Annual Utilization Report of Specialty Clinics
Facility Name:HIGH DESERT HEALTH SYSTEM AMBULATORY SURGICAL CTR.
OSHPD ID:306196511Report Status:Submitted
License Category:SurgicalReport Year:2011
Table of Contents
Click on any of the links listed below to view the corresponding section.
Section 1 - General Information
Section 2 - Clinic Description
Section 3 - Patients and Encounters
Section 4 - Income Statement
Section 5 - Major Capital Expenditures
Errors and Warnings
Section 1 - General Information
1.Facility Name:HIGH DESERT HEALTH SYSTEM AMBULATORY SURGICAL CTR.
2.OSHPD ID Number:306196511
3.Street Address:44900 NORTH 60TH STREET WEST
4.City:LANCASTER
5.Zip:93536
6.Facility Phone No.:( 661) 948 - 8581 ext.
7.Administrator Name:Beryl Brooks
8.Administrator E-mail Address:brbrooks@dhs.lacounty.gov
9.Was this clinic in operation at any time during the year?Yes
10.Operation Open From:1/1/2011
11.Operation Open To:12/31/2011
12.Name of Parent Corporation:
13.Corporate Business Address:
14.City:
15.State:
16.Zip:-
17.Person Completing Report:Beryl Brooks
18.Report Preparer's Phone No.:661-948-8581
19.Fax No.:661-945-8474
20.E-mail Address:brbrooks@dhs.co.la.ca.us
30.Submitted by:306196511
31.Submitted Date and Time:2/15/2012 4:21:49 PM
Section 2 - Clinic Description
LICENSE CATEGORY (TYPE) (Completed by OSHPD.)
Line
No.		(1)
1.License CategorySurgical
LICENSEE TYPE OF CONTROL
Line
No.		(1)
5.Select the category that best describes the licensee type of ownership of your clinic from drop down list:City or County
Section 3 - Patients and Encounters
PATIENTS AND ENCOUNTERS IN THE CALENDAR YEAR (ALL CLINICS)
Please report the total number of individual, unduplicated patients served and the total number of encounters for these patients. Please refer to the instructions for further details.
Line
No.		(1)
Unduplicated Patients
(2)

Encounters
1.Total, all locations under this license (Main, Mobile, Satellite, etc.)1,5081,508
SURGICAL CLINICS ONLY
Line
No.		(1)
Number
5.Number of surgical operating rooms on December 312
6.Total number of surgical operations performed during the calendar year1,508
PSYCHOLOGY CLINICS ONLY
Line
No.		Service Type(1)
Encounters
11.General Medical0
12.Substance Abuse (alcohol and drug)0
13.Mental Health Counseling0
14.All Other0
15.Total0
DIALYSIS CLINICS ONLY
Line
No.		(1)
Number
21.No. of Dialysis Stations0
22.Approved for In-Home Training(CAPD, CCPD)Undecided
Section 4 - Income Statement
INCOME STATEMENT
Line
No.		(1)
Total
1.Gross Patient Revenue$6,070,365
WRITE-OFFS AND ADJUSTMENTS:
2.Charity$2,892,750
3.Contractual Adjustments$1,131,638
4.Bad Debts$175,245
8.Other Adjustments$294,630
9.Total Write-Offs and Adjustments (lines 2-8)$4,494,263
10.Net Patient Revenue (line 1 minus line 9)$1,576,102
Other Operating Revenue:
11.Grants - Public0
12.Grants - Private0
13.Donations / Contributions0
19.Other0
20.Total Other Operating Revenue (sum lines 11 - 19)$0
25.Total Operating Revenue (line 10 + line 20)$1,576,102
Operating Expenses:
30.Salaries, Wages and Employee Benefits$2,599,802
31.Contract Services - Professional$511,078
32.Supplies$276,520
33.Rent / Depreciation / Mortgage Interest$18,658
34.Utilities$193,456
35.Professional Liability Insurance$20,190
36.Other Insurances0
44.All Other Expenses$3,912,714
45.Total Operating Expenses (sum lines 30 - 44)$7,532,418
50.Net From Operations (line 25 minus line 45)-$5,956,316

Section 5 - Major Capital Expenditures

Section 127285(3) of the Health and Safety Code requires each clinic 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 clinic 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 clinic 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 clinic 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