SUPERIOR COURT OF THE STATE OF CALIFORNIA
CENTRAL CIVIL WEST COURTHOUSE
|
Coordination
Proceeding
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) ) )))) |
PLAINTIFFS’ FIRST AMENDED AND CONSOLIDATED CLASS ACTION AND REPRESENTATIVE COMPLAINT
REDACTED VERSION |
TABLE OF CONTENTS
PAGE
I. NATURE OF THIS ACTION
II. parties
A. Class Action Plaintiffs
B. Representative Plaintiff
C. Defendants
III. jurisdiction and venue
IV. STATEMENT OF FACTS
A. The Origins of the Scheme to Set
Artificially High Gross Charges –
Tenet’s Desire to Improve Its Mediocre Financial Performance
B. Tenet’s False Claims That Proper
Strategic Initiatives Caused Tenet’s
Results to Improve Dramatically
C. The Medicare Inpatient Prospective Payment System
1. Traditional Medicare
2. Medicare Outlier Payments
D. Tenet’s Corporate Culture
E. Tenet’s Gross Charge Pricing
Scheme and Abuse of Medicare Outlier
Payments
F. The Impacts of the Gross Charge Pricing Scheme
G. Tenet Admits the Impact of Its Scheme and the Wrongful Charges
H. The Motivation for the Scheme –
Management Enrichment During the
Class Period
V. CLASS ACTION ALLEGATIONS
first cause of action
(Violations of Consumers Legal
Remedies)
SECOND cause of action
(Violations of the Unfair Competition
Law)
THIRD cause of action
(Breach of Contract)
FOURTH cause of action
(Breach of Implied Covenant of Good
Faith
and Fair Dealing)
FIFTH cause of action
(For Unjust Enrichment and Restitution)
SIXTH cause of action
(Creation of an Involuntary
Constructive Trust –
Civil Code, § 2224)
VI. PRAYER FOR RELIEF
I. NATURE OF THIS ACTION
1. Through its subsidiaries, defendant Tenet Healthcare Corporation (“Tenet” or the “Company”) owns or operates general acute care hospitals and related health care facilities serving communities in the State of California and in fifteen other states. In addition to operating primarily acute care hospitals, the Company operates rehabilitation hospitals, specialty hospitals, long-term care facilities, psychiatric facilities and medical office buildings near its general hospitals, as well as other ancillary health care businesses.
2. In late 1998 and throughout early 1999, Tenet’s earnings and stock price were not meeting the internal targets of Tenet executives. In response, in June 1999 Tenet executives launched an “aggressive pricing strategy,” more appropriately called the “Gross Charge Pricing Scheme,” specifically designed to primarily take advantage of the federal government’s Medicare outlier payment system. Tenet executives planned for the Gross Charge Pricing Scheme to dramatically increase Tenet’s revenues and profits. The gross price is also called the list price or sticker price by the industry. It is the highest price charged by a hospital for a service or product and is the price upon which a hospital’s cost to charge ratio is calculated for the purposes of Medicare reimbursements. Medicare outlier payments are additional payments made to hospitals for treating patients who are costlier to treat than the average patient within a given Diagnosis Related Group (“DRG”). A hospital receives outlier payments when its gross charges, adjusted by the hospital’s cost to charge (“CCR”) ratio, exceed DRG specific thresholds established by the Centers for Medicare and Medicaid Services (“CMS”).
3. The Tenet Gross Charge Pricing Scheme worked as follows. The Scheme had two main components that generated extra and inappropriate Medicare payments, including: (1) the application of the statewide average (“SWA”) cost-to-charge ratio; and, (2) the time lag impact. CMS uses a hospital’s most recent settled cost report to set the hospital’s cost-to-charge ratio. These settled cost reports are typically two to three years old. If a hospital raises its charges so much that its cost-to-charge ratio falls below a certain threshold (derived from the cost-to-charge ratio nationwide), then the cost-to-charge ratio used to calculate outlier payments defaults to the statewide average, which is considerably higher than the hospital’s actual cost-to-charge ratio and is above the CMS-established national threshold. Additionally, the application of the statewide average can occur for two reasons including: (1) raising charges beyond a CMS threshold level; and (2) as a result of a hospital being newly built as acquired, which was particularly beneficial to Tenet, since Tenet was rapidly acquiring hospitals and raising charges during the period. Tenet’s newly acquired hospitals are put on the statewide average until Tenet, as the new owner, has their first settled cost report. As a result, raising charges immediately after an acquisition became a key part of the scheme.
