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As submitted to California's Office of Statewide Health Planning and Development in accordance with Senate Bill 499 (SB 499) requirement for all general acute care hospitals with Structural Performance Category 1 (SPC-1) buildings to report annually with seismic safety compliance status, beds and services.
Senate Bill 499 (SB 499) Hospital ReportOffice of Statewide Health Planning and DevelopmentFacilities Development Division
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:
11125
Trinity Hospital
60 Easter Avenue
Weaverville
Mountain Communities Healthcare District
2016
[Confidential data left blank intentionally.]
[Confidential data left blank intentionally.]
Wally Couch
1/6/2017 11:32:11 AM
Provide the Hospital Owner and Year of Report per Section 130061(e)
[Confidential data left blank intentionally.]
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
For buildings For buildings which are planned for rebuild, retrofit or replacement this report shall identify; Whether the hospital owner intends to rebuild, retrofit or replace the building to SPC2, SPC3, SPC4, SPC4D or SPC5 per 130061(c)(1)(A). The deadline, as described in Section 130060 or 130061.5,for rebuild, retrofit or replacement of the building 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
01/01/2020SPC2RetrofitSecurity AdditionBLD-02525
60 Easter Avenue 07/01/2019
01/01/2020N/ARemoveConnecting Corridor Addition
BLD-02529
60 Easter Avenue 07/01/2019
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:2 of 34Report Year:
Security AdditionBuilding No: BLD-02525 Yes-SubmittedRetrofit/Replacement Project:
11125 H142985-53-00
0 RRU Sac - SECURITY ADD SPC 2 STRUCTURAL UPGRADE
12/26/2014
PEND No 12/31/202011/2/2016 12:00:00
AM
07/31/2015
Facility Number
Project Number
Sub Num Scope Date In
Plan Approved Date
Projected Start Date
Projected Completion Date Status
CEQA Review
For each building which is planned for rebuild, retrofit or replacement, provide the project numbers, per Section 130061(c)(1)(C). The projected construction start date or dates and projected Completion date or dates per Section 130061(c)(1)(D) and the most recent project status and approvals per Section 130061(c)(1)(E).
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:3 of 34Report Year:
BLD-02525 Security Addition
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
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
ObstetricalCesarean/Deliv
Provide the number of inpatient beds and patient days per type of service per building per Section 130061(c)(1)(F)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:4 of 34Report Year:
BLD-02529 Connecting Corridor Addition
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
ObstetricalCesarean/Deliv
Provide the number of inpatient beds and patient days per type of service per building per Section 130061(c)(1)(F)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:5 of 34Report Year:
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
BLD-02525 Security Addition
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)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:6 of 34Report Year:
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
BLD-02529 Connecting Corridor Addition
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)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:7 of 34Report Year:
BLD-02523 Main Hospital Building Remain
BLD-02525 Security Addition Retrofit
BLD-02526 16-Bed Addition Remain
BLD-02527 Lab and Radiology Addition Remain
BLD-02528 Emergency Generator Building Remain
BLD-02529 Connecting Corridor Addition Remove
For all buildings at the facility, indicate which ones are scheduled for general acute service removal.
Building Number Building Name
Building to be Removed / Replaced / Rebuilt
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:8 of 34Report Year:
No proposed new buildings to be constructed at this or another site.
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:9 of 34Report Year:
BLD-02529 Connecting Corridor AdditionBuilding Number: Removal Date:
07/01/2019
Planned Uses for the building to be removed from acute care service:
Planned use for building:
Inpatient services currently delivered in the building:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
Surgical
Anesthesia
Support Services
Administration
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 replaced, rebuilt, 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) and provide said date or dates for replaced or rebuild buildings as well.The planned uses of the building or buildings to be removed from acute care service per Section 130061(c)(2)(B) and provide said uses for replaced or rebuild buildings as well.The inpatient service currently delivered in the building or buildings per Section 130061(c)(2)(C)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:10 of 34Report Year:
Provide the number of inpatient beds and patient days per unit for the year of 2013, 2014, and 2015 for buildings to be removed from acute care services per Section 130061(c)(2)(D).
