don’t get harmed in the hospital jacqueline birnbaum’s...

s e p t e m b e r 2 01 3 ConsumerReports.org 31

DON’t get harmeD iN the hOspital Jacqueline Birnbaum’s father might have lived if not for a hospital-acquired infection she feels could have been avoided.

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surgery is scary. It usually involves having your body cut open, and sometimes things go wrong. You react badly to anes-

thesia, or suffer breathing or heart prob-lems. Or maybe the surgeon nicks a blood vessel, leaves an instrument inside, or even operates on the wrong body part.

Less dramatic but often as serious and far

more common is when things go wrong after you leave the operating room. Up to 30 percent of patients suffer infections, heart attacks, strokes, or other complica-tions after surgery and sometimes even die as a result. That’s what happened to Marvin Birnbaum, a retired New York City court reporter, after he developed an infection following hip replacement surgery, his daughter Jacqueline says.

Perhaps scariest of all, though many hospitals now gather data on those prob-lems, patients for the most part remain in the dark about surgical safety. Industry insiders have access to some of that infor-mation because hospitals track how well patients do and report results to state and national officials.

Plus, some hospitals submit data to na-tional registries so that they can see how they stack up against one another. But

that safety information remains largely hidden from patients.

“Consumers have very little to go on when trying to select a hospital for sur-gery, not knowing which ones do a good job at keeping surgery patients safe and which ones don’t,” says Lisa McGiffert, director of Consumers Union’s Safe Patient Project. “They might as well just throw a scalpel at a dartboard.”

Our new surgery Ratings are part of an ongoing effort to shed light on hospital quality and to push the health care indus-try toward more transparency. “Because patients and their families shouldn’t have to make such important decisions with so little information,” McGiffert says.

Showing the data Our Ratings for the first time make public a measure that some hospitals now use to

Your safer-surgery survival guideOur Ratings of 2,463 U.S. hospitals can help you find the right one

Inside

hospitals that make the grade page 33Check up on your hospital page 35six steps to safer surgery page 36

What’s behind our surgery ratings page 37surgery ratings page 37

32 consumer reports s e p t e m b e r 2 01 3

feature safer surgery

track quality—the percentage of Medicare patients undergoing surgery who die in the hospital or stay longer than expected.

We looked at results for 27 kinds of scheduled surgeries, which we combined into an overall surgery Rating, and also developed Ratings for five of those proce-dures: back surgery, replacements of the hip or knee, and procedures to remove blockages in arteries in the heart (angio-plasty) or neck (carotid artery surgery).

To develop the Ratings, we worked with MPA, a health care consulting firm with expertise in analyzing medical claims and clinical records. This project uses billing claims that hospitals submitted to Medi-care for patients 65 and older, from 2009 through 2011, and covers 2,463 hospitals in all 50 states plus Washington, D.C., and Puerto Rico.

“The beauty of this approach is that pre-ventable complications correlate with post-operative length of stay,” says Arnold Millstein, M.D., M.P.H., director of the Clinical Excellence Research Center at Stanford University. He was not involved in our analysis but has studied how hospi-tals measure and improve quality. “This is about as good as complications measure-ment can be when using existing claims data,” he says.

Some experts say that may not be good enough. For one thing, factors other than complications can contribute to extended hospital stays. In addition, “we are con-cerned that the methods used to generate these performance ratings have not been validated against gold-standard measures,” says David M. Shahian, M.D., vice presi-dent of the Lawrence Center for Quality and Safety at Massachusetts General Hos-pital. “They are based on claims data rather than clinical data from patient records.”

In addition, our surgery Ratings are just one indication of a hospital’s performance. “There are a lot of dimensions to hospital quality, and no single measure captures everything,” says Peter Cram, M.D., di-rector of general medicine at the Univer-sity of Iowa Carver College of Medicine.

But we think our Ratings offer vital infor-mation to patients and hospitals. “We wish we had access to more comprehensive, standardized information, but this is the best that is available,” says John Santa, M.D., M.P.H., medical director of Con-sumer Reports Health. “Our surgery Rat-ings give patients more information so that they can make informed choices be-fore surgery,” he adds. “And we hope that

by highlighting performance differences, we can motivate hospitals to improve.”

What we found Our analysis offers important and surpris-ing insights for patients and hospitals:• Some hospitals do a much better job than others. Our Ratings reflect wide variation, sometimes between hospitals only a few miles apart. For example, the Greater Bal-timore Medical Center earned high marks in our overall surgery Rating, as well as for several individual procedures. But the Johns Hopkins Bayview Medical Center, also in Baltimore, got a low Rating. A rep-resentative for the hospital said, “We han-dle many complex cases and are always looking for ways to address any opportuni-ties for improvement.”• Teaching hospitals, thought to represent the nation’s best and the recipients of gen-erous federal funding, often fell short in our surgery Ratings. Though some did rate high, on average teaching hospitals per-formed no better than other hospitals. • Urban and rural hospitals can excel. We found several urban hospitals that did well

despite often serving poorer, sicker pa-tients, including Mount Sinai Hospital in New York and University Hospitals Case Medical Center in Cleveland. And rural hospitals actually did better, on average, than other hospitals. • Big-name hospitals don’t always live up to their reputation when it comes to these surgery Ratings. For example, though several Mayo Clinic hospitals did well, others rated only average. And the Mayo Clinic Health System in Austin, Minn., got a low overall Rating. • Hospital choice matters more for some procedures than for others. For example, we found wider variation for several sur-geries, including hip and knee replace-ments and back surgery, than for others, such as colon surgery and hysterectomy. • Specialty hospitals tended to do better. For example, six of the top performers for carotid artery surgery were heart hospitals. But that’s not always the case. For example, Hospital for Special Surgery in New York, which specializes in orthopedics, earned high marks in our other Ratings that focus on infections related to surgical incisions. p

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turNarOuND Marcia Nelson, M.D., helped lead efforts to improve a struggling California hospital.

In this its 100th anniversary year, enloe medical Center in Chico, Calif., made our list of high-performing hospitals. but seven years ago, it was in trouble—patient satisfaction scores had hit rock bottom, key physicians and hospital leaders had left, and patient deaths had drawn the scrutiny of state and national officials. “It wasn’t the hospital we wanted it to be,” says marcia Nelson, m.D., vice president of medical affairs for the nonprofit hospital. “We committed to becoming a patient-centered environment.” she points to a yearly quality summit, where departments showcase results and choose initiatives for the coming year. “some people think this organization-wide focus on quality is something all hospitals do,” she says. “It isn’t. It’s something special we do, and we are seeing the benefit.”

One hospital’s success story


Fortunately, experts have developed ways to reduce many complications. For example, some hospitals have actually eliminated infections introduced through intravenous catheters by following a checklist. The best hospitals pay attention to detail, says Ateev Mehrotra, M.D., a lecturer at Harvard Medical School and a policy analyst at the nonprofit RAND Cor-poration. “It’s often the accumulation of a lot of little things instead of one big thing that leads to a worse outcome,” he says.

Little reason to improve Unfortunately, hospitals often have little incentive to improve patient safety. The

longer a patient stays in the hospital and the more tests and treatments he or she undergoes, the more money the hospital often makes, according to a study in the April 17, 2013, issue of the Journal of the American Medical Association.

Researchers looked at 12 institutions in a single hospital system and found that for privately insured patients, hospitals made $30,000 or more per patient when things went wrong. For Medicare patients, they also tended to make more, but it was closer to an additional $2,000.

Experts don’t think that hospitals sabo-tage patient safety. “In all my years of clin-ical practice, I never saw or heard of anyone intentionally causing a complication,”

But it got low marks in our hip and knee surgery Ratings, which look at how surgery patients fare over their entire hospital stay. A representative for the hospital said, “The results are not consistent with the data from our own research or with data from state and federal agencies.”

What can go wrongProblems during or after surgery often start small, then escalate, sometimes with devastating effect. Case in point: Marvin Birnbaum.

The only thing holding him back from enjoying retirement was a painful left hip, his daughter says. So he decided to get it replaced at St. Luke’s-Roosevelt Hospital Center in New York. The surgery itself went well. But what followed was hor-rific, she says, as her 85-year-old father and his team of doctors battled infection.

After running an eight-week gantlet of treatments, including open-heart surgery to treat an infected heart valve, her father’s body finally shut down. “He spent two more weeks in a persistent vegetative state before the family made the agonizing decision to remove life support,” says Birnbaum, a music therapist at New York University.

St. Luke’s-Roosevelt earned a low overall surgery Rating but scored well on commu-nications with patients and pain manage-ment in our previous hospital Ratings. A representative says its mortality rates for joint replacement surgeries are within the averages for New York hospitals. “Even under these high standards, pa-tients, unfortunately, still can develop complications,” he says. “It is a challenge that every hospital faces.”

Her father’s downward spiral started, Birnbaum says, with one of the most com-mon and serious types of complications—an infection he contracted in the hospital after the procedure. Surgical incisions, catheters, and intravenous lines give bacteria direct access to a patient’s bloodstream.

Surgery patients are also prone to blood clots, in part because reduced mobility prevents blood from circulating. Clots that break off and travel to the heart or lungs can be deadly. And the combination of ly-ing flat and shallow breathing hampers the body’s ability to clear the lungs, leav-ing patients susceptible to pneumonia.

Those are the most common serious complications. But of course, anyone re-cuperating in a hospital after surgery is vulnerable to a host of other mishaps, such as drug allergies or interactions, and falls.

Well-known hospitals don’t always live up to their reputations.

Hospitals that make the grade•Anne Arundel medical Center, Annapolis, md.

•Christ Hospital, Cincinnati

•enloe medical Center, Chico, Calif.

•Greater baltimore medical Center, baltimore

•memorial Health system, Colorado springs, Colo.

•Oklahoma Heart Hospital, Oklahoma City

•penrose-st. Francis Health services, Colorado springs, Colo.

•scripps Green Hospital, La Jolla, Calif.

•trinity rock Island, rock Island, Ill.

•Yavapai regional medical Center, prescott, Ariz.

We wanted to see which hospitals did well across a broad range of surgeries. So we looked first at hospitals that got our highest overall surgery Rating, then narrowed it down to those that regularly did at least 10 kinds of surgeries and got a high Rating in at least 30 percent of those, without earning a low Rating for any surgery. You might be surprised by the 10 U.S. hospitals, listed alphabetically, that meet that test.

says study author William Berry, M.D., M.P.H., director of the Safe Surgery 2015 initiative at the Harvard School of Public Health. And Medicare now penalizes hos-pitals if readmissions are too high for some conditions. That may encourage them to pay more attention to safety. But some hospitals may continue to avoid doing all that they can to improve patient safety. Berry says his research “sends a powerful message to policy makers about problems in the current system, but it may say some-thing entirely different to bean counters concerned primarily with profits.”

What’s in a name?Jacqueline Birnbaum says her father chose his hospital because he was familiar with it and it had a good reputation. But as our Ratings show, that may not be enough. As health care has grown more complex, how well a hospital is regarded in the commu-nity or among medical professionals doesn’t tell you all that you need to know.

For example, Massachusetts General Hospital earned top scores in U.S. News & World Report’s 2012-2013 rankings. And it did well in heart bypass surgery ratings, based on clinical data, that we previously published. But it earned a low mark in these overall surgery Ratings, as well as low Ratings for hip replacement and ca-rotid artery surgery.

Shahian, at Massachusetts General, says the hospital has “a robust quality-assessment program based on nationally validated methods.” He adds that the hos-pital often cares for complex cases and that Consumer Reports’ surgery Ratings don’t “account for the increased risk of these patients.”

Even hospitals recognized by experts as


Higher- and lower-rated hospitals for five common surgeriesOur overall surgery ratings, shown on page 37, are based on the percentage of a hospital’s medicare patients who die in the hospital or stay longer than expected, for 27 kinds of surgeries combined. below, we show how hospitals rated for five specific surgeries. We looked at hospitals that performed the most of each of those surgeries, and identified hospitals with our highest or lowest ratings in each procedure (listed alphabetically within procedure). Online subscribers can see how hospitals rated in those surgeries at ConsumerReports.org/hospitalratings. A few notable findings:


meeting a rigorous set of industry stan-dards often don’t perform better than oth-ers. For example, complication rates for hip replacements were only somewhat lower at hospitals designated as “joint replacement Centers of Excellence,” according to a Janu-ary 2013 study of 120,000 patients in the

journal Medical Care. “The criteria for the Center of Excellence designation make a lot of sense, and we came into this expecting to see a difference,” lead author Mehrotra says. “The results put consumers in an awk-ward position of not being able to feel as confident about their choice.”

How to chooseIdeally, you’d be able to peer beyond labels and subjective recommendations and look at hard numbers to see how hospitals stack up. Health care insiders do have access to some of that information. The American College of Surgeons, for example, analyzes

higher-rateD hOspitals lOWer-rateD hOspitals

hospital name rat

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hospital name rat

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KNee replaCemeNt ratiNgChristiana Care Health System Newark, Del. ⁄ &Z Beaumont Hospital—Royal Oak royal Oak, mich. ⁄ &BMcBride Clinic Orthopedic Hospital Oklahoma City &Z Florida Hospital Orlando, Fla. ⁄ &BNew Hanover Regional Medical Center Wilmington, N.C. &Z Hospital for Special Surgery New York ⁄ &BSaint Francis Hospital and Medical Center Hartford, Conn. ⁄ &Z Iowa Methodist Medical Center Des moines, Iowa ⁄ &BSt. Vincent’s Medical Center Riverside Jacksonville, Fla. &Z NCH Downtown Naples Hospital Naples, Fla. &Bhip replaCemeNt ratiNgOcala Regional Medical Center Ocala, Fla. &Z Hospital for Special Surgery New York ⁄ &BSaint Francis Hospital and Medical Center Hartford, Conn. ⁄ &Z Inova Mount Vernon Hospital Alexandria, Va. &BSaint John’s Health Center santa monica, Calif. &Z Massachusetts General Hospital boston ⁄ &BSwedish Medical Center-First Hill seattle &Z Sentara Leigh Hospital Norfolk, Va. &BWashington Hospital Healthcare System Fremont, Calif. &Z Thomas Jefferson University Hospital philadelphia ⁄ &BBaCK surgery ratiNg (spinal fusion or disc surgery in the neck or lower back)

Boone Hospital Center Columbia, mo. &Z Brookwood Medical Center birmingham, Ala. &BCenter for Spinal Surgery Nashville, tenn. &Z Huntsville Hospital Huntsville, Ala. &BCitrus Memorial Health System Inverness, Fla. &Z The Methodist Hospital Houston ⁄ &BKansas Spine Hospital Wichita, Kan. &Z St. Vincent Infirmary Medical Center Little rock, Ark. &BSt. Joseph’s Hospital and Medical Center phoenix ⁄ &Z Vidant Medical Center Greenville, N.C. ⁄ &BCOrONary aNgiOplasty ratiNg (a procedure to remove blockages in arteries supplying the heart, combined with the insertion of a stent)

Arkansas Heart Hospital Little rock, Ark. &Z Kaweah Delta Medical Center Visalia, Calif. &BKing’s Daughters Medical Center Ashland, Ky. &Z MedStar Washington Hospital Center Washington, D.C. ⁄ &BMount Sinai Hospital New York ⁄ &Z Methodist Healthcare Memphis Hospitals memphis, tenn. ⁄ &BNew York-Presbyterian Hospital New York ⁄ &Z North Florida Regional Medical Center Gainesville , Fla. € &BSt. Francis Hospital roslyn, N.Y. &Z Palm Beach Gardens Medical Center palm beach Gardens, Fla. &B

St. Joseph Mercy Oakland pontiac, mich. € &BCarOtiD artery surgery ratiNg (a procedure to remove blockages in arteries supplying the brain)

Baylor Jack and Jane Hamilton Heart and Vascular Hospital Dallas &Z Baptist Health Lexington Lexington, Ky. € &BKansas Heart Hospital Wichita, Kan. &Z Baptist St. Anthony Health System Amarillo, texas &BMother Frances Hospital—Tyler tyler, texas &Z Cookeville Regional Medical Center Cookeville, tenn. &BNebraska Heart Hospital Lincoln, Neb. &Z Massachusetts General Hospital boston ⁄ &BOklahoma Heart Hospital Oklahoma City &Z St. Francis Hospital roslyn, N.Y. &B

St. John Medical Center tulsa, Okla. € &B ⁄Member of the Association of American Medical College's Council of Teaching Hospitals. €Have the same surgical volumes for the listed procedure.

Better Worse5 4 3 2 1


•teaching hospitals were no better than other hospitals for hip, knee, and back surgeries but were better for angioplasty and carotid artery surgery.•specialty hospitals tended to do better overall, including for the procedures shown below.•scoring high in one procedure is no guarantee of success in others. st. Francis Hospital, in roslyn, N.Y., for example, got our highest rating for angioplasty but our lowest rating for carotid artery surgery.


hospital data as part of its National Surgi-cal Quality Improvement Program (NSQIP). “It allows hospitals to gauge how they’re doing compared to other hospitals, and to target specific areas for improvement,” says Clifford Ko, M.D., director of the Divi-sion of Research and Optimal Patient Care at the American College of Surgeons.

But most NSQIP data are off-limits to the public. When asked how consumers are supposed to evaluate the quality of their hospital, Ko responded that there really isn’t a good answer. “It can be a dif-ficult thing for consumers to evaluate the quality of their hospital,” he says, “be-cause there are so many possible ways to look at it and present the information.”

A safer future?“Dad always consulted Consumer Re-ports before buying anything,” Birn-baum says. She wishes these hospital Ratings had been available when her father had surgery in 2009. “People need to know this information,” she adds.

Thanks to health care reform, hospitals are encouraged to move to electronic

record keeping, which will make it easier to track data. And some professional organizations—such as those that focus on eye surgery, heart surgery, and joint replacement—are starting to make infor-mation available. The American College of Surgeons, for example, now pub-lishes some of its NSQIP data on the government’s Hospital Compare website. And the Society of Thoracic Surgeons now makes information on heart bypass surgery available for many hospitals and surgical groups, which we publish at ConsumerReports.org/heartratings.