4. As part of the scheme, in dramatic fashion, Tenet implemented across-the-board gross price increases at all of its hospitals during a short period of time, June 1999 through 2002. Implementation of the scheme required Tenet executives to set gross prices for hospital services at exorbitant levels and to inappropriately raise gross charges for all services at all Tenet hospitals in a manner that bore no relationship to costs, or to reasonable and customary charges for these services. This, in turn, triggered the use of the statewide average in a large percentage of Tenet hospitals, which in turn, triggered a material leap in Tenet’s outlier payments. In addition, due to the time lag between the price increases and the use of the therefore lower cost-to-charge ratios, outlier payments increased for hospitals that have charge increases that are greater than cost increases, for hospitals with CCRs that do not cause them to be on the statewide average. As a result of Tenet’s general charge increases and therefore falling cost-to-charge ratios, Tenet obtained substantial Medicare outlier payments from both application of the statewide average and time lag impacts, including receiving SWA based payments as a result of both raising charges so much that hospitals defaulted to the SWA, and as a result of hospital acquisitions.
5. Tenet’s executives knew the aggressive pricing strategy at the core of the scheme would increase reported profits, and hopefully Tenet’s share price, by generating additional patient service revenues without any additional costs. And, the increase in profits and share price would allow Tenet executives to accomplish the purpose of the scheme which was to allow these executives to enrich themselves through insider stock sales and performance-based bonuses.
6. The Gross Charge Pricing Scheme worked. From the end of 1999 to the present, Tenet’s Medicare inpatient outlier payments received each year increased in dramatic fashion, from $351 million in 2000 to $765 million in 2002. Tenet’s Medicare outlier payments ballooned to levels that were drastically higher than any other acute care hospital company. While Tenet’s charges become excessive at all of their hospitals, almost two-thirds of Tenet’s 2002 outlier payments, $481 million, came from hospitals that were able to use the statewide average multiplier. This represented 46 cents of the company’s $2.17 per share earnings. To put into perspective the dramatic impact of the Gross Charge Pricing Scheme, on August 7, 2003, Tenet announced that its Medicare outlier payments for the period January-June 2003, which had been calculated so as to reflect true cost to charge ratios without the inflation in existence during the scheme, had been reduced from $420 million in 2002 to $34 million in 2003, a 92% reduction.
7. These excessive Medicare outlier payments, as well as payments received from other payors as a result of the increases in charges, fueled an increase in revenues, profits and Tenet’s stock price. And Tenet’s executives successfully cashed in on hundreds of millions in insider stock sales and received lavish yearly bonuses as Tenet’s stock price increased.
8. While the Tenet executives got rich, the impact of the dramatic increase in gross charges was incurred by members of the proposed class: uninsured and/or self-insured patients who are the only patients who actually pay out of pocket for hospital services based on gross charges. Also impacted by the Gross Price Charging Scheme are Medicare and/or Medical patients who made co-payments based on Tenet’s inflated charges.
9. Tenet’s Gross Charge Pricing Scheme amounted to plain old unconscionable price gouging. This price gouging is clearly documented and proven based on reviews of: (1) the prices charged by all Tenet hospitals versus all non-Tenet hospitals; (2) the prices charged at each Tenet hospital versus non-Tenet hospitals; (3) the prices charged for each individual service (based on analyses of individual Diagnosis Related Groups (“DRG”s) and Major Diagnostic Categories (“MDC”s) at all Tenet hospitals versus all non-Tenet hospitals; and (4) the prices charged for each individual service at each Tenet hospital versus non-Tenet hospitals. All of these analyses show that Tenet hospitals clearly, consistently and dramatically charged more than did non-Tenet hospitals. And, such uniformly higher prices at Tenet hospitals cannot be the result of isolated practices, but instead are the result of a uniform policy emanating from Tenet headquarters, which was then implemented throughout the Tenet hospitals.