BLD-02529Building Nbr: Building Name: Connecting Corridor Addition Year of Information: 2013
Unit Type
Medical/Surgical (include GYN)
Perinatal (exclude Neborn/GYN)
Pediatric
Intensive Care
Coronary Care
Acute Respiratory Care
Burn
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Intensive Care Newborn Nursery
Rehabilitation Center Int. Care/Developmentally Disabled
Intermediate Care
Skilled Nursing
Chemical Dependency
Acute Psychiatric
25
0
0
0
0
0
0
Total Beds this Building per Service
26
Information Current As Of:
Patient Days
1402
Patient Days
Patient Days
Patient Days
Patient Days
0
0
0
0Total Beds this Building per Unit 51
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
0
0
7469
0
0
0
0
0
0
26
0
0
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:11 of 34Report Year:
Provide the number of inpatient beds and patient days per unit for the year of 2013, 2014, and 2015 for buildings to be removed from acute care services per Section 130061(c)(2)(D).
BLD-02529Building Nbr: Building Name: Connecting Corridor Addition Year of Information: 2014
Unit Type
Medical/Surgical (include GYN)
Perinatal (exclude Neborn/GYN)
Pediatric
Intensive Care
Coronary Care
Acute Respiratory Care
Burn
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Intensive Care Newborn Nursery
Rehabilitation Center Int. Care/Developmentally Disabled
Intermediate Care
Skilled Nursing
Chemical Dependency
Acute Psychiatric
25
0
0
0
0
0
0
Total Beds this Building per Service
0
Information Current As Of:
Patient Days
739
Patient Days
Patient Days
Patient Days
Patient Days
0
0
0
0Total Beds this Building per Unit 51
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
0
0
5320
0
0
0
0
0
0
26
0
0
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:12 of 34Report Year:
Provide the number of inpatient beds and patient days per unit for the year of 2013, 2014, and 2015 for buildings to be removed from acute care services per Section 130061(c)(2)(D).
BLD-02529Building Nbr: Building Name: Connecting Corridor Addition Year of Information: 2015
Unit Type
Medical/Surgical (include GYN)
Perinatal (exclude Neborn/GYN)
Pediatric
Intensive Care
Coronary Care
Acute Respiratory Care
Burn
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Intensive Care Newborn Nursery
Rehabilitation Center Int. Care/Developmentally Disabled
Intermediate Care
Skilled Nursing
Chemical Dependency
Acute Psychiatric
25
0
0
0
0
0
0
Total Beds this Building per Service
51
Information Current As Of:
Patient Days
1145
Patient Days
Patient Days
Patient Days
Patient Days
0
0
0
0Total Beds this Building per Unit 51
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
0
0
6866
0
0
0
0
0
0
26
0
0
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:13 of 34Report Year:
Provide the number of inpatient beds and patient days per type of service for the year of 2013, 2014, and 2015 for buildings to be removed from acute care services per Section 130061(c)(2)(D).
BLD-02529Building Nbr: Building Name:
Connecting Corridor Addition Year of Information: 2013
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 per service 0
Information Current As Of:
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
0
0
0
0
0
0
0
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:14 of 34Report Year:
Provide the number of inpatient beds and patient days per type of service for the year of 2013, 2014, and 2015 for buildings to be removed from acute care services per Section 130061(c)(2)(D).
BLD-02529Building Nbr: Building Name:
Connecting Corridor Addition Year of Information: 2014
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 per service 0
Information Current As Of:
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
0
0
0
0
0
0
0
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:15 of 34Report Year:
Provide the number of inpatient beds and patient days per type of service for the year of 2013, 2014, and 2015 for buildings to be removed from acute care services per Section 130061(c)(2)(D).
BLD-02529Building Nbr: Building Name:
Connecting Corridor Addition Year of Information: 2015
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
25
0
0
0
0
0
26
Total Beds this Building per service 51
Information Current As Of:
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
Patient Days
1145
0
0
0
0
0
6866
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:16 of 34Report Year:
No data reported for whether the general acute care services and beds will be relocated to a new, existing or retrofitted building and any corresponding building sites or project numbers for buildings with a Building Resolution of "Rebuild" or "Replace" per Section 130061(c)(2)(E).
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:17 of 34Report Year:
No data reported for Section 130061(c)(3).
