Was this hospital in operation at any time during the year?
Yes
10.
Operation Open From:
1/1/2015
11.
Operation Open To:
12/31/2015
12.
Name of Parent Corporation:
Providence Health System
13.
Corporate Business Address:
1810 Linda Avenue SW
14.
City:
Renton
15.
State:
WA
16.
Zip:
98057 -
17.
Person Completing Report:
Paul Steinke
18.
Report Preparer's Phone No.:
818-496-4449
19.
Fax No.:
20.
E-mail Address:
paul.steinke@providence.org
30.
Submitted by:
paul0385
31.
Submitted Date and Time:
2/15/2016 10:25:51 AM
32.
Corrected by:
achism
33.
Corrected Date and Time:
5/20/2016 3:38:17 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:
Non-profit Corporation (incl. Church-related)
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.)
General Medical / Surgical
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
(5)
Patient (Census) Days
GAC Bed Designations
1.
Medical / Surgical (include GYN)
245
89,425
13,367
51,831
2.
Perinatal (exclude Newborn / GYN)
35
12,775
3,586
9,265
3.
Pediatric
0
0
0
0
4.
Intensive Care
12
4,380
451
1,651
8,184
5.
Coronary Care
12
4,380
0
0
0
6.
Acute Respiratory Care
0
0
0
0
0
7.
Burn
0
0
0
0
0
8.
Intensive Care Newborn Nursery
12
4,380
319
38
3,727
9.
Rehabilitation Center
13
4,745
195
2,859
15.
Subtotal - GAC
329
120,085
17,918
75,866
16.
Chemical Dependency Recovery Hospital
0
0
0
0
17.
Acute Psychiatric
0
0
0
0
18.
Skilled Nursing
48
17,520
298
0
16,783
19.
Intermediate Care
0
0
0
0
20.
Intermediate Care / Developmentally Disabled
0
0
0
0
25.
Total (Sum of lines 15 thru 20)
377
137,605
18,216
92,649
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 Services
0
0
0
31.
Acute Psych - Chemical Dep Recovery Svcs
0
0
0
* 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 Nursery
25
3,032
6,058
* 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.
Locked
0
44.
Open
0
45.
Acute Psychiatric Total*
0
Acute Psychiatric Patients By Age Category on December 31
Line No.
(1) Number of Patients
46.
0 - 17 Years
0
47.
18 - 64 Years
0
49.
65 Years and Older
0
50.
Acute Psychiatric Total*
0
Acute Psychiatric Patients By Primary Payer on December 31
Line No.
(1) Number of Patients
51.
Medicare - Traditional
0
52.
Medicare - Managed Care
0
53.
Medi-Cal - Traditional
0
54.
Medi-Cal - Managed Care
0
55.
County Indigent Programs
0
56.
Other Third Parties - Traditional
0
57.
Other Third Parties - Managed Care
0
58.
Short-Doyle (includes Short-Doyle Medi-Cal)
0
59.
Other Indigent
0
64.
Other Payers
0
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 Care
No
73.
Skilled Nursing (SN)
No
74.
Intermediate Care (IC)
No
PALLIATIVE CARE PROGRAM
Line No.
(1)
80.
Did your hospital have an inpatient palliative care program during the report period?
Yes
PALLIATIVE CARE PROGRAM - An interdisciplinary team that sees patient, identifies needs, makes treatment recommendations, facilitaties patient and /or family decision making, and/or directly provides palliative care for patients with serious illness and their families.
If 'yes' on line 80, Please answer the questions below.
Line No.
(1)
81.
How many Advanced Practice Nurses(APN)Registered Nurses(RN) are on the inpatient palliative care team?
2
82.
How many of these APN/RNs are board certified by the National Board for Certification for Hospice and Palliative Nursing?
1
83.
How many Physicians are on the inpatient palliative care team?
1
84.
How many of these Physicians are board certified by the American Board of Medical Specialties?
1
85.
How many Social Workers are on the inpatient palliative care team?
1
86.
How many of these Social Workers hold an Advanced Certified Hospice and Palliative Social Worker credential from the National Association of Social Worker?
0
87.
How many Chaplains are on the inpatient palliative care team?
1
*Staffing data should only reflect inpatient palliative care team.
Line No.
(1)
90.
Did your hospital have outpatient palliative care services during the report period?
Yes
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.
Level II
Licensed Emergency Department Level
(Completed by OSHPD from DHS Data.)
Line No.
(1) January 1
(2) December 31
2.
Basic
Basic
Services Available on Premises
(Check all that apply.)
Line No.
Services Available
(1) 24 Hour
(2) On-Call
11.
Anesthesiologist
Yes
No
12.
Laboratory Services
Yes
No
13.
Operating Room
Yes
No
14.
Pharmacist
Yes
No
15.
Physician
Yes
No
16.
Psychiatric ER
No
Yes
17.
Radiology Services
Yes
No
Emergency Department Services
Line No.
EDS Visit Type
CPT 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.
Minor
99281
881
0
22.
Low/Moderate
99282
9,989
3
23.
Moderate
99283
38,909
20
24.
Severe without threat
99284
29,722
742
25.
Severe with threat
99285
11,446
8,030
30.
TOTAL
90,947
8,795
99,742
* 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.
32
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.
1,715
* 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).
Yes
Number of Ambulance Diversion Hours that occurred at Emergency Department
Line No.
Month
(1) Hours
51.
January
131
52.
February
58
53.
March
103
54.
April
27
55.
May
33
56.
June
30
57.
July
43
58.
August
56
59.
September
86
60.
October
60
61.
November
69
62.
December
80
65.
Total Hours
776
Section 5 - Surgery and Related Services
Surgical Services
Line No.
Surgical Services
(1) Surgical Operations
(2) Operating Room Minutes
1.
Inpatient
4,810
702,645
2.
Outpatient
1,873
169,445
Operating Rooms On December 31
Line No.
Operating Room Type
(1) Number
7.
Inpatient Only
0
8.
Outpatient Only
0
9.
Inpatient and Outpatient
10
10.
Total Operating Rooms
10
Ambulatory Surgical Program
Line No.
(1)
15.
Did your hospital have an organized ambulatory surgical program?
Yes
Live Births
Line No.
(1) Number
20.
Total Live Births (Count multiple births separately)*
3,326
21.
Live Births with Birth Weight Less Than 2500 grams (5 lbs. 8 oz.)
189
22.
Live Births with Birth Weight Less Than 1500 grams (3 lbs. 5 oz)
35
* 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 LDR
No
33.
Was your alternate setting was approved as LDRP
No
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?
1,136
Licensed Cardiology and Cardiovascular Surgery Services (Completed by OSHPD.)
Line No.
(1) Licensure
41.
Cardiovascular Surgery Services
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.
8
Cardiovascular Surgical Operations (with and without the HEART/LUNG MACHINE*)
Line No.
(1) Cardio-Pulmonary Bypass USED*
(2) Cardio-Pulmonary Bypass NOT USED
43.
Pediatric
0
0
44.
Adult
81
8
45.
Total Cardiovascular Surgical Operations
81
8
* 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.
75
* 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.
2
Cardiac Catheterization Visits
Line No.
(1) Diagnostic
(2) Therapeutic
56.
Pediatric - Inpatient
0
0
57.
Pediatric - Outpatient
0
0
58.
Adult - Inpatient
289
384
59.
Adult - Outpatient
188
106
60.
Total Cardiac Catheterization Visits
477
490
Distribution of Procedures Performed in Catheterization Laboratory
Line No.
(1) Procedures
65.
Diagnostic Cardiac Catheterization Procedures (LHC, R & LHC)
964
66.
Myocardial Biopsy
0
71.
Permanent Pacemaker Implantation
65
711.
Other Permanent Pacemaker Procedures (Generator or Lead Replacement)
All other catheterization procedures performed in the lab
0
85.
Total Catheterization Procedures
1,938
Percutaneous Transluminal Balloon Valvuloplasty(PTBV) is very rarely done in these times. Those that are done are generally on pediatric patients.
AICD procedures are frequently done in the cath lab and are very similar to permanent pacemaker implants.
NOTE: Do Not Include Any Of The Following As A Cardiac Catheterization:
Defibrillation
Temporary Pacemaker Insertion
Cardioversion
Pericardiocentesis
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.)