Annual Utilization Report of Hospitals
Facility Name:	PROVIDENCE HOLY CROSS MEDICAL CENTER
OSHPD ID:	106190385	Report Status:	Submitted
License Category:	General Acute Care Hospital	Report Year:	2004

Table of Content

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 Medical Services (EMS)

Section 5 - Surgery and Related Services

Section 6 - Major Capital Expenditures

General Comments

View Errors and Warnings

Section 1 - General Information
1.	Facility Name:	PROVIDENCE HOLY CROSS MEDICAL CENTER
2.	OSHPD ID Number:	106190385
3.	Street Address:	15031 RINALDI STREET
4.	City:	MISSION HILLS
5.	Zip:	91345
6.	Facility Phone No.:	( 818 ) 365 - 8051 ext.
7.	Administrator Name:	KERRY CARMODY
8.	Administrator E-mail Address:	KCARMODY@PROVIDENCE.ORG
9.	Was this hospital in operation at any time during the year?:	Yes
10.	Operation Open From:	1/1/2004
11.	Operation Open To:	12/31/2004
12.	Name of Parent Corporation:	PROVIDENCE HEALTH SYSTEM
13.	Corporate Street Address:	506 2ND AVE. SUITE 1200
14.	City:	SEATTLE
15.	State:	WA
16.	Zip:	98104 -
17.	Person Completing Report:	DAMON CIANCI
18.	Phone No.:	818-847-3026
19.	Fax No.:	818-847-3036
20.	E-mail Address:	Damon.Cianci@providence.org
30.	Submitted by:	106190385
31.	Submitted Date and Time:	2/11/2005 2:25:07 PM

Section 2 - Hospital Description

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 from drop down list: Non-profit 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 from drop down list: General Medical / Surgical

Section 3 - Inpatient Services

INPATIENT BED UTILIZATION - DO NOT INCLUDE NORMAL NEWBORNS IN BED UTILIZATION DATA

Line No. Bed Classification and General Acute Care (GAC) 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) 150 54,537 10,788 47,770 2. Perinatal (exclude Newborn / GYN) 14 5,124 2,156 4,311 3. Pediatric 0 0 0 0 4. Intensive Care 12 4,392 435 0 8,055 5. Coronary Care 12 4,392 0 0 0 6. Acute Respiratory Care 0 0 0 0 0 7. Burn 0 0 0 0 0 8. Intensive Care Newborn Nursery 5 1,830 144 0 921 9. Rehabilitation Center 13 4,758 361 4,289 15. Subtotal - GAC 206 75,033 13,884 65,346 16. Chemical Dependency Recovery Hospital 0 0 0 0 17. Acute Psychiatric 0 0 0 0 18. Skilled Nursing 48 17,568 471 16,209 19. Intermediate Care 0 0 0 0 20. Intermediate Care / Developmentally Disabled 0 0 0 0 25. Total (Sum of Lines 15 thru 20) 254 92,601 14,355 81,555

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 Discharges (5) Nursery Days 35. Newborn Nursery 28 2,262 4,749

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

Section 4 - Emergency Medical Services (EMS)

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)

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 Medical Service Visits By Type

Line No. EMS Visit Type* CPT Codes (1) Total (2) Admitted 21. Minor 99281 4,786 20 22. Low/Moderate 99282 8,655 102 23. Moderate 99283 16,521 2,815 24. Severe without threat 99284 11,493 3,915 25. Severe with threat 99285 1,621 776 30. Total EMS Visits 43,076 7,628

* DO NOT INCLUDE patients who register but leave 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. 16

Treatment Stations - 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 EMS. 0

Emergency Registrations, But Patient Leaves Without Being Seen*

Line No. (1) 45. Enter the number of EMS 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 Closure / Ambulance Diversion Hours

Line No. (1) 50. Did your hospital close its ED at any time during the year, resulting in ambulance diversion? If 'yes', fill out lines 51 through 65 below. Yes

Number of Hours Emergency Department Was Closed

Line No. Month (1) Hours 51. January 266 52. February 367 53. March 281 54. April 214 55. May 184 56. June 228 57. July 250 58. August 333 59. September 318 60. October 228 61. November 234 62. December 251 65. Total Hours 3,154

Section 5 - Surgery and Related Services

Surgical Services

Line No. Surgical Services (1) Surgical Operations (2) Operating Room Minutes 1. Inpatient 2,596 200,233 2. Outpatient 1,395 78,284

Operating Rooms On December 31

Line No. Operating Room Type (1) Number 7. Inpatient Only 0 8. Outpatient Only 0 9. Inpatient and Outpatient 8 10. Total Operating Rooms 8

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)* 2,373 21. Live Births with Birth Weight Less Than 2500 grams (5 lbs. 8 oz.) 91 22. Live Births with Birth Weight Less Than 1500 grams (3 lbs. 5 oz). 17

* 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 Center Information

Line No. (1) 31. Did your hospital have an approved alternate birthing 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 setting? Do not include C-Section deliveries. 0 37. How many of the live births reported on line 20 were C-Section deliveries? 875

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. 1

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 50 68 45. Total Cardiovascular Surgical Operations 50 68

* 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. 95

* 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. 1

Cardiac Catheterization Visits

Line No. (1) Diagnostic (2) Therapuetic 56. Pediatric - Inpatient 0 0 57. Pediatric - Outpatient 0 0 58. Adult - Inpatient 401 426 59. Adult - Outpatient 304 12 60. Total Cardiac Catheterization Visits 705 438

Distribution of Therapeutic Cardiac Catheterization Procedures

Complete this table if Therapeutic Cardiac Catheterization Visits are reported in column 2, line 60.

Line No. (1) Procedures 71. Permanent Pacemaker Implantation 0 72. Percutaneous Transluminal Coronary Angioplasty (PTCA) - WITH Stent 390 73. Percutaneous Transluminal Coronary Angioplasty (PTCA) - WITHOUT Stent 428 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 Procedures 818

NOTE: Do Not Include Any Of The Following As A Cardiac Catheterization:

Angiography - Non-coronary, Automatic Implantable Cardiac Defibrillator (AICD), Defibrillation, Cardioversion, Intra-Aortic Balloon Pump, Percutaneous Transluminal Angioplasty - Non-cardiac, Pericardiocentesis, or 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

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.) Yes

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. MRI $1,590,338 2/1/2004 Purchase 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)."

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:

Line 71. Pacemaker implantations are only done in surgery.

Errors and Warnings