Annual Utilization Report of Hospitals
Facility Name:CITY OF ANGELS MEDICAL CENTER-INGLESIDE CAMPUS
OSHPD ID:106190410Report Status:Submitted
License Category:General Acute Care HospitalReport Year:2008
Table of Contents
Click on any of the links listed below to view the corresponding section.
Section 1 - General Information
Section 2 - Hospital Description
Section 3 - Inpatient Services
Section 4 - Emergency Department Services (EDS)
Section 5 - Surgery and Related Services
Section 6 - Major Capital Expenditures
General Comments
View Errors and Warnings
Section 1 - General Information
1.Facility Name:CITY OF ANGELS MEDICAL CENTER-INGLESIDE CAMPUS
2.OSHPD ID Number:106190410
3.Street Address:7500 EAST HELLMAN AVENUE
4.City:ROSEMEAD
5.Zip:91770
6.Facility Phone No.:( 626) 288 - 1160 ext.
7.Administrator Name:Vicki Gant
8.Administrator E-mail Address:vgant@silverlakemc.com
9.Was this hospital in operation at any time during the year?Yes
10.Operation Open From:1/1/2008
11.Operation Open To:12/31/2008
12.Name of Parent Corporation:Intercare Resources
13.Corporate Business Address:1711 W. Temple St.
14.City:Los Angeles
15.State:CA
16.Zip:90026 -
17.Person Completing Report:Paul Musack
18.Report Preparer's Phone No.:213-989-6100
19.Fax No.:
20.E-mail Address:pmusack@silverlakemc.com
30.Submitted by:pmusack
31.Submitted Date and Time:2/11/2009 12:42:07 PM
Section 2 - Hospital Description
LICENSE CATEGORY (TYPE) (Completed by OSHPD.)
Line
No.		(1)
1.License Category:General Acute Care Hospital
LICENSEE TYPE OF CONTROL
Line
No.		(1)
5.Select the category that best describes the licensee type of control of your hospital (the type of organization that owns the license) from the list below:Investor - Corporation
PRINCIPAL SERVICE TYPE
Line
No.		(1)
25.Select the category that best describes the type of service provided to the majority of your patients. (The type or service is usually consistant with majority of, or mix of reported patient days.)Psychiatric
Section 3 - Inpatient Services
INPATIENT BED UTILIZATION - DO NOT INCLUDE NORMAL NEWBORNS IN BED UTILIZATION DATA
Line
No.		Bed Classification and Bed Designation
(1)


Licensed Beds as of 12/31
(2)



Licensed Bed Days
(3)

Hospital Discharges (including deaths)		(4)
Intra-hospital Transfers from Critical Care
(5)


Patient (Census) Days
GAC Bed Designations
1.Medical / Surgical (include GYN)0000
2.Perinatal (exclude Newborn / GYN)0000
3.Pediatric0000
4.Intensive Care00000
5.Coronary Care00000
6.Acute Respiratory Care00000
7.Burn00000
8.Intensive Care Newborn Nursery00000
9.Rehabilitation Center0000
15.Subtotal - GAC0000
16.Chemical Dependency Recovery Hospital0000
17.Acute Psychiatric7025,6203,04621,803
18.Skilled Nursing00000
19.Intermediate Care0000
20.Intermediate Care / Developmentally Disabled0000
25.Total (Sum of lines 15 thru 20)7025,6203,04621,803
Chemical Dependency Recovery Services In Licensed GAC and Acute Psychiatric Beds*
Line
No.		Bed Classification
(1)

Licensed
Beds
(3)

Hospital
Discharges


(5)
Patient
(Census)
Days
30.GAC - Chemical Dep Recovery Services000
31.Acute Psych - Chemical Dep Recovery Svcs000
* The licensed services data for these CDRS are to be included in lines 1 through 25 above.
Newborn Nursery Information
Line
No.		(1)
Nursery
Bassinets		(3)
*Nursery
Infants		(5)
Nursery
Days
35.Newborn Nursery000
* Nursery Infants are the "normal" newborn nursery equivalent to discharges from licensed beds.
Skilled Nursing Swing Beds (Completed by OSHPD.)
Line
No.		(1)
40.Number of licensed General Acute Care beds approved for Skilled Nursing Care:0
Complete lines 43 through 70 only if your hospital has licensed Acute Psychiatric or PHF beds. Include Chemical Dependency Recovery Services provided in licensed Acute Psychiatric beds.
Acute Psychiatric Patients By Unit on December 31
Line
No.		(1)
Number of Patients
43.Locked0
44.Open0
45.Acute Psychiatric Total*0
Acute Psychiatric Patients By Age Category on December 31
Line
No.		(1)
Number of Patients
46.0 - 17 Years0
47.18 - 64 Years0
49.65 Years and Older0
50.Acute Psychiatric Total*0
Acute Psychiatric Patients By Primary Payer on December 31
Line
No.		(1)
Number of Patients
51.Medicare - Traditional0
52.Medicare - Managed Care0
53.Medi-Cal - Traditional0
54.Medi-Cal - Managed Care0
55.County Indigent Programs0
56.Other Third Parties - Traditional0
57.Other Third Parties - Managed Care0
58.Short-Doyle (includes Short-Doyle Medi-Cal)0
59.Other Indigent0
64.Other Payers0
65.Acute Psychiatric Total*0
* Acute Psychiatric Total on lines 45, 50 and 65 must agree.
Short Doyle Contract Services
Line
No.		(1)
70.During the reporting period, did you provide any acute psychiatric care under a Short-Doyle contract?No
Inpatient Hospice Program
Line
No.		(1)
71.Did your hospital offer an inpatient hospice program during the report period?No
If 'yes' on line 71, what type of bed classification is used for this service? (Check all that apply.)
Line
No.		Bed Classification(1)
72.General Acute CareNo
73.Skilled Nursing (SN)No
74.Intermediate Care (IC)No
Section 4 - Emergency Department Services (EDS)
EMSA Trauma Center Designation on December 31
(Completed by OSHPD from EMSA data.)
Line
No.		(1)
Designation		(2)
Pediatric
1.
Licensed Emergency Department Level
(Completed by OSHPD from DHS Data.)
Line
No.		(1)
January 1		(2)
December 31
2.
Services Available on Premises
(Check all that apply.)
Line
No.		Services Available(1)
24 Hour		(2)
On-Call
11.AnesthesiologistNoNo
12.Laboratory ServicesNoNo
13.Operating RoomNoNo
14.PharmacistNoNo
15.PhysicianNoNo
16.Psychiatric ERNoNo
17.Radiology ServicesNoNo
Emergency Department Services
Line
No.		EDS Visit TypeCPT Codes
(1)

Visits not Resulting in Admission*		(2)
Admitted from ED (Enter Total Only if Details not Available)
(3)


Total ED Traffic
(1) + (2)
21.Minor9928100
22.Low/Moderate9928200
23.Moderate9928300
24.Severe without threat9928400
25.Severe with threat9928500
30.TOTAL000
* DO NOT INCLUDE patients who register but left without being seen, employee physicals and scheduled Clinic-type visits.
Emergency Medical Treatment Stations on December 31
Line
No.		(1)
35.Enter the number of emergency medical treatment stations.0
Treatment Station - A specific place within the emergency department adequate to treat one patient at a time. Do not count holding or observation beds.
Non-Emergency (Clinic) Visits Seen in Emergency Department
Line
No.		(1)
40.Enter the number of non-emergency (clinic) visits seen in ED.0
Emergency Registrations, But Patient Leaves Without Being Seen*
Line
No.		(1)
45.Enter the number of EDS registrations that did NOT result in treatment.0
* Include patients who arrived at ED, but did not register and left without being seen (if available)
Emergency Department Ambulance Diversion Hours
Line
No.		(1)
50.Were there periods when the ED was unable to receive any and all ambulance patients during the year and as a result ambulances were diverted to other hospitals? If 'yes' fill out lines 51 through 62 below. Count only those hours in which the ED was unavailable TO ALL PATIENTS (see instructions).No
Number of Ambulance Diversion Hours that occurred at Emergency Department
Line
No.		Month(1)
Hours
51.January0
52.February0
53.March0
54.April0
55.May0
56.June0
57.July0
58.August0
59.September0
60.October0
61.November0
62.December0
65.Total Hours0
Section 5 - Surgery and Related Services
Surgical Services
Line
No.		Surgical Services(1)
Surgical Operations		(2)
Operating Room Minutes
1.Inpatient00
2.Outpatient00
Operating Rooms On December 31
Line
No.		Operating Room Type(1)
Number
7.Inpatient Only0
8.Outpatient Only0
9.Inpatient and Outpatient0
10.Total Operating Rooms0
Ambulatory Surgical Program
Line
No.		(1)
15.Did your hospital have an organized ambulatory surgical program?No
Live Births
Line
No.		(1)
Number
20.Total Live Births (Count multiple births separately)*0
21.Live Births with Birth Weight Less Than 2500 grams (5 lbs. 8 oz.)0
22.Live Births with Birth Weight Less Than 1500 grams (3 lbs. 5 oz)0
* TOTAL LIVE BIRTHS on line 20 should approximate the number of Perinatal discharges shown in Section 3, line 2, column 3. Include LDR or LDRP births and C-Section deliveries.
Alternate Birthing (Outpatient) Center Information
Line
No.		(1)
31.Did your hospital have an approved alternate birthing (outpatient) program?No
32.Was your alternate setting was approved as LDRNo
33.Was your alternate setting was approved as LDRPNo
Other Live Birth Data
Line
No.		(1)
Number
36.How many of the live births reported on line 20 occurred in your alternative (outpatient) setting? Do not include C-Section deliveries.0
37.How many of the live births reported on line 20 were C-Section deliveries?0
Licensed Cardiology and Cardiovascular Surgery Services (Completed by OSHPD.)
Line
No.
(1)
Licensure
41.Not Licensed
Note: Complete lines 42 to 85 if licensed for Cardiovascular Surgery Services.
Complete lines 55 to 85 if licensed for Cardiac Catheterization only.
Licensed Cardiovascular Operating Rooms
Line
No.		(1)
42.Number of operating rooms licensed to perform cardiovascular surgery on December 31.0
Cardiovascular Surgical Operations (with and without the HEART/LUNG MACHINE*)
Line
No.		(1)
Cardio-Pulmonary
Bypass USED*		(2)
Cardio-Pulmonary
Bypass NOT USED
43.Pediatric00
44.Adult00
45.Total Cardiovascular Surgical Operations00
* Also refered to as Extracorporeal Bypass or "on-the-pump" (heart/lung machine).
Coronary Artery Bypass Graft (CABG) Surgeries*
Line
No.		(1)
50.Number of Coronary Artery Bypass Graft (CABG) surgeries performed.0
* Subset of cardiovascular surgeries reported on line 45 above.
Cardiac Catheterization Lab Rooms
Line
No.		(1)
55.Number of rooms equipped to perform cardiac catheterizations on December 31.0
Cardiac Catheterization Visits
Line
No.		(1)
Diagnostic
(2)
Therapuetic
56.Pediatric - Inpatient00
57.Pediatric - Outpatient00
58.Adult - Inpatient00
59.Adult - Outpatient00
60.Total Cardiac Catheterization Visits00
Distribution of Therapeutic Cardiac Catheterization Procedures
Complete this table if Therapeutic Cardiac Catheterization Visits are reported in line 60, column 2.
Line
No.		(1)
Procedures
71.Permanent Pacemaker Implantation0
72.Percutaneous Transluminal Coronary Angioplasty (PTCA) - WITH Stent0
73.Percutaneous Transluminal Coronary Angioplasty (PTCA) - WITHOUT Stent0
74.Atherectomy (PTCRA - rotablator, DCA, laser, other ablation, etc.)0
75.Thrombolytic Agents (Intracoronary only)0
76.Percutaneous Transluminal Balloon Valvulopasty (PTBV)0
84.All Other (including Radiofrequency Catheter Ablation)0
85.Total Therapeutic Cardiac Catheterization Procedures0
NOTE: Do Not Include Any Of The Following As A Cardiac Catheterization:
  • Angiography - Non-coronary
  • Intra-Aortic Balloon Pump
  • Automatic Implantable Cardiac Defibrillator (AICD)
  • Percutaneous Transluminal Angioplasty - Non-cardiac
  • Defibrillation
  • Pericardiocentesis
  • Cardioversion
  • Temporary Pacemaker Insertion
Section 6 - Major Capital Expenditures
Section 127285(3) of the Health and Safety Code requires each hospital to report "acquisitions of diagnostic or therapeutic equipment during the reporting period with a value in excess of five hundred thousand dollars ($500,000)."
Diagnostic and Therapeutic Equipment Acquired During The Report Period
Line
No.		(1)
1.Did your hospital acquire any diagnostic or therapeutic equipment that had a value in excess of $500,000? (If 'Yes', fill out lines 2 through 11, as necessary, below.)No
Diagnostic and Therapeutic Equipment Detail
Line
No.
(1)


Description of Equipment
(2)


Value		(3)
Date of Aquisition
MM/DD/YYYY
(4)


Means of Acquisition
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Building Projects Commenced During Report Period Costing Over $1,000,000
Section 127285(4) of the Health and Safety Code requires each hospital to report the "commencement of projects during the reporting period that require a capital expenditure for the facility or clinic in excess of one million dollars ($1,000,000)."
Line
No.		(1)
25.Did your hospital commence any building projects during the report period which will require an aggregate capital expenditure exceeding $1,000,000? (If 'Yes', fill out lines 26 through 30, as necessary, below.)No
Detail of Capital Expenditures
Line
No.
(1)


Description of Project		(2)
Projected Total Capital Expenditure
(3)

OSHPD Project No. (if applicable)
26.
27.
28.
29.
30.
General Comments:
Errors and Warnings