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:18 of 34Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-02525 Security Addition
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 general acute care hospital building that is rated SPC-1 per Section 130061(c)(4)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:19 of 34Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-02529 Connecting Corridor Addition
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 general acute care hospital building that is rated SPC-1 per Section 130061(c)(4)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:20 of 34Report Year:
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:
X
BLD-02523 Main Hospital Building
Retrofit Non-Conforming building to SPC 2 and NPC 3 and remove from service by 2030Configuration:
X
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 acute care hospital building per Section 130061(c)(5)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:21 of 34Report Year:
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:
BLD-02525 Security Addition
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 acute care hospital building per Section 130061(c)(5)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:22 of 34Report Year:
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:
BLD-02526 16-Bed Addition
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 acute care hospital building per Section 130061(c)(5)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:23 of 34Report Year:
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:
BLD-02527 Lab and Radiology Addition
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 acute care hospital building per Section 130061(c)(5)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:24 of 34Report Year:
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:
BLD-02528 Emergency Generator 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 acute care hospital building per Section 130061(c)(5)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:25 of 34Report Year:
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:
BLD-02529 Connecting Corridor Addition
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 acute care hospital building per Section 130061(c)(5)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:26 of 34Report Year:
BLD-02523 Main Hospital Building
X
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
X
X
X
X
X
50
25
Type of Service Provided
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
25
0
Total Beds this Building
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
Include information on the number of inpatient beds by type of Service provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:27 of 34Report Year:
BLD-02526 16-Bed Addition
X
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
X
X
X
X
4
4
Type of Service Provided
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
0
0
Total Beds this Building
Surgical
X
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
Include information on the number of inpatient beds by type of Service provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:28 of 34Report Year:
BLD-02527 Lab and Radiology Addition
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
X
X
0
0
Type of Service Provided
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
0
0
Total Beds this Building
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
Include information on the number of inpatient beds by type of Service provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:29 of 34Report Year:
BLD-02528 Emergency Generator Building
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
0
0
Type of Service Provided
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
0
0
0
0
0
0
Total Beds this Building
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
Include information on the number of inpatient beds by type of Service provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:30 of 34Report Year:
Building Number: Building Name:
Pediatric
Perinatal (Exclude Newborn / GYN)
Medical / Surgical (Include GYN)
Intermediate Care
Coronary Care
Intensive Care Rehabilitation Center
Chemical Dependency
Acute Respiratory Care
Skilled Nursing Burn
Intensive Care Newborn Nursery
Acute Psychiatric
Int. Care / Developmentally 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
BLD-02523 Main Hospital Building
25 1039
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 050 50
0 0
25 6623
0 0
0 0
Include information on the number of inpatient beds by type of unit provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:31 of 34Report Year:
Building Number: Building Name:
Pediatric
Perinatal (Exclude Newborn / GYN)
Medical / Surgical (Include GYN)
Intermediate Care
Coronary Care
Intensive Care Rehabilitation Center
Chemical Dependency
Acute Respiratory Care
Skilled Nursing Burn
Intensive Care Newborn Nursery
Acute Psychiatric
Int. Care / Developmentally 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
BLD-02526 16-Bed Addition
4 41
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 04 4
0 0
0 0
0 0
0 0
Include information on the number of inpatient beds by type of unit provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:32 of 34Report Year:
Building Number: Building Name:
Pediatric
Perinatal (Exclude Newborn / GYN)
Medical / Surgical (Include GYN)
Intermediate Care
Coronary Care
Intensive Care Rehabilitation Center
Chemical Dependency
Acute Respiratory Care
Skilled Nursing Burn
Intensive Care Newborn Nursery
Acute Psychiatric
Int. Care / Developmentally 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
BLD-02527 Lab and Radiology Addition
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 00 0
0 0
0 0
0 0
0 0
Include information on the number of inpatient beds by type of unit provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:33 of 34Report Year:
Building Number: Building Name:
Pediatric
Perinatal (Exclude Newborn / GYN)
Medical / Surgical (Include GYN)
Intermediate Care
Coronary Care
Intensive Care Rehabilitation Center
Chemical Dependency
Acute Respiratory Care
Skilled Nursing Burn
Intensive Care Newborn Nursery
Acute Psychiatric
Int. Care / Developmentally 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
BLD-02528 Emergency Generator Building
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 00 0
0 0
0 0
0 0
0 0
Include information on the number of inpatient beds by type of unit provided by buildings that are classified as SPC-2, SPC-3, SPC-4, SPC-4D and SPC-5 per Section 130061(e)
OSHPD FDD SB499 Report 1/8/2017 6:30 AMData Last Update: 01/06/2017 Submission Date: 01/06/2017 Printed:
111252016 Trinity Hospital Weaverville Page:34 of 34Report Year:
