL SAN GABRIEL VALLEY MEDICAL CENTER SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL SHERMAN OAKS HOSPITAL SILVER LAKE MEDICAL CENTER SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD ST MARY MEDICAL CENTER TARZANA TREATMENT CENTER TORRANCE MEMORIAL MEDICAL CENTER USC KENNETH NORRIS JR CANCER HOSPITAL USC VERDUGO HILLS HOSPITAL VALLEY PRESBYTERIAN HOSPITAL Page H
WEST COVINA MEDICAL CENTER, INC WEST HILLS HOSPITAL & MEDICAL CENTER WHITE MEMORIAL MEDICAL CENTER WHITTIER HOSPITAL MEDICAL CENTER AURORA VISTA DEL MAR HOSPITAL Region 5 COMMUNITY MEMORIAL HOSPITAL SAN BUENAVENTURA LOS ROBLES HOSPITAL & MEDICAL CENTER OJAI VALLEY COMMUNITY HOSPITAL SIMI VALLEY HOSPITAL & HEALTH CARE SERVICES ST JOHNS PLEASANT VALLEY HOSPITAL ST JOHNS REGIONAL MEDICAL CENTER VENTURA COUNTY MEDICAL CENTER Region 6 GOLETA VALLEY COTTAGE HOSPITAL LOMPOC VALLEY MEDICAL CENTER MARIAN REGIONAL MEDICAL CENTER SANTA BARBARA COTTAGE HOSPITAL SANTA BARBARA COUNTY PSYCHIATRIC HEALTH FACILITY Region 7 SANTA YNEZ VALLEY COTTAGE HOSPITAL FRENCH HOSPITAL MEDICAL CENTER SIERRA VISTA REGIONAL MEDICAL CENTER TWIN CITIES COMMUNITY HOSPITAL Region 8 ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI VALLEY BAKERSFIELD HEART HOSPITAL BAKERSFIELD MEMORIAL HOSPITAL DELANO REGIONAL MEDICAL CENTER GOOD SAMARITAN HOSPITAL KERN MEDICAL CENTER KERN VALLEY HEALTHCARE DISTRICT MERCY HOSPITAL RIDGECREST REGIONAL HOSPITAL SAN JOAQUIN COMMUNITY HOSPITAL Region 9 MAMMOTH HOSPITAL NORTHERN INYO HOSPITAL SOUTHERN INYO HOSPITAL Page I