10. The existence of the Gross Pricing Scheme is corroborated by data for the 108 Tenet hospitals reporting such data on the Federal Government’s CMS Federal Fiscal Year 2001 Medicare Provider Analysis and Review (“MedPAR”) file. This data shows that every one of the 108 Tenet hospitals exceed the average of the non-Tenet hospitals for the state in which they are located in its ratio of charges as a percentage of Medicare non-outlier payments. The fact that every single one of the Tenet hospitals exceeds the non-Tenet hospitals average for this ratio, that uses hospital specific charges compared to Medicare payments to define a standard for reasonable and customary charges, demonstrates very conclusively that Tenet charges resulted from a uniformly imposed pricing scheme. Additionally, while the MedPAR data tape is not yet available for 2002, the fact that Tenet outlier payments skyrocketed in 2002 makes it virtually certain that Tenet’s charges became comparatively higher in 2002, despite their astronomic 2001 levels. By the end of 2002, Tenet’s gross charges to actual cost ratio had risen to such an extent that in some hospitals the ratio exceeded 800%, including by way of example: Doctors Medical Center, Modesto, CA, 974%, Doctors Hospital, Manteca, CA, 940%, Redding Medical Center, Redding, CA, 897%, San Dimas Community Hospital, San Dimas, CA, 881%, and Garfield Medical Center, Monterey Park, CA, 881%.
11. The price gouging can be seen by examining charges for specific categories of treatment or products as well. For example, on drugs sold to patients in recent years, Tenet charged a gross price at least as high as 1,037% above actual costs. In other instances, Tenet charged an unfair and/or unconscionable amount for items like pacemaker implants, having a gross charge of 81% more than non-Tenet hospitals and 69% more for tracheotomies than non-Tenet hospitals. These charges, as well as virtually all of Tenet’s charges for hospital services, were not reasonable, customary or fair.
12. Plaintiffs estimate that Tenet overcharged tens of thousands, if not hundreds of thousands, of inpatients who are Class members, as well as hundreds of thousands, if not millions of outpatients, who are also members of the Class.
13. On an individual patient level, the effects of the Gross Price Charging Scheme were severe and foisted upon a particularly vulnerable segment of the population. For example, after receiving surgery for a broken femur, one plaintiff was billed more than $93,184. When the screws that set her leg failed, she was readmitted and, after another operation, charged an additional $80,923. The total charges imposed by Tenet for treatment of a broken leg were $174,107. Among these charges, Tenet attempted to bill her over $1,600 for a simple prescribed follow-up x-ray of her leg; in fact, she was able to obtain the same x-ray from a third party for just $64 with a cash discount or $129 without a cash discount. Her medical bill from Tenet is replete with other inflated items and overcharges. Tenet turned her account over to a collection agency, Central Financial Control and, as a result of the derogatory credit reports, was unable to refinance her house. In another example, one plaintiff, treated for a two-hour visit for an infection, was charged $48,374 by Tenet, including $3,000 for antibiotics and saline. And, not only are patients vulnerable in the hospital setting and not in a position to negotiate for fair prices, but they also do not receive their bills until after services are provided. It was these types of patients who are among those that Tenet charged unfair prices.
14. Tenet is now the target of several state and federal investigations into its charging practices because it has substantially higher than average gross charges and outlier payments than any other hospital or hospital system nationwide. The Company recently disclosed that it received an unusually large share of Medicare payments, in part because it “aggressively” raised hospital charges. “Aggressively” became the Company’s code word for its unlawful price gouging scheme after the scheme was revealed in November 2002.
15. And Tenet has now admitted that the impact of its Gross Charge Pricing Scheme impacted uninsured patients. In a conference with investors on December 3, 2002, Tenet executives conceded that its hospitals charged uninsured patients gross charges, which means, as Tenet executives further conceded, that it sends “its highest bill to customers who are least able or least likely to pay.” And Tenet’s former CEO has admitted that this pricing strategy was not “acceptable.”
16. By this class action and representative action, plaintiffs seek to enjoin Tenet from continuing to charge inflated, exorbitant, unconscionable and unfair prices for Tenet’s hospital services, to impose a constructive trust on all monies by which the Company was unjustly enriched, including the disgorgement of its profits (as well as fees, costs and interest on all such sums), to recover compensatory and punitive damages, and to provide a restitutionary remedy.
17. This class action and representative action alleges that Tenet’s practices and policies with respect to its pricing of Tenet’s hospital services violates the Consumers Legal Remedies Act (“CLRA”), Civ. Code § 1750, et seq., and constitutes unlawful, unfair and/or fraudulent business practices in violation of the Unfair Competition Law (“UCL”), Bus. & Prof. Code § 17200, et seq., and the common law of California to the detriment of plaintiffs and the Class, as well as to the general public in this State and across the United States.
II. parties
A. Class Action Plaintiffs
18. Plaintiff Cynthia Wall Jervis was a patient at San Ramon Regional Medical Center (“SRRMC”), a Tenet-owned hospital. After she broke her leg, an ambulance brought her to SRRMC because she requested that she be brought to the nearest hospital. She had no insurance because her husband’s COBRA coverage had just run out. She is a self-employed accountant who works out of her house.
19. SRRMC admitted her in order to perform surgery on her leg. Just prior to surgery, however, hospital personnel told her something was wrong with her heart. She pleaded with them to just perform the surgery on her leg because she was in a great deal of pain, and she offered to sign any kind of release necessary. Plaintiff and her husband repeatedly told hospital personnel that they did not want the tests to be done and just wanted the surgery done on her leg. But Company personnel refused to perform the surgery until they conducted tests on her heart; the tests came back normal, but caused a delay in performing the surgery of almost two days. After conducting the tests, SRRMC personnel performed the necessary surgery on her leg, implanting five screws, rods and a plate into her leg. She was in the hospital for eight days, from July 2 to July 9, 2001.
20. Three and a half months later, three of the five screws in her leg broke. She was re-admitted to SRRMC and they had to perform the surgery again, replacing the five-screw plate with an eight-screw plate. She was in the hospital for five days, from October 26 to October 30, 2001. The hospital bill for the second hospital stay came to $80,923.01.
21. Plaintiff’s doctor then prescribed x-rays to be taken at SRRMC. She was required (unnecessarily) to have a weekly follow-up x-ray for the first month and then monthly x-rays for the remainder of the year. She went to the first two scheduled x-rays, where she paid cash because she got a 50% reduction on her bill by paying cash. Each x-ray cost $453.20 instead of the $906.40 that Tenet tried to bill her initially. When she arrived for her third x-ray, the price had gone up to over $1,600. She left the hospital and went to her doctor’s office; she explained to her doctor that she could not afford this so he suggested she go to a small, private x-ray clinic. She did, and the cost there for the same x-ray was between $64 and $129, less than 1/10th of the price charged by Tenet, and which plaintiffs are informed and believe represents the reasonable and customary market price for this service.
22. Plaintiff Lauren Bishop is a resident of the county of Alameda, in the State of California. Ms. Bishop is self-insured. Ms. Bishop was treated at Tenet’s Doctors Medical Center in San Pablo for burns she received from boiling water on June 20, 2000, and for her approximately 15 minute visit was charged by Tenet for pharmaceuticals only (which as alleged below consisted of burn salve and two 4” by 4” gauze bandages) the sum of $1,145. These charges are exorbitant and vastly inflated bearing no reasonable relationship to the cost for the treatment Ms. Bishop received or to the reasonable and customary price for this treatment.
23. Plaintiff Averil Empson is a resident of Redding, Cal ifornia. Plaintiff Empson was treated at Redding Medical Center in Redding, California on July 26, 2002, for an infection. For her two-hour visit, she was charged $48,374.78 by Tenet, $3,000 of which consisted of pharmaceutical charges only for “antibiotics and saline” provided to her during that treatment. These charges are exorbitant and vastly inflated, bearing no reasonable relationship to the cost for the treatment Ms. Empson received in Tenet’s hands or to the reasonable and customary price for this treatment.
24. Plaintiff Gary Klatt is a resident of Mt. Shasta, California and is self-insured. Mr. Klatt underwent a quadruple bypass procedure on August 2, 2001 at Redding Medical Center. The bill for the surgery and subsequent treatment for staph infection was approximately $300,000. The statement for those services shows that, at a minimum, $74,000 was for prescription drugs, pharmaceuticals, and pharmaceutical supplies. Plaintiff Klatt is 60 years old and an uninsured veteran. Although the Veterans Health Administration paid approximately $62,000 of the overall charges, plaintiff Klatt and his family have been responsible for the balance of approximately $233,000 and were forced to file for bankruptcy as a result. The charges by Tenet are exorbitant, vastly inflated, and bear no reasonable relationship to the cost for the treatment Mr. Klatt received in Tenet’s hands or to the reasonable and customary price for this treatment.
25. Plaintiff Raquel Delgadillo was a patient at Suburban Medical Center in Los Angeles, California, a hospital owned and operated by Tenet. Plaintiff Delgadillo was treated at Suburban Medical Center on July 5, 2001 on an emergency basis, for chest pains. She was uninsured at the time of treatment. She was treated as an outpatient and was released after a few hours. In connection with this treatment, she was billed $3,036.20, for services and prescription drugs. Thereafter, despite contesting this bill, Ms. Delgadillo was subjected to Tenet’s overly-aggressive collections practices.
26. Plaintiff Andrea Wallace is a resident of Modesto, California and was a patient at Doctors Medical Center (“DMC”), a Tenet-owned hospital. On October 26, 2001, plaintiff Wallace sought treatment at DMC on an emergency basis for symptoms she believed could be related to a previously diagnosed ulcer. Plaintiff Wallace advised DMC personnel that she was uninsured, that she had been previously diagnosed with an ulcer, and did not want any extraordinary treatment other than to confirm that her ulcer was not bleeding. Contrary to plaintiff Wallace’s request, DMC personnel immediately began a battery of tests, including an EKG and x‑rays. In addition, plaintiff Wallace was charged over $1,700.00 for various pharmaceuticals, including $460.60 for two 300 mg doses of Tagamet, which is available as an over-the-counter antacid medicine, and almost $800.00 for morphine injections, which Ms. Wallace indicated she did not want or need at the time, but which DMC personnel insisted on providing her.
27. In total, plaintiff Wallace’s outpatient visit to DMC of just a few hours in duration resulted in a bill of $8,692.85. The conclusion reached by DMC personnel and conveyed to plaintiff Wallace as she left DMC was that her ulcer was not bleeding, and there was nothing wrong with her.
28. Since receiving her bill for $8,692.85, plaintiff Wallace has been, and continues to be, harassed by DMC’s collection service, including threats to attach her wages and negatively impact her credit. Plaintiff Wallace continues to contest the charges. The charges by Tenet are exorbitant, vastly inflated, and bear no reasonable relationship to the cost for the treatment plaintiff Wallace received while in Tenet’s care or the reasonable and customary price for such treatment.
29. Plaintiff Sylvia Castro was admitted April-June 1999 at Tenet’s Doctor’s Hospital Medical Center in San Pablo for bypass surgery. For her hospital visit, she was charged $65,000, of which her insurance company has paid approximately $35,000. Ms. Castro was also charged approximately $10,000 additionally for her surgeon’s services. A significant portion of Tenet’s charges was for prescription drugs, pharmaceuticals, and pharmaceutical supplies. Even the statement provided to plaintiff Castro, however, shows that, at a minimum, Tenet charged approximately $30,000 for prescription drugs and pharmaceutical supplies. The charges by Tenet are exorbitant, vastly inflated, and bear no reasonable relationship to the cost for the treatment Ms. Castro received in Tenet’s hands or to the reasonable and customary price for this treatment.
B. Representative Plaintiff
30. Plaintiff Congress of California Seniors (“CCS”) is a nonprofit organization representing over 650,000 Californian senior citizens and their families. It is located at 1228 “N” Street, Suite 29, Sacramento, California. Many CCS members have obtained, and continue to obtain, health care services from Tenet and have been injured, and continue to be injured, by the wrongful and illegal conduct alleged herein. As an unincorporated association, CCS has standing to pursue this representative action pursuant to Bus. & Prof. Code §§ 17200, 17203, 17204, 17500 and 17535 and, inter alia, the decisions of the Supreme Court of California in Stop Youth Addiction, Inc. v. Lucky Stores, Inc., 17 Cal. 4th 553 (1998), and Committee on Children’s Television, Inc. v. General Foods Corp., 35 Cal. 3d 197 (1983).
C. Defendants
31. Tenet Healthcare Corporation (together with its subsidiaries referred to as “Tenet” or the “Company”) is the second largest investor-owned health care services company in the United States. As of December 31, 2002, its subsidiaries and affiliates (collectively “subsidiaries”) owned or operated 114 domestic general hospitals with 27,870 licensed beds and related health care facilities serving urban and rural communities in 16 states. Related health care facilities included a small number of rehabilitation hospitals, specialty hospitals, long-term-care facilities, a psychiatric facility and medical office buildings – all of which are located on the same campus as, or nearby, one of its general hospitals. Subsidiaries also owned physician practices and various ancillary health care businesses, including outpatient surgery centers, home health care agencies, occupational and rural health care clinics and health maintenance organizations. A publicly traded company, Tenet reports its results on a quarterly and annual basis to the Securities and Exchange Commission, and in doing so, includes the financial performance of all of its hospitals.
32. Each of its general hospitals offers acute care hospital services, including operating and recovery room services, radiology services, respiratory therapy services, clinical laboratory services, and pharmacy services; most offer intensive care, critical care and/or coronary care, physical therapy, orthopedic, oncology and outpatient services. A number of the hospitals also offer tertiary care services such as open-heart surgery, neonatal intensive care and neurology. Eight of its hospitals – Memorial Medical Center, USC University Hospital, St. Louis University Hospital, Hahnemann University Hospital, Sierra Medical Center, Western Medical Center, St. Christopher’s Hospital for Children and the Cleveland Clinic Florida Hospital – offer quaternary care in such areas as heart, lung, liver and kidney transplants. USC University Hospital, Sierra Medical Center and Good Samaritan Hospital also offer gamma-knife brain surgery, and St. Louis University Hospital, Hahnemann University Hospital and Memorial Medical Center offer bone marrow transplants. Except for one small hospital that has not sought to be accredited, each of its hospitals that are eligible for accreditation is fully accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities (in the case of rehabilitation hospitals), the American Osteopathic Association (in the case of two hospitals) or another appropriate accreditation agency.
33. Through March 10, 2003, Tenet organized these general hospitals and its other health care related facilities into three operating segments or divisions. The divisions’ economic characteristics, the nature of their operations, the regulatory environment in which they operated and the manner in which they were managed were all similar. The components of these divisions shared certain resources and they took direction on setting prices from Tenet. Accordingly, Tenet aggregated these divisions into a single reportable operating segment, as that term is defined by Statement of Financial Accounting Standards No. 131, “Disclosures about Segments of an Enterprise and Related Information.”
