provide the hospital owner and year of report per section ... facility number: hospital...

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Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact 2 e-mail Address: Contact 3 e-mail Address:: Name of Submitter: Submission Date: 12127 Ronald Reagan UCLA Medical Center 757 Westwood Plaza Los Angeles Regents of the University of California 2010 Richard Azar 1/19/2011 2:56:25 PM Provide the Hospital Owner and Year of Report per Section 130061(e) Report Status: 1/20/2011 8:38 AM Data Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date: 12127 2010 Ronald Reagan UCLA Medical Center Los Angeles Page:1 of 128 Report Year:

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Page 1: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Facility Number:

Hospital Owner/Licensee:

City:

Address:

Facility Name:

Year of Reporting:

Contact 1 e-mail Address:

Contact 2 e-mail Address:

Contact 3 e-mail Address::

Name of Submitter:

Submission Date:

12127

Ronald Reagan UCLA Medical Center

757 Westwood Plaza

Los Angeles

Regents of the University of California

2010

Richard Azar

1/19/2011 2:56:25 PM

Provide the Hospital Owner and Year of Report per Section 130061(e)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:1 of 128Report Year:

Page 2: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

For buildings which are planned for retrofit or replacement the report shall identify: Whether the hospital owner intends to retrofit or replace the building to SPC 2 or SPC 5 per section 130061(c)(1)(A). The deadline, as described in Section 130060 or 130061.5, for retrofit or replacement of the bulding that the hospital owner intends to meet, and the applicable extension for which the hospital owner has been approved per Section 130061(c)(1)(B)

Bldg.No. Building Name Alternate Building Address

Building Resolution

Final SPC RatingIf Required

Extension Date

Anticipated Completion Date

06/01/2008N/ARemoveDentistry01 757 Westwood Plaza

06/01/2008N/ARemoveLibrary Building02 757 Westwood Plaza

06/01/2008N/ARemoveSchool of Medicine (East)

03 757 Westwood Plaza

06/01/2008N/ARemoveSchool of Medicine (West)

04 757 Westwood Plaza

06/01/2008N/ARemoveSchool of Public Health05 757 Westwood Plaza

06/01/2008N/ARemoveBrain Research Institute06 757 Westwood Plaza

06/01/2008N/ARemoveMedical Center08 757 Westwood Plaza

06/01/2008N/ARemoveOutpatient Wing09 757 Westwood Plaza

06/01/2008N/ARemoveClinical Research10 757 Westwood Plaza

06/01/2008N/ARemoveMarion Davies Children's Clinic

11 757 Westwood Plaza

06/01/2008N/ARemoveJules Stein Eye Institute12 757 Westwood Plaza

06/01/2008N/ARemoveCHS South Parking Structure

13 757 Westwood Plaza

06/01/2008N/ARemoveEmergency Services Building

14 757 Westwood Plaza

06/01/2008N/ARemoveParking Structure "E"15 757 Westwood Plaza

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:2 of 128Report Year:

Page 3: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:3 of 128Report Year:

Page 4: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

01 Dentistry

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:4 of 128Report Year:

Page 5: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

02 Library Building

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:5 of 128Report Year:

Page 6: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

03 School of Medicine (East)

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:6 of 128Report Year:

Page 7: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

04 School of Medicine (West)

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:7 of 128Report Year:

Page 8: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

05 School of Public Health

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:8 of 128Report Year:

Page 9: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

06 Brain Research Institute

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:9 of 128Report Year:

Page 10: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

07 Neuropsychiatric Institute

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

X

11

324611

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:10 of 128Report Year:

Page 11: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

08 Medical Center

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:11 of 128Report Year:

Page 12: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

09 Outpatient Wing

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:12 of 128Report Year:

Page 13: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

10 Clinical Research

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:13 of 128Report Year:

Page 14: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

11 Marion Davies Children's Clinic

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:14 of 128Report Year:

Page 15: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

12 Jules Stein Eye Institute

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:15 of 128Report Year:

Page 16: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

13 CHS South Parking Structure

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:16 of 128Report Year:

Page 17: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

14 Emergency Services Building

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:17 of 128Report Year:

Page 18: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

15 Parking Structure "E"

Nursing

Building Number: Building Name:

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

0

00

Type of Service Provided

Inpatient Beds

Inpatient Beds

Inpatient Days

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

0

0

0

0

0

0

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

Inpatient Days

0

0

0

0

0

0

Total Beds this Building

Surgical ObstetricalRecovery

AnesthesiaNewborn/WellBaby

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

Provide the number of inpaient beds and patient days per type of service per building per Section 130061(c)(1)(F)

ObstetricalCesarean/Deliv

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:18 of 128Report Year:

Page 19: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

01 Dentistry

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:19 of 128Report Year:

Page 20: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

02 Library Building

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:20 of 128Report Year:

Page 21: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

03 School of Medicine (East)

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:21 of 128Report Year:

Page 22: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

04 School of Medicine (West)

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:22 of 128Report Year:

Page 23: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

05 School of Public Health

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:23 of 128Report Year:

Page 24: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

06 Brain Research Institute

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:24 of 128Report Year:

Page 25: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

07 Neuropsychiatric Institute

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

11 3246

0 0 11 11

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:25 of 128Report Year:

Page 26: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

08 Medical Center

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:26 of 128Report Year:

Page 27: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

09 Outpatient Wing

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:27 of 128Report Year:

Page 28: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

10 Clinical Research

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:28 of 128Report Year:

Page 29: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

11 Marion Davies Children's Clinic

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:29 of 128Report Year:

Page 30: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

12 Jules Stein Eye Institute

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:30 of 128Report Year:

Page 31: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

13 CHS South Parking Structure

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:31 of 128Report Year:

Page 32: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

14 Emergency Services Building

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:32 of 128Report Year:

Page 33: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Pediatric

Perinatal (excluse Newborn / GYN)

Medical / Surgical (Include GYN)

Intermediate Card

Coronary Care

Intensive Care Rehabilitation Center

Chemical Dependency

Acute Respiratory Care

Skilled Nursing Burn

intensive Care Newborn Nursery

Acute Psychiatric

Int. Care / development Disabled

Total Beds this Building Per Unit

Total Beds this Building Per Service

InpatientBed

InpatientDays

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

InpatientDays

InpatientBed

15 Parking Structure "E"

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0 0 0

0 0

0 0

0 0

0 0

Provide the number of Inpatient beds and patient days per type of unit per building per Section 130061(c)(1)(F)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:33 of 128Report Year:

Page 34: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

01 Dentistry X

02 Library Building X

03 School of Medicine (East) X

04 School of Medicine (West) X

05 School of Public Health X

06 Brain Research Institute X

07 Neuropsychiatric Institute X

08 Medical Center X

09 Outpatient Wing X

10 Clinical Research X

11 Marion Davies Children's Clinic X

12 Jules Stein Eye Institute X

13 CHS South Parking Structure X

14 Emergency Services Building X

15 Parking Structure "E" X

For all buildings at the facility, indicate which ones are scheduled for general acute service removal.

Building Number

Building Name

Building to be Removed

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:34 of 128Report Year:

Page 35: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

N_1 Ronald Reagan UCLA Medical Center X

List ALL proposed new buildings to be constructd at this or another site.

Building Number

Building Name New Site

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:35 of 128Report Year:

Page 36: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

01Building Number:

Building Name:

Dentistry Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:36 of 128Report Year:

Page 37: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

01Building Number:

Building Name:

Dentistry Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:37 of 128Report Year:

Page 38: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

01Building Number:

Building Name:

Dentistry Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:38 of 128Report Year:

Page 39: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

02Building Number:

Building Name:

Library Building Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:39 of 128Report Year:

Page 40: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

02Building Number:

Building Name:

Library Building Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:40 of 128Report Year:

Page 41: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

02Building Number:

Building Name:

Library Building Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:41 of 128Report Year:

Page 42: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

03Building Number:

Building Name:

School of Medicine (East) Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:42 of 128Report Year:

Page 43: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

03Building Number:

Building Name:

School of Medicine (East) Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:43 of 128Report Year:

Page 44: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

03Building Number:

Building Name:

School of Medicine (East) Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:44 of 128Report Year:

Page 45: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

04Building Number:

Building Name:

School of Medicine (West) Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:45 of 128Report Year:

Page 46: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

04Building Number:

Building Name:

School of Medicine (West) Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:46 of 128Report Year:

Page 47: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

04Building Number:

Building Name:

School of Medicine (West) Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:47 of 128Report Year:

Page 48: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

05Building Number:

Building Name:

School of Public Health Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:48 of 128Report Year:

Page 49: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

05Building Number:

Building Name:

School of Public Health Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:49 of 128Report Year:

Page 50: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

05Building Number:

Building Name:

School of Public Health Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:50 of 128Report Year:

Page 51: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

06Building Number:

Building Name:

Brain Research Institute Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:51 of 128Report Year:

Page 52: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

06Building Number:

Building Name:

Brain Research Institute Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:52 of 128Report Year:

Page 53: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

06Building Number:

Building Name:

Brain Research Institute Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:53 of 128Report Year:

Page 54: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

07Building Number:

Building Name:

Neuropsychiatric Institute Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

11

0

0

0

0

0

0

Total Beds this Building

11

X

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:54 of 128Report Year:

Page 55: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

07Building Number:

Building Name:

Neuropsychiatric Institute Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

11

0

0

0

0

0

0

Total Beds this Building

11

X

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:55 of 128Report Year:

Page 56: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

07Building Number:

Building Name:

Neuropsychiatric Institute Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

11

0

0

0

0

0

0

Total Beds this Building

11

X

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:56 of 128Report Year:

Page 57: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

08Building Number:

Building Name:

Medical Center Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

06/01/2008

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:57 of 128Report Year:

Page 58: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

08Building Number:

Building Name:

Medical Center Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

X

X

X

X

0

0

0

0

0

0

0

Total Beds this Building

0

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:58 of 128Report Year:

Page 59: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

08Building Number:

Building Name:

Medical Center Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

X

X

X

X

0

0

0

0

0

0

0

Total Beds this Building

0

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:59 of 128Report Year:

Page 60: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

09Building Number:

Building Name:

Outpatient Wing Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:60 of 128Report Year:

Page 61: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

09Building Number:

Building Name:

Outpatient Wing Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:61 of 128Report Year:

Page 62: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

09Building Number:

Building Name:

Outpatient Wing Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:62 of 128Report Year:

Page 63: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

10Building Number:

Building Name:

Clinical Research Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:63 of 128Report Year:

Page 64: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

10Building Number:

Building Name:

Clinical Research Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:64 of 128Report Year:

Page 65: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

10Building Number:

Building Name:

Clinical Research Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:65 of 128Report Year:

Page 66: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

11Building Number:

Building Name:

Marion Davies Children's Clinic Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:66 of 128Report Year:

Page 67: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

11Building Number:

Building Name:

Marion Davies Children's Clinic Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:67 of 128Report Year:

Page 68: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

11Building Number:

Building Name:

Marion Davies Children's Clinic Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:68 of 128Report Year:

Page 69: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

12Building Number:

Building Name:

Jules Stein Eye Institute Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:69 of 128Report Year:

Page 70: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

12Building Number:

Building Name:

Jules Stein Eye Institute Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:70 of 128Report Year:

Page 71: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

12Building Number:

Building Name:

Jules Stein Eye Institute Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:71 of 128Report Year:

Page 72: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

13Building Number:

Building Name:

CHS South Parking Structure Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:72 of 128Report Year:

Page 73: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

13Building Number:

Building Name:

CHS South Parking Structure Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:73 of 128Report Year:

Page 74: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

13Building Number:

Building Name:

CHS South Parking Structure Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:74 of 128Report Year:

Page 75: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

14Building Number:

Building Name:

Emergency Services Building Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:75 of 128Report Year:

Page 76: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

14Building Number:

Building Name:

Emergency Services Building Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:76 of 128Report Year:

Page 77: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

14Building Number:

Building Name:

Emergency Services Building Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:77 of 128Report Year:

Page 78: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

15Building Number:

Building Name:

Parking Structure "E" Year of Information:

2008

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:78 of 128Report Year:

Page 79: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

15Building Number:

Building Name:

Parking Structure "E" Year of Information:

2009

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:79 of 128Report Year:

Page 80: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Provide the number of inpaient beds and patient days per type of service for the year of 2008, 2009 and 2010 for buildings to be removed from acute care services per Section 130061(c)(2)(D)

15Building Number:

Building Name:

Parking Structure "E" Year of Information:

2010

Type of Services Provided

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Inpatient Beds

Surgical

Anesthesia

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Support Services

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

0

0

0

0

0

0

0

Total Beds this Building

0

Information Current As Of:

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:80 of 128Report Year:

Page 81: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

10 Clinical ResearchBuilding Number: Removal Date:

06/01/2008

Planned Uses for the building to be removed from acute care service:

Planned use for building: Clinic Jurisdiction: Local Authority

Inpatient services currently delivered in the building:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Surgical

Anesthesia

Support ServicesAdministration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

OutpatientSurgery

Central PlantEmergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

For the building or buildings to be removed from acute care service, provide the following:

The projected date or dates the building will be removed from service per Section 130061 (c)(2)(A)The planned uses of the building or buildings to be removed from acute care service per Section 130061(c)(2)(B)The inpatient service currently delivered in the building or buildings per Section 130061(c)(20(C)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:81 of 128Report Year:

Page 82: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

12 Jules Stein Eye InstituteBuilding Number: Removal Date:

06/01/2008

Planned Uses for the building to be removed from acute care service:

Planned use for building: Clinic Jurisdiction: Local Authority

Inpatient services currently delivered in the building:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Surgical

Anesthesia

Support ServicesAdministration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

OutpatientSurgery

Central PlantEmergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

For the building or buildings to be removed from acute care service, provide the following:

The projected date or dates the building will be removed from service per Section 130061 (c)(2)(A)The planned uses of the building or buildings to be removed from acute care service per Section 130061(c)(2)(B)The inpatient service currently delivered in the building or buildings per Section 130061(c)(20(C)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:82 of 128Report Year:

Page 83: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Report whether the general acute care services and beds will be relocated to a new or retrofittrd building and any corresponding building sites or project numbers per Section 130061(c)(2)(E)

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

07 Neuropsychiatric Institute

Nursing N/A

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

07 Neuropsychiatric Institute

Rehabilitation Therapy

N/A

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

07 Neuropsychiatric Institute

Rehabilitation Center

N/A

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:83 of 128Report Year:

Page 84: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Nursing Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Intensive Care Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:84 of 128Report Year:

Page 85: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Pediatric Adolescent Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Psychiatric Nursing Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:85 of 128Report Year:

Page 86: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Obstetrical Ante Postprtum

Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Surgical Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:86 of 128Report Year:

Page 87: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Anesthesia Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

ClinicalLab Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:87 of 128Report Year:

Page 88: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Radiological/Imaging Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Pharmaceutical Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:88 of 128Report Year:

Page 89: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Dietetic Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Administration Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:89 of 128Report Year:

Page 90: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Support Services Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Obstetrical Cesarean/Deliv

Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:90 of 128Report Year:

Page 91: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Obstetrical Recovery Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Newborn/Well Baby Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:91 of 128Report Year:

Page 92: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Emergency Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL081736 0 DECOMMISSIONING OF THE CHS COMPLEX (BLGS 01-15), EXCLUDING NPIH (BLDG 07)

08/26/2008 09/15/2008 11/12/2008 11/12/2008 CLSD

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Rehabilitation Therapy

Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:92 of 128Report Year:

Page 93: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Renal Dialysis Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

CentralPlant Relocated to new & other Building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:93 of 128Report Year:

Page 94: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Medical/Surgical(Include GYN)

Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Perinatal (exclude Newborn / GYN))

Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:94 of 128Report Year:

Page 95: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Pediatric Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Intensive Care Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:95 of 128Report Year:

Page 96: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Coronary Care) Relocated to new building

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Intensive Care Newborn Nursery

Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:96 of 128Report Year:

Page 97: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL081736 0 DECOMMISSIONING OF THE CHS COMPLEX (BLGS 01-15), EXCLUDING NPIH (BLDG 07)

08/26/2008 09/15/2008 11/12/2008 11/12/2008 CLSD

08 Medical Center

Rehabilitation Center

Removed from hospital services

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Acute Psychiatric Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:97 of 128Report Year:

Page 98: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number:

Building Name:

Will general acutr care services and beds will be relocated to a new or retrofittrd building?

Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status Number Number Num in Date Date Date

12127 HL981912 0 UCLA - WESTWOOD REPLACEMENT HOSPITAL 10/28/1998 10/03/2000 04/06/2001 12/23/2008 CLSD

08 Medical Center

Intermediate Care Relocated to new building

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:98 of 128Report Year:

Page 99: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

01 Dentistry

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:99 of 128Report Year:

Page 100: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

02 Library Building

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:100 of 128

Report Year:

Page 101: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

03 School of Medicine (East)

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:101 of 128

Report Year:

Page 102: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

04 School of Medicine (West)

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:102 of 128

Report Year:

Page 103: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

05 School of Public Health

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

121272010 Ronald Reagan UCLA Medical Center Los Angeles Page:103 of 128

Report Year:

Page 104: Provide the Hospital Owner and Year of Report per Section ... Facility Number: Hospital Owner/Licensee: City: Address: Facility Name: Year of Reporting: Contact 1 e-mail Address: Contact

Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

06 Brain Research Institute

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

07 Neuropsychiatric Institute

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

X

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

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Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

08 Medical Center

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

09 Outpatient Wing

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

10 Clinical Research

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

11 Marion Davies Children's Clinic

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

12 Jules Stein Eye Institute

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

13 CHS South Parking Structure

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

14 Emergency Services Building

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Building Number: Building Name:

Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

15 Parking Structure "E"

Type of Service Provided

Surgical

Anesthesia

Support Services

Administration

Dietetic

Pharmaceutical

Clinical Lab

Radiological/Imaging

OutpatientSurgery

Central Plant

RehabilitationTherapy

Renal Dialysis

Obstetrical Cesarean/Deliv

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

Report any general acute care hospital inpatient service that is provided in any genaral acute care hospital building that is rated SPC-1 per Section 130061(c)(4)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

01 Dentistry

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

02 Library Building

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

03 School of Medicine (East)

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

04 School of Medicine (West)

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

05 School of Public Health

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

Report Status: 1/20/2011 8:38 AMData Last Update: 01/19/2011 Submission Date: 01/19/2011 Print Date:

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

06 Brain Research Institute

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

07 Neuropsychiatric Institute

Remove from GAC service by 1/1/2013Configuration:

X

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

08 Medical Center

Replace with new SPC 5 and NPC 4 or NPC 5 buildingConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

09 Outpatient Wing

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

10 Clinical Research

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

11 Marion Davies Children's Clinic

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

12 Jules Stein Eye Institute

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

13 CHS South Parking Structure

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

14 Emergency Services Building

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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Nursing

IntensiveCare

Pediatric/Adolescent

PsychiatricNursing

ObstetricalAnte/Postprtum

IntermediateCare

Skilled Nursing

Support Services

Administration

Dietetic

Pharmaceutical

Radiological/Imaging

Clinical Lab

Anesthesia

Surgical

ObstetricalRecovery

Newborn/WellBaby

Emergency

Nuclear Medicine

RehabilitationTherapy

Renal Dialysis

OutpatientSurgery

Central Plant

Obstetrical Cesarean/Deliv

Building Number:

Type of Service Provided

Building Name:

15 Parking Structure "E"

N/AConfiguration:

Report the final configuration of all buildings on the hospital campus showing how each building will comply with the SPC-5/NPC-4 or 5 requirements whether by retrofit or by replacement and the type of service that will be provided in each general actue care hospital building per Section 130061(c)(5)

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