But all of those cases involve voluntary reporting, and some are limited to a small number of hospitals. As Berry and his Harvard colleagues help hospitals in-stitute safer surgery practices, one of their biggest frustrations is getting that information to consumers.

“If you have ever been a patient, then you have been on the wrong side of the power equation,” Berry says. “Now is re-

the safest hospitals pay close attention to details.

Check up on your hospital

by tHe numbers 226 Hospitals with highest surgery rating 221 Hospitals with lowest ratingp

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Check up on your surgeon1 look at state licensing boards. Administrators In medicine has links to state medical boards (docboard.org/docfinder.html), which have information on licensing and disciplinary actions against physicians. 1 make sure your doctor is board certified. the American board of medical specialties (CertificationMatters.org) can tell you whether your doctor has completed an approved residency program and passed a written and, in some cases, oral exam in one of at least 24 medical specialty areas.

1 use our hospital ratings. the surgery ratings on page 37 show how hospitals in your area compared. For a list of all rated hospitals, see the ipad version of our story or go to ConsumerReports.org/surgeryratings. subscribers to our website can get more detailed information at ConsumerReports.org/hospitalratings. Once there, click on: •Your state for an overview of how hospitals performed in our safety score, which includes information from surgical and nonsurgical patients, as well as ratings on other measures, such as readmissions, bloodstream infections, and communication about drugs. •A hospital’s name for even more details, including its rating for five surgeries: back surgery, hip and knee replacements, and surgeries to clear blockages in the arteries in the heart (angioplasty) or neck (carotid artery surgery). • What’s behind Our ratings for a

1 talk with your surgeon. experts we spoke with said they welcome hard questions because informed patients tend do better. Ask about the percentage of patients seen by the surgeon who suffer infections, blood clots, heart attacks, or other complications; how many patients are readmitted or die within 30 days; and how those percentages compare with national averages. Also ask how often he or she performs the procedure. many surgeons know the answers; if they won’t answer, look elsewhere.

detailed description of our methodology. 1 Consider other sources. Good sources include Hospital Compare (hospitalcompare.hhs.gov), state health departments, and the Leapfrog Group (leapfroggroup.org), a nonprofit organization that collects data on hospital quality for employer members and their employees.1 Know what insurance covers. Verify which hospitals are in your plan’s network (and be aware that even if a hospital is in the network, doctors who practice there may not be); the difference between in-network and out-of-network costs, such as deductibles or coinsurance; and whether your procedure requires pre-authorization. 1 get firsthand experiences. Anecdotal experiences aren’t always reliable, but it can help to talk to friends and family members (especially those who work in hospitals) about their stay.



six steps to safer surgery

1go preparedstart healthy. be as active as possible in

the weeks leading up to surgery. make sure blood pressure and blood sugar are well controlled. If you smoke, quit—even if only temporarily—because smoking slows recovery and increases your risk of infection.

schedule carefully. Having surgery early in the week is best. research shows that the death rate for patients having scheduled surgeries is higher later in the week and on weekends. staffing may be lighter on weekends, nights, and holidays, and it can take longer to get lab results. time of day may matter, too: earlier surgeries may benefit from a fresher surgical team.

appoint an advocate. Ask a friend or family member to help monitor your care, by asserting your needs and preferences, asking questions, retaining copies of important medical documents, and advocating for you if problems arise. Ideally, your companion should help you during check-in and discharge, and visit daily.

2avoid infections rid your body of harmful bacteria.

Carefully follow your surgeon’s instructions for cleaning your body before you go to the hospital.

get your nose swabbed. that can check for methicillin-resistant staphylococcus aureus (mrsA), a hard-to-treat bacteria you might bring into the hospital with you.

ask about antibiotics. For most in-patient procedures, antibiotics should be started within an hour of your surgery and, in most cases, stopped 24 hours later.

say no to razors. razor nicks provide an opening for infection. If hair must be removed, electric clippers are safer.

stay warm. the drop in body temperature that occurs during surgery can impede blood

flow and impair immune function. Ask whether a surgical blanket or another technique will be used to keep you warm.

insist on clean hands. Ask your nurses, doctors, and anyone who touches you to wash their hands before examining you if you didn’t see them do so.

ask every day whether tubes can be removed. the longer urinary catheters, central lines, or breathing tubes stay in your body, the greater your risk of developing a potentially deadly infection.

3prevent blood clots assess your clot risk. make sure your

doctor asks about factors such as smoking or use of oral contraceptives that can increase the risk of developing a clot, which can cause leg pain or, more dangerously, travel to your lungs.

ask about prevention. You may need to take blood-thinning medications or to use inflatable cuffs on your legs after surgery to prevent blood clots.

get moving. When you’re able, make sure a hospital staff member helps you get out of bed to sit in a chair or walk down the hall.

4protect your heart Know your risk. If you are 50 or older,

your doctor should check your risk of having a heart attack or stroke. to assess your risk, use our calculator at ConsumerReports.org/heartrisk.

ask about beta-blockers. If you are at high risk for heart attack or stroke, ask whether you should be given beta-blockers before surgery to protect the heart from stress hormones that can trigger a too-rapid heartbeat. If you already take

beta-blockers, make sure they are not stopped while you’re in the hospital.

5Keep breathing talk about sleep apnea. tell your

doctor and anesthesiologist whether you have sleep apnea, which can increase the risks of anesthesia and pain medications. If you haven’t been diagnosed with sleep apnea but have been told that you snore loudly or you are unusually tired during the day, talk to your doctor about being checked for the condition.

Do deep-breathing and coughing exercises. make sure someone teaches you those exercises when you are recovering from surgery. they can help prevent pneumonia and partial collapse of the lungs.

6get the right drugs Bring a drug list. make sure it

includes over-the-counter and prescription medications, vitamins, and herbals, as well as any drug allergies.

track your meds. the most common drug errors are inadvertent changes to existing medications. Ask your doctor about any changes to your drug regimen during your hospital stay.

Some hospitals and surgeons now use checklists before procedures to reduce complications, much as airline pilots do before taking off. We think all hospitals should do so. And we think patients and families should use checklists, too, to make sure they do what they can to stay safe while in the hospital. Here’s ours:

ally the time to bring the consumer’s voice into the discussion about quality.”

Consumers Union, the policy arm of Consumer Reports, aims to do just that through its Safe Patient Project. It works with patient advocates to highlight the things that can go wrong in hospitals and to urge state and federal governments, as well as hospital administrators, to take steps necessary to improve patient safety.

Safe Patient Project goals include: • Expanding public reporting by hospitals on surgical-site infections. That’s now re-quired nationally only for colon surgery and abdominal hysterectomy.• Requiring federally funded hospital safety projects to publicly report their results. • Establishing a standardized way for pa-tients to report medical errors.

If you think you have been harmed in

the hospital, contact your local or state health department or if you are on Medi-care, your state’s Medicare Quality Im-provement Organization.

“An effective way to get hospitals and legislatures to focus on the problem is for patients to share their stories,” says McGiffert at the Safe Patient Project. To tell us yours, go to safepatientproject.org/share-your-story. p

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september 2 01 3 consumer reports 1


how to choose a hospital

Use your smart phone to download the redLaser or shopsavvy app and scan the code for video.

What’s behind our surgery Ratingsthe ratings on the following pages look at how hospitals nationwide compare in avoiding adverse events in medicare patients duringtheir hospital stay for surgery. specifically, the ratings are based on the percentage of a hospital’s surgery patients who died in the hospital or stayed longer than expected for their procedure. research shows those measures are correlated with complications, and some hospitals themselves use this approach to monitor quality. to develop the ratings, we worked with mpA, a health care consulting firm with expertise in analyzing billing claims and clinical records data and in helping hospitals use the information to improve patient safety. the analysis looked at medicare claims data from 2009 through 2011 for patients undergoing 27 categories of common

scheduled surgeries. For each hospital, the results for all procedures are combined into an overall surgery rating. In addition, we have ratings for five of those procedures on our website (ConsumerReports.org/hospitalratings): back surgery, replacement of the hip or knee, and surgery to remove blockages in arteries in the heart (angioplasty) or neck (carotid artery surgery). the rates are risk-adjusted based on patient characteristics, such as age, gender, and other health conditions, including high blood pressure and diabetes. the ratings don’t take into account complications that became apparent after patients were discharged from the hospital. We have ratings for the 2,463 U.s. acute-care or critical-access hospitals with sufficient medicare fee-for-service in-patient surgical claims data from patients 65 and older.

We don’t have ratings for Veterans Affairs hospitals and hospitals that see mostly medicare Advantage patients, such as many Kaiser hospitals, because they use another reporting system. the hospitals shown below are organized by state and listed by their rating. Hospitals with the same rating are alphabetized. For a full description of our methodology, as well as more information on hospitals, go to ConsumerReports.org/hospitalratings.

Hospital name Surgery Rating

ALABAMAJack Hughston Memorial Hospital Phenix City &XThomas Hospital Fairhope &XAndalusia Regional Hospital Andalusia &CBaptist Medical Center East Montgomery &CCrestwood Medical Center Huntsville &CCullman Regional Medical Center Cullman &CDeKalb Regional Medical Center Fort Payne &CHelen Keller Hospital Sheffield &CJackson Hospital and Clinic Montgomery &CMarshall Medical Center North Guntersville &CMarshall Medical Center South Boaz &CMedical Center Enterprise Enterprise &CMedical West Bessemer &CNorthport Medical Center Northport &CPrinceton Baptist Medical Center Birmingham &CProvidence Hospital Mobile &CRussell Medical Center Alexander City &CRussellville Hospital Russellville &CShelby Baptist Medical Center Alabaster &CSouth Baldwin Regional Medical Center Foley &CStringfellow Memorial Hospital Anniston &CVaughan Regional Medical Center Selma &CWalker Baptist Medical Center Jasper &CDCH Regional Medical Center Tuscaloosa &VFlowers Hospital Dothan &VHuntsville Hospital Huntsville &VNortheast Alabama Regional Medical Center Anniston &VSoutheast Alabama Medical Center Dothan &VBaptist Medical Center South Montgomery &BBrookwood Medical Center Birmingham &BDecatur General Hospital Decatur &B


ALABAMA continuedEast Alabama Medical Center Opelika &BEliza Coffee Memorial Hospital Florence &BGadsden Regional Medical Center Gadsden &BMobile Infirmary Medical Center Mobile &BRiverview Regional Medical Center Gadsden &BSpringhill Memorial Hospital Mobile &BSt. Vincent's Birmingham Birmingham &BSt. Vincent's East Birmingham &BTrinity Medical Center Birmingham &BUniversity of Alabama Hospital Birmingham &BALASKAAlaska Native Medical Center Anchorage &CAlaska Regional Hospital Anchorage &CCentral Peninsula General Hospital Soldotna &CFairbanks Memorial Hospital Fairbanks &CMat-Su Regional Medical Center Palmer &CProvidence Alaska Medical Center Anchorage &VARIzoNAArizona orthopedic Surgical Hospital Chandler &ZArizona Spine and Joint Hospital Mesa &ZArrowhead Hospital Glendale &ZBanner Baywood Medical Center Mesa &ZBanner Boswell Medical Center Sun City &ZBanner Heart Hospital Mesa &ZMayo Clinic Hospital Phoenix &ZNorthwest Medical Center Tucson &Zoro Valley Hospital Oro Valley &ZScottsdale Healthcare Thompson Peak Hospital Scottsdale &ZScottsdale Healthcare—osborn Medical Center Scottsdale &ZSurgical Specialty Hospital of Arizona Phoenix &ZYavapai Regional Medical Center Prescott &Z


ARIzoNA continuedBanner Del E. Webb Medical Center Sun City West &XMercy Gilbert Medical Center Gilbert &XScottsdale Healthcare Shea Medical Center Scottsdale &XUniversity of Arizona Medical Center—University Campus Tucson &XYavapai Regional Medical Center—East Prescott Valley &XArizona Regional Medical Center Mesa &CBanner Desert Medical Center Mesa &CBanner Estrella Medical Center Phoenix &CBanner Gateway Medical Center Gilbert &CBanner Good Samaritan Medical Center Phoenix &CBanner Thunderbird Medical Center Glendale &CCarondelet St. Joseph's Hospital Tucson &CCarondelet St. Mary's Hospital Tucson &CCasa Grande Regional Medical Center Casa Grande &CChandler Regional Medical Center Chandler &CFlagstaff Medical Center Flagstaff &CJohn C. Lincoln Deer Valley Hospital Phoenix &CJohn C. Lincoln North Mountain Hospital Phoenix &CKingman Regional Medical Center Kingman &CMountain Vista Medical Center Mesa &Coasis Hospital Phoenix &CParadise Valley Hospital Phoenix &CPayson Regional Medical Center Payson &CPhoenix Baptist Hospital Phoenix &CSierra Vista Regional Health Center Sierra Vista &CSt. Joseph's Hospital and Medical Center Phoenix &CSt. Luke's Medical Center Phoenix &CSummit Healthcare Regional Medical Center Show Low &C

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ARIzoNA continuedTMC Healthcare Tucson &CValley View Medical Center Fort Mohave &CVerde Valley Medical Center Cottonwood &CWest Valley Hospital Goodyear &CYuma Regional Medical Center Yuma &CHavasu Regional Medical Center Lake Havasu City &VWestern Arizona Regional Medical Center Bullhead City &VARKANSASArkansas Heart Hospital Little Rock &ZArkansas Surgical Hospital North Little Rock &ZMedical Center of South Arkansas El Dorado &ZMercy Hospital Rogers Rogers &ZPhysicians' Specialty Hospital Fayetteville &XBaxter Regional Medical Center Mountain Home &CConway Regional Medical Center Conway &CJefferson Regional Medical Center Pine Bluff &CMercy Hospital Hot Springs Hot Springs National Park &CNEA Baptist Memorial Hospital Jonesboro &CNorth Arkansas Regional Medical Center Harrison &CNorthwest Medical Center Springdale &Couachita County Medical Center Camden &CSaline Memorial Hospital Benton &CSparks Regional Medical Center Fort Smith &CSt. Bernards Medical Center Jonesboro &CSt. Vincent Medical Center—North Sherwood &CSummit Medical Center Van Buren &CUAMS Medical Center Little Rock &CWashington Regional Medical Center Fayetteville &CWhite County Medical Center Searcy &CArkansas Methodist Medical Center Paragould &VMercy Hospital Fort Smith Fort Smith &VNational Park Medical Center Hot Springs &VSaint Mary's Regional Medical Center Russellville &VBaptist Health Medical Center—North Little Rock North Little Rock &BBaptist Health Medical Center—Little Rock Little Rock &BSt. Vincent Infirmary Medical Center Little Rock &BWhite River Medical Center Batesville &BCALIFoRNIAAlvarado Hospital San Diego &ZCentinela Hospital Medical Center Inglewood &ZEisenhower Medical Center Rancho Mirage &ZEnloe Medical Center Chico &ZFrench Hospital Medical Center San Luis Obispo &ZFresno Heart and Surgical Hospital Fresno &ZFresno Surgical Hospital Fresno &ZHoag orthopedic Institute Irvine &Z


CALIFoRNIA continuedMercy Medical Center Redding Redding &Zoroville Hospital Oroville &ZSacramento Medical Center Sacramento &ZSaint John's Health Center Santa Monica &ZScripps Green Hospital La Jolla &ZSequoia Hospital Redwood City &ZShasta Regional Medical Center Redding &ZSt. Helena Hospital Napa Valley Saint Helena &ZSt. Joseph Hospital Orange &ZSutter Lakeside Hospital Lakeport &ZSutter Surgical Hospital—North Valley Yuba City &ZUC San Diego Health System San Diego &ZUniversity of California, Irvine Healthcare Orange &ZWashington Hospital Healthcare System Fremont &ZAlta Bates Summit Medical Center Berkeley &XAlta Bates Summit Medical Center—Summit Campus Oakland &XBakersfield Heart Hospital Bakersfield &XChapman Medical Center Orange &XClovis Community Medical Center Clovis &XDesert Valley Hospital Victorville &XEl Camino Hospital Mountain View &XFallbrook Hospital Fallbrook &XGoleta Valley Cottage Hospital Santa Barbara &XHenry Mayo Newhall Memorial Hospital Valencia &XJohn F. Kennedy Memorial Hospital Indio &XMarian Medical Center Santa Maria &XMercy General Hospital Sacramento &XMercy Hospitals of Bakersfield Bakersfield &XMethodist Hospital of Sacramento Sacramento &Xolympia Medical Center Los Angeles &XPomerado Hospital Poway &XPresbyterian Intercommunity Hospital Whittier &XProvidence Tarzana Medical Center Tarzana &XRedwood Memorial Hospital Fortuna &XSaddleback Memorial Medical Center Laguna Hills &XSierra Nevada Memorial Hospital Grass Valley &XSt. Elizabeth Community Hospital Red Bluff &XSt. Francis Medical Center Lynwood &XSt. Joseph Hospital Eureka &XSt. Joseph's Medical Center Stockton &XSt. Jude Medical Center Fullerton &XSt. Mary Medical Center Long Beach &XStanislaus Surgical Hospital Modesto &XSutter Amador Hospital Jackson &XSutter Auburn Faith Hospital Auburn &XSutter Davis Hospital Davis &XSutter Medical Center, Sacramento Sacramento &X


CALIFoRNIA continuedThousand oaks Surgical Hospital Thousand Oaks &XVerdugo Hills Hospital Glendale &XAdventist Medical Center—Hanford Hanford &CAnaheim Regional Medical Center Anaheim &CArroyo Grande Community Hospital Arroyo Grande &CBarton Memorial Hospital South Lake Tahoe &CBrotman Medical Center Culver City &CCalifornia Pacific Medical Center San Francisco &CCedars-Sinai Medical Center Los Angeles &CChinese Hospital San Francisco &CCity of Hope's Helford Clinical Research Hospital Duarte &CCommunity Hospital of the Monterey Peninsula Monterey &CCommunity Regional Medical Center Fresno &CDameron Hospital Stockton &CDelano Regional Medical Center Delano &CDesert Regional Medical Center Palm Springs &CDoctors Medical Center—San Pablo Campus San Pablo &CDominican Hospital Santa Cruz &CDowney Regional Medical Center Downey &CEden Medical Center Castro Valley &CEl Centro Regional Medical Center El Centro &CEmanuel Medical Center Turlock &CFeather River Hospital Paradise &CFountain Valley Regional Hospital and Medical Center Fountain Valley &CFrank R. Howard Memorial Hospital Willits &CFremont-Rideout Health Group Marysville &CGarfield Medical Center Monterey Park &CGlendale Memorial Hospital and Health Center Glendale &CGood Samaritan Hospital Los Angeles &CHealdsburg District Hospital Healdsburg &CHemet Valley Medical Center Hemet &CHoag Memorial Hospital Presbyterian Newport Beach &CHollywood Presbyterian Medical Center Los Angeles &CJohn Muir Medical Center, Concord Concord &CJohn Muir Medical Center, Walnut Creek Walnut Creek &CKeck Hospital of USC Los Angeles &CLakewood Regional Medical Center Lakewood &CLodi Memorial Hospital Lodi &CLoma Linda University Medical Center Loma Linda &CLompoc Valley Medical Center Lompoc &CLong Beach Memorial Medical Center Long Beach &CLos Alamitos Medical Center Los Alamitos &CLos Robles Hospital and Medical Center Thousand Oaks &CMarin General Hospital Greenbrae &C




CALIFoRNIA continuedMarina Del Rey Hospital Marina Del Rey &CMarshall Medical Center Placerville &CMemorial Medical Center Modesto &CMercy Hospital of Folsom Folsom &CMercy Medical Center Merced Merced &CMercy Medical Center Mount Shasta Mount Shasta &CMercy San Juan Medical Center Carmichael &CMethodist Hospital of Southern California Arcadia &CMills-Peninsula Health Services Burlingame &CMission Hospital Mission Viejo &CNorthBay Medical Center Fairfield &CNovato Community Hospital Novato &Co'Connor Hospital San Jose &Coakland Medical Center Oakland &Corange Coast Memorial Medical Center Fountain Valley &CPalm Drive Hospital Sebastopol &CPalmdale Regional Medical Center Palmdale &CPalomar Medical Center Escondido &CParkview Community Hospital Medical Center Riverside &CPatients' Hospital of Redding Redding &CPetaluma Valley Hospital Petaluma &CPioneers Memorial Healthcare District Brawley &CPlacentia-Linda Hospital Placentia &CPomona Valley Hospital Medical Center Pomona &CProvidence Holy Cross Medical Center Mission Hills &CProvidence Little Company of Mary Medical Center Torrance &CProvidence Little Company of Mary Medical Center San Pedro San Pedro &CProvidence Saint Joseph Medical Center Burbank &CQueen of the Valley Medical Center Napa &CRancho Springs Medical Center Murrieta &CRedlands Community Hospital Redlands &CRiverside Community Hospital Riverside &CRonald Reagan University of California Los Angeles Medical Center Los Angeles &CSaint Agnes Medical Center Fresno &CSaint Francis Memorial Hospital San Francisco &CSaint Louise Regional Hospital Gilroy &CSalinas Valley Memorial Healthcare System Salinas &CSan Antonio Community Hospital Upland &CSan Gabriel Valley Medical Center San Gabriel &CSan Ramon Regional Medical Center San Ramon &CSanta Barbara Cottage Hospital Santa Barbara &CSanta Clara Medical Center Santa Clara &CSanta Rosa Memorial Hospital Santa Rosa &CScripps Memorial Hospital—Encinitas Encinitas &CScripps Memorial Hospital—La Jolla La Jolla &C


CALIFoRNIA continuedScripps Mercy Hospital San Diego &CSharp Chula Vista Medical Center Chula Vista &CSharp Coronado Hospital and Healthcare Center Coronado &CSharp Grossmont Hospital La Mesa &CSharp Memorial Hospital San Diego &CSierra View District Hospital Porterville &CSierra Vista Regional Medical Center San Luis Obispo &CSimi Valley Hospital and Health Care Services Simi Valley &CSonora Regional Medical Center Sonora &CSt. Bernardine Medical Center San Bernardino &CSt. John's Pleasant Valley Hospital Camarillo &CSt. John's Regional Medical Center Oxnard &CSt. Luke's Hospital San Francisco &CSt. Mary's Medical Center San Francisco &CSt. Vincent Medical Center Los Angeles &CStanford Hospital and Clinics Palo Alto &CSutter Maternity and Surgery Center of Santa Cruz Santa Cruz &CSutter Medical Center of Santa Rosa, Chanate Campus Santa Rosa &CSutter Roseville Medical Center Roseville &CSutter Solano Medical Center Vallejo &CSutter Tracy Community Hospital Tracy &CTahoe Forest Hospital District Truckee &CTorrance Memorial Medical Center Torrance &CTri-City Medical Center Oceanside &CUCSF Medical Center San Francisco &CUkiah Valley Medical Center Ukiah &CUniversity of California, Davis Medical Center Sacramento &CVallejo Medical Center Vallejo &CValley Presbyterian Hospital Van Nuys &CValleyCare Medical Center Pleasanton &CWatsonville Community Hospital Watsonville &CWest Anaheim Medical Center Anaheim &CWest Hills Hospital and Medical Center West Hills &CWhite Memorial Medical Center Los Angeles &CAntelope Valley Hospital Lancaster &VBakersfield Memorial Hospital Bakersfield &VBeverly Hospital Montebello &VCommunity Memorial Health System Ventura &VGlendale Adventist Medical Center Glendale &VRegional Medical Center of San Jose San Jose &VSan Joaquin Community Hospital Bakersfield &VSanta Monica-UCLA Medical Center and orthopaedic Hospital Santa Monica &VSt. Joseph Health St. Mary Apple Valley &VSt. Rose Hospital Hayward &VTwin Cities Community Hospital Templeton &V


CALIFoRNIA continuedCitrus Valley Medical Center— Inter-Community Campus Covina &BDoctors Medical Center Modesto &BGood Samaritan Hospital San Jose &BHuntington Memorial Hospital Pasadena &BKaweah Delta Medical Center Visalia &BNorthridge Hospital Medical Center—Roscoe Boulevard Campus Northridge &BSeton Medical Center Daly City &BSutter Delta Medical Center Antioch &BCoLoRADoAvista Adventist Hospital Louisville &ZExempla Saint Joseph Hospital Denver &ZMcKee Medical Center Loveland &ZMemorial Health System Colorado Springs &ZorthoColorado Hospital Lakewood &ZPenrose-St. Francis Health Services Colorado Springs &ZPorter Adventist Hospital Denver &ZPoudre Valley Hospital Fort Collins &ZUniversity of Colorado Hospital Aurora &ZValley View Hospital Glenwood Springs &ZAnimas Surgical Hospital Durango &XExempla Lutheran Medical Center Wheat Ridge &XLongmont United Hospital Longmont &XMercy Regional Medical Center Durango &XMontrose Memorial Hospital Montrose &XPresbyterian-St. Luke's Medical Center Denver &XSt. Anthony Hospital Lakewood &XSt. Mary's Hospital and Medical Center Grand Junction &XYampa Valley Medical Center Steamboat Springs &XBoulder Community Hospital Boulder &CCommunity Hospital Grand Junction &CDelta County Memorial Hospital Delta &CExempla Good Samaritan Medical Center Lafayette &CLittleton Adventist Hospital Littleton &CMedical Center of Aurora Aurora &CMedical Center of the Rockies Loveland &CNorth Colorado Medical Center Greeley &CNorth Suburban Medical Center Thornton &CParker Adventist Hospital Parker &CParkview Medical Center Pueblo &CRose Medical Center Denver &CSan Luis Valley Regional Medical Center Alamosa &CSky Ridge Medical Center Lone Tree &CSouthwest Memorial Hospital Cortez &CSt. Anthony North Hospital Westminster &CSt. Mary-Corwin Medical Center Pueblo &CSt. Thomas More Hospital Canon City &CSwedish Medical Center Englewood &CVail Valley Medical Center Vail &CSt. Anthony Summit Medical Center Frisco &B




CoNNECTICUTDanbury Hospital Danbury &ZSaint Francis Hospital and Medical Center Hartford &ZDay Kimball Hospital Putnam &XNew Milford Hospital New Milford &XBridgeport Hospital Bridgeport &CBristol Hospital Bristol &CGreenwich Hospital Greenwich &CGriffin Hospital Derby &CHartford Hospital Hartford &CLawrence + Memorial Hospital New London &CManchester Memorial Hospital Manchester &CMidState Medical Center Meriden &CMiddlesex Hospital Middletown &CMilford Hospital Milford &CNorwalk Hospital Norwalk &CRockville General Hospital Vernon Rockville &CSaint Mary's Hospital Waterbury &CSt. Vincent's Medical Center Bridgeport &CStamford Hospital Stamford &CThe Charlotte Hungerford Hospital Torrington &CThe Hospital of Central Connecticut New Britain &CThe William W. Backus Hospital Norwich &CUniversity of Connecticut Health Center, John Dempsey Hospital Farmington

&C

Waterbury Hospital Waterbury &CWindham Hospital Willimantic &CYale-New Haven Hospital New Haven &CDELAWAREBeebe Medical Center Lewes &XChristiana Care Health System Newark &CNanticoke Memorial Hospital Seaford &CSt. Francis Hospital Wilmington &CBayhealth Medical Center Dover &BDISTRICT oF CoLUMBIAMedStar Georgetown University Hospital Washington, D.C. &CGeorge Washington University Hospital Washington, D.C. &BMedStar Washington Hospital Center Washington, D.C. &BProvidence Hospital Washington, D.C. &BSibley Memorial Hospital Washington, D.C. &BFLoRIDADoctors Hospital of Sarasota Sarasota &ZGulf Breeze Hospital Gulf Breeze &ZGulf Coast Medical Center Panama City &ZMayo Clinic Jacksonville Jacksonville &ZMunroe Regional Medical Center Ocala &Zocala Regional Medical Center Ocala &ZSacred Heart Hospital on the Emerald Coast Miramar Beach &ZTwin Cities Hospital Niceville &ZCape Canaveral Hospital Cocoa Beach &X


FLoRIDA continuedCharlotte Regional Medical Center Punta Gorda &XCitrus Memorial Health System Inverness &XFlorida Hospital DeLand DeLand &XFlorida Hospital Heartland Medical Center Sebring &XFlorida Hospital Waterman Tavares &XNorth Shore Medical Center Miami &XSarasota Memorial Hospital Sarasota &XSt. Anthony's Hospital Saint Petersburg &XWest Boca Medical Center Boca Raton &XBaptist Hospital Pensacola &CBay Medical Center Sacred Heart Panama City &CBayfront Medical Center Saint Petersburg &CBert Fish Medical Center New Smyrna Beach &CBlake Medical Center Bradenton &CBoca Raton Regional Hospital Boca Raton &CBrandon Regional Hospital Brandon &CBrooksville Regional Hospital Brooksville &CBroward Health Medical Center Fort Lauderdale &CBroward Health North Deerfield Beach &CCentral Florida Regional Hospital Sanford &CCoral Gables Hospital Coral Gables &CDelray Medical Center Delray Beach &CDoctors Hospital Coral Gables &CEdward White Hospital Saint Petersburg &CEnglewood Community Hospital Englewood &CFawcett Memorial Hospital Port Charlotte &CFlorida Hospital Fish Memorial Orange City &CFlorida Hospital Memorial Medical Center Daytona Beach &CFlorida Hospital North Pinellas Tarpon Springs &CFlorida Hospital Tampa Tampa &CFlorida Hospital zephyrhills Zephyrhills &CFlorida Hospital—Carrollwood Tampa &CFlorida Hospital—Flagler Palm Coast &CGood Samaritan Medical Center West Palm Beach &CH. Lee Moffitt Cancer Center and Research Institute Tampa &CHeart of Florida Regional Medical Center Davenport &CHighlands Regional Medical Center Sebring &CHoly Cross Hospital Fort Lauderdale &CIndian River Medical Center Vero Beach &CJackson Hospital Marianna &CLake City Medical Center Lake City &CLake Wales Medical Center Lake Wales &CLakewood Ranch Medical Center Bradenton &CLawnwood Regional Medical Center Fort Pierce &CLee Memorial Hospital Fort Myers &CManatee Memorial Hospital Bradenton &CMease Countryside Hospital Safety Harbor &CMease Hospital Dunedin Dunedin &C


FLoRIDA continuedMedical Center of Trinity Trinity &CMemorial Hospital Miramar Miramar &CMemorial Hospital West Pembroke Pines &CMemorial Hospital of Tampa Tampa &CMorton Plant North Bay Hospital New Port Richey &CMount Sinai Medical Center Miami Beach &CNorth okaloosa Medical Center Crestview &CNorthside Hospital and Heart Institute Saint Petersburg &CNorthwest Medical Center Margate &Coak Hill Hospital Brooksville &Corange Park Medical Center Orange Park &Cosceola Regional Medical Center Kissimmee &CPalm Springs General Hospital Hialeah &CPalms West Hospital Loxahatchee &CPalms of Pasadena Hospital Saint Petersburg &CParrish Medical Center Titusville &CPasco Regional Medical Center Dade City &CPeace River Regional Medical Center Port Charlotte &CPhysicians Regional Medical Center—Pine Ridge Naples &CPlantation General Hospital Plantation &CPutnam Community Medical Center Palatka &CRaulerson Hospital Okeechobee &CRegional Medical Center—Bayonet Point Hudson &CSacred Heart Hospital of Pensacola Pensacola &CSebastian River Medical Center Sebastian &CSeven Rivers Regional Medical Center Crystal River &CShands Jacksonville Medical Center Jacksonville &CSouth Florida Baptist Hospital Plant City &CSouth Miami Hospital Miami &CSt. Cloud Regional Medical Center Saint Cloud &CSt. Lucie Medical Center Port St. Lucie &CSt. Mary's Medical Center West Palm Beach &CSt. Petersburg General Hospital Saint Petersburg &CSt. Vincent's Medical Center Riverside Jacksonville &CSt. Vincent's Medical Center Southside Jacksonville &CThe Villages Health System The Villages &CUniversity Hospital and Medical Center Tamarac &CVenice Regional Medical Center Venice &CWellington Regional Medical Center West Palm Beach &CWestside Regional Medical Center Plantation &CWinter Haven Hospital Winter Haven &CWuesthoff Medical Center—Rockledge Rockledge &CAventura Hospital and Medical Center Aventura &VBaptist Hospital of Miami Miami &V




FLoRIDA continuedBaptist Medical Center Beaches Jacksonville Beach &VBethesda Memorial Hospital Boynton Beach &VBroward Health Coral Springs Coral Springs &VBroward Health Imperial Point Fort Lauderdale &VCape Coral Hospital Cape Coral &VCleveland Clinic Florida Weston &VFort Walton Beach Medical Center Fort Walton Beach &VJ.F.K. Medical Center Atlantis &VJackson Health System Miami &VJupiter Medical Center Jupiter &VLakeland Regional Medical Center Lakeland &VLehigh Regional Medical Center Lehigh Acres &VLower Keys Medical Center Key West &VSouth Bay Hospital Sun City Center &VSouth Lake Hospital Clermont &VSt. Joseph's Hospital Tampa &VTown and Country Hospital Tampa &VUniversity of Miami Hospital Miami &VWest Florida Hospital Pensacola &VWuesthoff Medical Center—Melbourne Melbourne &VBaptist Medical Center Jacksonville &BCapital Regional Medical Center Tallahassee &BFlagler Hospital Saint Augustine &BFlorida Hospital Orlando &BGulf Coast Medical Center Fort Myers &BHalifax Health Medical Center of Daytona Beach Daytona Beach &BHealth Central Ocoee &BHolmes Regional Medical Center Melbourne &BKendall Regional Medical Center Miami &BLargo Medical Center Largo &BLeesburg Regional Medical Center Leesburg &BMartin Health System Stuart &BMemorial Hospital Jacksonville Jacksonville &BMemorial Regional Hospital Hollywood &BMorton Plant Hospital Clearwater &BNCH Downtown Naples Hospital Naples &BNorth Florida Regional Medical Center Gainesville &Borlando Regional Medical Center Orlando &BPalm Beach Gardens Medical Center Palm Beach Gardens &BPalmetto General Hospital Hialeah &BShands at the University of Florida Gainesville &BTallahassee Memorial HealthCare Tallahassee &BTampa General Hospital Tampa &BGEoRGIAAthens Regional Medical Center Athens &X


GEoRGIA continuedFairview Park Hospital Dublin &XHughston Hospital Columbus &XNewton Medical Center Covington &XNortheast Georgia Medical Center Gainesville &XNorthside Hospital—Cherokee Canton &XRockdale Medical Center Conyers &XAtlanta Medical Center Atlanta &CCandler Hospital Savannah &CCartersville Medical Center Cartersville &CColiseum Northside Hospital Macon &CColquitt Regional Medical Center Moultrie &CDeKalb Medical at North Decatur Decatur &CDoctors Hospital Augusta &CEast Georgia Regional Medical Center Statesboro &CEastside Medical Center Snellville &CEmory Johns Creek Hospital Johns Creek &CEmory University Hospital Atlanta &CEmory University Hospital Midtown Atlanta &CFannin Regional Hospital Blue Ridge &CGeorgia Health Sciences Medical Center Augusta &CGordon Hospital Calhoun &CHamilton Medical Center Dalton &CHenry Medical Center Stockbridge &CHouston Medical Center Warner Robins &CJohn D. Archbold Memorial Hospital Thomasville &CMayo Clinic Health System in Waycross Waycross &CMemorial Health Savannah &CNorth Fulton Regional Hospital Roswell &CNorthside Hospital Atlanta &Coptim Medical Center—Tattnall Reidsville &CPhoebe North Albany &CPiedmont Fayette Hospital Fayetteville &CPiedmont Newnan Hospital Newnan &CRedmond Regional Medical Center Rome &CSouthern Regional Medical Center Riverdale &CSpalding Regional Medical Center Griffin &CStephens County Hospital Toccoa &CTanner Medical Center Carrollton &CThe Medical Center Columbus &CTift Regional Medical Center Tifton &CTrinity Hospital of Augusta Augusta &CUniversity Hospital Augusta &CUpson Regional Medical Center Thomaston &CWellStar Cobb Hospital Austell &CWest Georgia Health La Grange &CPhoebe Putney Memorial Hospital Albany &VSaint Joseph's Hospital of Atlanta Atlanta &VSouth Georgia Medical Center Valdosta &V


GEoRGIA continuedSt. Francis Hospital Columbus &VWellStar Douglas Hospital Douglasville &VColiseum Medical Centers Macon &BFloyd Medical Center Rome &BGwinnett Hospital System Lawrenceville &BMedical Center of Central Georgia Macon &BNorthside Hospital—Forsyth Cumming &BPiedmont Hospital Atlanta &BPiedmont Mountainside Hospital Jasper &BSoutheast Georgia Health System Brunswick Campus Brunswick &BSt. Joseph's Hospital Savannah &BSt. Mary's Health Care System Athens &BWellStar Kennestone Hospital Marietta &BHAWAIICastle Medical Center Kailua &CKuakini Medical Center Honolulu &CMaui Memorial Medical Center Wailuku &CPali Momi Medical Center Aiea &CStraub Clinic & Hospital Honolulu &CQueen's Medical Center Honolulu &BIDAHoKootenai Medical Center Coeur D'Alene &ZPortneuf Medical Center Pocatello &ZSt. Luke's Regional Medical Center Boise &ZNorthwest Specialty Hospital Post Falls &XSt. Luke's Magic Valley Medical Center Twin Falls &XBingham Memorial Hospital Blackfoot &CCassia Regional Medical Center Burley &CEastern Idaho Regional Medical Center Idaho Falls &CMadison Memorial Hospital Rexburg &CMountain View Hospital Idaho Falls &CSaint Alphonsus Medical Center—Nampa Nampa &CSaint Alphonsus Regional Medical Center Boise &CSt. Joseph Regional Medical Center Lewiston &CSt. Luke's Wood River Medical Center Ketchum &CWest Valley Medical Center Caldwell &CILLINoISAlton Memorial Hospital Alton &ZDecatur Memorial Hospital Decatur &ZGenesis Medical Center, Illini Campus Silvis &ZSt. Margaret's Hospital Spring Valley &ZTrinity Rock Island Rock Island &ZAdventist Hinsdale Hospital Hinsdale &XAdvocate Good Samaritan Hospital Downers Grove &XAdvocate Good Shepherd Hospital Barrington &XAlexian Brothers Medical Center Elk Grove Village &XCGH Medical Center Sterling &XEdward Hospital Naperville &X



ILLINoIS continuedFHN Memorial Hospital Freeport &XHammond-Henry Hospital Geneseo &XHoly Cross Hospital Chicago &XKatherine Shaw Bethea Hospital Dixon &XMorris Hospital & Healthcare Centers Morris &XNorthwestern Lake Forest Hospital Lake Forest &XPekin Hospital Pekin &XRockford Memorial Hospital Rockford &XRush oak Park Hospital Oak Park &XAdvocate BroMenn Medical Center Normal &CAdvocate Condell Medical Center Libertyville &CAdvocate Illinois Masonic Medical Center Chicago &CAdvocate Lutheran General Hospital Park Ridge &CAdvocate South Suburban Hospital Hazel Crest &CAdvocate Trinity Hospital Chicago &CAnderson Hospital Maryville &CBlessing Hospital Quincy &CCarle Foundation Hospital Urbana &CCentegra Hospital—McHenry McHenry &CCentegra Hospital—Woodstock Woodstock &CCentral DuPage Hospital Winfield &CCrossroads Community Hospital Mount Vernon &CDelnor Hospital Geneva &CElmhurst Memorial Hospital Elmhurst &CFranciscan St. James Hospital and Health Centers Olympia Fields &CGateway Regional Medical Center Granite City &CGibson Area Hospital and Health Services Gibson City &CGood Samaritan Regional Health Center Mount Vernon &CGottlieb Memorial Hospital Melrose Park &CGraham Hospital Canton &CHeartland Regional Medical Center Marion &CHerrin Hospital Herrin &CIllinois Valley Community Hospital Peru &CIngalls Memorial Hospital Harvey &CIroquois Memorial Hospital and Resident Home Watseka &CLittle Company of Mary Hospital and Health Care Centers Evergreen Park &CLouis A. Weiss Memorial Hospital Chicago &CLoyola University Medical Center Maywood &CMacNeal Hospital Berwyn &CMcDonough District Hospital Macomb &CMemorial Hospital of Carbondale Carbondale &CMercy Hospital and Medical Center Chicago &CMethodist Medical Center of Illinois Peoria &CMetroSouth Medical Center Blue Island &CMount Sinai Hospital Chicago &CNorthShore University Health System Evanston Hospital Evanston &C


ILLINoIS continuedNorthShore University Health System Skokie Hospital Skokie &CNorthwest Community Hospital Arlington Heights &CNorthwestern Memorial Hospital Chicago &CoSF Saint Anthony Medical Center Rockford &CoSF Saint Elizabeth Medical Center Ottawa &CoSF Saint James—John W. Albrecht Medical Center Pontiac &CoSF St. Joseph Medical Center Bloomington &CoSF St. Mary Medical Center Galesburg &Cour Lady of the Resurrection Medical Center Chicago &CPalos Community Hospital Palos Heights &CPassavant Area Hospital Jacksonville &CProctor Hospital Peoria &CProvena Covenant Medical Center Urbana &CProvena Mercy Medical Center Aurora &CProvena Saint Joseph Hospital Elgin &CProvena St. Mary's Hospital Kankakee &CProvena United Samaritans Medical Center Danville &CResurrection Medical Center Chicago &CRiverside Medical Center Kankakee &CRush University Medical Center Chicago &CRush-Copley Medical Center Aurora &CSaint Anthony's Health Center Alton &CSaint Joseph Hospital Chicago &CSaints Mary & Elizabeth Medical Center Chicago &CSarah Bush Lincoln Health Center Mattoon &CSherman Hospital Elgin &CSilver Cross Hospital New Lenox &CSt. Alexius Medical Center Hoffman Estates &CSt. Anthony's Memorial Hospital Effingham &CSt. Elizabeth's Hospital Belleville &CSt. John's Hospital Springfield &CSt. Mary's Hospital Decatur &CSt. Mary's Hospital Streator &CSwedish Covenant Hospital Chicago &CSwedishAmerican Hospital Rockford &CUniversity of Chicago Medical Center Chicago &CUniversity of Illinois Hospital & Health Sciences System Chicago &CVista Medical Center East Waukegan &CWest Suburban Medical Center Oak Park &CWestlake Hospital Melrose Park &CAdventist La Grange Memorial Hospital La Grange &VProvena Saint Joseph Medical Center Joliet &VSt. Mary's Hospital Centralia &VAdvocate Christ Medical Center Oak Lawn &BGalesburg Cottage Hospital Galesburg &BKishwaukee Community Hospital DeKalb &BMemorial Hospital Belleville &B


ILLINoIS continuedMemorial Medical Center Springfield &BoSF Saint Francis Medical Center Peoria &BSaint Francis Hospital Evanston &BINDIANACommunity Heart and Vascular Hospital Indianapolis &ZIndiana orthopaedic Hospital Indianapolis &ZIndiana University Health Ball Memorial Hospital Muncie &ZIndiana University Health Bloomington Hospital Bloomington &ZMemorial Hospital and Health Care Center Jasper &ZMonroe Hospital Bloomington &Zorthopaedic Hospital of Lutheran Health Network Fort Wayne &ZParkview ortho Hospital Fort Wayne &ZParkview Hospital Randallia Fort Wayne &ZSt. Vincent Heart Center of Indiana Indianapolis &ZCommunity Hospital East Indianapolis &XCommunity Hospital South Indianapolis &XDupont Hospital Fort Wayne &XElkhart General Healthcare System Elkhart &XFranciscan St. Elizabeth Health—Lafayette Central Lafayette &XHendricks Regional Health Danville &XMemorial Hospital of South Bend South Bend &XPhysicians' Medical Center New Albany &XPorter Regional Hospital Valparaiso &XSaint Joseph Regional Medical Center—Plymouth Campus Plymouth &XSt. Vincent Carmel Hospital Carmel &XClark Memorial Hospital Jeffersonville &CColumbus Regional Hospital Columbus &CCommunity Hospital Munster &CCommunity Hospital North Indianapolis &CCommunity Hospital of Anderson and Madison County Anderson &CCommunity Howard Regional Hospital Kokomo &CDeaconess Hospital Evansville &CFloyd Memorial Hospital and Health Services New Albany &CFranciscan St. Anthony Health—Crown Point Crown Point &CFranciscan St. Anthony Health—Michigan City Michigan City &CFranciscan St. Elizabeth Health—Crawfords-ville Crawfordsville &CFranciscan St. Elizabeth Health—Lafayette East Lafayette &CFranciscan St. Francis Health—Indianapolis Indianapolis &CFranciscan St. Francis Health—Mooresville Mooresville &CFranciscan St. Margaret Health—Hammond Hammond &CGood Samaritan Hospital Vincennes &CHancock Regional Hospital Greenfield &CIndiana University Health Arnett Hospital Lafayette &CIndiana University Health Goshen Hospital Goshen &C




INDIANA continuedIndiana University Health La Porte Hospital La Porte &CIndiana University Health North Hospital Carmel &CIndiana University Health University Hospital Indianapolis &CIndiana University Health West Hospital Avon &CKing's Daughters' Health Madison &CKosciusko Community Hospital Warsaw &CLutheran Hospital of Indiana Fort Wayne &CMajor Hospital Shelbyville &CMarion General Hospital Marion &CMethodist Hospitals Gary &CReid Hospital and Health Care Services Richmond &CRiverview Hospital Noblesville &CSaint Joseph Regional Medical Center Mishawaka &CSchneck Medical Center Seymour &CSt. Catherine Hospital East Chicago &CSt. Joseph Hospital Fort Wayne &CSt. Joseph Hospital and Health Center Kokomo &CSt. Mary Medical Center Hobart &CSt. Mary's Medical Center of Evansville Evansville &CSt. Vincent Anderson Regional Hospital Anderson &CTerre Haute Regional Hospital Terre Haute &CUnion Hospital Terre Haute &CWitham Memorial Hospital Lebanon &CHenry County Hospital New Castle &VIndiana University Health Tipton Hospital Tipton &VSt. Vincent Indianapolis Hospital Indianapolis &VThe Heart Hospital at Deaconess Gateway Newburgh &VDearborn County Hospital Lawrenceburg &BKentuckiana Medical Center Clarksville &BIoWAMercy Medical Center—North Iowa Mason City &ZTrinity Bettendorf Bettendorf &ZIowa Specialty Hospital—Clarion Clarion &XMahaska Health Partnership Oskaloosa &XMarshalltown Medical & Surgical Center Marshalltown &XMercy Medical Center—Dubuque Dubuque &XMercy Medical Center—Sioux City Sioux City &Xottumwa Regional Health Center Ottumwa &XSt. Anthony Regional Hospital Carroll &XAlegent Creighton Health Mercy Hospital Council Bluffs &CAllen Memorial Hospital Waterloo &CCovenant Medical Center Waterloo &CFinley Hospital Dubuque &CGenesis Medical Center—Davenport Davenport &CLakes Regional Healthcare Spirit Lake &C


IoWA continuedMary Greeley Medical Center Ames &CMercy Iowa City Iowa City &CMercy Medical Center—Clinton Clinton &CMercy Medical Center—Des Moines Des Moines &CSkiff Medical Center Newton &CSpencer Hospital Spencer &CSt. Luke's Health System, Inc. Sioux City &CSt. Luke's Hospital Cedar Rapids &CTrinity Regional Medical Center Fort Dodge &CUniversity of Iowa Hospitals and Clinics Iowa City &CJennie Edmundson Hospital Council Bluffs &VGreat River Medical Center West Burlington &BIowa Lutheran Hospital Des Moines &BIowa Methodist Medical Center Des Moines &BMercy Medical Center—Cedar Rapids Cedar Rapids &BKANSASHeartland Surgical Specialty Hospital Overland Park &ZKansas City orthopaedic Institute Leawood &ZKansas Medical Center Andover &ZKansas Spine Hospital Wichita &ZKansas Surgery and Recovery Center Wichita &ZSaint Luke's South Hospital Overland Park &ZSummit Surgical, LLC Hutchinson &ZGreat Bend Regional Hospital Great Bend &XSalina Surgical Hospital Salina &XShawnee Mission Medical Center Shawnee Mission &XStormont-Vail HealthCare Topeka &XCoffeyville Regional Medical Center Coffeyville &CHutchinson Regional Medical Center Hutchinson &CKansas Heart Hospital Wichita &CLabette Health Parsons &CLawrence Memorial Hospital Lawrence &CMenorah Medical Center Overland Park &CMercy Regional Health Center Manhattan &Colathe Medical Center Olathe &CPratt Regional Medical Center Pratt &CProvidence Medical Center Kansas City &CSalina Regional Health Center Salina &CSt. Francis Health Center Topeka &CThe University of Kansas Hospital Kansas City &CVia Christi Hospital in Pittsburg Pittsburg &CVia Christi Hospital on St. Francis Wichita &CWesley Medical Center Wichita &CWestern Plains Medical Complex Dodge City &CHays Medical Center Hays &Voverland Park Regional Medical Center Overland Park &VNewman Regional Health Emporia &BNewton Medical Center Newton &BSt. Catherine Hospital Garden City &B


KENTUCKYFlaget Memorial Hospital Bardstown &ZSaint Joseph East Lexington &ZMeadowview Regional Medical Center Maysville &XSaint Joseph Hospital Lexington &XSt. Claire Regional Medical Center Morehead &XBaptist Health Corbin Corbin &CBaptist Health Madisonville Madisonville &CBaptist Health Paducah Paducah &CBaptist Health Richmond Richmond &CEphraim McDowell Regional Medical Center Danville &CFrankfort Regional Medical Center Frankfort &CHardin Memorial Hospital Elizabethtown &CHazard ARH Regional Medical Center Hazard &CJackson Purchase Medical Center Mayfield &CJennie Stuart Medical Center Hopkinsville &CJewish Hospital—Shelbyville Shelbyville &CKing's Daughters Medical Center Ashland &CLourdes Hospital Paducah &Cour Lady of Bellefonte Hospital Ashland &Cowensboro Medical Health System Owensboro &CPikeville Medical Center Pikeville &CSaint Joseph—London London &CSt. Elizabeth Edgewood Edgewood &CSt. Elizabeth Fort Thomas Fort Thomas &CTaylor Regional Hospital Campbellsville &CTriStar Greenview Regional Hospital Bowling Green &CTwin Lakes Regional Medical Center Leitchfield &CBaptist Health Lexington Lexington &VBaptist Health Louisville Louisville &VMedical Center at Bowling Green Bowling Green &VMurray-Calloway County Hospital Murray &VNorton Hospital Louisville &VJewish Hospital Louisville &BLake Cumberland Regional Hospital Somerset &B

Saint Joseph Mount Sterling Mount Sterling &BT.J. Samson Community Hospital Glasgow &BUniversity of Kentucky Albert B. Chandler Hospital Lexington &BUniversity of Louisville Hospital Louisville &BLoUISIANAHeart Hospital of Lafayette Lafayette &ZLouisiana Heart Hospital Lacombe &Zochsner Medical Center New Orleans &ZP & S Surgical Hospital Monroe &ZCHRISTUS Schumpert Medical Center Shreveport &XCentral Louisiana Surgical Hospital Alexandria &X




LoUISIANA continuedGreen Clinic Surgical Hospital Ruston &XIberia Medical Center New Iberia &Xochsner Medical Center—Baton Rouge Baton Rouge &XSpecialists Hospital—Shreveport Shreveport &XAmerican Legion Hospital Crowley &CCHRISTUS St. Frances Cabrini Hospital Alexandria &CCHRISTUS St. Patrick Hospital of Lake Charles Lake Charles &CDauterive Hospital New Iberia &CEast Jefferson General Hospital Metairie &CGlenwood Regional Medical Center West Monroe &CJennings American Legion Hospital Jennings &CLafayette Surgical Specialty Hospital Lafayette &CLake Charles Memorial Hospital Lake Charles &CLane Regional Medical Center Zachary &CMinden Medical Center Minden &Cochsner Baptist Medical Center New Orleans &Cochsner Medical Center—Kenner Kenner &Copelousas General Health System Opelousas &Cour Lady of Lourdes Regional Medical Center Lafayette &CSlidell Memorial Hospital Slidell &CSouthern Surgical Hospital Slidell &CSt. Tammany Parish Hospital Covington &CThe NeuroMedical Center Surgical Hospital Baton Rouge &CThibodaux Regional Medical Center Thibodaux &CTouro Infirmary New Orleans &CTulane Medical Center New Orleans &CWK Bossier Health Center Bossier City &CWest Calcasieu Cameron Hospital Sulphur &CWest Jefferson Medical Center Marrero &CWillis-Knighton Medical Center Shreveport &CWoman's Hospital Baton Rouge &CWomen and Children's Hospital Lake Charles &CBaton Rouge General Medical Center Baton Rouge &VLSU Health Sciences Center Shreveport &VLafayette General Medical Center Lafayette &VLakeview Regional Medical Center Covington &VNorthern Louisiana Medical Center Ruston &VRapides Regional Medical Center Alexandria &VNorth oaks Medical Center Hammond &Bour Lady of the Lake Regional Medical Center Baton Rouge &BRegional Medical Center of Acadiana Lafayette &BSt. Francis Medical Center Monroe &BTerrebonne General Medical Center Houma &BMAINESt. Mary's Regional Medical Center Lewiston &X


MAINE continuedAroostook Medical Center Presque Isle &CCentral Maine Medical Center Lewiston &CEastern Maine Medical Center Bangor &CHenrietta D. Goodall Hospital Sanford &CInland Hospital Waterville &CMaine Coast Memorial Hospital Ellsworth &CMaine Medical Center Portland &CMaineGeneral Medical Center—Waterville Campus Waterville &CMayo Regional Hospital Dover-Foxcroft &CMid Coast Hospital Brunswick &CPen Bay Medical Center Rockport &CSouthern Maine Medical Center Biddeford &CSt. Joseph Hospital Bangor &CFranklin Memorial Hospital Farmington &VMiles Memorial Hospital Damariscotta &VYork Hospital York &VMercy Hospital of Portland Portland &BMARYLANDAnne Arundel Medical Center Annapolis &ZCarroll Hospital Center Westminster &ZGreater Baltimore Medical Center Baltimore &ZMedStar Union Memorial Hospital Baltimore &ZMemorial Hospital at Easton Maryland Easton &ZMercy Medical Center Baltimore &ZPeninsula Regional Medical Center Salisbury &ZSuburban Hospital Bethesda &ZWashington Adventist Hospital Takoma Park &ZFrederick Memorial Hospital Frederick &XGarrett County Memorial Hospital Oakland &XHarford Memorial Hospital Havre De Grace &XKernan orthopaedics and Rehabilitation Baltimore &XMedStar Franklin Square Medical Center Baltimore &X

MedStar St. Mary's Hospital Leonardtown &XUniversity of Maryland Medical Center Baltimore &XAtlantic General Hospital Berlin &CBaltimore Washington Medical Center Glen Burnie &CCalvert Memorial Hospital Prince Frederick &CDoctors Community Hospital Lanham &CFort Washington Medical Center Fort Washington &CHoly Cross Hospital Silver Spring &CHoward County General Hospital Columbia &CJohns Hopkins Hospital Baltimore &CMedStar Good Samaritan Hospital Baltimore &CMedStar Harbor Hospital Baltimore &C


MARYLAND continuedMedStar Montgomery Medical Center Olney &CMeritus Medical Center Hagerstown &CNorthwest Hospital Randallstown &CPrince George's Hospital Center Cheverly &CSaint Agnes Hospital Baltimore &CShady Grove Adventist Hospital Rockville &CUnion Hospital Elkton &CUpper Chesapeake Medical Center Bel Air &CWestern Maryland Regional Medical Center Cumberland &C

Civista Health La Plata &VSinai Hospital of Baltimore Baltimore &VUniversity of Maryland St. Joseph Medical Center Towson &VChester River Health System Chestertown &BJohns Hopkins Bayview Medical Center Baltimore &BMASSACHUSETTSCarney Hospital Boston &ZCooley Dickinson Hospital Northampton &ZBaystate Franklin Medical Center Greenfield &XBaystate Medical Center Springfield &XFalmouth Hospital Falmouth &XHoly Family Hospital and Medical Center Methuen &XMercy Medical Center Springfield &XNewton-Wellesley Hospital Newton Lower Falls &XUMass Memorial Medical Center Worcester &XAnna Jaques Hospital Newburyport &CBeth Israel Deaconess Hospital—Milton Milton &CBeth Israel Deaconess Medical Center Boston &CBeverly Hospital Beverly &CBoston Medical Center Boston &CBrigham and Women's Faulkner Hospital Boston &CCape Cod Hospital Hyannis &CEmerson Hospital Concord &CGood Samaritan Medical Center Brockton &CHallmark Health System Melrose &CHealth Alliance Hospitals Leominster &CHeywood Hospital Gardner &CHolyoke Medical Center Holyoke &CJordan Hospital Plymouth &CLowell General Hospital Lowell &CMassachusetts Eye and Ear Infirmary Boston &CMerrimack Valley Hospital Haverhill &CMetroWest Medical Center Framingham &CMilford Regional Medical Center Milford &CMorton Hospital and Medical Center Taunton &CMount Auburn Hospital Cambridge &CNew England Baptist Hospital Boston &CNorth Adams Regional Hospital North Adams &C




MASSACHUSETTS continuedNorth Shore Medical Center Salem &CNorwood Hospital Norwood &CQuincy Medical Center Quincy &CSaint Vincent Hospital Worcester &CSaints Medical Center Lowell &CSignature Healthcare Brockton Hospital Brockton &CSouth Shore Hospital South Weymouth &CSt. Elizabeth's Medical Center Brighton &CSturdy Memorial Hospital Attleboro &CTufts Medical Center Boston &CUMass Memorial—Marlborough Hospital Marlborough &CWinchester Hospital Winchester &CBerkshire Medical Center Pittsfield &VLawrence General Hospital Lawrence &VSaint Anne's Hospital Fall River &VBrigham and Women's Hospital Boston &BLahey Hospital & Medical Center, Burlington Burlington &BMassachusetts General Hospital Boston &BSouthcoast Hospitals Group Fall River &BMICHIGANBeaumont Hospital—Troy Troy &ZBell Hospital Ishpeming &ZLakeland Regional Medical Center—St. Joseph Saint Joseph &ZMetro Health Hospital Wyoming &ZProMedica Bixby Hospital Adrian &ZScheurer Hospital Pigeon &ZSt. Joseph Mercy Livingston Hospital Howell &ZDickinson County Healthcare System Iron Mountain &XHillsdale Community Health Center Hillsdale &XHuron Medical Center Bad Axe &Xoaklawn Hospital Marshall &Xotsego Memorial Hospital Gaylord &XPennock Hospital Hastings &XPortage Health Hancock &XProvidence Hospital Southfield &XSaint Mary's Health Care Grand Rapids &XSt. Joseph Mercy Port Huron Port Huron &XAllegan General Hospital Allegan &CAllegiance Health Jackson &CAlpena Regional Medical Center Alpena &CBorgess Medical Center Kalamazoo &CBronson Battle Creek Battle Creek &CBronson Methodist Hospital Kalamazoo &CChelsea Community Hospital Chelsea &CCommunity Health Center of Branch County Coldwater &CCovenant Medical Center Saginaw &CCrittenton Hospital Medical Center Rochester &C


MICHIGAN continuedDetroit Receiving Hospital/University Health Center Detroit &CGarden City Hospital Garden City &CGenesys Regional Medical Center Grand Blanc &CHarper University Hospital/Hutzel Women's Hospital Detroit &CHenry Ford Hospital Detroit &CHenry Ford Macomb Hospitals Clinton Township &CHenry Ford West Bloomfield Hospital West Bloomfield &CHenry Ford Wyandotte Hospital Wyandotte &CHolland Hospital Holland &CKarmanos Cancer Center Detroit &CMarquette General Health System Marquette &CMcLaren Bay Region Bay City &CMcLaren Central Michigan Mount Pleasant &CMcLaren Flint Flint &CMcLaren Greater Lansing Lansing &CMcLaren Lapeer Region Lapeer &CMcLaren Macomb Mount Clemens &CMcLaren Northern Michigan Petoskey &CMcLaren oakland Pontiac &CMecosta County Medical Center Big Rapids &CMemorial Healthcare Owosso &CMemorial Medical Center of West Michigan Ludington &CMercy Health Partners, Hackley Campus Muskegon &CMercy Health Partners, Mercy Campus Muskegon &CMercy Hospital Cadillac Cadillac &CMercy Hospital Grayling Grayling &CMercy Memorial Hospital System Monroe &CMidMichigan Medical Center—Gratiot Alma &CMidMichigan Medical Center—Midland Midland &Coakwood Heritage Hospital Taylor &Coakwood Southshore Medical Center Trenton &CPort Huron Hospital Port Huron &CProMedica Herrick Hospital Tecumseh &CSinai-Grace Hospital Detroit &CSpectrum Health—Grand Rapids Grand Rapids &CSpectrum Health Gerber Memorial Fremont &CSt. John Macomb-oakland Hospital Warren &CSt. Joseph Health System Tawas City &CSt. Joseph Mercy Hospital Ypsilanti &CSt. Joseph Mercy oakland Pontiac &CSt. Mary Mercy Hospital Livonia &CSt. Mary's of Michigan Saginaw &C


MICHIGAN continued

University of Michigan Hospitals and Health Centers Ann Arbor &CWar Memorial Hospital Sault Sainte Marie &CWest Branch Regional Medical Center West Branch &CWest Shore Medical Center Manistee &CBotsford Hospital Farmington Hills &VDMC Huron Valley-Sinai Hospital Commerce Township &Voakwood Annapolis Hospital Wayne &VSt. John Hospital and Medical Center Detroit &VBeaumont Hospital—Royal oak Royal Oak &BBeaumont Hospital—Grosse Pointe Grosse Pointe &BHurley Medical Center Flint &BMunson Medical Center Traverse City &Boakwood Hospital & Medical Center—Dearborn Dearborn &BSparrow Hospital Lansing &BMINNESoTAAbbott Northwestern Hospital Minneapolis &Z

Douglas County Hospital Alexandria &ZEssentia Health St. Joseph's Medical Center Brainerd &ZFairview Ridges Hospital Burnsville &ZFairview Southdale Hospital Edina &ZLake Region Healthcare Fergus Falls &ZLakeview Hospital Stillwater &ZMayo Clinic Health System in Albert Lea Albert Lea &ZMercy Hospital Coon Rapids &ZRegions Hospital Saint Paul &ZRice Memorial Hospital Willmar &ZRidgeview Medical Center Waconia &ZSanford Bemidji Medical Center Bemidji &ZSt. Francis Regional Medical Center Shakopee &ZDistrict one Hospital Faribault &XEssentia Health St. Mary's Hospital—Detroit Lakes Detroit Lakes &X

Grand Itasca Clinic and Hospital Grand Rapids &X

Mayo Clinic Health System in Red Wing Red Wing &XNew Ulm Medical Center New Ulm &XNorth Memorial Medical Center Robbinsdale &XNorthfield Hospital Northfield &XPark Nicollet Methodist Hospital Saint Louis Park &XRegina Medical Center Hastings &XRochester Methodist Hospital Rochester &XSt. Gabriel's Hospital Little Falls &XSt. John's Hospital Saint Paul &XUnited Hospital Saint Paul &X




MINNESoTA continuedUnity Hospital Fridley &XWinona Health Winona &XWoodwinds Health Campus Woodbury &XBuffalo Hospital Buffalo &CCambridge Medical Center Cambridge &CCuyuna Regional Medical Center Crosby &C

Essentia Health—Virginia Virginia &CFairview Lakes Health Services Wyoming &CHennepin County Medical Center Minneapolis &CHutchinson Health Hutchinson &CMayo Clinic—Saint Marys Hospital Rochester &CMayo Clinic Health System in Mankato Mankato &CMayo Clinic Health System in New Prague New Prague &Colmsted Medical Center Rochester &Cowatonna Hospital Owatonna &CRiverwood Healthcare Center Aitkin &CSt. Cloud Hospital Saint Cloud &CSt. Joseph's Area Health Services Park Rapids &CSt. Joseph's Hospital Saint Paul &CSt. Luke's Hospital Duluth &CEssentia Health St. Mary's Medical Center Duluth &VMayo Clinic Health System in Fairmont Fairmont &VMayo Clinic Health System in Austin Austin &BSanford Medical Center Thief River Falls Thief River Falls &BUniversity of Minnesota Medical Center, Fairview Minneapolis &B

MISSISSIPPIBaptist Memorial Hospital—Golden Triangle Columbus &CBaptist Memorial Hospital—North Mississippi Oxford &CBaptist Memorial Hospital—Union County New Albany &CCentral Mississippi Medical Center Jackson &CCrossgates River oaks Hospital Brandon &CDelta Regional Medical Center Greenville &CGilmore Memorial Regional Medical Center Amory &CGreenwood Leflore Hospital Greenwood &CKing's Daughters Medical Center Brookhaven &CMagnolia Regional Health Center Corinth &CMississippi Baptist Medical Center Jackson &CNatchez Regional Medical Center Natchez &CNorth Mississippi Medical Center—Tupelo Tupelo &CRiver Region Medical Center Vicksburg &CSouth Central Regional Medical Center Laurel &C


MISSISSIPPI continuedSouthwest Mississippi Regional Medical Center McComb &CUniversity Hospitals and Health System, University of Mississippi Medical Center Jackson

&CAnderson Regional Medical Center Meridian &VBiloxi Regional Medical Center Biloxi &VRiver oaks Hospital Flowood &VRush Foundation Hospital Meridian &VBaptist Memorial Hospital—Desoto Southaven &BForrest General Hospital Hattiesburg &BGarden Park Medical Center Gulfport &BMemorial Hospital at Gulfport Gulfport &BoCH Regional Medical Center Starkville &BSinging River Health System Pascagoula &BSt. Dominic-Jackson Memorial Hospital Jackson &BWesley Medical Center Hattiesburg &BMISSoURIBoone Hospital Center Columbia &ZSaint Luke's North Hospital—Barry Road Kansas City &ZHannibal Regional Hospital Hannibal &XLester E. Cox Medical Centers Springfield &XMercy Hospital Washington Washington &XMissouri Baptist Medical Center Saint Louis &XProgress West HealthCare Center Saint Charles &XSaint Luke's East Hospital Lee's Summit &XAudrain Medical Center Mexico &CBarnes-Jewish West County Hospital Saint Louis &CBelton Regional Medical Center Belton &CBothwell Regional Health Center Sedalia &CCapital Region Medical Center Jefferson City &CCenterpoint Medical Center Independence &CChristian Hospital Saint Louis &CCitizens Memorial Hospital Bolivar &CCox Medical Center Branson Branson &CFreeman Hospital West Joplin &CGolden Valley Memorial Healthcare Clinton &CHeartland Regional Medical Center Saint Joseph &CLee's Summit Medical Center Lee's Summit &CLiberty Hospital Liberty &CMercy Hospital Jefferson Crystal City &CMercy Hospital Joplin Joplin &CMercy Hospital Lebanon Lebanon &CMercy Hospital Springfield Springfield &CMissouri Delta Medical Center Sikeston &CNorth Kansas City Hospital North Kansas City &CNortheast Regional Medical Center Kirksville &Cozarks Medical Center West Plains &CPhelps County Regional Medical Center Rolla &C


MISSoURI continuedPoplar Bluff Regional Medical Center Poplar Bluff &CResearch Medical Center Kansas City &CSSM DePaul Health Center Bridgeton &CSSM St. Clare Health Center Fenton &CSSM St. Joseph Health Center Saint Charles &CSSM St. Joseph Hospital West Lake Saint Louis &CSSM St. Mary's Health Center Saint Louis &CSaint Francis Medical Center Cape Girardeau &CSaint Louis University Hospital Saint Louis &CSaint Luke's Hospital of Kansas City Kansas City &C

Southeast Hospital Cape Girardeau &CSt. Joseph Medical Center Kansas City &CSt. Mary's Medical Center Blue Springs &CSt. Mary's Health Center Jefferson City &CTruman Medical Center—Lakewood Kansas City &CUniversity of Missouri Hospitals and Clinics Columbia &CWomen's and Children's Hospital Columbia &CBarnes-Jewish Hospital Saint Louis &VBarnes-Jewish St. Peters Hospital Saint Peters &VMercy Hospital St. Louis Saint Louis &VSt. Luke's Hospital Chesterfield &VWestern Missouri Medical Center Warrensburg &VDes Peres Hospital Saint Louis &BLake Regional Health System Osage Beach &BSt. Anthony's Medical Center Saint Louis &BMoNTANABillings Clinic Billings &ZGreat Falls Clinic Medical Center Great Falls &ZKalispell Regional Medical Center Kalispell &ZSt. Patrick Hospital Missoula &ZSt. Vincent Healthcare Billings &ZBenefis Hospitals Great Falls &XBozeman Deaconess Hospital Bozeman &XThe HealthCenter Kalispell &XCommunity Medical Center Missoula &CMarcus Daly Memorial Hospital Hamilton &CNorth Valley Hospital Whitefish &CSt. James Healthcare Butte &CSt. Peter's Hospital Helena &CNEBRASKALincoln Surgical Hospital Lincoln &ZMary Lanning Healthcare Hastings &ZMidwest Surgical Hospital Omaha &ZNebraska Heart Hospital Lincoln &ZNebraska orthopaedic Hospital Omaha &ZSaint Elizabeth Regional Medical Center Lincoln &ZColumbus Community Hospital Columbus &XFremont Area Medical Center Fremont &XAlegent Creighton Health Bergan Mercy Medical Center Omaha &C




NEBRASKA continuedAlegent Creighton Health Immanuel Medical Center Omaha &CAlegent Creighton Health Lakeside Hospital Omaha &CAlegent Creighton Health Midlands Hospital Papillion &CAlegent Creighton Health—Creighton University Medical Center Omaha &CBryan Medical Center Lincoln &CCommunity Hospital McCook &CFaith Regional Health Services Norfolk &CGood Samaritan Hospital Kearney &CGreat Plains Regional Medical Center North Platte &CNebraska Medical Center Omaha &CNebraska Methodist Hospital Omaha &CNebraska Spine Hospital Omaha &CRegional West Medical Center Scottsbluff &CSaint Francis Medical Center Grand Island &CNEVADASierra Surgery Hospital Carson City &ZRenown South Meadows Medical Center Reno &XSaint Mary's Regional Medical Center Reno &XCarson Tahoe Regional Healthcare Carson City &CDesert Springs Hospital Medical Center Las Vegas &CMesa View Regional Hospital Mesquite &CNorth Vista Hospital North Las Vegas &CNorthern Nevada Medical Center Sparks &CRenown Regional Medical Center Reno &CSouthern Hills Hospital and Medical Center Las Vegas &CSpring Valley Hospital Medical Center Las Vegas &CSt. Rose Dominican Hospitals—San Martin Campus Las Vegas &CSt. Rose Dominican Hospitals—Siena Campus Henderson &CSummerlin Hospital Medical Center Las Vegas &CSunrise Hospital and Medical Center Las Vegas &CUniversity Medical Center Las Vegas &CCentennial Hills Hospital Medical Center Las Vegas &VMountainView Hospital Las Vegas &VSt. Rose Dominican Hospitals—Rose de Lima Campus Henderson &VValley Hospital Medical Center Las Vegas &VNEW HAMPSHIREExeter Hospital Exeter &ZFrisbie Memorial Hospital Rochester &XAlice Peck Day Memorial Hospital Lebanon &CCatholic Medical Center Manchester &CCheshire Medical Center Keene &CConcord Hospital Concord &CDartmouth-Hitchcock Medical Center Lebanon &C


NEW HAMPSHIRE continuedElliot Hospital Manchester &CLakes Region General Hospital Laconia &CLittleton Regional Hospital Littleton &CMonadnock Community Hospital Peterborough &C

Parkland Medical Center Derry &CSouthern New Hampshire Medical Center Nashua &CSt. Joseph Hospital Nashua &CWentworth-Douglass Hospital Dover &CPortsmouth Regional Hospital Portsmouth &BNEW JERSEYHackensack University Medical Center Hackensack &XHackensack University Medical Center Mountainside Montclair &Xocean Medical Center Brick Township &XRiverview Medical Center Red Bank &XAtlantiCare Regional Medical Center Atlantic City &CBayonne Medical Center Bayonne &CBayshore Community Hospital Holmdel &CCape Regional Medical Center Cape May Court House &CCapital Health Medical Center—Hopewell Pennington &CCapital Health Regional Medical Center Trenton &CCentraState Healthcare System Freehold &CChilton Hospital Pompton Plains &CChrist Hospital Jersey City &CClara Maass Medical Center Belleville &CCommunity Medical Center Toms River &CDeborah Heart and Lung Center Browns Mills &CHackettstown Regional Medical Center Hackettstown &CHunterdon Medical Center Flemington &CJersey Shore University Medical Center Neptune &CKennedy Memorial Hospitals—University Medical Center Cherry Hill &CLibertyHealth—Jersey City Medical Center Jersey City &CLourdes Medical Center of Burlington County Willingboro &CMemorial Hospital of Salem County Salem &CMonmouth Medical Center Long Branch &CMorristown Medical Center Morristown &CNewark Beth Israel Medical Center Newark &CNewton Medical Center Newton &Coverlook Medical Center Summit &CPalisades Medical Center North Bergen &CRobert Wood Johnson University Hospital Rahway Rahway &CRobert Wood Johnson University Hospital at Hamilton Hamilton &CSaint Barnabas Medical Center Livingston &CSaint Clare's Health System Denville &C


NEW JERSEY continuedSomerset Medical Center Somerville &CSouth Jersey Healthcare—Elmer Hospital Elmer &CSouth Jersey Healthcare—Regional Medical Center Vineland &CSouthern ocean Medical Center Manahawkin &CSt. Luke's Hospital—Warren Campus Phillipsburg &CTrinitas Regional Medical Center Elizabeth &CUnderwood-Memorial Hospital Woodbury &CUniversity Medical Center of Princeton at Plainsboro Plainsboro &CUniversity of Medicine and Dentistry of New Jersey—University Hospital Newark

&C

Valley Hospital Ridgewood &CVirtua Memorial Mount Holly &Cour Lady of Lourdes Medical Center Camden &VSt. Mary's Hospital Passaic &VCooper Health System Camden &BEnglewood Hospital and Medical Center Englewood &BHoly Name Medical Center Teaneck &BJFK Medical Center Edison &BRaritan Bay Medical Center Perth Amboy &BRobert Wood Johnson University Hospital New Brunswick &BSaint Michael's Medical Center Newark &BSaint Peter's University Hospital New Brunswick &BShore Medical Center Somers Point &BSt. Francis Medical Center Trenton &BSt. Joseph's Regional Medical Center Paterson &BVirtua Berlin Berlin &BVirtua Voorhees Voorhees &BNEW MEXICoPresbyterian Hospital Albuquerque &ZCarlsbad Medical Center Carlsbad &XChristus St. Vincent Regional Medical Center Santa Fe &CEastern New Mexico Medical Center Roswell &CGerald Champion Regional Medical Center Alamogordo &CGila Regional Medical Center Silver City &CLovelace Medical Center Albuquerque &CLovelace Regional Hospital Roswell &CLovelace Westside Hospital Albuquerque &CLovelace Women's Hospital Albuquerque &CMemorial Medical Center Las Cruces &CMountainView Regional Medical Center Las Cruces &CPlains Regional Medical Center Clovis &CRehoboth McKinley Christian Health Care Services Gallup &CSan Juan Regional Medical Center Farmington &CUniversity of New Mexico Hospitals Albuquerque &C




NEW YoRKKenmore Mercy Hospital Kenmore &ZMount Sinai Hospital New York &ZNYU Langone Medical Center New York &ZNew York-Presbyterian Hospital New York &ZHighland Hospital of Rochester Rochester &XSt. John's Riverside Hospital Yonkers &XAdirondack Medical Center Saranac Lake &CAlbany Memorial Hospital Albany &CArnot ogden Medical Center Elmira &CAuburn Community Hospital Auburn &CAurelia osborn Fox Memorial Hospital Oneonta &CBassett Medical Center Cooperstown &CBrookhaven Memorial Hospital Medical Center Patchogue &CBrooks Memorial Hospital Dunkirk &CChamplain Valley Physicians Hospital Medical Center Plattsburgh &CChenango Memorial Hospital Norwich &CClaxton-Hepburn Medical Center Ogdensburg &CClifton Springs Hospital and Clinic Clifton Springs &CColumbia Memorial Hospital Hudson &CCommunity Memorial Hospital Hamilton &CCorning Hospital Corning &CCrouse Hospital Syracuse &CEllis Hospital Schenectady &CErie County Medical Center Buffalo &CF.F. Thompson Hospital Canandaigua &CFaxton-St. Luke's Healthcare Utica &CFranklin Hospital Valley Stream &CGeneva General Hospital Geneva &CGlens Falls Hospital Glens Falls &CGood Samaritan Hospital Suffern &CGood Samaritan Hospital Medical Center West Islip &CHealth Alliance Hospital—Broadway Campus Kingston &CHudson Valley Hospital Center Cortlandt Manor &CHuntington Hospital Huntington &CKALEIDA Health Buffalo &CLawrence Hospital Center Bronxville &CLenox Hill Hospital New York &CLong Island Jewish Medical Center New Hyde Park &CMaimonides Medical Center Brooklyn &CMemorial Sloan-Kettering Cancer Center New York &CMercy Medical Center Rockville Centre &CMount St. Mary's Hospital and Health Cen-ter Lewiston &CNew York Community Hospital Brooklyn &CNew York Downtown Hospital New York &CNew York Methodist Hospital Brooklyn &CNew York Westchester Square Medical Center Bronx &C


NEW YoRK continuedNorth Shore University Hospital Manhasset &CNorthern Dutchess Hospital Rhinebeck &CNyack Hospital Nyack &Colean General Hospital Olean &Cour Lady of Lourdes Memorial Hospital Binghamton &CPhelps Memorial Hospital Center Sleepy Hollow &CRochester General Hospital Rochester &CRome Memorial Hospital Rome &CRoswell Park Cancer Institute Buffalo &CSUNY Downstate Medical Center University Hospital Brooklyn &CSaint Francis Hospital and Health Centers Poughkeepsie &CSamaritan Hospital Troy &CSamaritan Medical Center Watertown &CSaratoga Hospital Saratoga Springs &CSisters of Charity Hospital of Buffalo Buffalo &CSound Shore Medical Center of Westchester New Rochelle &CSouth Nassau Communities Hospital Oceanside &CSouthampton Hospital Southampton &CSouthside Hospital Bay Shore &CSt. Catherine of Siena Medical Center Smithtown &CSt. Elizabeth Medical Center Utica &CSt. Francis Hospital Roslyn &CSt. Joseph Hospital Bethpage &CSt. Joseph's Hospital Elmira &CSt. Luke's Cornwall Hospital Newburgh &CSt. Mary's Healthcare Amsterdam &CSt. Mary's Hospital Troy &CSt. Peter's Hospital Albany &CStaten Island University Hospital Staten Island &CStony Brook University Medical Center Stony Brook &CStrong Memorial Hospital of the University of Rochester Rochester &CUnited Memorial Medical Center Batavia &CUpstate University Hospital Syracuse &CVassar Brothers Medical Center Poughkeepsie &CWestchester Medical Center Valhalla &CCayuga Medical Center at Ithaca Ithaca &VForest Hills Hospital Forest Hills &VMontefiore Medical Center Bronx &VNew York Hospital Queens Flushing &VNorthern Westchester Hospital Mount Kisco &Vorange Regional Medical Center Middletown &VPeconic Bay Medical Center Riverhead &VRichmond University Medical Center Staten Island &V


NEW YoRK continuedSt. Joseph's Hospital Health Center Syracuse &VUnity Hospital Rochester &VWoman's Christian Association Hospital Jamestown &VAlbany Medical Center Albany &BBeth Israel Medical Center New York &BCanton-Potsdam Hospital Potsdam &BFlushing Hospital Medical Center Flushing &BGlen Cove Hospital Glen Cove &BHealth Alliance Hospital—Mary's Avenue Campus Kingston &BHospital for Special Surgery New York &BJohn T. Mather Memorial Hospital Port Jefferson &BLutheran Medical Center Brooklyn &BMercy Hospital Buffalo &BPlainview Hospital Plainview &BPutnam Hospital Center Carmel &BSt. Charles Hospital Port Jefferson &BSt. Luke's-Roosevelt Hospital Center New York &BUnited Health Services Hospitals— Binghamton Binghamton &BWhite Plains Hospital Center White Plains &BWinthrop-University Hospital Mineola &BNoRTH CARoLINAMargaret R. Pardee Memorial Hospital Hendersonville &ZNorth Carolina Specialty Hospital Durham &ZHalifax Regional Medical Center Roanoke Rapids &XPresbyterian Hospital Huntersville Huntersville &XRandolph Hospital Asheboro &XRex Healthcare Raleigh &XWake Forest Baptist Health—Lexington Medical Center Lexington &XAlamance Regional Medical Center Burlington &CAlbemarle Health Elizabeth City &CBetsy Johnson Regional Hospital Dunn &CBrunswick Novant Medical Center Bolivia &CCaldwell Memorial Hospital Lenoir &CCarolinaEast Health System New Bern &CCarolinas Medical Center-University Charlotte &CCarteret General Hospital Morehead City &CCatawba Valley Medical Center Hickory &CCentral Carolina Hospital Sanford &CCleveland Regional Medical Center Shelby &CColumbus Regional Healthcare System Whiteville &CDuke Raleigh Hospital Raleigh &CDuke University Hospital Durham &CFirstHealth Moore Regional Hospital Pinehurst &CForsyth Medical Center Winston-Salem &CFrye Regional Medical Center Hickory &C




NoRTH CARoLINA continuedGaston Memorial Hospital Gastonia &CGrace Hospital Morganton &CGranville Health System Oxford &CHigh Point Regional Health System High Point &CIredell Memorial Hospital Statesville &CLake Norman Regional Medical Center Mooresville &CLenoir Memorial Hospital Kinston &CMedWest—Harris Sylva &CMedWest—Haywood Clyde &CMedical Park Hospital Winston-Salem &CMission Hospital Asheville &CMorehead Memorial Hospital Eden &CMurphy Medical Center Murphy &CNash Health Care Systems Rocky Mount &CNew Hanover Regional Medical Center Wilmington &CNorthern Hospital of Surry County Mount Airy &CPark Ridge Health Hendersonville &CPerson Memorial Hospital Roxboro &CPresbyterian Hospital Charlotte &CPresbyterian-orthopaedic Hospital Charlotte &CRowan Regional Medical Center Salisbury &CRutherford Regional Health System Rutherfordton &CScotland Health Care System Laurinburg &CSt. Luke's Hospital Columbus &CThe outer Banks Hospital Nags Head &CTransylvania Regional Hospital Brevard &CUniversity of North Carolina Hospitals Chapel Hill &CVidant Edgecombe Hospital Tarboro &CWake Forest Baptist Medical Center Winston-Salem &CWakeMed Cary Hospital Cary &CWakeMed Raleigh Campus Raleigh &CWatauga Medical Center Boone &CWayne Memorial Hospital Goldsboro &CWilkes Regional Medical Center North Wilkesboro &CWilson Medical Center Wilson &CCarolinas Medical Center—Mercy Charlotte &VCarolinas Medical Center—NorthEast Concord &VDurham Regional Hospital Durham &VHugh Chatham Memorial Hospital Elkin &VJohnston Health Smithfield &VSoutheastern Health Lumberton &VStanly Regional Medical Center Albemarle &VCape Fear Valley Medical Center Fayetteville &BCarolinas Medical Center Charlotte &BCarolinas Medical Center—Union Monroe &BCone Health Greensboro &BDavis Regional Medical Center Statesville &B


NoRTH CARoLINA continuedonslow Memorial Hospital Jacksonville &BPresbyterian Hospital Matthews Matthews &BSampson Regional Medical Center Clinton &BVidant Chowan Hospital Edenton &BVidant Medical Center Greenville &BNoRTH DAKoTASanford Health Bismarck &ZTrinity Health Minot &ZAltru Health System Grand Forks &CEssentia Health Fargo Fargo &CSanford Medical Center Fargo Fargo &CSt. Alexius Medical Center Bismarck &CoHIoChrist Hospital Cincinnati &ZFulton County Health Center Wauseon &ZGrant Medical Center Columbus &ZInstitute for orthopaedic Surgery Lima &ZLicking Memorial Hospital Newark &ZMount Carmel New Albany Surgical Hospital New Albany &ZNorthside Medical Center Youngstown &ZParma Community General Hospital Parma &ZSamaritan Regional Health System Ashland &ZSouthwest General Health Center Middleburg Heights &ZSt. Elizabeth Boardman Health Center Boardman &ZAdena Medical Center Chillicothe &XBlanchard Valley Hospital Findlay &XEuclid Hospital Euclid &XEvendale Medical Center Cincinnati &XMarymount Hospital Garfield Heights &XMedina Hospital Medina &XMercy Hospital Clermont Batavia &XMercy Hospital Mount Airy Cincinnati &Xohio Valley Medical Center Springfield &XohioHealth Marion General Hospital Marion &XSelby General Hospital Marietta &XSt. Elizabeth Health Center Youngstown &XSt. John Medical Center Westlake &XSumma Western Reserve Hospital Cuyahoga Falls &XSurgical Hospital at Southwoods Youngstown &XThe Jewish Hospital Cincinnati &XUniversity Hospitals Case Medical Center Cleveland &XUniversity Hospitals Conneaut Medical Center Conneaut &XAffinity Medical Center Massillon &CAlliance Community Hospital Alliance &CAshtabula County Medical Center Ashtabula &CAultman Hospital Canton &CBerger Health System Circleville &C


oHIo continuedBethesda North Hospital Cincinnati &CCleveland Clinic Foundation Cleveland &CClinton Memorial Hospital Wilmington &CCommunity Hospitals and Wellness Centers Bryan &CDublin Methodist Hospital Dublin &CEMH Elyria Medical Center Elyria &CEast ohio Regional Hospital Martins Ferry &CFairfield Medical Center Lancaster &CFairview Hospital Cleveland &CFirelands Regional Health System Sandusky &CFisher-Titus Medical Center Norwalk &CFort Hamilton Hospital Hamilton &CGalion Community Hospital Galion &CGenesis HealthCare System Zanesville &CGood Samaritan Hospital Cincinnati &CGood Samaritan Hospital Dayton &CGrandview Medical Center Dayton &CGreene Memorial Hospital Xenia &CHolzer Medical Center Gallipolis &CJoint Township District Memorial Hospital Saint Marys &CKettering Medical Center Kettering &CKnox Community Hospital Mount Vernon &CLake Health Concord Township &CLakewood Hospital Lakewood &CLima Memorial Health System Lima &CMarietta Memorial Hospital Marietta &CMary Rutan Hospital Bellefontaine &CMcCullough-Hyde Memorial Hospital Oxford &CMedCentral—Shelby Hospital Shelby &CMemorial Hospital Fremont &CMercer Health Coldwater &CMercy Health—Fairfield Hospital Fairfield &CMercy Hospital Anderson Cincinnati &CMercy Hospital Western Hills Cincinnati &CMercy Medical Center Canton &CMercy Regional Medical Center Lorain &CMercy St. Charles Hospital Oregon &CMercy St. Vincent Medical Center Toledo &CMercy Tiffin Hospital Tiffin &CMetroHealth Medical Center Cleveland &CMount Carmel Columbus &CMount Carmel St. Ann's Westerville &CProMedica Flower Hospital Sylvania &CProMedica St. Luke's Hospital Maumee &CRiverside Methodist Hospital Columbus &CRobinson Memorial Hospital Ravenna &CSalem Community Hospital Salem &CSouth Pointe Hospital Warrensville Heights &CSoutheastern ohio Regional Medical Center Cambridge &CSpringfield Regional Medical Center Springfield &CSt. Joseph Health Center Warren &C




oHIo continuedSt. Rita's Medical Center Lima &CSumma Barberton Citizens Hospital Barberton &CSumma Health System Akron &CSycamore Medical Center Miamisburg &CThe University of Toledo Medical Center Toledo &CTrinity Health System Steubenville &CTrumbull Memorial Hospital Warren &CUnion Hospital Dover &CUniversity Hospital Cincinnati &CUniversity Hospitals Geauga Medical Center Chardon &CUpper Valley Medical Center Troy &CWayne Hospital Greenville &CWest Chester Hospital West Chester &CWooster Community Hospital Wooster &CAkron General Medical Center Akron &VDoctors Hospital Columbus &VJames Cancer Hospital and Solove Research Institute Columbus &VLutheran Hospital Cleveland &VMedCentral—Mansfield Hospital Mansfield &VMercy St. Anne Hospital Toledo &Vohio State University Medical Center Columbus &VProMedica Bay Park Hospital Oregon &VProMedica Toledo Hospital Toledo &VSt. Vincent Charity Medical Center Cleveland &VWood County Hospital Bowling Green &VAtrium Medical Center Middletown &BHillcrest Hospital Cleveland &BMiami Valley Hospital Dayton &BSouthern ohio Medical Center Portsmouth &BoKLAHoMAMcBride Clinic orthopedic Hospital Oklahoma City &Zoklahoma Heart Hospital Oklahoma City &Zoklahoma Heart Hospital South Campus Oklahoma City &ZJane Phillips Medical Center Bartlesville &XNorthwest Surgical Hospital Oklahoma City &Xoklahoma Center for orthopedic and Multi-Specialty Surgery Oklahoma City &Xoklahoma Surgical Hospital Tulsa &XSt. John Broken Arrow Broken Arrow &XSt. Mary's Regional Medical Center Enid &XValley View Regional Hospital Ada &XWoodward Regional Hospital Woodward &XCommunity Hospital Oklahoma City &CDeaconess Hospital Oklahoma City &CDuncan Regional Hospital Duncan &CGrady Memorial Hospital Chickasha &CGreat Plains Regional Medical Center Elk City &CHillcrest Hospital—South Tulsa &C


oKLAHoMA continuedHillcrest Hospital Claremore Claremore &CHillcrest Medical Center Tulsa &CINTEGRIS Canadian Valley Hospital Yukon &CIntegris Baptist Medical Center Oklahoma City &CIntegris Baptist Regional Health Center Miami &CIntegris Bass Baptist Health Center Enid &CIntegris Grove General Hospital Grove &CJackson County Memorial Hospital Altus &CMcAlester Regional Health Center McAlester &CMedical Center of Southeastern oklahoma Durant &CMercy Hospital Ardmore Ardmore &CNorman Regional Health System Norman &CoU Medical Center Oklahoma City &Coklahoma Spine Hospital Oklahoma City &Coklahoma State University Medical Center Tulsa &CPonca City Medical Center Ponca City &CSaint Francis Hospital Tulsa &CSouthwestern Medical Center Lawton &CSt. Anthony Hospital Oklahoma City &CSt. Anthony Shawnee Hospital Shawnee &CStillwater Medical Center Stillwater &CTahlequah City Hospital Tahlequah &CIntegris Southwest Medical Center Oklahoma City &VMercy Hospital oklahoma City Oklahoma City &VMidwest Regional Medical Center Midwest City &VTulsa Spine and Specialty Hospital Tulsa &VComanche County Memorial Hospital Lawton &BMuskogee Regional Medical Center Muskogee &BSt. John Medical Center Tulsa &BoREGoNProvidence Portland Medical Center Portland &ZGood Samaritan Regional Medical Center Corvallis &XLegacy Meridian Park Hospital Tualatin &XMid-Columbia Medical Center The Dalles &XProvidence Hood River Memorial Hospital Hood River &XRogue Valley Medical Center Medford &XSaint Alphonsus Medical Center—ontario Ontario &XSalem Hospital Salem &XAdventist Medical Center Portland &CAshland Community Hospital Ashland &CBay Area Hospital Coos Bay &CGood Shepherd Health Care System Hermiston &C


oREGoN continuedLegacy Emanuel Hospital and Health Center Portland &CLegacy Good Samaritan Hospital and Medical Center Portland &CLegacy Mount Hood Medical Center Gresham &CMcKenzie-Willamette Medical Center Springfield &CMercy Medical Center Roseburg &CoHSU Hospital Portland &CProvidence Medford Medical Center Medford &CProvidence Milwaukie Hospital Milwaukie &CProvidence St. Vincent Medical Center Portland &CProvidence Willamette Falls Medical Center Oregon City &CSacred Heart Medical Center at RiverBend Springfield &CSaint Alphonsus Medical Center—Baker City Baker City &CSamaritan Albany General Hospital Albany &CSilverton Hospital Silverton &CSky Lakes Medical Center Klamath Falls &CSt. Charles Medical Center—Bend Bend &CThree Rivers Medical Center Grants Pass &CTuality Healthcare Hillsboro &CWillamette Valley Medical Center McMinnville &CPENNSYLVANIACoordinated Health—Bethlehem Bethlehem &ZHeritage Valley Sewickley Sewickley &ZoSS orthopaedic Specialty Hospital York &ZSaint Vincent Health Center Erie &ZSurgical Institute of Reading Wyomissing &ZSurgical Specialty Center at Coordinated Health Allentown &ZWilliamsport Regional Medical Center Williamsport &ZButler Health System Butler &XDoylestown Hospital Doylestown &XDuBois Regional Medical Center DuBois &XEvangelical Community Hospital Lewisburg &XFox Chase Cancer Center—American oncologic Hospital Philadelphia &XMeadville Medical Center Meadville &XPalmerton Hospital Palmerton &XRegional Hospital of Scranton Scranton &XThe Good Samaritan Hospital Lebanon &XUPMC Passavant Pittsburgh &XUPMC Presbyterian Shadyside Pittsburgh &XUPMC St. Margaret Pittsburgh &XACMH Hospital Kittanning &CAbington Health Lansdale Hospital Lansdale &CAllegheny Valley Hospital Natrona Heights &C




PENNSYLVANIA continuedAltoona Regional Health System Altoona &CAria Health Philadelphia &CBerwick Hospital Center Berwick &CBrandywine Hospital Coatesville &CBryn Mawr Hospital Bryn Mawr &CCanonsburg General Hospital Canonsburg &CCarlisle Regional Medical Center Carlisle &CChester County Hospital West Chester &CClarion Hospital Clarion &CClearfield Hospital Clearfield &CCole Memorial Coudersport &CConemaugh Memorial Medical Center Johnstown &CCrozer-Chester Medical Center Upland &CEaston Hospital Easton &CElk Regional Health Center Saint Marys &CEphrata Community Hospital Ephrata &CExcela Health Westmoreland Hospital Greensburg &CExcela Latrobe Area Hospital Latrobe &CForbes Regional Hospital Monroeville &CGeisinger Medical Center Danville &CGeisinger Wyoming Valley Medical Center Wilkes-Barre &CGeisinger-Bloomsburg Hospital Bloomsburg &CGeisinger-Community Medical Center Scranton &CGettysburg Hospital Gettysburg &CGrand View Hospital Sellersville &CHanover Hospital Hanover &CHazleton General Hospital Hazleton &CHeritage Valley Beaver Beaver &CHoly Redeemer Hospital and Medical Center Meadowbrook &CHoly Spirit Hospital Camp Hill &CHospital of the University of Pennsylvania Philadelphia &CIndiana Regional Medical Center Indiana &CJameson Hospital New Castle &CJeanes Hospital Philadelphia &CJefferson Regional Medical Center Jefferson Hills &CLancaster Regional Medical Center Lancaster &CLankenau Medical Center Wynnewood &CLehigh Valley Hospital Allentown &CLehigh Valley Hospital—Muhlenberg Bethlehem &CLewistown Hospital Lewistown &CLower Bucks Hospital Bristol &CMagee-Womens Hospital of UPMC Pittsburgh &CMemorial Hospital York &CMercy Fitzgerald Hospital Darby &C


PENNSYLVANIA continuedMonongahela Valley Hospital Monongahela &CMoses Taylor Hospital Scranton &CNazareth Hospital Philadelphia &CPaoli Hospital Paoli &CPenn Presbyterian Medical Center Philadelphia &CPhoenixville Hospital Phoenixville &CPocono Medical Center East Stroudsburg &CReading Hospital and Medical Center West Reading &CRiddle Hospital Media &CRobert Packer Hospital Sayre &CSacred Heart Hospital Allentown &CSharon Regional Health System Sharon &CSoldiers and Sailors Memorial Hospital Wellsboro &CSt. Clair Memorial Hospital Pittsburgh &CSt. Joseph Medical Center Reading &CSt. Luke's Hospital—Miners Campus Coaldale &CTemple University Hospital Philadelphia &CUPMC Hamot Erie &CUPMC Horizon Greenville &CUPMC Mercy Pittsburgh &CUPMC Northwest Seneca &CUniontown Hospital Uniontown &CWarren General Hospital Warren &CWashington Hospital Washington &CWayne Memorial Hospital Honesdale &CWaynesboro Hospital Waynesboro &CWestern Pennsylvania Hospital Pittsburgh &CWilkes-Barre General Hospital Wilkes-Barre &CYork Hospital York &CAbington Memorial Hospital Abington &VChambersburg Hospital Chambersburg &VEinstein Medical Center Philadelphia Philadelphia &VHahnemann University Hospital Philadelphia &VLancaster General Health Lancaster &VPenn State Milton S. Hershey Medical Cen-ter Hershey &VPinnacle Health System Harrisburg &VPottstown Memorial Medical Center Pottstown &VSchuylkill Medical Center—East Norwegian Street Pottsville &VSchuylkill Medical Center—South Jackson Street Pottsville &VSt. Luke's University Hospital—Bethlehem Campus Bethlehem &VSt. Mary Medical Center Langhorne &VAllegheny General Hospital Pittsburgh &BDelaware County Memorial Hospital Drexel Hill &BMount Nittany Medical Center State College &B


PENNSYLVANIA continuedPennsylvania Hospital Philadelphia &BThomas Jefferson University Hospital Philadelphia &BPUERTo RICoAshford Presbyterian Community Hospital San Juan &CHospital De Damas Ponce &CHospital De La Concepcion San German &CHospital Interamericano De Medicina Avanzada Caguas &CHospital Menonita De Cayey Cayey &CHospital San Pablo Bayamon &CAuxilio Mutuo Hospital San Juan &VCardiovascular Center of Puerto Rico and the Caribbean San Juan &VDr. Ramon E. Betances Hospital—Mayaguez Medical Center Branch Mayaguez &VHospital Pavia-Santurce San Juan &VSt. Luke's Episcopal Hospital Ponce &BRHoDE ISLANDSouth County Hospital Wakefield &ZKent County Memorial Hospital Warwick &CMemorial Hospital of Rhode Island Pawtucket &CRoger Williams Medical Center Providence &CSt. Joseph Health Services of Rhode Island North Providence &CWesterly Hospital Westerly &CWomen & Infants Hospital of Rhode Island Providence &CLandmark Medical Center Woonsocket &VMiriam Hospital Providence &VNewport Hospital Newport &VRhode Island Hospital Providence &VSoUTH CARoLINABon Secours St. Francis Health System Greenville &ZPatewood Memorial Hospital Greenville &ZAnMed Health Medical Center Anderson &Xoconee Medical Center Seneca &XBaptist Easley Hospital Easley &CBon Secours St. Francis Xavier Hospital Charleston &CGeorgetown Memorial Hospital Georgetown &CGrand Strand Regional Medical Center Myrtle Beach &CGreer Memorial Hospital Greer &CHillcrest Memorial Hospital Simpsonville &CHilton Head Hospital Hilton Head Island &CKershawHealth Camden &CLaurens County Health Care System Clinton &CNewberry County Memorial Hospital Newberry &CPiedmont Medical Center Rock Hill &CProvidence Hospital Columbia &CRegional Medical Center Orangeburg &CSelf Regional Healthcare Greenwood &C




SoUTH CARoLINA continuedSpartanburg Regional Medical Center Spartanburg &CSprings Memorial Hospital Lancaster &CTrident Medical Center Charleston &CWaccamaw Community Hospital Murrells Inlet &CMUSC Medical Center of Medical University of South Carolina Charleston &VMary Black Memorial Hospital Spartanburg &VPalmetto Health Richland Columbia &VTuomey Healthcare System Sumter &VAiken Regional Medical Centers Aiken &BBeaufort Memorial Hospital Beaufort &BCarolinas Hospital System Florence &BConway Medical Center Conway &BEast Cooper Medical Center Mount Pleasant &BGreenville Memorial Hospital Greenville &BLexington Medical Center West Columbia &BMcLeod Regional Medical Center Florence &BPalmetto Health Baptist Columbia &BRoper Hospital Charleston &BSoUTH DAKoTADakota Plains Surgical Center Aberdeen &ZSanford University of South Dakota Medical Center Sioux Falls &ZSioux Falls Surgical Center Sioux Falls &ZSiouxland Surgery Center Dakota Dunes &ZAvera Heart Hospital of South Dakota Sioux Falls &XBlack Hills Surgery Center Rapid City &XAvera McKennan Hospital and University Health Center Sioux Falls &CAvera Queen of Peace Hospital Mitchell &CAvera Sacred Heart Hospital Yankton &CAvera St. Luke's Hospital Aberdeen &CAvera St. Mary's Hospital Pierre &CLewis and Clark Specialty Hospital Yankton &CPrairie Lakes Healthcare System Watertown &CRapid City Regional Hospital Rapid City &CSpearfish Regional Hospital Spearfish &CTENNESSEECenter for Spinal Surgery Nashville &ZSaint Thomas Hospital Nashville &ZTriStar StoneCrest Medical Center Smyrna &XWellmont Holston Valley Medical Center Kingsport &XBaptist Hospital Nashville &CCookeville Regional Medical Center Cookeville &CCumberland Medical Center Crossville &CDyersburg Regional Medical Center Dyersburg &CFort Sanders Regional Medical Center Knoxville &CGateway Medical Center Clarksville &CHarton Regional Medical Center Tullahoma &C


TENNESSEE continuedHeritage Medical Center Shelbyville &CJohnson City Medical Center Johnson City &CLaughlin Memorial Hospital Greeneville &CLeConte Medical Center Sevierville &CMaury Regional Hospital Columbia &CMethodist Medical Center of oak Ridge Oak Ridge &CMorristown-Hamblen Healthcare System Morristown &CParkridge Medical Center Chattanooga &CParkwest Medical Center Knoxville &CPhysicians Regional Medical Center Knoxville &CSaint Francis Hospital Memphis &CSaint Francis Hospital—Bartlett Bartlett &CSkyridge Medical Center Cleveland &CSouthern Tennessee Medical Center Winchester &CSumner Regional Medical Center Gallatin &CTriStar Hendersonville Medical Center Hendersonville &CTriStar Horizon Medical Center Dickson &CTriStar Skyline Medical Center Nashville &CTriStar Southern Hills Medical Center Nashville &CTurkey Creek Medical Center Knoxville &CUniversity Medical Center Lebanon &CVanderbilt Hospital and Clinics Nashville &CWilliamson Medical Center Franklin &CBlount Memorial Hospital Maryville &VHenry County Medical Center Paris &VIndian Path Medical Center Kingsport &VMiddle Tennessee Medical Center Murfreesboro &VRegional Hospital of Jackson Jackson &VTriStar Summit Medical Center Hermitage &VTristar Centennial Medical Center Nashville &VBaptist Memorial Hospital—Memphis Memphis &BErlanger Medical Center Chattanooga &BJackson-Madison County General Hospital Jackson &BMemorial Health Care System Chattanooga &BMethodist Healthcare Memphis Hospitals Memphis &BThe University of Tennessee Medical Center Knoxville &BWellmont Bristol Regional Medical Center Bristol &BTEXASAbilene Regional Medical Center Abilene &ZAustin Surgical Hospital Austin &ZBaylor All Saints Medical Center at Fort Worth Fort Worth &ZCovenant Medical Center Lubbock &ZEl Paso Specialty Hospital El Paso &ZHill Country Memorial Hospital Fredericksburg &ZHouston orthopedic and Spine Hospital Bellaire &Z


TEXAS continuedLongview Regional Medical Center Longview &ZMethodist Ambulatory Surgery Hospital San Antonio &ZMother Frances Hospital—Tyler Tyler &ZNorth Central Surgical Center Dallas &ZNorthwest Hills Surgical Hospital Austin &ZPhysicians Surgical Hospital—Quail Creek Amarillo &ZSouth Texas Spine and Surgical Hospital San Antonio &ZSt. Luke's Lakeside Hospital The Woodlands &ZToPS Surgical Specialty Hospital Houston &ZTexas Spine & Joint Hospital Tyler &ZUniversity of Texas Southwestern Medical Center Dallas &ZBaylor Medical Center at Uptown Dallas &XBaylor orthopedic and Spine Hospital at Arlington Arlington &XBrazosport Regional Health System Lake Jackson &XBrownwood Regional Medical Center Brownwood &XCHRISTUS Spohn Hospital Alice Alice &XCornerstone Regional Hospital Edinburg &XFoundation Surgical Hospital of San Antonio San Antonio &XGood Shepherd Medical Center Longview &XGrace Medical Center Lubbock &XHouston Physicians Hospital Webster &XKnapp Medical Center Weslaco &XLake Granbury Medical Center Granbury &XScott & White Hospital—Brenham Brenham &XScott & White Hospital at Round Rock Round Rock &XSouth Texas Surgical Hospital Corpus Christi &XSugar Land Surgical Hospital Sugar Land &XTexas Health Presbyterian Hospital Denton Denton &XTexas orthopedic Hospital Houston &XThe Physicians Centre Hospital Bryan &XUSMD Hospital at Fort Worth Fort Worth &XAngleton Danbury Medical Center Angleton &CBaylor Jack and Jane Hamilton Heart and Vascular Hospital Dallas &CBaylor Medical Center at Frisco Frisco &CBaylor Medical Center at Garland Garland &CBaylor Medical Center at Irving Irving &CBaylor Medical Center at Waxahachie Waxahachie &CBaylor Regional Medical Center at Grape-vine Grapevine &CBayshore Medical Center Pasadena &CBrownsville Doctors Hospital Brownsville &CCHRISTUS Santa Rosa Health System San Antonio &CCHRISTUS St. John Hospital Nassau Bay &CCHRISTUS St. Michael Health System Texarkana &CCedar Park Regional Medical Center Cedar Park &C




TEXAS continuedCentral Texas Medical Center San Marcos &CCollege Station Medical Center College Station &CCorpus Christi Medical Center Corpus Christi &CDallas Regional Medical Center Mesquite &CDeTar Healthcare System Victoria &CDoctors Hospital at Renaissance Edinburg &CDoctors Hospital at White Rock Lake Dallas &CDoctors Hospital of Laredo Laredo &CEast El Paso Physicians Medical Center El Paso &CEast Texas Medical Center Athens Athens &CFirst Street Hospital Bellaire &CFort Duncan Regional Medical Center Eagle Pass &CGood Shepherd Medical Center—Marshall Marshall &CGuadalupe Regional Medical Center Seguin &CHarlingen Medical Center Harlingen &CHillcrest Baptist Medical Center Waco &CHopkins County Memorial Hospital Sulphur Springs &CHouston Northwest Medical Center Houston &CHuguley Memorial Medical Center Fort Worth &CHunt Regional Healthcare Greenville &CHuntsville Memorial Hospital Huntsville &CKell West Regional Hospital Wichita Falls &CKingwood Medical Center Kingwood &CLake Pointe Medical Center Rowlett &CLas Colinas Medical Center Irving &CLas Palmas Medical Center El Paso &CLubbock Heart Hospital Lubbock &CMedical Center of Arlington Arlington &CMedical Center of McKinney McKinney &CMedical Center of Plano Plano &CMedical City Dallas Hospital Dallas &CMemorial Hermann Katy Hospital Katy &CMemorial Hermann Northeast Humble &CMemorial Hermann Northwest Hospital Houston &CMemorial Hermann Sugar Land Hospital Sugar Land &CMemorial Medical Center—Livingston Livingston &CMethodist Charlton Medical Center Dallas &CMethodist Hospital for Surgery Addison &CMethodist Mansfield Medical Center Mansfield &CMethodist Stone oak Hospital San Antonio &CMethodist Sugar Land Hospital Sugar Land &CMethodist Willowbrook Hospital Houston &CMetroplex Adventist Hospital Killeen &CMidland Memorial Hospital Midland &CMission Regional Medical Center Mission &CNacogdoches Medical Center Nacogdoches &C


TEXAS continuedNavarro Regional Hospital Corsicana &CNorth Cypress Medical Center Cypress &CNorth Hills Hospital North Richland Hills &CoakBend Medical Center Richmond &Codessa Regional Medical Center Odessa &CPalestine Regional Medical Center—East Palestine &CPalo Pinto General Hospital Mineral Wells &CPampa Regional Medical Center Pampa &CParis Regional Medical Center Paris &CParkland Health & Hospital System Dallas &CPeterson Regional Medical Center Kerrville &CProvidence Health Center Waco &CRio Grande Regional Hospital McAllen &CScott & White Memorial Hospital Temple &CSeton Medical Center Austin Austin &CSeton Medical Center Williamson Round Rock &CSeton Northwest Hospital Austin &CSierra Providence East Medical Center El Paso &CSouthwest General Hospital San Antonio &CSt. David's Medical Center Austin &CSt. David's North Austin Medical Center Austin &CSt. David's Round Rock Medical Center Round Rock &CSt. David's South Austin Medical Center Austin &CSt. Joseph Medical Center Houston &CSt. Joseph Regional Health Center Bryan &CSt. Luke's Patients Medical Center Pasadena &CSt. Luke's Sugar Land Hospital Sugar Land &CSt. Luke's The Woodlands Hospital The Woodlands &CSt. Mark's Medical Center La Grange &CTexas Health Arlington Memorial Hospital Arlington &CTexas Health Harris Methodist Hospital Fort Worth Fort Worth &CTexas Health Harris Methodist Hospital Hurst-Euless-Bedford Bedford &CTexas Health Harris Methodist Hospital Southwest Fort Worth Fort Worth &CTexas Health Harris Methodist Hospital Stephenville Stephenville &CTexas Health Presbyterian Hospital Dallas Dallas &CTexas Health Presbyterian Hospital Plano Plano &CTexas Health Presbyterian Hospital Rockwall Rockwall &CTexas Health Presbyterian Hospital-WNJ Sherman &CThe Heart Hospital Baylor Plano Plano &CThe Hospital at Westlake Medical Center Austin &CThe Medical Center of Southeast Texas Port Arthur &CThe Woman's Hospital of Texas Houston &CTitus Regional Medical Center Mount Pleasant &CTomball Regional Medical Center Tomball &C


TEXAS continuedUSMD Hospital at Arlington Arlington &CUnited Regional Health Care System Wichita Falls &CUniversity General Hospital Houston &CUniversity Medical Center at Brackenridge Austin &CUniversity of Texas M.D. Anderson Cancer Center Houston &CUniversity of Texas Medical Branch Hospitals Galveston &CVal Verde Regional Medical Center Del Rio &CValley Baptist Medical Center—Brownsville Brownsville &CValley Baptist Medical Center—Harlingen Harlingen &CValley Regional Medical Center Brownsville &CWadley Regional Medical Center Texarkana &CWeatherford Regional Medical Center Weatherford &CWest Houston Medical Center Houston &CWise Regional Health System Decatur &CWoodland Heights Medical Center Lufkin &CBaptist Hospitals of Southeast Texas Beaumont &VBaptist St. Anthony Health System Amarillo &VBaylor University Medical Center Dallas &VCHRISTUS St. Catherine Hospital Katy &VCitizens Medical Center Victoria &VConroe Regional Medical Center Conroe &VDenton Regional Medical Center Denton &VEast Texas Medical Center Tyler Tyler &VMedical Center of Lewisville Lewisville &VMemorial Hermann—Texas Medical Center Houston &VMemorial Medical Center—Lufkin Lufkin &VMethodist Richardson Medical Center Richardson &VNix Health Care System San Antonio &VPark Plaza Hospital Houston &VPlaza Medical Center of Fort Worth Fort Worth &VProvidence Memorial Hospital El Paso &VSan Angelo Community Medical Center San Angelo &VSan Jacinto Methodist Hospital Baytown &VSouth Texas Health System Edinburg &VTexas Health Harris Methodist Hospital Cleburne Cleburne &VTexoma Medical Center Denison &VBaptist Medical Center San Antonio &BBaylor Medical Center at Carrollton Carrollton &BCHRISTUS Hospital—St. Elizabeth Beaumont &BCHRISTUS Spohn Hospital Corpus Christi Memorial Corpus Christi &BClear Lake Regional Medical Center Webster &BHendrick Health System Abilene &BLaredo Medical Center Laredo &B




TEXAS continuedMedical Center Health System Odessa &BMemorial Hermann Memorial City Medical Center Houston &BMethodist Dallas Medical Center Dallas &BMethodist Hospital San Antonio &BNacogdoches Memorial Hospital Nacogdoches &BNorthwest Texas Healthcare System Amarillo &BShannon Medical Center San Angelo &BSierra Medical Center El Paso &BSt. Luke's Episcopal Hospital Houston &BThe Methodist Hospital Houston &BUniversity Medical Center Lubbock &BUTAHCache Valley Specialty Hospital North Logan &ZDixie Regional Medical Center Saint George &ZLDS Hospital Salt Lake City &ZLakeview Hospital Bountiful &ZPark City Medical Center Park City &ZThe orthopedic Specialty Hospital Murray &ZUtah Valley Regional Medical Center Provo &ZCastleview Hospital Price &XJordan Valley Medical Center West Jordan &XUniversity of Utah Health Care—Hospital and Clinics Salt Lake City &XValley View Medical Center Cedar City &XAlta View Hospital Sandy &CAmerican Fork Hospital American Fork &CDavis Hospital and Medical Center Layton &CIntermountain Medical Center Murray &CLogan Regional Hospital Logan &CMcKay-Dee Hospital Center Ogden &CMountain View Hospital Payson &Cogden Regional Medical Center Ogden &CSalt Lake Regional Medical Center Salt Lake City &CSt. Mark's Hospital Salt Lake City &CTimpanogos Regional Hospital Orem &CVERMoNTFletcher Allen Health Care Burlington &XNorthwestern Medical Center Saint Albans &XBrattleboro Memorial Hospital Brattleboro &CCentral Vermont Medical Center Berlin &CCopley Hospital Morrisville &CNortheastern Vermont Regional Hospital Saint Johnsbury &CPorter Medical Center Middlebury &CRutland Regional Medical Center Rutland &CSouthwestern Vermont Medical Center Bennington &C


VIRGINIAAugusta Health Fishersville &ZInova Fair oaks Hospital Fairfax &ZMartha Jefferson Hospital Charlottesville &ZWythe County Community Hospital Wytheville &ZBon Secours-DePaul Medical Center Norfolk &XCarilion New River Valley Medical Center Christiansburg &XMary Immaculate Hospital Newport News &XPrince William Hospital Manassas &XBon Secours Maryview Medical Center Portsmouth &CBon Secours Memorial Regional Medical Center Mechanicsville &CBon Secours St. Francis Medical Center Midlothian &CBon Secours St. Mary's Hospital Richmond &CCarilion Medical Center Roanoke &CCentra Lynchburg General Hospital Lynchburg &CCentra Southside Community Hospital Farmville &CCulpeper Regional Hospital Culpeper &CDanville Regional Medical Center Danville &CHalifax Regional Health System South Boston &CInova Alexandria Hospital Alexandria &CInova Fairfax Hospital Falls Church &CInova Loudoun Hospital Leesburg &CMary Washington Hospital Fredericksburg &CMontgomery Regional Hospital Blacksburg &CRappahannock General Hospital Kilmarnock &CReston Hospital Center Reston &CRiverside Regional Medical Center Newport News &CRiverside Walter Reed Hospital Gloucester &CRockingham Memorial Hospital Harrisonburg &CSentara CarePlex Hospital Hampton &CSentara Leigh Hospital Norfolk &CSentara Northern Virginia Medical Center Woodbridge &CSentara Princess Anne Hospital Virginia Beach &CSentara Virginia Beach General Hospital Virginia Beach &CSentara Williamsburg Regional Medical Center Williamsburg &CShenandoah Memorial Hospital Woodstock &CSmyth County Community Hospital Marion &CTwin County Regional Hospital Galax &CVirginia Hospital Center—Arlington Arlington &CWinchester Medical Center Winchester &CChesapeake Regional Medical Center Chesapeake &VFauquier Hospital Warrenton &VLewis-Gale Medical Center Salem &VMemorial Hospital Martinsville &V


VIRGINIA continuedSouthside Regional Medical Center Petersburg &VUniversity of Virginia Medical Center Charlottesville &VVCU Health System Richmond &VCJW Medical Center Richmond &BHenrico Doctors' Hospital Richmond &BInova Mount Vernon Hospital Alexandria &BJohnston Memorial Hospital Abingdon &BLewisGale Hospital Alleghany Low Moor &BSentara Norfolk General Hospital Norfolk &BSentara obici Hospital Suffolk &BWASHINGToNJefferson Healthcare Port Townsend &Zoverlake Hospital Medical Center Bellevue &ZProvidence Centralia Hospital Centralia &ZProvidence St. Mary Medical Center Walla Walla &ZSwedish Medical Center—First Hill Seattle &ZUW Medicine/Valley Medical Center Renton &ZWenatchee Valley Medical Center Wenatchee &ZEvergreenHealth Medical Center Kirkland &XGrays Harbor Community Hospital Aberdeen &XIsland Hospital Anacortes &XLourdes Medical Center Pasco &Xolympic Medical Center Port Angeles &XProvidence Regional Medical Center Everett Everett &XSt. Anthony Hospital Gig Harbor &XTri-State Memorial Hospital Clarkston &XValley Hospital Spokane Valley &XCapital Medical Center Olympia &CCentral Washington Hospital Wenatchee &CDeaconess Hospital Spokane &CHarrison Medical Center Bremerton &CHighline Medical Center Burien &CKadlec Regional Medical Center Richland &CKennewick General Hospital Kennewick &CLegacy Salmon Creek Medical Center Vancouver &CMultiCare Good Samaritan Hospital Puyallup &CMultiCare Tacoma General Hospital Tacoma &CMulticare Auburn Medical Center Auburn &CPeaceHealth Southwest Medical Center Vancouver &CPeaceHealth St. Joseph Medical Center Bellingham &CProvidence Holy Family Hospital Spokane &CProvidence Sacred Heart Medical Center & Children's Hospital Spokane &CProvidence St. Peter Hospital Olympia &C




WASHINGToN continuedPullman Regional Hospital Pullman &CSamaritan Healthcare Moses Lake &CSkagit Valley Hospital Mount Vernon &CSt. Francis Hospital Federal Way &CSwedish Medical Center—Cherry Hill Campus Seattle &CSwedish/Edmonds Edmonds &CUW Medicine/Harborview Medical Center Seattle &CUniversity of Washington Medical Center Seattle &CVirginia Mason Medical Center Seattle &CWalla Walla General Hospital Walla Walla &CWhidbey General Hospital Coupeville &CYakima Regional Medical and Cardiac Center Yakima &CYakima Valley Memorial Hospital Yakima &CPeaceHealth St. John Medical Center Longview &VUW Medicine/Northwest Hospital & Medical Center Seattle &VSt. Clare Hospital Lakewood &BSt. Joseph Medical Center Tacoma &BWEST VIRGINIAGreenbrier Valley Medical Center Ronceverte &XBluefield Regional Medical Center Bluefield &CCAMC Teays Valley Hospital Hurricane &CCabell Huntington Hospital Huntington &CCamden Clark Medical Center Parkersburg &CCharleston Area Medical Center Charleston &CFairmont General Hospital Fairmont &CMonongalia General Hospital Morgantown &Cohio Valley Medical Center Wheeling &CPlateau Medical Center Oak Hill &CPrinceton Community Hospital Princeton &CRaleigh General Hospital Beckley &CSaint Francis Hospital Charleston &CThomas Memorial Hospital South Charleston &CWeirton Medical Center Weirton &CWest Virginia University Hospitals Morgantown &CWheeling Hospital Wheeling &CCity Hospital Martinsburg &VDavis Memorial Hospital Elkins &BSt. Mary's Medical Center Huntington &BUnited Hospital Center Bridgeport &BWISCoNSINAurora Sheboygan Memorial Medical Center Sheboygan &ZBellin Memorial Hospital Green Bay &ZBeloit Health System Beloit &ZGundersen Lutheran Medical Center La Crosse &ZMidwest orthopedic Specialty Hospital Franklin &Z


WISCoNSIN continuedoconomowoc Memorial Hospital Oconomowoc &Zorthopaedic Hospital of Wisconsin—Glen-dale Milwaukee &ZRiverview Hospital Association Wisconsin Rapids &ZSt. Vincent Hospital Green Bay &ZTheda Clark Medical Center Neenah &ZUniversity of Wisconsin Hospital and Clinics Madison &ZAurora Memorial Hospital of Burlington Burlington &XAurora St. Luke's Medical Center Milwaukee &XBeaver Dam Community Hospitals Beaver Dam &XLakeview Medical Center Rice Lake &XMayo Clinic Health System in Eau Claire Eau Claire &XMinistry Saint Clare's Hospital Weston &XMinistry Saint Mary's Hospitals Rhinelander &XMinistry Saint Michael's Hospital Stevens Point &Xoakleaf Surgical Hospital Eau Claire &XSacred Heart Hospital Eau Claire &XSt. Elizabeth Hospital Appleton &XSt. Joseph's Hospital Chippewa Falls &XWatertown Regional Medical Center Watertown &XAgnesian HealthCare Fond Du Lac &CAmery Regional Medical Center Amery &CAppleton Medical Center Appleton &CAspirus Wausau Hospital Wausau &CAurora BayCare Medical Center Green Bay &CAurora Lakeland Medical Center Elkhorn &CAurora Medical Center Kenosha &CAurora Medical Center—Manitowoc County Two Rivers &CAurora Medical Center Grafton Grafton &CAurora Medical Center of oshkosh Oshkosh &CAurora Medical Center of Washington County Hartford &CAurora West Allis Medical Center West Allis &CBay Area Medical Center Marinette &CBerlin Memorial Hospital Berlin &CColumbia St. Mary's Hospital Milwaukee Milwaukee &CColumbia St. Mary's ozaukee Hospital Mequon &CCommunity Memorial Hospital Menomonee Falls &CFort HealthCare Fort Atkinson &CFroedtert Memorial Lutheran Hospital Milwaukee &CHoly Family Memorial Manitowoc &CHoward Young Medical Center Woodruff &CMayo Clinic Health System—Franciscan Healthcare in La Crosse La Crosse &C


WISCoNSIN continuedMemorial Medical Center—Ashland Ashland &CMercy Hospital and Trauma Center Janesville &CMercy Medical Center Oshkosh &CMeriter Hospital Madison &CMinistry Saint Joseph's Hospital Marshfield &CMonroe Clinic Monroe &CSauk Prairie Memorial Hospital & Clinics Prairie Du Sac &CSt. Clare Hospital Baraboo &CSt. Joseph's Community Hospital of West Bend West Bend &CSt. Mary's Hospital Madison &CSt. Mary's Hospital Medical Center Green Bay &CSt. Nicholas Hospital Sheboygan &CUnited Health System—Kenosha Campus Kenosha &CVernon Memorial Healthcare Viroqua &CWaukesha Memorial Hospital Waukesha &CWheaton Franciscan Healthcare—All Saints Racine &CWheaton Franciscan Healthcare—Elmbrook Memorial Brookfield &CWheaton Franciscan Healthcare—St. Francis Milwaukee &CWheaton Franciscan Healthcare—St. Joseph's Milwaukee &CWYoMINGMountain View Regional Hospital Casper &XCheyenne Regional Medical Center Cheyenne &CIvinson Memorial Hospital Laramie &CLander Regional Hospital Lander &CSheridan Memorial Hospital Sheridan &CSt. John's Medical Center and Living Center Jackson &CWest Park Hospital Cody &CWyoming Medical Center Casper &C



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