34. The following table lists, by state, the general hospitals owned or leased by its subsidiaries and operated domestically as of December 31, 2002:
|
Hospital |
|
Location |
|
Licensed Beds |
|
Status |
|
|
Alabama |
|
|
|
|
|
|
|
|
|
Brookwood Medical Center |
|
Birmingham |
|
586 |
|
Owned |
|
|
|
|
|
|
|
|
|
|
|
Central Arkansas Hospital |
|
Searcy |
|
193 |
|
Owned |
|
|
National Park Medical Center |
|
Hot Springs |
|
166 |
|
Owned |
|
|
Regional Medical Center of NEA(1) |
|
Jonesboro |
|
104 |
|
Owned |
|
|
St. Mary’s Regional Medical Center |
|
Russellville |
|
170 |
|
Owned |
|
|
|
|
|
|
|
|
|
|
|
Alvarado Hospital Medical Center/SDRI |
|
San Diego |
|
311 |
|
Owned |
|
|
Brotman Medical Center |
|
Culver City |
|
420 |
|
Owned |
|
|
Centinela Hospital Medical Center |
|
Inglewood |
|
370 |
|
Owned |
|
|
Century City Hospital |
|
Los Angeles |
|
190 |
|
Leased |
|
|
Chapman Medical Center |
|
Orange |
|
114 |
|
Leased |
|
|
Coastal Communities Hospital |
|
Santa Ana |
|
178 |
|
Owned |
|
|
Community Hospital of Huntington Park |
|
Huntington Park |
|
81 |
|
Leased |
|
|
Community Hospital of Los Gatos |
|
Los Gatos |
|
143 |
|
Leased |
|
|
Daniel Freeman Marina Hospital |
|
Marina del Rey |
|
166 |
|
Owned |
|
|
Daniel Freeman Memorial Hospital |
|
Inglewood |
|
358 |
|
Owned |
|
|
Desert Regional Medical Center |
|
Palm Springs |
|
393 |
|
Leased |
|
|
Doctors Hospital of Manteca |
|
Manteca |
|
73 |
|
Owned |
|
|
Doctors Medical Center |
|
Modesto |
|
465 |
|
Owned |
|
|
Doctors Medical Center |
|
San Pablo |
|
232 |
|
Leased |
|
|
Encino-Tarzana Regional Medical Center(2) |
|
Encino |
|
151 |
|
Leased |
|
|
Encino-Tarzana Regional Medical Center(2) |
|
Tarzana |
|
236 |
|
Leased |
|
|
Fountain Valley Regional Hospital and Medical Center |
|
Fountain Valley |
|
400 |
|
Owned |
|
|
Garden Grove Hospital and Medical Center |
|
Garden Grove |
|
167 |
|
Owned |
|
|
Garfield Medical Center |
|
Monterey Park |
|
210 |
|
Owned |
|
|
Greater El Monte Community Hospital |
|
South El Monte |
|
117 |
|
Owned |
|
|
Irvine Regional Hospital and Medical Center |
|
Irvine |
|
176 |
|
Leased |
|
|
John F. Kennedy Memorial Hospital |
|
Indio |
|
162 |
|
Owned |
|
|
Lakewood Regional Medical Center |
|
Lakewood |
|
161 |
|
Owned |
|
|
Los Alamitos Medical Center |
|
Los Alamitos |
|
167 |
|
Owned |
|
|
Midway Hospital Medical Center |
|
Los Angeles |
|
225 |
|
Owned |
|
|
Mission Hospital of Huntington Park |
|
Huntington Park |
|
109 |
|
Owned |
|
|
Monterey Park Hospital |
|
Monterey Park |
|
101 |
|
Owned |
|
|
Placentia Linda Hospital |
|
Placentia |
|
114 |
|
Owned |
|
|
Queen of Angels/Hollywood Presbyterian Medical Center |
|
Los Angeles |
|
434 |
|
Owned |
|
|
Redding Medical Center |
|
Redding |
|
269 |
|
Owned |
|
|
San Dimas Community Hospital |
|
San Dimas |
|
93 |
|
Owned |
|
|
San Ramon Regional Medical Center |
|
San Ramon |
|
123 |
|
Owned |
|
|
Santa Ana Hospital Medical Center |
|
Santa Ana |
|
69 |
|
Leased |
|
|
Sierra Vista Regional Medical Center |
|
San Luis Obispo |
|
201 |
|
Owned |
|
|
Suburban Medical Center |
|
Paramount |
|
182 |
|
Leased |
|
|
Twin Cities Community Hospital |
|
Templeton |
|
84 |
|
Owned |
|
|
USC University Hospital(3) |
|
Los Angeles |
|
269 |
|
Leased |
|
|
Western Medical Center |
||||||