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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:
10295
Frank R Howard Memorial Hospital
1 Madrone Street
Willits
Willits Hospital Inc. dba Frank R. Howard Memorial Hospital
2012
Frank R. Howard Memorial Hospital - 10295
10/15/2012 12:10:38 PM
Provide the Hospital Owner and Year of Report per Section 130061(e)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:1 of 50Report Year:
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 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
07/01/201401/01/2015SPC5ReplaceOriginal HospitalBLD-00460
1 Madrone Street
07/01/201401/01/2015SPC5ReplaceRadiologyBLD-00461
1 Madrone Street
07/01/201401/01/2015SPC5ReplacePlant OperationsBLD-00462
1 Madrone Street
07/01/201401/01/2015SPC5ReplaceAdministrationBLD-00464
1 Madrone Street
07/01/201401/01/2015SPC5ReplaceMaterials ManagementBLD-00466
1 Madrone Street
07/01/201401/01/2015SPC5ReplaceMedical RecordsBLD-00467
1 Madrone Street
07/01/201401/01/2015SPC5ReplaceCT TrailerBLD-00468
1 Madrone Street
07/01/201401/01/2015SPC5ReplaceCanopyBLD-03101
1 Madrone Street
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:2 of 50Report Year:
Original HospitalBuilding No: BLD-00460 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
RadiologyBuilding No: BLD-00461 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
Plant OperationsBuilding No: BLD-00462 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date 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).
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:3 of 50Report Year:
AdministrationBuilding No: BLD-00464 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
Materials ManagementBuilding No: BLD-00466 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
Medical RecordsBuilding No: BLD-00467 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
CT TrailerBuilding No: BLD-00468 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:4 of 50Report Year:
CanopyBuilding No: BLD-03101 Yes-SubmittedRetrofit/Replacement Project:
10295 HS102235-0 0 REPLACEMENT HOSPITAL 11/16/2010 12:00:00
AM
4/30/2012 12:00:00
AM
06/15/2012 06/15/2014 PEND No
Facility Project Sub Scope Date Plan Approved Proj. Start Proj. Completed Status CEQANumber Number Num in Date Date Date Review_
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:5 of 50Report Year:
BLD-00460 Original Hospital
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
X
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
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:6 of 50Report Year:
BLD-00461 Radiology
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
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:7 of 50Report Year:
BLD-00462 Plant Operations
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X0
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:8 of 50Report Year:
BLD-00464 Administration
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
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:9 of 50Report Year:
BLD-00466 Materials Management
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
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:10 of 50Report Year:
BLD-00467 Medical Records
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
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:11 of 50Report Year:
BLD-00468 CT Trailer
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
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:12 of 50Report Year:
BLD-03101 Canopy
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:13 of 50Report 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-00460 Original Hospital
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:14 of 50Report 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-00461 Radiology
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:15 of 50Report 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-00462 Plant Operations
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:16 of 50Report 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-00464 Administration
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:17 of 50Report 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-00466 Materials Management
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:18 of 50Report 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-00467 Medical Records
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:19 of 50Report 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-00468 CT Trailer
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:20 of 50Report 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-03101 Canopy
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:21 of 50Report Year:
BLD-00460 Original Hospital Replace
BLD-00461 Radiology Replace
BLD-00462 Plant Operations Replace
BLD-00463 Nursing Unit Replace
BLD-00464 Administration Replace
BLD-00465 Operating Rooms Replace
BLD-00466 Materials Management Replace
BLD-00467 Medical Records Replace
BLD-00468 CT Trailer Replace
BLD-03101 Canopy Replace
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
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:22 of 50Report Year:
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:23 of 50Report Year:
Report 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)
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00460 Original Hospital
Dietetic Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00460 Original Hospital
Administration Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00460 Original Hospital
Support Services Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00461 Radiology
Radiological/Imaging Relocated to new building
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:24 of 50Report Year:
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00462 Plant Operations
CentralPlant Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00463 Nursing Unit
Nursing Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00463 Nursing Unit
Intensive Care Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00463 Nursing Unit
Emergency Relocated to new building
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:25 of 50Report Year:
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00463 Nursing Unit
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, Existing or retrofittrd building?
BLD-00463 Nursing Unit
Intensive Care Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00464 Administration
Administration Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00465 Operating Rooms
Surgical Relocated to new building
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:26 of 50Report Year:
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00465 Operating Rooms
Anesthesia Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00466 Materials Management
Support Services Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00467 Medical Records
Administration Relocated to new building
Building Number:
Building Name:
Will general acutr care services and beds will be relocated to a new, Existing or retrofittrd building?
BLD-00468 CT Trailer
Radiological/Imaging Relocated to new building
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:27 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00460 Original Hospital
Type of Service Provided
Surgical
Anesthesia
Support Services
Administration
Dietetic
Pharmaceutical
Clinical Lab
Radiological/Imaging
OutpatientSurgery
Central Plant
RehabilitationTherapy
Renal Dialysis
X
X
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:28 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00461 Radiology
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:29 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00462 Plant Operations
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:30 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00464 Administration
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:31 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00466 Materials Management
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:32 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00467 Medical Records
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:33 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-00468 CT Trailer
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:34 of 50Report Year:
Building Number: Building Name:
Nursing
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
BLD-03101 Canopy
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:35 of 50Report 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-00460 Original Hospital
N/AConfiguration:
X
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 actue care hospital building per Section 130061(c)(5)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:36 of 50Report 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-00461 Radiology
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:37 of 50Report 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-00462 Plant Operations
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:38 of 50Report 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
X
BLD-00463 Nursing Unit
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:39 of 50Report 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-00464 Administration
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:40 of 50Report 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-00465 Operating Rooms
N/AConfiguration:
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 actue care hospital building per Section 130061(c)(5)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:41 of 50Report 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-00466 Materials Management
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:42 of 50Report 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-00467 Medical Records
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:43 of 50Report 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-00468 CT Trailer
N/AConfiguration:
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)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:44 of 50Report 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-03101 Canopy
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: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:45 of 50Report Year:
BLD-00463 Nursing Unit
X
X
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
X
38
34
Type of Service Provided
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
Inpatient Beds
4
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, and SPC-5 per Section 130061(e)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:46 of 50Report Year:
BLD-00465 Operating Rooms
Nursing
Building Number: Building Name:
IntensiveCare
Pediatric/Adolescent
PsychiatricNursing
ObstetricalAnte/Postprtum
IntermediateCare
Skilled Nursing
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, and SPC-5 per Section 130061(e)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:47 of 50Report 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-00463 Nursing Unit
34 4848
0 0
0 0
4 548
0 0
0 0
0 0
0 0
0 0
0 0 38 38
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, and SPC-5 per Section 130061(e)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:48 of 50Report 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-00465 Operating Rooms
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
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, and SPC-5 per Section 130061(e)
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:49 of 50Report Year:
Report Status: 11/5/2012 1:25 PMData Last Update: 10/15/2012 Submission Date: 10/15/2012 Print Date:
102952012 Frank R Howard Memorial Hospital Willits Page:50 of 50Report Year:
