Table: health_facilities_state_enforcement_actions_1997_2023_data_file , facility_name like K*

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  *

facid	facility_name	ltc	fac_type_code	fac_fdr	district_office	penalty_issue_date	penalty_number	disposition	penalty_type	penalty_detail	penalty_category	penalty_category_other	violation_from_date	violation_to_date	appealed	appeal_due_date	appeal_received_date	class_assessed_initial	class_assessed_final	total_amount_initial	total_amount_due_final	total_penalty_offset_amount	total_collected_amount	total_balance_due	aclaims_visit_number	eventid	death_related	intakeid_all	priority_all	sfy
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-03-06 00:00:00	020002492	Closed	Citation	Citation B (HSC 1424)	Administration	None	1999-12-01 00:00:00	1999-12-01 00:00:00	No	2000-03-30 00:00:00	None	B	None	1000	1000	-350	650	0	020011415	A99999	N	None	None	SFY1999-00
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-04-05 00:00:00	020002510	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	1998-10-28 00:00:00	1999-11-20 00:00:00	No	2000-06-06 00:00:00	None	A	None	8000	24000	-12000	12000	0	020011554	A99999	N	None	None	SFY1999-00
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-05-30 00:00:00	020002523	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2000-01-13 00:00:00	None	Yes	2000-12-14 00:00:00	2000-06-09 00:00:00	A	A	9000	9000	-9000	0	0	020011754	A99999	N	None	None	SFY1999-00
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-05-30 00:00:00	020002524	Closed	Citation	Citation B (HSC 1424)	Administration	None	2000-02-06 00:00:00	2000-03-15 00:00:00	No	2000-06-23 00:00:00	None	B	None	1000	1000	0	1000	0	020011759	A99999	N	None	None	SFY1999-00
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-06-13 00:00:00	020002529	Closed	Citation	Citation AA (HSC 1424)	Patient Care	None	1999-12-29 00:00:00	1999-12-29 00:00:00	Yes	2000-12-14 00:00:00	2000-06-19 00:00:00	AA	AA	25000	25000	-25000	0	0	020011821	A99999	Y	None	None	SFY1999-00
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-10-03 00:00:00	020002565	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2000-08-22 00:00:00	None	No	2000-11-03 00:00:00	None	B	None	900	2700	0	2700	0	020012323	A99999	N	None	None	SFY2000-01
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-12-22 00:00:00	020002578	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2000-11-13 00:00:00	None	No	2001-01-24 00:00:00	None	B	None	900	900	-315	585	0	020012778	A99999	N	None	None	SFY2000-01
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2000-12-22 00:00:00	020002579	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2000-09-30 00:00:00	None	No	2001-01-24 00:00:00	None	B	None	900	900	-315	585	0	020012779	A99999	N	None	None	SFY2000-01
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2001-04-05 00:00:00	020002609	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2001-02-28 00:00:00	None	No	2001-04-30 00:00:00	None	B	None	1000	1000	-1000	0	0	020013256	A99999	N	None	None	SFY2000-01
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2002-09-13 00:00:00	020002717	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-07-02 00:00:00	2002-07-18 00:00:00	No	2002-10-28 00:00:00	None	B	None	600	600	-210	390	0	020014563	A99999	N	None	None	SFY2002-03
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2002-09-30 00:00:00	020002720	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-04-07 00:00:00	None	No	2002-10-25 00:00:00	None	B	None	600	600	-210	390	0	020014526	A99999	N	None	None	SFY2002-03
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2003-01-13 00:00:00	020002735	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-08-18 00:00:00	2002-09-06 00:00:00	No	2003-02-04 00:00:00	None	B	None	900	900	-315	585	0	020014716	A99999	N	None	None	SFY2002-03
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2003-01-16 00:00:00	020002736	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2002-08-06 00:00:00	None	No	2003-02-11 00:00:00	None	B	None	900	900	-315	585	0	020014721	A99999	N	None	None	SFY2002-03
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2003-06-04 00:00:00	020002756	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2003-03-30 00:00:00	None	No	2003-06-25 00:00:00	None	B	None	1000	3000	-1050	1950	0	020015311	A99999	N	None	None	SFY2002-03
020000042	KAISER PERMANENTE POST-ACUTE CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2014-12-03 00:00:00	020011148	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2014-08-16 00:00:00	2014-08-16 00:00:00	No	2014-12-24 00:00:00	None	B	None	1500	1500	-525	975	0	None	K6K811	N	CA00409788	B	SFY2014-15
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2017-10-03 00:00:00	020013333	Closed	Citation	Citation B (HSC 1424)	Medication	None	2016-03-24 00:00:00	2016-03-24 00:00:00	No	2017-10-24 00:00:00	None	B	None	1500	1500	0	1500	0	None	NLPT11	N	None	None	SFY2017-18
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2018-10-04 00:00:00	020014454	Closed	Citation	Citation B (HSC 1424)	Physical Environment	None	2018-05-14 00:00:00	2018-05-14 00:00:00	Yes	2018-10-25 00:00:00	2018-10-22 00:00:00	B	B	2000	1600	0	1600	0	None	GODY11	N	CA00587286, CA00588942	A, B	SFY2018-19
020000112	KYAKAMEENA CARE CENTER	LTC	SNF	Skilled Nursing Facility	East Bay	2023-11-15 00:00:00	020019280	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2023-09-08 00:00:00	2023-09-08 00:00:00	No	2023-12-08 00:00:00	None	B	None	2000	2000	0	2000	0	None	KOUF11	N	CA00859624, CA00859624	B, B	SFY2023-24
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2000-03-22 00:00:00	030002003	Closed	Citation	Citation B (HSC 1424)	Other	NEGLECT/ABUSE	2000-02-15 00:00:00	None	Yes	2000-04-17 00:00:00	2000-03-28 00:00:00	B	None	800	800	0	800	0	030013976	A99999	N	None	None	SFY1999-00
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2000-05-03 00:00:00	030002013	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	1999-12-05 00:00:00	None	Yes	2000-05-31 00:00:00	2000-05-22 00:00:00	A	A	8000	8000	-6400	1600	0	030014121	A99999	N	None	None	SFY1999-00
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2000-05-03 00:00:00	030002014	Closed	Citation	Citation A (HSC 1424)	Staffing	None	1999-12-05 00:00:00	None	No	2000-05-31 00:00:00	None	A	A Trebled	8000	24000	-12000	12000	0	030014122	A99999	N	None	None	SFY1999-00
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2000-10-20 00:00:00	030002041	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2000-09-05 00:00:00	None	No	2000-11-10 00:00:00	None	A	A	8000	8000	-6000	2000	0	030014674	A99999	N	None	None	SFY2000-01
030001254	KAISER FOUNDATION HOSPITAL MANTECA D/P SNF	LTC	SNF	Skilled Nursing Facility	Sacramento	2002-06-11 00:00:00	030002095	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2001-09-29 00:00:00	None	No	2002-07-05 00:00:00	None	A	None	16000	16000	-5600	10400	0	030015937	A99999	N	None	None	SFY2001-02
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2004-01-02 00:00:00	030002153	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2003-08-28 00:00:00	None	Yes	2004-02-02 00:00:00	2004-01-14 00:00:00	B	B	600	600	0	600	0	030017971	A99999	N	None	None	SFY2003-04
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2004-01-05 00:00:00	030002154	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-08-24 00:00:00	None	No	2004-02-02 00:00:00	None	B	None	1000	1000	-350	650	0	030017065	A99999	N	None	None	SFY2003-04
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2004-01-04 00:00:00	030002155	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-08-24 00:00:00	None	No	2004-02-02 00:00:00	None	B	None	1000	1000	-350	650	0	030017065	A99999	N	None	None	SFY2003-04
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2004-12-03 00:00:00	030002304	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2004-05-09 00:00:00	None	No	2004-12-24 00:00:00	None	B	None	1000	1000	-350	650	0	030020273	A99999	N	None	None	SFY2004-05
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2006-07-21 00:00:00	030003184	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2005-09-22 00:00:00	2005-09-22 00:00:00	No	2006-08-11 00:00:00	None	B	None	500	500	0	500	0	None	DXQ811	N	None	None	SFY2006-07
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2006-10-13 00:00:00	030003414	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2006-07-30 00:00:00	2006-07-30 00:00:00	No	2006-11-03 00:00:00	None	B	None	1000	1000	-350	650	0	None	RDYD11	N	CA00088841	B	SFY2006-07
030001254	KAISER FOUNDATION HOSPITAL MANTECA D/P SNF	LTC	SNF	Skilled Nursing Facility	Sacramento	2007-10-05 00:00:00	030004322	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2005-11-30 00:00:00	2005-11-30 00:00:00	Yes	2007-10-29 00:00:00	2007-10-12 00:00:00	B	B	1000	500	0	500	0	None	UGB111	N	CA00069089	B	SFY2007-08
030001254	KAISER FOUNDATION HOSPITAL MANTECA D/P SNF	LTC	SNF	Skilled Nursing Facility	Sacramento	2008-02-06 00:00:00	030004653	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-10-28 00:00:00	2007-10-28 00:00:00	No	2008-02-29 00:00:00	None	B	None	1000	1000	-350	650	0	None	GIWJ11	N	CA00130805	B	SFY2007-08
030001254	KAISER FOUNDATION HOSPITAL MANTECA D/P SNF	LTC	SNF	Skilled Nursing Facility	Sacramento	2008-03-28 00:00:00	030004798	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-06-20 00:00:00	2007-06-20 00:00:00	No	2008-04-25 00:00:00	None	B	None	1000	1000	-350	650	0	None	1JKJ11	N	CA00118506	B	SFY2007-08
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2009-09-21 00:00:00	030006555	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2006-10-15 00:00:00	2006-10-15 00:00:00	No	2009-10-13 00:00:00	None	A	None	20000	20150	-7000	13150	0	None	XFJY11	N	CA00100171, CA00100852	B, B	SFY2009-10
030001254	KAISER FOUNDATION HOSPITAL MANTECA D/P SNF	LTC	SNF	Skilled Nursing Facility	Sacramento	2010-07-01 00:00:00	030007345	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	FAILURE TO REPORT	2008-10-24 00:00:00	2008-10-24 00:00:00	No	2010-07-27 00:00:00	None	B	None	1000	1000	-350	650	0	None	1GXT11	N	CA00167683	B	SFY2010-11
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2010-10-14 00:00:00	030007626	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2008-05-30 00:00:00	2008-05-30 00:00:00	No	2010-11-04 00:00:00	None	B	None	600	600	-210	390	0	None	7ING11	N	CA00162210	B	SFY2010-11
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2010-10-14 00:00:00	030007627	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2008-05-30 00:00:00	2008-05-30 00:00:00	No	2010-11-04 00:00:00	None	B	None	1000	1000	-350	650	0	None	7ING11	N	CA00162210	B	SFY2010-11
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2012-07-12 00:00:00	030009390	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2008-10-23 00:00:00	2008-10-23 00:00:00	No	2012-08-02 00:00:00	None	B	None	1000	1000	-350	650	0	None	K3C811	N	CA00167694	B	SFY2012-13
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2013-09-26 00:00:00	030010156	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2010-07-16 00:00:00	2010-07-16 00:00:00	No	2013-10-17 00:00:00	None	B	None	1000	1000	-350	650	0	None	Z69W11	N	CA00239622	C	SFY2013-14
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2014-12-24 00:00:00	030011200	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2014-10-03 00:00:00	2014-10-03 00:00:00	No	2015-01-16 00:00:00	None	B	None	2000	2000	0	2000	0	None	Y7S411	N	CA00416395	A	SFY2014-15
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2019-01-11 00:00:00	030014663	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2017-03-27 00:00:00	2017-03-27 00:00:00	No	2019-02-01 00:00:00	None	B	None	2000	2000	-700	1300	0	None	VT4F11	N	CA00534111, CA00534111	B, B	SFY2018-19
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2019-03-27 00:00:00	030014902	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2018-11-28 00:00:00	2018-11-28 00:00:00	No	2019-04-17 00:00:00	None	A	None	10000	10000	-3500	6500	0	None	JDD611	N	CA00613838	B	SFY2018-19
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2022-03-17 00:00:00	030017487	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2021-11-10 00:00:00	2021-11-10 00:00:00	No	2022-04-08 00:00:00	None	B	None	2000	2000	-700	1300	0	None	4FHQ11	N	CA00760924, CA00760924	B, B	SFY2021-22
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2022-03-17 00:00:00	030017488	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-11-10 00:00:00	2021-11-10 00:00:00	No	2022-04-08 00:00:00	None	B	None	2000	2000	-700	1300	0	None	4FHQ11	N	CA00760924, CA00760924, CA00760924	B, B, B	SFY2021-22
040001366	KINGS HEALTHCARE & WELLNESS CENTER, LP	LTC	SNF	Skilled Nursing Facility	Fresno	2002-05-02 00:00:00	040001319	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2001-05-16 00:00:00	2001-05-16 00:00:00	Yes	2002-08-21 00:00:00	2002-08-09 00:00:00	B	B	800	800	0	800	0	040014071	A99999	N	None	None	SFY2001-02
040001366	KINGS HEALTHCARE & WELLNESS CENTER, LP	LTC	SNF	Skilled Nursing Facility	Fresno	2002-05-20 00:00:00	040001320	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2002-04-12 00:00:00	None	No	2002-06-12 00:00:00	None	B	None	1000	1000	-350	650	0	040014072	A99999	N	None	None	SFY2001-02
040001366	KINGS HEALTHCARE & WELLNESS CENTER, LP	LTC	SNF	Skilled Nursing Facility	Fresno	2002-09-23 00:00:00	040001321	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-08-15 00:00:00	None	No	2002-10-16 00:00:00	None	B	None	800	800	-280	520	0	040014073	A99999	N	None	None	SFY2002-03
040001366	KINGS HEALTHCARE & WELLNESS CENTER, LP	LTC	SNF	Skilled Nursing Facility	Fresno	2009-10-14 00:00:00	040006613	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2009-06-13 00:00:00	2009-06-13 00:00:00	No	2009-11-04 00:00:00	None	B	None	800	800	-280	520	0	None	F7KL11	N	CA00192282	C	SFY2009-10
040001366	KINGS HEALTHCARE & WELLNESS CENTER, LP	LTC	SNF	Skilled Nursing Facility	Fresno	2018-05-17 00:00:00	040014081	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-11-23 00:00:00	2017-11-23 00:00:00	No	2018-06-08 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	FH2S11	N	CA00562274	B	SFY2017-18
040001366	KINGS HEALTHCARE & WELLNESS CENTER, LP	LTC	SNF	Skilled Nursing Facility	Fresno	2018-05-17 00:00:00	040014084	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-06-15 00:00:00	2017-06-15 00:00:00	No	2018-06-08 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	FH2S11	N	CA00537737	B	SFY2017-18
630012080	KINDRED HOSPITAL BREA D/P SNF	LTC	SNF	Skilled Nursing Facility	Orange	2011-07-27 00:00:00	060008424	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2011-06-12 00:00:00	2011-06-12 00:00:00	No	2011-08-17 00:00:00	None	B	None	1000	1600	-350	1250	0	None	U45V11	N	CA00272675	D	SFY2011-12
630012080	KINDRED HOSPITAL BREA D/P SNF	LTC	SNF	Skilled Nursing Facility	Orange	2012-02-28 00:00:00	060009042	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2011-12-14 00:00:00	2011-12-14 00:00:00	No	2012-03-20 00:00:00	None	B	None	1500	1500	-525	975	0	None	2BI611	N	CA00293425	C	SFY2011-12
630012080	KINDRED HOSPITAL BREA D/P SNF	LTC	SNF	Skilled Nursing Facility	Orange	2019-12-18 00:00:00	060015614	Closed	Citation	Citation B (HSC 1424)	Problem Transfer	None	2019-10-24 00:00:00	2019-10-24 00:00:00	No	2020-01-08 00:00:00	None	B	None	2000	2000	-700	1300	0	None	W8G011	N	CA00661049, CA00661049	A, A	SFY2019-20
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2000-12-15 00:00:00	070002365	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2000-06-15 00:00:00	None	Yes	2001-11-07 00:00:00	2001-01-05 00:00:00	A	A	8000	8000	0	8000	0	070015091	A99999	N	None	None	SFY2000-01
070001130	KCARE HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Jose	2003-07-08 00:00:00	070002517	Closed	Citation	Citation B (HSC 1424)	Administration	None	2003-05-06 00:00:00	None	No	2003-07-31 00:00:00	None	B	None	400	400	-140	260	0	070019167	A99999	N	None	None	SFY2003-04
070001130	KCARE HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Jose	2005-08-01 00:00:00	070002602	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2005-07-21 00:00:00	None	No	2005-08-23 00:00:00	None	B	None	800	800	-280	520	0	070020487	A99999	N	None	None	SFY2005-06
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2008-02-07 00:00:00	070004595	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2007-12-06 00:00:00	2007-12-06 00:00:00	Yes	2008-03-05 00:00:00	2008-02-14 00:00:00	B	B	900	450	0	450	0	None	6YHQ11	N	CA00137347	A	SFY2007-08
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2008-02-07 00:00:00	070004668	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2007-12-06 00:00:00	2007-12-06 00:00:00	Yes	2008-03-05 00:00:00	2008-02-14 00:00:00	B	B	900	450	0	450	0	None	6YHQ11	N	CA00137347	A	SFY2007-08
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2008-02-07 00:00:00	070004669	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2007-12-06 00:00:00	2007-12-06 00:00:00	Yes	2008-03-05 00:00:00	2008-02-14 00:00:00	B	B	900	450	0	450	0	None	6YHQ11	N	CA00137347	A	SFY2007-08
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2008-12-12 00:00:00	070005519	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2008-09-28 00:00:00	2008-09-28 00:00:00	Yes	2009-01-14 00:00:00	2008-12-31 00:00:00	B	B	875	437.5	0	437.5	0	None	X5BF11	N	CA00165376	B	SFY2008-09
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2010-03-22 00:00:00	070007057	Closed	Citation	Citation B (HSC 1424)	Physical Environment	None	2010-03-09 00:00:00	2010-03-09 00:00:00	No	2010-04-19 00:00:00	None	B	None	750	750	0	750	0	None	09W111	N	CA00221275	B	SFY2009-10
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2011-05-04 00:00:00	070008212	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2011-03-19 00:00:00	2011-03-19 00:00:00	Yes	2011-05-25 00:00:00	2011-05-12 00:00:00	B	B	500	325	0	325	0	None	ZUQN11	N	CA00262994	B	SFY2010-11
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2011-08-16 00:00:00	070008477	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2011-07-22 00:00:00	2011-07-22 00:00:00	No	2011-09-06 00:00:00	None	B	None	650	650	-227.5	422.5	0	None	NOV011	N	CA00277164	B	SFY2011-12
070001130	KCARE HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Jose	2013-05-02 00:00:00	070009874	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-04-01 08:00:00	2013-04-01 08:00:00	No	2013-05-23 00:00:00	None	FTR BR	None	200	200	0	200	0	None	W6RL11	None	CA00349465	C	SFY2012-13
070001130	KCARE HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Jose	2013-05-02 00:00:00	070009877	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-04-02 08:00:00	2013-04-02 08:00:00	No	2013-05-23 00:00:00	None	FTR RES	None	600	600	0	600	0	None	W6RL11	None	CA00349465	C	SFY2012-13
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2014-09-10 00:00:00	070010985	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2014-08-21 00:00:00	2014-08-21 00:00:00	No	2014-10-01 00:00:00	None	B	None	1000	1000	-350	650	0	None	KEB311	N	CA00410603	B	SFY2014-15
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2016-05-17 00:00:00	070012257	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2016-04-29 00:00:00	2016-04-29 00:00:00	No	2016-06-08 00:00:00	None	B	None	500	500	-175	325	0	None	25EV11	N	CA00486458	B	SFY2015-16
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2017-11-08 00:00:00	070013585	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2017-07-18 00:00:00	2017-07-18 00:00:00	No	2017-12-04 00:00:00	None	B	None	2000	2000	-700	1300	0	None	6PIZ11	N	CA00556744, CA00556753	B, B	SFY2017-18
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2018-03-13 00:00:00	070013888	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2018-02-12 00:00:00	2018-02-12 00:00:00	No	2018-04-03 00:00:00	None	B	None	2000	2000	-700	1300	0	None	MG1X11	N	CA00573748, CA00575142	B, B	SFY2017-18
070001130	KCARE HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Jose	2023-05-31 00:00:00	070015881	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2020-05-08 00:00:00	2020-05-08 00:00:00	No	2023-06-21 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	2U1T11	Y	CA00688176, CA00688176, CA00689065, CA00689065	B, B, B, B	SFY2022-23
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2024-05-06 00:00:00	070020005	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-04-29 00:00:00	2023-04-29 00:00:00	No	2024-05-28 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	YEW511	N	CA00838453	B	SFY2023-24
070000066	KATHERINE HEALTHCARE	LTC	SNF	Skilled Nursing Facility	San Jose	2024-05-17 00:00:00	070020095	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2024-04-22 00:00:00	2024-04-22 00:00:00	No	2024-06-10 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	GHAS11	N	None	None	SFY2023-24
090001471	KASEY'S HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Diego	2006-04-06 00:00:00	090003001	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2006-03-09 00:00:00	2006-03-09 00:00:00	No	2006-04-27 00:00:00	None	B	None	950	950	-332.5	617.5	0	None	R3O111	N	None	None	SFY2005-06
090001471	KASEY'S HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Diego	2007-03-20 00:00:00	090003817	Closed	Citation	Citation B (HSC 1424)	Staffing	None	2006-12-06 00:00:00	2006-12-06 00:00:00	No	2007-04-10 00:00:00	None	B	None	900	900	-315	585	0	None	7QFH11	N	CA00100687	B	SFY2006-07
090001471	KASEY'S HOME	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Diego	2007-11-13 00:00:00	090004440	Closed	Citation	Citation B (HSC 1424)	Physical Environment	None	2007-09-25 00:00:00	2007-09-25 00:00:00	Yes	2007-12-06 00:00:00	2007-11-26 00:00:00	B	B	850	425	0	425	0	None	SS5O11	N	None	None	SFY2007-08
080000068	KEARNY MESA CONVALESCENT AND NURSING HOME	LTC	SNF	Skilled Nursing Facility	San Diego	2018-12-20 00:00:00	100014664	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2018-05-26 00:00:00	2018-05-26 00:00:00	No	2019-01-11 00:00:00	None	B	None	800	800	0	800	0	None	EQCN11	N	CA00588800	B	SFY2018-19
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2000-08-30 00:00:00	120001393	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2000-05-28 00:00:00	2000-05-28 00:00:00	No	2000-09-29 00:00:00	None	B	None	1000	1000	-350	650	0	120014269	A99999	N	None	None	SFY2000-01
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2001-04-06 00:00:00	120001450	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2001-03-10 00:00:00	None	No	2001-05-01 00:00:00	None	B	None	1000	3000	-1050	1950	0	120014963	A99999	N	None	None	SFY2000-01
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2001-12-20 00:00:00	120001541	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2001-11-04 00:00:00	None	No	2002-01-15 00:00:00	None	B	None	1000	1000	0	1000	0	120015796	A99999	N	None	None	SFY2001-02
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2002-01-03 00:00:00	120001544	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2001-11-22 00:00:00	None	No	2002-01-25 00:00:00	None	B	None	1000	1000	0	1000	0	120015821	A99999	N	None	None	SFY2001-02
120001448	KAWEAH DELTA DISTRICT HOSPITAL D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2002-03-12 00:00:00	120001641	Closed	Citation	Citation B (HSC 1424)	Other	ABUSE/NEGLET	2001-05-09 00:00:00	2001-05-09 00:00:00	No	2002-04-09 00:00:00	None	B	None	500	500	-175	325	0	120017270	A99999	N	None	None	SFY2001-02
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2002-10-03 00:00:00	120001742	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-09-11 00:00:00	None	No	2002-10-29 00:00:00	None	B	None	1000	1000	-350	650	0	120016409	A99999	N	None	None	SFY2002-03
120001449	KAWEAH HEALTH SKILLED NURSING CENTER	LTC	SNF	Skilled Nursing Facility	Bakersfield	2004-02-20 00:00:00	120001770	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2003-08-20 00:00:00	None	Yes	2004-06-07 00:00:00	2004-05-18 00:00:00	A	A	20000	16500	0	16500	0	120020375	A99999	N	None	None	SFY2003-04
120001449	KAWEAH HEALTH SKILLED NURSING CENTER	LTC	SNF	Skilled Nursing Facility	Bakersfield	2004-03-10 00:00:00	120001772	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2003-06-23 00:00:00	None	Yes	2004-07-20 00:00:00	2004-03-29 00:00:00	A	A	20000	20000	0	20000	0	120019921	A99999	Y	None	None	SFY2003-04
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2004-03-29 00:00:00	120001774	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2003-10-19 00:00:00	None	No	2004-04-20 00:00:00	None	B	None	1000	1000	0	1000	0	120020217	A99999	N	None	None	SFY2003-04
120001451	KAWEAH HEALTH MEDICAL CENTER D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2006-04-10 00:00:00	120002968	Closed	Citation	Citation B (HSC 1424)	Administration	None	2005-06-30 00:00:00	2005-06-30 00:00:00	No	2006-05-01 00:00:00	None	B	None	500	500	-175	325	0	None	GPHJ11	N	CA00054049	C	SFY2005-06
120001451	KAWEAH HEALTH MEDICAL CENTER D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2006-04-10 00:00:00	120002969	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2005-06-30 00:00:00	2005-06-30 00:00:00	No	2006-05-01 00:00:00	None	B	None	1000	1000	-350	650	0	None	GPHJ11	N	CA00054049	C	SFY2005-06
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2006-10-05 00:00:00	120003377	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2005-01-16 00:00:00	2005-01-16 00:00:00	No	2006-10-27 00:00:00	None	B	None	1000	1600	-350	1250	0	None	5HB311	N	CA00037590	C	SFY2006-07
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2007-02-02 00:00:00	120003666	Closed	Citation	Citation B (HSC 1424)	Administration	None	2006-12-09 00:00:00	2006-12-09 00:00:00	No	2007-02-23 00:00:00	None	B	None	1000	1000	-350	650	0	None	029711	N	CA00100966	B	SFY2006-07
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2007-10-31 00:00:00	120004268	Closed	Citation	Citation B (HSC 1424)	Problem Transfer	None	2007-05-29 00:00:00	2007-05-29 00:00:00	Yes	2007-11-26 00:00:00	2007-10-31 00:00:00	B	B	1000	1000	-869	131	0	None	3HHW11	N	CA00118857	A	SFY2007-08
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2007-10-31 00:00:00	120004269	Closed	Citation	Citation B (HSC 1424)	Problem Transfer	None	2007-06-27 00:00:00	2007-06-27 00:00:00	Yes	2007-11-26 00:00:00	2007-10-31 00:00:00	B	B	1000	1000	-869	131	0	None	3HHW11	N	CA00118857	A	SFY2007-08
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2008-01-24 00:00:00	120004552	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2007-04-01 00:00:00	2007-04-01 00:00:00	No	2008-02-15 00:00:00	None	B	None	1000	1000	-350	650	0	None	4IYQ11	N	CA00111113	C	SFY2007-08
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2008-06-09 00:00:00	120004583	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2006-02-25 00:00:00	2006-02-25 00:00:00	No	2008-06-30 00:00:00	None	B	None	1000	1000	0	1000	0	None	VL5911	N	CA00135225	B	SFY2007-08
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2008-04-02 00:00:00	120004714	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2007-12-18 00:00:00	2007-12-18 00:00:00	Yes	2008-04-23 00:00:00	2009-07-13 00:00:00	A	A	10000	9500	0	9500	0	None	RQQE11	N	CA00135217, CA00135224, CA00135408	B, B, B	SFY2007-08
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2008-08-20 00:00:00	120004849	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2008-03-11 00:00:00	2008-03-11 00:00:00	No	2008-09-11 00:00:00	None	B	None	1000	1000	0	1000	0	None	9C7R11	N	CA00143652	C	SFY2008-09
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2009-03-19 00:00:00	120005171	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-09-27 00:00:00	2007-09-27 00:00:00	Yes	2013-12-20 00:00:00	2009-03-19 00:00:00	B	B	1000	1000	0	1000	0	None	ODWV11	N	CA00127769, CA00127931	A, C	SFY2008-09
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2010-09-01 00:00:00	120007409	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2010-03-18 00:00:00	2010-03-18 00:00:00	No	2010-09-23 00:00:00	None	B	None	1000	1000	-350	650	0	None	JS9311	N	CA00222143	C	SFY2010-11
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2010-12-15 00:00:00	120007459	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2010-06-16 00:00:00	2010-06-16 00:00:00	No	2011-01-05 00:00:00	None	B	None	1000	1000	-350	650	0	None	N1BD11	N	CA00231611	C	SFY2010-11
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2011-03-16 00:00:00	120007780	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2009-04-01 00:00:00	2009-04-01 00:00:00	No	2011-04-07 00:00:00	None	B	None	1000	1000	-350	650	0	None	UUHP11	N	CA00184845	B	SFY2010-11
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2011-02-23 00:00:00	120007820	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2009-04-16 00:00:00	2009-04-16 00:00:00	Yes	2011-03-16 00:00:00	2011-02-24 00:00:00	B	None	1000	1000	-350	650	0	None	8GRJ11	N	CA00185177, CA00185223	B, B	SFY2010-11
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2011-03-16 00:00:00	120007824	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2009-04-11 00:00:00	2009-04-11 00:00:00	No	2011-04-07 00:00:00	None	B	None	1000	1000	-350	650	0	None	B8F211	N	CA00186599	B	SFY2010-11
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2011-03-16 00:00:00	120007827	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2009-04-11 00:00:00	2009-04-11 00:00:00	No	2011-04-07 00:00:00	None	B	None	1000	1000	-350	650	0	None	B8F211	N	CA00186599	B	SFY2010-11
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2013-09-16 00:00:00	120007933	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2009-09-07 00:00:00	2009-09-07 00:00:00	No	2013-10-07 00:00:00	None	B	None	1000	1700	0	1700	0	None	DDFT11	N	CA00201096	B	SFY2013-14
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2013-09-16 00:00:00	120009509	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2012-01-23 00:00:00	2012-01-23 00:00:00	No	2013-10-07 00:00:00	None	B	None	2000	2650	0	2650	0	None	PKO111	N	None	None	SFY2013-14
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2014-02-11 00:00:00	120010167	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2011-03-18 00:00:00	2011-03-18 00:00:00	No	2014-03-05 00:00:00	None	A	None	5000	5000	0	5000	0	None	WZUZ11	N	CA00264891	B	SFY2013-14
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2014-03-26 00:00:00	120010482	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2012-09-24 00:00:00	2012-09-24 00:00:00	Yes	2014-04-17 00:00:00	2014-04-03 00:00:00	A	A	10000	6500	0	6500	0	None	XTRD11	N	CA00327025	B	SFY2013-14
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2014-03-26 00:00:00	120010562	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2012-04-10 00:00:00	2012-04-10 00:00:00	Yes	2014-04-17 00:00:00	2014-03-26 00:00:00	B	None	2000	2000	0	2000	0	None	OYJH11	N	CA00321936	B	SFY2013-14
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2015-02-04 00:00:00	120011224	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2014-09-05 00:00:00	2014-09-05 00:00:00	Yes	2015-02-26 00:00:00	2015-02-04 00:00:00	A	None	10000	10000	0	10000	0	None	IS6W11	N	CA00412107	B	SFY2014-15
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2015-06-22 00:00:00	120011478	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2015-03-11 00:00:00	2015-03-11 00:00:00	No	2015-07-13 00:00:00	None	A	None	10000	10000	0	10000	0	None	0P7Y11	N	CA00434858, CA00435200	B, B	SFY2014-15
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2015-09-14 00:00:00	120011664	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2015-05-27 00:00:00	2015-05-27 00:00:00	No	2015-10-05 00:00:00	None	A	None	20000	20000	0	20000	0	None	7Z7V11	N	CA00444452	B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2015-11-09 00:00:00	120011779	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2015-05-05 00:00:00	2015-05-05 00:00:00	No	2015-12-03 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	4O5611	N	CA00442217, CA00442593	A, B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2015-11-09 00:00:00	120011780	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2015-05-05 00:00:00	2015-05-05 00:00:00	No	2015-12-03 00:00:00	None	B	None	2000	2000	-700	1300	0	None	4O5611	N	CA00442217, CA00442593	A, B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2015-12-29 00:00:00	120011910	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2015-10-29 00:00:00	2015-10-29 00:00:00	No	2016-01-19 00:00:00	None	B	None	2000	2000	0	2000	0	None	QE7X11	N	CA00463762	B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-01-29 00:00:00	120011967	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2015-12-05 00:00:00	2015-12-05 00:00:00	No	2016-02-22 00:00:00	None	B	None	2000	2000	0	2000	0	None	7OHF11	N	CA00468199	B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-01-29 00:00:00	120011977	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2015-12-11 00:00:00	2015-12-11 00:00:00	No	2016-02-22 00:00:00	None	B	None	2000	2000	0	2000	0	None	0YR211	N	CA00468877	B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-02-22 00:00:00	120012021	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2015-12-11 00:00:00	2015-12-11 00:00:00	No	2016-03-14 00:00:00	None	A	None	20000	60000	0	60000	0	None	KD4O11	N	CA00468784	B	SFY2015-16
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-02-22 00:00:00	120012022	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2015-12-24 00:00:00	2015-12-24 00:00:00	No	2016-03-14 00:00:00	None	B	None	2000	6000	0	6000	0	None	U31K11	N	CA00470196	B	SFY2015-16
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-04-19 00:00:00	120012164	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2016-03-04 00:00:00	2016-03-04 00:00:00	No	2016-05-10 00:00:00	None	B	None	2000	2000	-700	1300	0	None	032T11	N	CA00479742	B	SFY2015-16
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-08-08 00:00:00	120012485	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2016-06-15 00:00:00	2016-06-15 00:00:00	No	2016-08-29 00:00:00	None	B	None	2000	2000	0	2000	0	None	MTG011	N	CA00492006	B	SFY2016-17
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-09-22 00:00:00	120012551	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2016-08-01 00:00:00	2016-08-01 00:00:00	No	2016-10-13 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	CL1E11	N	CA00497615	B	SFY2016-17
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2016-10-11 00:00:00	120012608	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2016-08-31 00:00:00	2016-08-31 00:00:00	No	2016-11-01 00:00:00	None	B	None	2000	6000	-2100	3900	0	None	TGE911	N	CA00501306	B	SFY2016-17
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2017-11-29 00:00:00	120013637	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2017-08-26 00:00:00	2017-08-26 00:00:00	No	2017-12-20 00:00:00	None	B	None	2000	6000	-2100	3900	0	None	C4GH11	N	CA00549988	B	SFY2017-18
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2017-12-05 00:00:00	120013657	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2017-09-07 00:00:00	2017-09-07 00:00:00	No	2017-12-27 00:00:00	None	B	None	2000	2000	0	2000	0	None	M2R511	N	CA00551806	B	SFY2017-18
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2018-02-22 00:00:00	120013754	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2017-10-02 00:00:00	2017-10-02 00:00:00	No	2018-03-15 00:00:00	None	B	None	2000	2000	0	2000	0	None	FQ3711	N	None	None	SFY2017-18
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2018-10-30 00:00:00	120014512	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2018-06-15 00:00:00	2018-06-15 00:00:00	No	2018-11-21 00:00:00	None	B	None	2000	2000	-700	1300	0	None	EIQZ11	N	CA00600215	B	SFY2018-19
120001449	KAWEAH HEALTH SKILLED NURSING CENTER	LTC	SNF	Skilled Nursing Facility	Bakersfield	2018-11-19 00:00:00	120014571	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2018-10-29 00:00:00	2018-10-29 00:00:00	No	2018-12-12 00:00:00	None	B	None	2000	2000	0	2000	0	None	UYWF11	N	CA00609833	B	SFY2018-19
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2019-08-14 00:00:00	120015249	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2019-05-24 00:00:00	2019-05-24 00:00:00	No	2019-09-04 00:00:00	None	B	None	2000	6000	-2100	3900	0	None	WBGZ11	N	CA00639091	B	SFY2019-20
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2019-11-13 00:00:00	120015447	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2019-09-17 00:00:00	2019-09-17 00:00:00	No	2019-12-04 00:00:00	None	A	None	20000	20000	0	20000	0	None	ZW5L11	N	CA00655277, CA00655277	A, A	SFY2019-20
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2019-11-13 00:00:00	120015458	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2019-09-17 00:00:00	2019-09-17 00:00:00	No	2019-12-04 00:00:00	None	A	None	20000	20000	0	20000	0	None	ZW5L11	N	CA00655277, CA00655277	A, A	SFY2019-20
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2020-02-21 00:00:00	120015595	Closed	Citation	Citation AA (HSC 1424)	Patient Care	None	2019-08-31 00:00:00	2019-08-31 00:00:00	Yes	2020-03-13 00:00:00	2020-03-13 00:00:00	AA	AA	100000	40050	-50	40000	0	None	OSBC11	Y	CA00652990, CA00652990, CA00661315, CA00661315, CA00661315	B, B, B, B, B	SFY2019-20
120001528	KELLY & SCOTT'S CARE HOME INC. #3	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	Bakersfield	2021-05-24 00:00:00	120016454	Closed	Citation	Citation A (HSC 1424)	Patient Care	Governing Body	2021-02-27 00:00:00	2021-02-27 00:00:00	No	2021-06-15 00:00:00	None	A	None	10000	10000	-3500	6500	0	None	GKKP11	N	CA00727257, CA00727257	B, B	SFY2020-21
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-06-02 00:00:00	120016525	Closed	Citation	Citation B (HSC 1424)	Patient Record	None	2021-01-27 00:00:00	2021-01-27 00:00:00	No	2021-06-23 00:00:00	None	B	None	2000	3450	0	3450	0	None	090E11	N	CA00720752, CA00720752, CA00720752, CA00720752	B, B, B, B	SFY2020-21
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-06-30 00:00:00	120016569	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-05-10 00:00:00	2021-05-10 00:00:00	No	2021-07-21 00:00:00	None	B	None	2000	2400	0	2400	0	None	CL1911	N	CA00736424	A	SFY2020-21
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-09-15 00:00:00	120016847	Closed	Citation	Citation A (HSC 1424)	Physical Environment	None	2021-07-09 00:00:00	2021-07-09 00:00:00	No	2021-10-06 00:00:00	None	A	None	20000	21250	-7000	14250	0	None	8MOR11	N	CA00740970, CA00740970, CA00740970, CA00740970, CA00740970, CA00740970, CA00740970, CA00740970, CA00741513, CA00741513, CA00741513, CA00741526, CA00741526, CA00741526, CA00742052, CA00742052, CA00743586, CA00743586	A, A, A, A, A, A, A, A, B, B, B, B, B, B, A, A, A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-11-24 00:00:00	120017051	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-08-05 00:00:00	2021-08-05 00:00:00	No	2021-12-17 00:00:00	None	B	None	2000	6200	-2100	4100	0	None	QRLV11	N	CA00747449, CA00747449, CA00747449, CA00747449, CA00747449, CA00747449, CA00747506, CA00747506, CA00747506, CA00747506, CA00747506, CA00747832, CA00747832	A, A, A, A, A, A, A, A, A, A, A, A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-12-28 00:00:00	120017105	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-09-17 00:00:00	2021-09-17 00:00:00	No	2022-01-19 00:00:00	None	B	None	2000	3400	0	3400	0	None	DLEU11	N	CA00754176	B	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-12-28 00:00:00	120017180	Closed	Citation	Citation B (HSC 1424)	Dietary	Dietary	2021-08-18 00:00:00	2021-08-18 00:00:00	No	2022-01-19 00:00:00	None	B	None	2000	2000	0	2000	0	None	IWD411	N	CA00751292	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2021-12-28 00:00:00	120017181	Open	Citation	Citation A (HSC 1424)	Medication	None	2021-08-18 00:00:00	2021-08-18 00:00:00	No	2022-01-19 00:00:00	None	A	None	20000	20000	0	0	20000	None	IWD411	N	CA00751290, CA00751290, CA00751290	A, A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-07 00:00:00	120017296	Open	Citation	Citation B (HSC 1424)	Medication	None	2021-11-29 00:00:00	2021-11-29 00:00:00	No	2022-03-01 00:00:00	None	B	None	2000	2000	0	0	2000	None	CZT311	N	CA00764181	B	SFY2021-22
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-04 00:00:00	120017297	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-11-24 00:00:00	2021-11-24 00:00:00	No	2022-02-28 00:00:00	None	B	None	2000	2000	-700	1300	0	None	14R011	N	CA00762519	B	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-23 00:00:00	120017373	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-02 00:00:00	2022-02-02 00:00:00	Yes	2022-03-16 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-23 00:00:00	120017374	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	Yes	2022-03-16 00:00:00	2022-03-17 00:00:00	B	None	3000	3750	0	0	3750	None	VCWU11	N	CA00773858	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017378	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-02 00:00:00	2022-02-02 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3750	0	0	3750	None	RVLE11	N	CA00773860	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017379	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	RVLE11	N	CA00773860	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-23 00:00:00	120017380	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-16 00:00:00	2022-03-17 00:00:00	B	None	3000	3550	0	0	3550	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017384	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-03-01 00:00:00	120017385	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-22 00:00:00	2022-03-17 00:00:00	B	None	3000	3550	0	0	3550	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017386	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017387	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017388	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3900	0	0	3900	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017389	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3900	0	0	3900	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017390	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017391	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-24 00:00:00	120017398	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-02 00:00:00	2022-02-02 00:00:00	Yes	2022-03-17 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	80BE11	N	CA00774099, CA00774099	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017399	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-02 00:00:00	2022-02-02 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	80BE11	N	CA00774099, CA00774099	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017401	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017402	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017403	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3750	0	0	3750	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017404	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3750	0	0	3750	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017405	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017406	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-09 00:00:00	2022-02-09 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017407	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017408	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-28 00:00:00	120017409	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-21 00:00:00	2022-03-17 00:00:00	B	None	3000	3650	0	0	3650	None	VCWU11	N	CA00773858	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-28 00:00:00	120017410	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-21 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-28 00:00:00	120017411	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-21 00:00:00	2022-03-17 00:00:00	B	None	3000	3650	0	0	3650	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-28 00:00:00	120017412	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-21 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017413	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-28 00:00:00	120017414	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-21 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-28 00:00:00	120017415	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-21 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017416	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-03-01 00:00:00	120017417	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-22 00:00:00	2022-03-17 00:00:00	B	None	3000	3550	0	0	3550	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017418	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017419	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-18 00:00:00	B	None	3000	3700	0	0	3700	None	VCWU11	N	CA00773858, CA00773858	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017425	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017426	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017427	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017428	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017429	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	No	2022-03-18 00:00:00	None	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017430	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-02 00:00:00	2022-02-02 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017431	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017432	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017433	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017434	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017435	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017436	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017437	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3000	0	0	3000	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017438	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-03-11 00:00:00	120017441	Closed	Citation	Citation A (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-04-04 00:00:00	2022-03-28 00:00:00	A	A	25000	15000	0	15000	0	None	4JZX11	N	CA00774374	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017442	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-03 00:00:00	2022-02-03 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017443	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-02 00:00:00	2022-02-02 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3750	0	0	3750	None	VCWU11	N	CA00773858	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-03-01 00:00:00	120017444	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-04 00:00:00	2022-02-04 00:00:00	Yes	2022-03-22 00:00:00	2022-03-17 00:00:00	B	None	3000	3550	0	0	3550	None	VCWU11	N	CA00773858	A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-02-25 00:00:00	120017445	Open	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-02-07 00:00:00	2022-02-07 00:00:00	Yes	2022-03-18 00:00:00	2022-03-17 00:00:00	B	None	3000	3700	0	0	3700	None	T4WN11	N	CA00773847, CA00773847	A, A	SFY2021-22
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-03-15 00:00:00	120017467	Closed	Citation	Citation A (HSC 1424)	Problem Transfer	None	2022-02-08 00:00:00	2022-02-08 00:00:00	Yes	2022-04-06 00:00:00	2022-03-16 00:00:00	A	A	25000	15000	0	15000	0	None	QDOW11	N	CA00774703	A	SFY2021-22
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-10-03 00:00:00	120017943	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2021-11-21 00:00:00	2021-11-21 00:00:00	No	2022-10-24 00:00:00	None	B	None	2000	2000	-700	1300	0	None	8HK811	N	CA00765566	B	SFY2022-23
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-10-03 00:00:00	120017944	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-11-30 00:00:00	2021-11-30 00:00:00	No	2022-10-24 00:00:00	None	B	None	2000	2000	-700	1300	0	None	8HK811	N	CA00765566	B	SFY2022-23
120000695	KERN VALLEY HEALTHCARE DISTRICT D/P SNF	LTC	SNF	Skilled Nursing Facility	Bakersfield	2022-12-22 00:00:00	120018157	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2022-07-24 00:00:00	2022-07-24 00:00:00	No	2023-01-13 00:00:00	None	A	None	25000	25000	-8750	16250	0	None	SQ5E11	N	CA00795224	B	SFY2022-23
630017642	KERN RIVER TRANSITIONAL CARE	LTC	SNF	Skilled Nursing Facility	Bakersfield	2023-05-04 00:00:00	120018461	Open	Citation	Citation B (HSC 1424)	Administration	None	2022-10-13 00:00:00	2022-10-13 00:00:00	Yes	2023-05-25 00:00:00	2023-05-17 00:00:00	B	None	3000	3000	0	0	3000	None	T3RK11	N	CA00806685, CA00807358	B, B	SFY2022-23
630017642	KERN RIVER TRANSITIONAL CARE	LTC	SNF	Skilled Nursing Facility	Bakersfield	2023-04-07 00:00:00	120018464	Closed	Citation	Citation B (HSC 1424)	Administration	None	2022-10-13 00:00:00	2022-10-13 00:00:00	Yes	2023-04-28 00:00:00	2023-04-28 00:00:00	B	None	3000	3000	-3000	0	0	None	T3RK11	N	CA00806685, CA00807358	B, B	SFY2022-23
120001449	KAWEAH HEALTH SKILLED NURSING CENTER	LTC	SNF	Skilled Nursing Facility	Bakersfield	2023-10-03 00:00:00	120019053	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2023-04-26 00:00:00	2023-04-26 00:00:00	No	2023-10-24 00:00:00	None	A	None	25000	25000	-8750	16250	0	None	WPOM11	N	CA00839179	B	SFY2023-24
630017642	KERN RIVER TRANSITIONAL CARE	LTC	SNF	Skilled Nursing Facility	Bakersfield	2024-04-16 00:00:00	120019780	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	Abusefailtoreport/prevent	2023-09-19 00:00:00	2023-09-19 00:00:00	No	2024-05-07 00:00:00	None	B	None	2000	2000	-700	1300	0	None	FUEH11	N	CA00866219, CA00866384	A, A	SFY2023-24
630017642	KERN RIVER TRANSITIONAL CARE	LTC	SNF	Skilled Nursing Facility	Bakersfield	2024-03-12 00:00:00	120019784	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-09-19 00:00:00	2023-09-19 00:00:00	No	2024-04-02 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	FUEH11	N	CA00866219, CA00866384	A, A	SFY2023-24
630017642	KERN RIVER TRANSITIONAL CARE	LTC	SNF	Skilled Nursing Facility	Bakersfield	2024-03-12 00:00:00	120019809	Open	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-09-25 00:00:00	2023-09-25 00:00:00	No	2024-04-02 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	FUEH11	N	CA00863371, CA00863371	B, B	SFY2023-24
630017642	KERN RIVER TRANSITIONAL CARE	LTC	SNF	Skilled Nursing Facility	Bakersfield	2024-03-12 00:00:00	120019814	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-09-21 00:00:00	2023-09-21 00:00:00	No	2024-04-02 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	FUEH11	N	CA00863045	A	SFY2023-24
240000617	KENDALL HOUSE	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Bernardino	2003-01-09 00:00:00	240001745	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-07-06 00:00:00	None	No	2003-01-31 00:00:00	None	B	None	1000	1000	-350	650	0	240017131	A99999	N	None	None	SFY2002-03
240000617	KENDALL HOUSE	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	San Bernardino	2004-12-28 00:00:00	240001837	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2004-11-29 00:00:00	None	No	2005-01-31 00:00:00	None	B	None	850	850	-297.5	552.5	0	240019934	A99999	N	None	None	SFY2004-05
240000365	KNOLLS WEST POST ACUTE LLC	LTC	SNF	Skilled Nursing Facility	San Bernardino	2016-04-20 00:00:00	240012201	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2015-10-28 00:00:00	2015-10-28 00:00:00	No	2016-05-11 00:00:00	None	B	None	1000	1000	-350	650	0	None	YSQ511	N	CA00463781	B	SFY2015-16
240000365	KNOLLS WEST POST ACUTE LLC	LTC	SNF	Skilled Nursing Facility	San Bernardino	2016-05-26 00:00:00	240012285	Closed	Citation	Citation B (HSC 1424)	Medication	None	2016-04-15 00:00:00	2016-04-15 00:00:00	No	2016-06-17 00:00:00	None	B	None	2000	2000	-700	1300	0	None	5V0F11	N	None	None	SFY2015-16
240000365	KNOLLS WEST POST ACUTE LLC	LTC	SNF	Skilled Nursing Facility	San Bernardino	2017-11-22 00:00:00	240013646	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-09-29 00:00:00	2017-09-29 00:00:00	No	2017-12-15 00:00:00	None	A	None	10000	10000	-3500	6500	0	None	LJ4R11	N	CA00555065	A	SFY2017-18
240000365	KNOLLS WEST POST ACUTE LLC	LTC	SNF	Skilled Nursing Facility	San Bernardino	2023-01-26 00:00:00	240018318	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2022-12-13 00:00:00	2022-12-13 00:00:00	No	2023-02-16 00:00:00	None	B	None	150	150	0	150	0	None	GFZ311	N	None	None	SFY2022-23
240000365	KNOLLS WEST POST ACUTE LLC	LTC	SNF	Skilled Nursing Facility	San Bernardino	2023-08-02 00:00:00	240019019	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-04-20 00:00:00	2023-04-20 00:00:00	No	2023-08-23 00:00:00	None	A	None	3500	10500	0	0	10500	None	SECB11	N	CA00837667	B	SFY2023-24
250000762	KEVIN HOUSE	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	Riverside	2019-03-08 00:00:00	250014853	Closed	Citation	Citation B (HSC 1424)	Other	DPS Health, Hyg, Grooming	2018-08-28 00:00:00	2018-08-28 00:00:00	No	2019-03-29 00:00:00	None	B	None	1000	1000	-350	650	0	None	RHPF11	N	CA00611580	B	SFY2018-19
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2002-08-29 00:00:00	910001481	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-05-17 00:00:00	2002-08-29 00:00:00	No	2002-10-02 00:00:00	None	B	None	700	700	-245	455	0	910007216	A99999	N	None	None	SFY2002-03
910000324	KENNEDY CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2005-10-31 00:00:00	910001526	Closed	Citation	Citation B (HSC 1424)	Medication	None	2004-12-14 00:00:00	2004-12-14 00:00:00	No	2005-11-22 00:00:00	None	B	None	1000	1000	-350	650	0	910008578	A99999	N	None	None	SFY2005-06
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2007-03-16 00:00:00	910003824	Closed	Citation	Citation B (HSC 1424)	Administration	None	2007-03-13 00:00:00	2007-03-13 00:00:00	No	2007-04-06 00:00:00	None	B	None	1000	1000	-1000	0	0	None	999999	N	None	None	SFY2006-07
910000324	KENNEDY CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2008-09-17 00:00:00	910005431	Closed	Citation	Citation A (HSC 1424)	Other	Abuse Sexual	2007-05-31 00:00:00	2007-05-31 00:00:00	Yes	2008-10-21 00:00:00	2008-07-22 00:00:00	A	Dismissed by Court	19000	0	0	0	0	None	YLRU11	N	CA00116200, CA00116917	B, B	SFY2008-09
910000324	KENNEDY CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2013-05-16 00:00:00	910008788	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2011-07-24 00:00:00	2011-07-24 00:00:00	Yes	2013-06-07 00:00:00	2013-05-20 00:00:00	A	A	20000	12000	0	12000	0	None	HE1F11	N	CA00277040, CA00277044, CA00277203	C, H, C	SFY2012-13
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2018-04-02 00:00:00	910013948	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-10-18 00:00:00	2017-10-18 00:00:00	No	2018-04-23 00:00:00	None	A	None	16000	16000	-5600	10400	0	None	DVVS11	N	CA00556655	A	SFY2017-18
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2018-07-20 00:00:00	910014245	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2018-03-26 00:00:00	2018-03-26 00:00:00	No	2018-08-10 00:00:00	None	B	None	2000	2000	-700	1300	0	None	DRLN11	N	CA00580455	A	SFY2018-19
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2019-01-18 00:00:00	910014726	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2018-07-18 00:00:00	2018-07-18 00:00:00	Yes	2019-02-11 00:00:00	2019-02-08 00:00:00	A	B	15000	9000	0	9000	0	None	EDKC11	Y	CA00592067, CA00601133	B, A	SFY2018-19
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2019-06-21 00:00:00	910015180	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2019-03-27 00:00:00	2019-03-27 00:00:00	No	2019-07-12 00:00:00	None	A	None	20000	60000	0	60000	0	None	GMDL11	N	None	None	SFY2018-19
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2019-10-24 00:00:00	910015479	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2019-06-10 00:00:00	2019-06-10 00:00:00	No	2019-11-14 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	Y9NC11	N	CA00648151, CA00648151, CA00648151	A, A, A	SFY2019-20
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2020-04-03 00:00:00	910015833	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2020-02-14 00:00:00	2020-02-14 00:00:00	No	2020-04-24 00:00:00	None	B	None	2000	2300	0	2300	0	None	GHDW11	N	CA00676256	A	SFY2019-20
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2022-01-20 00:00:00	910017281	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2021-07-06 00:00:00	2021-07-06 00:00:00	No	2022-02-10 00:00:00	None	B	None	2000	2000	-700	1300	0	None	UKU911	N	CA00745212	A	SFY2021-22
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2023-05-10 00:00:00	910018737	Open	Citation	Citation A (HSC 1424)	Other	QualityOfCare/NursingSvcs	2023-03-19 00:00:00	2023-03-19 00:00:00	No	2023-06-01 00:00:00	None	A	None	20000	20000	0	20000	0	None	1UEP11	N	CA00829728, CA00829728, CA00832391	B, B, B	SFY2022-23
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2023-06-30 00:00:00	910018918	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-05-12 00:00:00	2023-05-12 00:00:00	No	2023-07-24 00:00:00	None	B	None	3000	3000	0	3000	0	None	GPRU11	N	CA00840753	A	SFY2022-23
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2023-11-30 00:00:00	910019419	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2023-02-03 00:00:00	2023-02-03 00:00:00	No	2023-12-21 00:00:00	None	B	None	3000	3000	0	3000	0	None	3CJY11	N	CA00824923	B	SFY2023-24
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2023-12-21 00:00:00	910019524	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2023-11-06 00:00:00	2023-11-06 00:00:00	No	2024-01-12 00:00:00	None	B	None	3000	3000	0	3000	0	None	D0FM11	N	CA00868790	B	SFY2023-24
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2024-06-11 00:00:00	910020300	Open	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2024-04-23 00:00:00	2024-04-23 00:00:00	No	2024-07-02 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	8GG911	N	CA00899394, CA00899394, CA00899394, CA00899394, CA00899394, CA00900547	B, B, B, B, B, B	SFY2023-24
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2024-06-14 00:00:00	910020322	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2024-03-14 00:00:00	2024-03-14 00:00:00	No	2024-07-08 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	J0O211	N	CA00898765, CA00898765, CA00898765, CA00898765, CA00898765, CA00898765	A, A, A, A, A, A	SFY2023-24
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2017-05-10 00:00:00	920013186	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2012-05-18 00:00:00	2012-05-18 00:00:00	No	2017-06-01 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	BCW011	N	CA00311759	C	SFY2016-17
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2018-01-22 00:00:00	920013755	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2014-06-18 00:00:00	2014-06-18 00:00:00	No	2018-02-12 00:00:00	None	B	None	2000	2000	-700	1300	0	None	94MU11	N	CA00403074	B	SFY2017-18
910000324	KENNEDY CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-07-22 00:00:00	920015942	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2019-02-23 00:00:00	2019-02-23 00:00:00	Yes	2020-08-12 00:00:00	2020-08-11 00:00:00	A	B	20000	14400	-400	14000	0	None	UP6Q11	Y	CA00678600	B	SFY2020-21
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-11-18 00:00:00	920016158	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2020-05-19 00:00:00	2020-05-19 00:00:00	Yes	2020-12-11 00:00:00	2020-11-30 00:00:00	A	B	20000	10300	-300	10000	0	None	94JS11	Y	CA00701917, CA00701917	B, B	SFY2020-21
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-11-25 00:00:00	920016166	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2020-10-15 00:00:00	2020-10-15 00:00:00	No	2020-12-18 00:00:00	None	B	None	2000	2000	-700	1300	0	None	KJKY11	N	CA00709009	A	SFY2020-21
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-11-25 00:00:00	920016167	Closed	Citation	Citation B (HSC 1424)	Dietary	None	2020-10-15 00:00:00	2020-10-15 00:00:00	No	2020-12-18 00:00:00	None	B	None	2000	2000	-700	1300	0	None	KJKY11	N	CA00709009	A	SFY2020-21
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-11-25 00:00:00	920016168	Closed	Citation	Citation B (HSC 1424)	Physical Environment	None	2020-10-15 00:00:00	2020-10-15 00:00:00	No	2020-12-18 00:00:00	None	B	None	2000	2000	-700	1300	0	None	KJKY11	N	CA00709009, CA00709009, CA00709009	A, A, A	SFY2020-21
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-04-14 00:00:00	920016414	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2021-03-01 00:00:00	2021-03-01 00:00:00	No	2021-05-05 00:00:00	None	B	None	2000	2100	-700	1400	0	None	2QTX11	N	CA00727757, CA00727796	B, B	SFY2020-21
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-06-25 00:00:00	920016634	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-04-28 00:00:00	2017-04-28 00:00:00	No	2021-07-16 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	OP8811	N	None	None	SFY2020-21
970000029	KINGSLEY MANOR CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-07-22 00:00:00	920016748	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2021-04-21 00:00:00	2021-04-21 00:00:00	No	2021-08-12 00:00:00	None	A	None	20000	20000	0	20000	0	None	T72811	N	CA00734174	A	SFY2021-22
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-08-26 00:00:00	920016846	Closed	Citation	Citation AA (HSC 1424)	Patient Care	None	2021-05-27 00:00:00	2021-05-27 00:00:00	Yes	2021-09-17 00:00:00	2021-09-16 00:00:00	AA	A	100000	20050	-50	20000	0	None	X13111	Y	CA00738375	A	SFY2021-22
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-09-17 00:00:00	920016932	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2021-08-05 00:00:00	2021-08-05 00:00:00	No	2021-10-08 00:00:00	None	B	None	2000	2000	-700	1300	0	None	1CB011	N	CA00746910	B	SFY2021-22
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-05-26 00:00:00	920017669	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2021-12-10 00:00:00	2021-12-10 00:00:00	Yes	2022-06-17 00:00:00	2022-06-16 00:00:00	A	B	20000	12000	0	12000	0	None	UVTC11	N	CA00764890, CA00764890	A, A	SFY2021-22
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-08-25 00:00:00	920017925	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2022-05-14 00:00:00	2022-05-14 00:00:00	Yes	2022-09-16 00:00:00	2022-09-06 00:00:00	A	A	25000	17200	0	0	17200	None	JVHH11	N	CA00788883, CA00788883, CA00788883, CA00788883	B, B, B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-09-16 00:00:00	920018001	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2022-06-20 00:00:00	2022-06-20 00:00:00	No	2022-10-07 00:00:00	None	A	None	25000	25100	-8750	16350	0	None	0DTE11	N	CA00790589	B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-09-26 00:00:00	920018015	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2021-10-19 00:00:00	2021-10-19 00:00:00	No	2022-10-17 00:00:00	None	A	None	20000	20000	0	20000	0	None	5OAE11	N	CA00793738, CA00793738, CA00793738	B, B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-10-20 00:00:00	920018100	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2022-07-04 00:00:00	2022-07-04 00:00:00	No	2022-11-10 00:00:00	None	A	None	25000	75000	-26250	48850	-100	None	GKAO11	N	CA00795570, CA00795570	B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-11-02 00:00:00	920018129	Closed	Citation	Citation B (HSC 1424)	Problem Transfer	None	2022-09-06 00:00:00	2022-09-06 00:00:00	No	2022-11-28 00:00:00	None	B	None	3000	3000	0	3000	0	None	7DYC11	N	CA00802192, CA00802192, CA00802192	A, A, A	SFY2022-23
910000324	KENNEDY CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-12-13 00:00:00	920018238	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2022-09-01 00:00:00	2022-09-01 00:00:00	No	2023-01-04 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	OX1R11	N	CA00803715	B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-01-11 00:00:00	920018297	Closed	Citation	Citation Willful Material Falsification (HSC 1424(f)(1))	Willful Material Falsification	None	2022-09-30 00:00:00	2022-09-30 00:00:00	No	2023-02-02 00:00:00	None	WF	None	25000	25050	-8750	16300	0	None	RFZN11	None	CA00808935, CA00808935, CA00808935	B, B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-01-11 00:00:00	920018299	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2022-10-29 00:00:00	2022-10-29 00:00:00	No	2023-02-02 00:00:00	None	A	None	25000	75000	-26250	48750	0	None	RFZN11	N	CA00808935, CA00808935, CA00808935	B, B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-01-20 00:00:00	920018343	Closed	Citation	Citation AA (HSC 1424)	Patient Care	None	2022-04-25 00:00:00	2022-04-25 00:00:00	No	2023-02-10 00:00:00	None	AA	None	120000	120000	0	120000	0	None	5FLI11	Y	CA00808938, CA00808938, CA00808938	A, A, A	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-03-08 00:00:00	920018485	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-01-05 00:00:00	2023-01-05 00:00:00	No	2023-03-29 00:00:00	None	B	None	3000	3200	0	3200	0	None	471C11	N	CA00819585	B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-04-04 00:00:00	920018600	Closed	Citation	Citation Willful Material Falsification (HSC 1424(f)(1))	Willful Material Falsification	None	2023-01-15 00:00:00	2023-01-15 00:00:00	No	2023-04-25 00:00:00	None	WF	None	7500	7800	0	7800	0	None	IJ4K11	None	CA00826109, CA00826109, CA00826109	B, B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-04-26 00:00:00	920018689	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-02-21 00:00:00	2023-02-21 00:00:00	No	2023-05-17 00:00:00	None	B	None	3000	3150	-1050	2100	0	None	CYUT11	N	CA00827857	B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-06-02 00:00:00	920018822	Open	Citation	Citation AA (HSC 1424)	Patient Care	None	2022-12-27 00:00:00	2022-12-27 00:00:00	Yes	2023-06-23 00:00:00	2023-06-12 00:00:00	AA	None	120000	120150	0	0	120150	None	IJ4K11	Y	CA00826109, CA00826109, CA00826109, CA00826109	B, B, B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-06-21 00:00:00	920018888	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-03-14 00:00:00	2023-03-14 00:00:00	Yes	2023-07-13 00:00:00	2023-06-30 00:00:00	A	None	25000	75050	0	0	75050	None	6OY311	N	CA00831494, CA00832076	B, B	SFY2022-23
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-08-11 00:00:00	920019054	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-04-05 00:00:00	2023-04-05 00:00:00	Yes	2023-09-01 00:00:00	2023-08-31 00:00:00	A	None	25000	75000	0	0	75000	None	MVNF11	N	CA00844567, CA00844567, CA00844567, CA00844567, CA00844672, CA00844672, CA00844672, CA00844672, CA00844672	B, B, B, B, B, B, B, B, B	SFY2023-24
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-09-25 00:00:00	920019199	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-08-05 00:00:00	2023-08-05 00:00:00	Yes	2023-10-16 00:00:00	2023-09-26 00:00:00	A	None	25000	25000	0	0	25000	None	DERK11	N	CA00854694, CA00854694, CA00854694	B, B, B	SFY2023-24
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2024-02-05 00:00:00	920019694	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-12-05 00:00:00	2023-12-05 00:00:00	Yes	2024-02-26 00:00:00	2024-02-12 00:00:00	A	None	25000	75000	0	0	75000	None	A0RQ11	N	CA00873958	B	SFY2023-24
910000324	KENNEDY CARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2024-03-20 00:00:00	920019885	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2024-02-08 00:00:00	2024-02-08 00:00:00	No	2024-04-11 00:00:00	None	B	None	3000	3000	0	3000	0	None	TGLU11	N	CA00884011, CA00884011	B, B	SFY2023-24
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2011-03-09 00:00:00	940008016	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2010-04-22 00:00:00	2010-04-22 00:00:00	No	2011-03-30 00:00:00	None	B	None	1000	1000	-350	650	0	None	B1LG11	N	None	None	SFY2010-11
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2011-09-26 00:00:00	940008592	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2011-02-07 00:00:00	2011-02-07 00:00:00	No	2011-10-17 00:00:00	None	B	None	500	500	0	500	0	None	H9US11	N	CA00258541	B	SFY2011-12
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2017-01-20 00:00:00	940012895	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2016-01-25 00:00:00	2016-01-25 00:00:00	Yes	2017-02-10 00:00:00	2017-02-02 00:00:00	A	B	10000	10000	0	10000	0	None	FJ6Q11	N	CA00490332	A	SFY2016-17
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2018-06-01 00:00:00	940014119	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2017-12-13 00:00:00	2017-12-13 00:00:00	No	2018-06-22 00:00:00	None	B	None	2000	2000	-700	1300	0	None	WSC311	N	CA00572729, CA00572729, CA00572729, CA00572729, CA00572729	A, A, A, A, A	SFY2017-18
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2018-06-18 00:00:00	940014138	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-12-15 00:00:00	2017-12-15 00:00:00	Yes	2018-07-10 00:00:00	2018-06-27 00:00:00	A	None	20000	20000	0	20000	0	None	QH5L11	N	CA00565297, CA00565297, CA00576295, CA00576295	B, B, B, B	SFY2017-18
960001875	K & S GROUP HOMES	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2001-07-23 00:00:00	960000919	Closed	Citation	Citation B (HSC 1424)	Administration	None	2001-06-25 00:00:00	None	No	2001-09-13 00:00:00	None	B	None	1000	1000	-350	650	0	960007902	A99999	N	None	None	SFY2001-02
960001875	K & S GROUP HOMES	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2005-05-23 00:00:00	960001115	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2005-04-29 00:00:00	None	No	2005-06-20 00:00:00	None	B	None	800	800	-280	520	0	960010167	A99999	N	None	None	SFY2004-05
960002056	K AND S GROUP HOME #2	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2007-06-04 00:00:00	960004009	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-04-18 00:00:00	2007-04-18 00:00:00	No	2007-06-25 00:00:00	None	B	None	900	900	-315	585	0	None	M83N11	N	None	None	SFY2006-07
960001875	K & S GROUP HOMES	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2010-10-07 00:00:00	960007621	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2010-09-11 00:00:00	2010-09-11 00:00:00	No	2010-10-28 00:00:00	None	B	None	1000	1000	-350	650	0	None	WUJY11	N	None	None	SFY2010-11
960001875	K & S GROUP HOMES	LTC	ICFDDH	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2011-12-07 00:00:00	960008790	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2011-10-29 00:00:00	2011-10-29 00:00:00	No	2011-12-29 00:00:00	None	B	None	1000	1000	0	1000	0	None	0JH311	N	None	None	SFY2011-12
960001210	KRONENTHAL HOUSE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2014-04-22 00:00:00	960010650	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2012-10-13 00:00:00	2012-10-13 00:00:00	No	2014-05-13 00:00:00	None	B	None	1000	1000	-350	650	0	None	H8CJ11	N	CA00332898	B	SFY2013-14
960001210	KRONENTHAL HOUSE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2019-08-09 00:00:00	960015297	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2019-04-29 00:00:00	2019-04-29 00:00:00	No	2019-08-30 00:00:00	None	B	None	1000	1000	0	1000	0	None	B6DB11	N	CA00635638, CA00637764	B, B	SFY2019-20
970000111	KEI-AI LOS ANGELES HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2002-12-05 00:00:00	970001383	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-09-13 00:00:00	2002-12-04 00:00:00	No	2003-01-03 00:00:00	None	B	None	850	850	-297.5	552.5	0	970007417	A99999	N	None	None	SFY2002-03
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2013-11-19 00:00:00	030010257	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 12 - 24 Days	None	2012-02-08 00:00:00	2012-04-24 00:00:00	No	2013-12-04 00:00:00	None	AP NHPPD	None	30000	30000	0	30000	0	None	Y20Y11	None	None	None	SFY2013-14
120000377	KINGSTON HEALTHCARE CENTER, LLC	LTC	SNF	Skilled Nursing Facility	Bakersfield	2014-06-06 00:00:00	120010338	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2013-01-01 00:00:00	2013-03-18 00:00:00	Yes	2014-06-21 00:00:00	None	AP NHPPD	UPHELD	15000	15000	0	15000	0	None	2IXS11	None	None	None	SFY2013-14
040000002	KINGSBURG CENTER	LTC	SNF	Skilled Nursing Facility	Fresno	2022-03-02 00:00:00	810017375	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2019-10-01 00:00:00	2019-12-31 00:00:00	No	2022-03-17 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	MLI211	None	None	None	SFY2021-22
030000074	KIT CARSON NURSING & REHABILITATION CENTER	LTC	SNF	Skilled Nursing Facility	Stockton	2022-03-08 00:00:00	810017450	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2019-10-01 00:00:00	2019-12-31 00:00:00	No	2022-03-23 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	1RX511	None	None	None	SFY2021-22
910000276	KEI-AI SOUTH BAY HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 3	2023-03-14 00:00:00	810018468	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2020-10-01 00:00:00	2020-12-31 00:00:00	No	2023-04-05 00:00:00	None	AP NHPPD	None	25000	25000	0	25000	0	None	0NTC11	None	None	None	SFY2022-23
240000365	KNOLLS WEST POST ACUTE LLC	LTC	SNF	Skilled Nursing Facility	San Bernardino	2023-12-20 00:00:00	810019469	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 12 - 24 Days	None	2020-10-01 00:00:00	2020-12-31 00:00:00	No	2024-01-11 00:00:00	None	AP NHPPD	None	50000	50000	0	50000	0	None	D5RV11	None	None	None	SFY2023-24
140000190	KAISER FOUNDATION HOSPITAL - WALNUT CREEK	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-03-04 00:00:00	020004729	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-24 00:00:00	2007-12-24 00:00:00	No	2008-03-25 00:00:00	None	FTR AE	None	600	600	0	600	0	None	V5CQ11	N	CA00136710	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-03-10 00:00:00	020004776	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-17 00:00:00	2007-12-17 00:00:00	No	2008-04-01 00:00:00	None	FTR AE	None	4000	4000	0	4000	0	None	HZVT11	N	CA00139549	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-03-27 00:00:00	020004830	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-20 08:00:00	2007-11-20 08:00:00	No	2008-04-18 00:00:00	None	FTR AE	None	900	900	0	900	0	None	EQFU11	N	CA00134033	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-03-27 00:00:00	020004831	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-27 09:00:00	2007-11-27 09:00:00	No	2008-04-18 00:00:00	None	FTR AE	None	200	200	0	200	0	None	EQFU11	N	CA00134033	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-03-28 00:00:00	020004840	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2008-03-03 15:00:00	2008-03-03 15:00:00	No	2008-04-21 00:00:00	None	FTR AE	None	300	300	0	300	0	None	HCNI11	N	CA00143402	C	SFY2007-08
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-09 00:00:00	020004869	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-02-22 14:30:00	2008-02-22 14:30:00	No	2008-04-30 00:00:00	None	FTR AE	None	300	300	0	300	0	None	LZN911	N	CA00142602	C	SFY2007-08
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-09 00:00:00	020004870	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-02-17 17:00:00	2008-02-17 17:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	700	700	0	700	0	None	LZN911	N	CA00142597	C	SFY2007-08
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-10 00:00:00	020004871	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-02-15 21:05:00	2008-02-15 21:05:00	No	2008-05-01 00:00:00	None	FTR AE	None	700	700	0	700	0	None	LZN911	N	CA00142244	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-10 00:00:00	020004873	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-07 14:30:00	2007-11-07 14:30:00	No	2008-05-01 00:00:00	None	FTR AE	None	3200	3200	0	3200	0	None	34PF11	N	CA00135353	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-10 00:00:00	020004874	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-10-24 09:00:00	2007-10-24 09:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	2200	2200	0	2200	0	None	34PF11	N	CA00132829	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-14 00:00:00	020004876	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-10-14 11:00:00	2007-10-14 11:00:00	No	2008-05-05 00:00:00	None	FTR AE	None	3200	3200	0	3200	0	None	34PF11	N	CA00132829	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-14 00:00:00	020004878	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-12 07:00:00	2007-11-12 07:00:00	No	2008-05-05 00:00:00	None	FTR AE	None	400	400	0	400	0	None	3E6S11	N	CA00133040	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-14 00:00:00	020004880	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-19 11:30:00	2007-11-19 11:30:00	No	2008-05-05 00:00:00	None	FTR AE	None	1100	1100	0	1100	0	None	9C6511	N	CA00134114	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-14 00:00:00	020004881	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-13 16:30:00	2007-11-13 16:30:00	No	2008-05-05 00:00:00	None	FTR AE	None	300	300	0	300	0	None	9C6511	N	CA00132828	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-14 00:00:00	020004884	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-09 15:30:00	2007-11-09 15:30:00	No	2008-05-05 00:00:00	None	FTR AE	None	700	700	0	700	0	None	9C6511	N	CA00132827	C	SFY2007-08
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-14 00:00:00	020004903	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-03-07 09:30:00	2008-03-07 09:30:00	No	2008-05-05 00:00:00	None	FTR AE	None	2000	2000	0	2000	0	None	SNPQ11	N	CA00145681	C	SFY2007-08
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-17 00:00:00	020004929	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-01 11:00:00	2007-12-01 11:00:00	No	2008-05-09 00:00:00	None	FTR AE	None	1500	1500	0	1500	0	None	3X9911	N	CA00135676	C	SFY2007-08
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-04-16 00:00:00	020004930	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-16 17:00:00	2007-11-16 17:00:00	No	2008-05-08 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	3X9911	N	CA00135670	C	SFY2007-08
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-08-11 00:00:00	020005274	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-07-15 14:20:00	2008-07-15 14:20:00	No	2008-09-05 00:00:00	None	FTR AE	None	800	800	0	800	0	None	698M11	N	CA00157850	C	SFY2008-09
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-08-11 00:00:00	020005276	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-07-08 14:38:00	2008-07-08 14:38:00	No	2008-09-05 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	698M11	N	CA00157850	C	SFY2008-09
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-08-12 00:00:00	020005314	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-03-11 10:25:00	2008-03-11 10:25:00	No	2008-09-05 00:00:00	None	FTR AE	None	6800	6800	0	6800	0	None	FWQS11	N	CA00151876	C	SFY2008-09
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-11-04 00:00:00	020005569	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-07-21 12:24:00	2008-07-21 12:24:00	No	2008-12-04 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	HKIT11	N	CA00160215	C	SFY2008-09
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-12-04 00:00:00	020005660	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-11-18 18:01:00	2008-11-18 18:01:00	No	2009-01-05 00:00:00	None	FTR AE	None	100	100	0	100	0	None	OM0V11	N	CA00169155	C	SFY2008-09
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2008-12-04 00:00:00	020005661	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-01-05 11:21:00	2008-01-05 11:21:00	No	2009-01-05 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	29YU11	N	CA00141767	C	SFY2008-09
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2009-02-09 00:00:00	020005855	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-01-01 11:49:00	2009-01-01 11:49:00	No	2009-03-10 00:00:00	None	FTR AE	None	700	700	0	700	0	None	599U11	N	CA00174669	C	SFY2008-09
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2009-04-21 00:00:00	020005962	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2009-01-26 00:00:00	2009-01-26 00:00:00	No	2009-05-12 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	4OG511	N	CA00176168	B	SFY2008-09
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2009-04-15 00:00:00	020006084	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-02-14 03:44:00	2009-02-14 03:44:00	No	2009-05-06 00:00:00	None	FTR AE	None	1200	1200	0	1200	0	None	4FDS11	N	CA00179856	C	SFY2008-09
140000190	KAISER FOUNDATION HOSPITAL - WALNUT CREEK	Non-LTC	GACH	General Acute Care Hospital	East Bay	2009-12-17 00:00:00	020006798	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2009-03-20 16:00:00	2009-03-20 16:00:00	No	2010-01-13 00:00:00	None	FTR BR	None	4900	4900	-1225	3675	0	None	WVIT11	None	CA00188238	C	SFY2009-10
140000148	KINDRED HOSPITAL - SAN FRANCISCO BAY AREA	Non-LTC	GACH	General Acute Care Hospital	East Bay	2010-02-18 00:00:00	020007000	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2010-01-05 16:13:00	2010-01-05 16:13:00	No	2010-03-12 00:00:00	None	FTR AE	None	100	100	0	100	0	None	GGX811	N	CA00214808	C	SFY2009-10
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2010-08-31 00:00:00	020007530	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2010-02-08 00:27:00	2010-02-08 00:27:00	No	2010-09-24 00:00:00	None	FTR BR	None	1100	1100	0	1100	0	None	HSX911	None	CA00220322	C	SFY2010-11
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2010-09-28 00:00:00	020007601	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2010-06-24 08:30:00	2010-06-24 08:30:00	No	2010-10-20 00:00:00	None	FTR BR	None	700	700	0	700	0	None	SUCE11	None	CA00194279	C	SFY2010-11
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2011-12-14 00:00:00	020008742	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2011-06-03 00:00:00	2011-06-03 00:00:00	No	2012-06-22 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	6XLN11	N	CA00232584	A	SFY2011-12
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2012-05-24 00:00:00	020009089	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE05 - Death during or up to 24 hours after surgery	None	2010-09-16 00:00:00	2010-09-16 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	DBTF11	Y	CA00243799	B	SFY2011-12
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2012-04-19 00:00:00	020009115	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach by h/c worker within facility/hc system	None	2009-08-11 00:00:00	2009-08-11 00:00:00	No	2013-03-08 00:00:00	None	AP BR	None	50000	50000	-12500	37500	0	None	NBYY11	None	CA00203912	C	SFY2011-12
630011203	KAISER FOUNDATION HOSPITAL - ANTIOCH	Non-LTC	GACH	General Acute Care Hospital	East Bay	2015-03-11 00:00:00	020011316	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2013-09-09 00:00:00	2013-09-09 00:00:00	No	2015-04-02 00:00:00	None	FTR AE	None	400	400	0	400	0	None	9Q1D11	N	CA00370134	C	SFY2014-15
630011203	KAISER FOUNDATION HOSPITAL - ANTIOCH	Non-LTC	GACH	General Acute Care Hospital	East Bay	2015-04-21 00:00:00	020011395	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	Retention Foreign Object	2014-09-02 00:00:00	2014-09-02 00:00:00	No	2015-05-12 00:00:00	None	AP NON-IJ	None	14392	14392	0	14392	0	None	LEM611	N	CA00416790	C	SFY2014-15
140000190	KAISER FOUNDATION HOSPITAL - WALNUT CREEK	Non-LTC	GACH	General Acute Care Hospital	East Bay	2016-10-20 00:00:00	020012655	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2015-09-26 00:00:00	2015-09-26 00:00:00	No	2016-11-10 00:00:00	None	FTR BR	None	600	600	-150	450	0	None	QPLY11	None	CA00463342	C	SFY2016-17
140000190	KAISER FOUNDATION HOSPITAL - WALNUT CREEK	Non-LTC	GACH	General Acute Care Hospital	East Bay	2017-02-22 00:00:00	020012990	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	Retained Foreign Object	2016-09-21 00:00:00	2016-09-21 00:00:00	No	2017-03-15 00:00:00	None	AP NON-IJ	None	3750	3750	0	3750	0	None	9Z6811	N	CA00505221	C	SFY2016-17
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2017-10-18 00:00:00	020013546	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	Nursing Services	2016-01-12 00:00:00	2016-01-12 00:00:00	No	2017-11-08 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	06Q411	Y	CA00471992	C	SFY2017-18
630015029	KAISER FOUNDATION HOSPITAL - SAN LEANDRO	Non-LTC	GACH	General Acute Care Hospital	East Bay	2018-01-22 00:00:00	020013747	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2015-07-14 00:00:00	2015-07-14 00:00:00	No	2018-04-19 00:00:00	None	AP NON-IJ	None	10781	10781	0	10781	0	None	6BRF11	Y	CA00475154	C	SFY2017-18
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2018-06-12 00:00:00	020014189	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2016-08-26 00:00:00	2016-08-26 00:00:00	No	2019-04-12 00:00:00	None	AP BR	None	12750	12750	0	12750	0	None	QD1811	None	CA00534112	D	SFY2017-18
140001086	KAISER FOUNDATION HOSPITAL - FREMONT	Non-LTC	GACH	General Acute Care Hospital	East Bay	2018-10-12 00:00:00	020014551	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2014-07-15 00:00:00	2014-07-15 00:00:00	No	2018-11-02 00:00:00	None	AP BR	None	0	0	0	0	0	None	QD3O11	None	CA00418633	C	SFY2018-19
070001239	KAISER FOUNDATION HOSPITAL HOSPICE - OAKLAND	Non-LTC	HOSPICE	Hospice	East Bay	2019-03-14 00:00:00	020014912	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach of IT system theft/loss of edevice/med rec	None	2016-12-02 00:00:00	2016-12-02 00:00:00	No	2019-04-04 00:00:00	None	AP BR	None	0	0	0	0	0	None	QG3K11	None	CA00514297	D	SFY2018-19
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2019-04-03 00:00:00	020015015	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2014-07-15 00:00:00	2014-07-15 00:00:00	No	2019-04-24 00:00:00	None	AP BR	None	0	0	0	0	0	None	R13B11	None	CA00406693, CA00406693	D, D	SFY2018-19
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2021-04-23 00:00:00	020017898	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2020-09-02 00:00:00	2020-09-02 00:00:00	No	2022-09-15 00:00:00	None	AP BR	None	30000	30000	0	30000	0	None	7LWH11	None	CA00704754	D	SFY2020-21
140000188	KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2021-04-23 00:00:00	020017902	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2020-09-02 00:00:00	2020-09-02 00:00:00	No	2021-05-14 00:00:00	None	FTR RES	None	11400	11400	0	11400	0	None	7LWH11	None	CA00704754, CA00704754	D, D	SFY2020-21
630015029	KAISER FOUNDATION HOSPITAL - SAN LEANDRO	Non-LTC	GACH	General Acute Care Hospital	East Bay	2022-06-17 00:00:00	020019050	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2018-08-31 00:00:00	2018-08-31 00:00:00	No	2023-09-14 00:00:00	None	AP BR	None	7500	7500	-1875	5625	0	None	WPSO11	None	CA00614174	D	SFY2021-22
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2008-03-26 00:00:00	030004516	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-10-01 00:00:00	2007-10-01 00:00:00	No	2008-04-18 00:00:00	None	FTR AE	None	500	500	0	500	0	None	VFMI11	N	CA00129057	B	SFY2007-08
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2008-03-26 00:00:00	030004825	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE01 - Surgery performed on a wrong body part	None	2007-09-01 00:00:00	2007-09-01 00:00:00	No	2008-04-17 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	JZVT11	N	CA00128667	B	SFY2007-08
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2008-04-11 00:00:00	030004919	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2007-07-17 00:00:00	2007-07-17 00:00:00	No	2008-05-05 00:00:00	None	FTR AE	None	900	900	0	900	0	None	8NJV11	N	CA00122137	B	SFY2007-08
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-06-23 00:00:00	030007326	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2009-04-27 00:00:00	2009-04-27 00:00:00	No	2010-07-14 00:00:00	None	FTR BR	None	600	600	0	600	0	None	Y2D911	None	CA00187752	B	SFY2009-10
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-11-19 00:00:00	030007727	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE03 - Wrong surgical procedure performed on a patient	None	2008-02-21 00:00:00	2008-02-21 00:00:00	No	2010-12-14 00:00:00	None	FTR AE	None	37400	37400	0	37400	0	None	H40K11	N	CA00180801	B	SFY2010-11
630011683	KAISER FOUNDATION HOSPITAL MODESTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-03-18 00:00:00	030010537	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-08-02 00:00:00	2011-08-02 00:00:00	No	2014-04-09 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	DLER11	N	CA00282704	B	SFY2013-14
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-07-18 00:00:00	030010570	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2012-11-15 00:00:00	2012-11-15 00:00:00	No	2014-08-08 00:00:00	None	FTR BR	None	700	700	-175	525	0	None	HP2B11	None	CA00335235	C	SFY2014-15
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-07-18 00:00:00	030010571	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2012-11-15 00:00:00	2012-11-15 00:00:00	No	2014-08-08 00:00:00	None	FTR RES	None	1800	1800	-450	1350	0	None	HP2B11	None	CA00335235	C	SFY2014-15
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-04-14 00:00:00	030010625	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2012-07-03 00:00:00	2012-07-03 00:00:00	No	2014-05-05 00:00:00	None	FTR AE	None	2300	2300	0	2300	0	None	0GVC11	N	CA00320003	B	SFY2013-14
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-04-29 00:00:00	030010679	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-02-12 00:00:00	2009-02-12 00:00:00	No	2014-05-20 00:00:00	None	FTR AE	None	100	100	0	100	0	None	ZO1Z11	N	CA00178329	B	SFY2013-14
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-05-06 00:00:00	030010706	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-07-03 00:00:00	2008-07-03 00:00:00	No	2014-05-28 00:00:00	None	FTR AE	None	300	300	0	300	0	None	60ER11	N	CA00156661	B	SFY2013-14
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-05-27 00:00:00	030010741	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2011-07-13 00:00:00	2011-07-13 00:00:00	No	2014-06-17 00:00:00	None	FTR RES	None	600	600	-150	450	0	None	5PLV11	None	CA00276626	B	SFY2013-14
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-06-10 00:00:00	030010748	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2010-04-22 00:00:00	2010-04-22 00:00:00	No	2010-07-01 00:00:00	None	FTR RES	None	1200	1200	0	1200	0	None	ZMJZ11	None	CA00226866	B	SFY2009-10
630011683	KAISER FOUNDATION HOSPITAL MODESTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-06-17 00:00:00	030010819	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2012-03-09 00:00:00	2012-03-09 00:00:00	No	2014-07-09 00:00:00	None	FTR AE	None	200	200	0	200	0	None	408B11	N	CA00303659	D	SFY2013-14
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-07-18 00:00:00	030010863	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2010-02-13 00:00:00	2010-02-13 00:00:00	No	2014-08-08 00:00:00	None	FTR BR	None	900	900	0	900	0	None	BRGC11	None	CA00220341	B	SFY2014-15
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-07-18 00:00:00	030010864	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2010-02-13 00:00:00	2010-02-13 00:00:00	No	2014-08-08 00:00:00	None	FTR RES	None	800	800	0	800	0	None	BRGC11	None	CA00220341	B	SFY2014-15
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2014-08-28 00:00:00	030010967	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-06-30 00:00:00	2008-06-30 00:00:00	No	2014-09-19 00:00:00	None	FTR AE	None	2400	2400	0	2400	0	None	1Q6711	N	CA00158855	B	SFY2014-15
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-04-20 00:00:00	030011406	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-03-19 00:00:00	2008-03-19 00:00:00	No	2015-05-11 00:00:00	None	FTR AE	None	400	400	0	400	0	None	5H5711	N	CA00145430	B	SFY2014-15
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-04-20 00:00:00	030011408	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE03 - Wrong surgical procedure performed on a patient	None	2008-06-25 00:00:00	2008-06-25 00:00:00	No	2015-05-11 00:00:00	None	FTR AE	None	2500	2500	0	2500	0	None	1KI111	N	CA00158266	B	SFY2014-15
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-04-22 00:00:00	030011415	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2009-06-25 00:00:00	2009-06-25 00:00:00	No	2015-05-13 00:00:00	None	FTR AE	None	100	100	0	100	0	None	2T4X11	N	CA00193727	B	SFY2014-15
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-05-06 00:00:00	030011433	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE19 - Death/disability due to electric shock	None	2011-05-03 00:00:00	2011-05-03 00:00:00	No	2015-05-28 00:00:00	None	FTR AE	None	300	300	0	300	0	None	T0UJ11	N	CA00269224	B	SFY2014-15
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-05-11 00:00:00	030011461	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-03-29 00:00:00	2008-03-29 00:00:00	No	2015-06-02 00:00:00	None	FTR AE	None	600	600	0	600	0	None	EVKR11	N	CA00146448	B	SFY2014-15
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-05-11 00:00:00	030011462	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2013-02-11 00:00:00	2013-02-11 00:00:00	No	2015-06-02 00:00:00	None	FTR AE	None	400	400	0	400	0	None	OXPQ11	N	CA00344332	D	SFY2014-15
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-05-11 00:00:00	030011463	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE08 - Death/disability due to intravascular air embolism	None	2012-08-29 00:00:00	2012-08-29 00:00:00	No	2015-06-02 00:00:00	None	FTR AE	None	400	400	0	400	0	None	D7D111	N	CA00324919	D	SFY2014-15
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-05-11 00:00:00	030011464	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE03 - Wrong surgical procedure performed on a patient	None	2012-06-27 00:00:00	2012-06-27 00:00:00	No	2015-06-02 00:00:00	None	FTR AE	None	300	300	0	300	0	None	X2Y311	N	CA00316868	D	SFY2014-15
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-06-16 00:00:00	030011564	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2009-10-02 00:00:00	2009-10-02 00:00:00	No	2015-07-07 00:00:00	None	FTR BR	None	100	100	-25	75	0	None	E2KE11	None	CA00204416	B	SFY2014-15
100000853	KAISER FOUNDATION HOSPITAL - HOSPICE	Non-LTC	HOSPICE	Hospice	Sacramento	2015-06-19 00:00:00	030011574	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach of IT system theft/loss of edevice/med rec	None	2014-11-26 00:00:00	2014-11-26 00:00:00	No	2015-07-10 00:00:00	None	FTR RES	None	400	400	0	400	0	None	BN0W11	None	CA00422420	C	SFY2014-15
100000853	KAISER FOUNDATION HOSPITAL - HOSPICE	Non-LTC	HOSPICE	Hospice	Sacramento	2015-06-26 00:00:00	030011584	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-08-06 00:00:00	2013-08-06 00:00:00	No	2015-07-17 00:00:00	None	FTR BR	None	400	400	0	400	0	None	DG0N11	None	CA00367162	D	SFY2014-15
100000853	KAISER FOUNDATION HOSPITAL - HOSPICE	Non-LTC	HOSPICE	Hospice	Sacramento	2015-06-26 00:00:00	030011585	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-08-06 00:00:00	2013-08-06 00:00:00	No	2015-07-17 00:00:00	None	FTR RES	None	700	700	0	700	0	None	DG0N11	None	CA00367162	D	SFY2014-15
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-03 00:00:00	030011649	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-27 00:00:00	2007-12-27 00:00:00	No	2015-08-24 00:00:00	None	FTR AE	None	300	300	0	300	0	None	FGBG11	N	CA00137267	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-03 00:00:00	030011650	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-01-24 00:00:00	2008-01-24 00:00:00	No	2015-08-24 00:00:00	None	FTR AE	None	13300	13300	0	13300	0	None	FGBG11	N	CA00137267	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-03 00:00:00	030011651	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-01-29 00:00:00	2008-01-29 00:00:00	No	2015-08-24 00:00:00	None	FTR AE	None	12800	12800	0	12800	0	None	FGBG11	N	CA00137267	B	SFY2015-16
630011683	KAISER FOUNDATION HOSPITAL MODESTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-10 00:00:00	030011652	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-02-05 00:00:00	2009-02-05 00:00:00	No	2015-08-31 00:00:00	None	FTR AE	None	4300	4300	0	4300	0	None	968011	N	CA00182761	B	SFY2015-16
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-11 00:00:00	030011663	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2013-01-17 00:00:00	2013-01-17 00:00:00	No	2015-09-01 00:00:00	None	FTR AE	None	100	100	0	100	0	None	D8FL11	N	CA00340706	D	SFY2015-16
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-17 00:00:00	030011670	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2014-07-09 00:00:00	2014-07-09 00:00:00	No	2015-09-08 00:00:00	None	FTR BR	None	600	600	0	600	0	None	JHBA11	None	CA00415173	D	SFY2015-16
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-08-17 00:00:00	030011671	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2014-07-09 00:00:00	2014-07-09 00:00:00	No	2015-09-08 00:00:00	None	FTR RES	None	700	700	0	700	0	None	JHBA11	None	CA00415173	D	SFY2015-16
100000853	KAISER FOUNDATION HOSPITAL - HOSPICE	Non-LTC	HOSPICE	Hospice	Sacramento	2015-09-28 00:00:00	030011749	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2014-07-26 00:00:00	2014-07-26 00:00:00	No	2015-10-19 00:00:00	None	FTR BR	None	8200	8200	0	8200	0	None	U2E011	None	CA00419294	C	SFY2015-16
100000853	KAISER FOUNDATION HOSPITAL - HOSPICE	Non-LTC	HOSPICE	Hospice	Sacramento	2015-09-28 00:00:00	030011750	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2014-07-26 00:00:00	2014-07-26 00:00:00	No	2015-10-19 00:00:00	None	FTR RES	None	8200	8200	0	8200	0	None	U2E011	None	CA00419294	C	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-07 00:00:00	030011880	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2009-08-02 00:00:00	2009-08-02 00:00:00	No	2015-12-29 00:00:00	None	FTR RES	None	500	500	0	500	0	None	KLXS11	None	CA00233381	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-07 00:00:00	030011881	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2010-11-02 00:00:00	2010-11-02 00:00:00	No	2015-12-29 00:00:00	None	FTR RES	None	1900	1900	0	1900	0	None	WD6G11	None	CA00249724	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-07 00:00:00	030011882	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2010-11-22 00:00:00	2010-11-22 00:00:00	No	2015-12-29 00:00:00	None	FTR RES	None	900	900	0	900	0	None	Y69711	None	CA00251234	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-10 00:00:00	030011889	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2010-06-10 00:00:00	2010-06-10 00:00:00	No	2016-01-01 00:00:00	None	FTR BR	None	700	700	0	700	0	None	I7TO11	None	CA00247216	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-10 00:00:00	030011890	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach by h/c worker within facility/hc system	None	2010-06-10 00:00:00	2010-06-10 00:00:00	No	2016-01-01 00:00:00	None	FTR RES	None	700	700	0	700	0	None	I7TO11	None	CA00247216	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-14 00:00:00	030011893	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2010-08-17 00:00:00	2010-08-17 00:00:00	No	2016-01-05 00:00:00	None	FTR BR	None	900	900	0	900	0	None	MIQJ11	None	CA00243660	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-14 00:00:00	030011894	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2010-08-17 00:00:00	2010-08-17 00:00:00	No	2016-01-05 00:00:00	None	FTR RES	None	800	800	0	800	0	None	MIQJ11	None	CA00243660	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-14 00:00:00	030011895	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach by h/c worker within facility/hc system	None	2010-07-25 00:00:00	2010-07-25 00:00:00	No	2016-01-05 00:00:00	None	FTR RES	None	300	300	0	300	0	None	LUDI11	None	CA00238348	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2015-12-17 00:00:00	030011901	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach by h/c worker within facility/hc system	None	2010-06-17 00:00:00	2010-06-17 00:00:00	No	2016-01-08 00:00:00	None	FTR RES	None	900	900	0	900	0	None	1HDL11	None	CA00233506	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-01-14 00:00:00	030011960	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2012-05-16 00:00:00	2012-05-16 00:00:00	No	2016-02-05 00:00:00	None	FTR RES	None	700	700	0	700	0	None	FQ0411	None	CA00312032	E	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-01-14 00:00:00	030011962	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach by person other than a h/c worker	None	2012-03-18 00:00:00	2012-03-18 00:00:00	No	2016-02-05 00:00:00	None	FTR RES	None	300	300	0	300	0	None	50U611	None	CA00304330	E	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-06-28 00:00:00	030012001	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2012-03-23 00:00:00	2012-03-23 00:00:00	No	2016-07-20 00:00:00	None	FTR RES	None	3300	3300	0	3300	0	None	ECS511	None	CA00309025	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-02-01 00:00:00	030012003	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2012-06-24 00:00:00	2012-06-24 00:00:00	No	2016-02-23 00:00:00	None	FTR BR	None	700	700	0	700	0	None	8Q3S11	None	CA00329855	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-02-05 00:00:00	030012015	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-07-16 00:00:00	2013-07-16 00:00:00	No	2016-02-29 00:00:00	None	FTR BR	None	2200	2200	0	2200	0	None	DKD011	None	CA00366107	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-02-05 00:00:00	030012016	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-07-16 00:00:00	2013-07-16 00:00:00	No	2016-02-29 00:00:00	None	FTR RES	None	2200	2200	0	2200	0	None	DKD011	None	CA00366107	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-02-09 00:00:00	030012024	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-09-18 00:00:00	2013-09-18 00:00:00	No	2016-03-02 00:00:00	None	FTR BR	None	100	100	0	100	0	None	LC6711	None	CA00371392	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-02-09 00:00:00	030012026	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-09-18 00:00:00	2013-09-18 00:00:00	No	2016-03-02 00:00:00	None	FTR RES	None	100	100	0	100	0	None	LC6711	None	CA00371392	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-02-12 00:00:00	030012032	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-05-23 00:00:00	2013-05-23 00:00:00	No	2016-03-07 00:00:00	None	FTR RES	None	800	800	0	800	0	None	UO4Z11	None	CA00356910	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-05-03 00:00:00	030012224	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-11-24 00:00:00	2009-11-24 00:00:00	No	2016-05-24 00:00:00	None	FTR AE	None	4700	4700	0	4700	0	None	8Q0S11	N	CA00214998	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-05-04 00:00:00	030012225	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2011-10-07 00:00:00	2011-10-07 00:00:00	No	2016-05-25 00:00:00	None	FTR RES	None	3500	3500	0	3500	0	None	4QC111	None	CA00286814	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-05-24 00:00:00	030012270	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2010-07-26 00:00:00	2010-07-26 00:00:00	No	2016-06-15 00:00:00	None	FTR BR	None	2100	2100	0	2100	0	None	IHKX11	None	CA00243658	B	SFY2015-16
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-05-24 00:00:00	030012271	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach by h/c worker within facility/hc system	None	2010-07-26 00:00:00	2010-07-26 00:00:00	No	2016-06-15 00:00:00	None	FTR RES	None	2000	2000	0	2000	0	None	IHKX11	None	CA00243658	B	SFY2015-16
030000973	KAISER FOUNDATION HOSPITAL MANTECA	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-05-24 00:00:00	030012272	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2009-12-04 00:00:00	2009-12-04 00:00:00	No	2016-06-15 00:00:00	None	FTR AE	None	200	200	0	200	0	None	LLYE11	N	CA00217313	B	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-06-28 00:00:00	030012358	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2012-03-23 00:00:00	2012-03-23 00:00:00	No	2016-07-20 00:00:00	None	FTR BR	None	3100	3100	0	3100	0	None	ECS511	None	CA00309025	D	SFY2015-16
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-10-26 00:00:00	030012688	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2009-06-17 00:00:00	2009-06-17 00:00:00	No	2016-11-17 00:00:00	None	FTR AE	None	700	700	0	700	0	None	4GTL11	N	CA00193453	B	SFY2016-17
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-10-26 00:00:00	030012689	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2014-01-13 00:00:00	2014-01-13 00:00:00	No	2016-11-17 00:00:00	None	FTR AE	None	300	300	0	300	0	None	RB5F11	N	CA00384693	C	SFY2016-17
630011683	KAISER FOUNDATION HOSPITAL MODESTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-05-16 00:00:00	030013209	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2013-05-13 00:00:00	2013-05-13 00:00:00	No	2017-06-07 00:00:00	None	FTR AE	None	400	400	0	400	0	None	1Z4411	N	CA00356078	B	SFY2016-17
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-05-18 00:00:00	030013214	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2013-10-10 00:00:00	2013-10-10 00:00:00	No	2017-06-09 00:00:00	None	FTR AE	None	200	200	0	200	0	None	KNKV11	N	CA00373817	D	SFY2016-17
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-05-19 00:00:00	030013216	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2013-12-07 00:00:00	2013-12-07 00:00:00	No	2017-06-12 00:00:00	None	FTR AE	None	100	100	0	100	0	None	5ZE411	N	CA00380450	D	SFY2016-17
630011683	KAISER FOUNDATION HOSPITAL MODESTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2018-06-15 00:00:00	030014150	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE08 - Death/disability due to intravascular air embolism	None	2016-04-26 00:00:00	2016-04-26 00:00:00	No	2018-07-09 00:00:00	None	FTR AE	None	100	100	0	100	0	None	Z7IW11	Y	CA00486910	B	SFY2017-18
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2018-07-19 00:00:00	030014253	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-06-17 00:00:00	2015-06-17 00:00:00	No	2018-08-09 00:00:00	None	FTR AE	None	700	700	0	700	0	None	9U2Q11	N	CA00448622	D	SFY2018-19
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2019-10-01 00:00:00	030015426	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2019-07-15 00:00:00	2019-07-15 00:00:00	No	2019-10-22 00:00:00	None	FTR AE	None	1100	1100	0	1100	0	None	JYHU11	N	CA00648408	C	SFY2019-20
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2021-05-20 00:00:00	030016527	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2016-03-20 00:00:00	2016-03-20 00:00:00	No	2021-06-11 00:00:00	None	FTR AE	None	4100	4100	0	4100	0	None	543D11	Y	CA00487028	B	SFY2020-21
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2022-02-25 00:00:00	030018732	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2015-07-01 00:00:00	2015-07-01 00:00:00	No	2023-06-08 00:00:00	None	AP BR	None	15000	15000	-3750	11250	0	None	LYF411	None	CA00603270	D	SFY2021-22
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-06-01 00:00:00	030018815	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-10-01 00:00:00	2020-10-01 00:00:00	No	2023-06-22 00:00:00	None	FTR AE	None	4200	4200	0	4200	0	None	FFIM11	N	CA00713107	C	SFY2022-23
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-08-30 00:00:00	030019099	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2019-12-07 00:00:00	2019-12-07 00:00:00	No	2023-09-21 00:00:00	None	FTR AE	None	1900	1900	0	1900	0	None	8OU111	N	CA00669744	B	SFY2023-24
030000133	KAISER FOUNDATION HOSPITAL - SOUTH SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-08-30 00:00:00	030019100	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2021-10-20 00:00:00	2021-10-20 00:00:00	No	2023-09-21 00:00:00	None	FTR AE	None	200	200	0	200	0	None	LX6J11	N	CA00758764	B	SFY2023-24
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2024-01-22 00:00:00	030019504	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE08 - Death/disability due to intravascular air embolism	None	2022-11-30 00:00:00	2022-11-30 00:00:00	Yes	2024-02-12 00:00:00	2024-01-31 00:00:00	FTR AE	FTR AE	33900	32900	0	32900	0	None	J1WF11	Y	CA00867612	B	SFY2023-24
030001370	KAISER FOUNDATION HOSPITAL - ROSEVILLE	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-08-15 00:00:00	030019698	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2013-03-01 00:00:00	2013-03-01 00:00:00	No	2024-03-13 00:00:00	None	AP BR	None	15000	15000	-3750	11250	0	None	Y9WH11	None	CA00498532	D	SFY2023-24
030000130	KAISER FOUNDATION HOSPITAL - SACRAMENTO	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2024-04-03 00:00:00	030019887	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2023-01-23 00:00:00	2023-01-23 00:00:00	No	2024-04-24 00:00:00	None	FTR AE	None	13100	13100	0	13100	0	None	NEOV11	N	CA00844788	E	SFY2023-24
040000949	KAISER FOUNDATION HOSPITAL - FRESNO	Non-LTC	GACH	General Acute Care Hospital	Fresno	2008-07-15 00:00:00	040005237	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2008-07-09 00:00:00	2008-07-09 00:00:00	No	2008-08-05 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	KX9F12	N	CA00129602	A	SFY2008-09
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2010-06-14 00:00:00	040007264	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2009-11-02 11:53:00	2009-11-02 11:53:00	No	2010-07-05 00:00:00	None	FTR AE	None	2800	2800	0	2800	0	None	9CJE11	N	CA00211223	D	SFY2009-10
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-04-10 00:00:00	060004904	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-01-02 00:00:00	2008-01-02 00:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	5300	5300	0	5300	0	None	FQW011	N	CA00142665	A	SFY2007-08
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-04-10 00:00:00	060004905	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-10-01 00:00:00	2007-10-01 00:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	14600	14600	0	14600	0	None	FQW011	N	CA00142665	A	SFY2007-08
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-04-10 00:00:00	060004908	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-09-13 00:00:00	2007-09-13 00:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	16400	16400	0	16400	0	None	FQW011	N	CA00142665	A	SFY2007-08
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-04-10 00:00:00	060004910	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-11 00:00:00	2007-12-11 00:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	7500	7500	0	7500	0	None	FQW011	N	CA00142665	A	SFY2007-08
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-04-10 00:00:00	060004911	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-11 00:00:00	2007-12-11 00:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	8800	8800	0	8800	0	None	FQW011	N	CA00142665	A	SFY2007-08
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-04-10 00:00:00	060004912	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-08-02 00:00:00	2007-08-02 00:00:00	No	2008-05-01 00:00:00	None	FTR AE	None	20600	20600	0	20600	0	None	FQW011	N	CA00142665	A	SFY2007-08
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-12-22 00:00:00	060005724	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-06-01 08:00:00	2008-06-01 08:00:00	No	2008-12-19 00:00:00	None	FTR AE	None	13200	13200	0	13200	0	None	CKCU11	N	CA00153756	C	SFY2008-09
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-03-03 00:00:00	060007018	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-05-08 00:00:00	2008-05-08 00:00:00	No	2010-03-29 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	8YKF11	N	CA00160741	B	SFY2009-10
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-05-10 00:00:00	060007200	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-05-15 08:00:00	2008-05-15 08:00:00	No	2010-06-01 00:00:00	None	FTR AE	None	15000	15000	0	15000	0	None	8YKF11	N	CA00160741	B	SFY2009-10
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-05-10 00:00:00	060007202	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-06-07 08:00:00	2008-06-07 08:00:00	No	2010-06-07 00:00:00	None	FTR AE	None	12700	12700	0	12700	0	None	8YKF11	N	CA00160741	B	SFY2009-10
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-05-10 00:00:00	060007203	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-06-12 08:00:00	2008-06-12 08:00:00	No	2010-06-07 00:00:00	None	FTR AE	None	12200	12200	0	12200	0	None	8YKF11	N	CA00160741	B	SFY2009-10
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-05-10 00:00:00	060007204	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-06-23 08:00:00	2008-06-23 08:00:00	No	2010-06-07 00:00:00	None	FTR AE	None	11100	11100	0	11100	0	None	8YKF11	N	CA00160741	B	SFY2009-10
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-09-23 00:00:00	060007595	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-06-30 08:00:00	2008-06-30 08:00:00	No	2010-10-18 00:00:00	None	FTR AE	None	12400	12400	0	12400	0	None	1F9Q11	N	CA00167613	B	SFY2010-11
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2010-09-23 00:00:00	060007596	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-07-11 08:00:00	2008-07-11 08:00:00	No	2010-10-18 00:00:00	None	FTR AE	None	11300	11300	0	11300	0	None	1F9Q11	N	CA00167613	B	SFY2010-11
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-05-09 00:00:00	060008124	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-06-22 08:00:00	2009-06-22 08:00:00	No	2011-05-31 00:00:00	None	FTR AE	None	13200	13200	0	13200	0	None	NWTG11	N	CA00208222	B	SFY2010-11
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-05-09 00:00:00	060008125	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-06-22 08:00:00	2009-06-22 08:00:00	No	2011-05-31 00:00:00	None	FTR AE	None	13200	13200	0	13200	0	None	NWTG11	N	CA00208222	B	SFY2010-11
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-12-14 00:00:00	060008630	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2010-12-07 08:00:00	2010-12-07 08:00:00	No	2012-01-06 00:00:00	None	FTR BR	None	600	600	0	600	0	None	4IGU11	None	CA00254322	E	SFY2011-12
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-10-25 00:00:00	060008662	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2010-11-01 08:00:00	2010-11-01 08:00:00	No	2011-11-16 00:00:00	None	FTR AE	None	400	400	0	400	0	None	TMYS11	N	CA00253058	B	SFY2011-12
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-12-14 00:00:00	060008700	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2010-12-07 08:00:00	2010-12-07 08:00:00	No	2012-01-06 00:00:00	None	FTR BR	None	300	300	0	300	0	None	4IGU11	None	CA00254322	E	SFY2011-12
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-02-17 00:00:00	060008984	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2009-10-07 08:00:00	2009-10-07 08:00:00	No	2012-03-12 00:00:00	None	FTR AE	None	4500	4500	0	4500	0	None	L7JO11	N	CA00211320	B	SFY2011-12
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-02-17 00:00:00	060008990	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-09-19 08:00:00	2011-09-19 08:00:00	No	2012-03-12 00:00:00	None	FTR AE	None	6600	6600	0	6600	0	None	DKUC11	N	CA00285225	B	SFY2011-12
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-03-22 00:00:00	060009105	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2009-03-04 08:00:00	2009-03-04 08:00:00	No	2012-04-12 00:00:00	None	FTR AE	None	4500	4500	0	4500	0	None	BEMU11	N	CA00195103	C	SFY2011-12
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-04-09 00:00:00	060009199	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-01-04 08:00:00	2011-01-04 08:00:00	No	2012-04-30 00:00:00	None	FTR AE	None	1100	1100	0	1100	0	None	B5OE11	N	CA00257273	B	SFY2011-12
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-04-13 00:00:00	060009229	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2011-04-12 08:00:00	2011-04-12 08:00:00	No	2012-05-04 00:00:00	None	FTR AE	None	500	500	0	500	0	None	GBQM11	N	CA00269168	B	SFY2011-12
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2013-07-29 00:00:00	060010038	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2011-03-18 00:00:00	2011-03-18 00:00:00	No	2013-08-19 00:00:00	None	FTR AE	None	4500	4500	0	4500	0	None	NFVC11	N	CA00264197	B	SFY2013-14
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2013-07-29 00:00:00	060010041	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2011-07-29 00:00:00	2011-07-29 00:00:00	No	2013-08-19 00:00:00	None	FTR AE	None	800	800	0	800	0	None	G74Y11	N	CA00280522	B	SFY2013-14
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-02 00:00:00	060010595	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2010-08-03 00:00:00	2010-08-03 00:00:00	No	2014-08-15 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	E6TS11	N	CA00239949	D	SFY2013-14
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-08-07 00:00:00	060010916	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-09-24 00:00:00	2013-09-24 00:00:00	No	2014-08-28 00:00:00	None	FTR RES	None	5400	5400	0	5400	0	None	FF5611	None	CA00378499	B	SFY2014-15
060000018	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - LAKEVIEW	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-08-07 00:00:00	060010917	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-09-24 00:00:00	2013-09-24 00:00:00	No	2014-08-28 00:00:00	None	FTR BR	None	5100	5100	0	5100	0	None	FF5611	None	CA00378499	B	SFY2014-15
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-10-24 00:00:00	060011036	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2014-03-24 00:00:00	2014-03-24 00:00:00	No	2014-11-17 00:00:00	None	FTR AE	None	4400	4400	0	4400	0	None	0Y0X11	N	CA00399078	D	SFY2014-15
630013929	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM	Non-LTC	GACH	General Acute Care Hospital	Orange	2016-10-17 00:00:00	060012639	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2014-01-20 00:00:00	2014-01-20 00:00:00	No	2016-11-07 00:00:00	None	FTR RES	None	3700	3700	-925	2775	0	None	62KL11	None	CA00395101	C	SFY2016-17
630013929	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM	Non-LTC	GACH	General Acute Care Hospital	Orange	2016-10-17 00:00:00	060012646	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2014-01-20 00:00:00	2014-01-20 00:00:00	No	2016-11-07 00:00:00	None	FTR BR	None	3700	3700	-925	2775	0	None	62KL11	None	CA00395101	C	SFY2016-17
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2017-07-27 00:00:00	060013368	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-04-18 00:00:00	2017-04-18 00:00:00	No	2017-08-17 00:00:00	None	FTR AE	None	800	800	0	800	0	None	DZC511	N	CA00533508	D	SFY2017-18
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-05-22 00:00:00	060014099	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-12-30 00:00:00	2017-12-30 00:00:00	No	2018-06-13 00:00:00	None	FTR AE	None	4100	4100	0	4100	0	None	D19I11	N	CA00574011	D	SFY2017-18
630013929	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-06-07 00:00:00	060014132	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2018-01-06 00:00:00	2018-01-06 00:00:00	No	2018-06-28 00:00:00	None	FTR AE	None	700	700	0	700	0	None	MIXC11	Y	CA00571227	B	SFY2017-18
630013929	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-06-07 00:00:00	060014133	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2018-01-06 00:00:00	2018-01-06 00:00:00	No	2018-12-28 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	MIXC11	Y	CA00571227	B	SFY2017-18
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-07-02 00:00:00	060014212	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-10-10 00:00:00	2017-10-10 00:00:00	No	2018-07-24 00:00:00	None	FTR AE	None	5100	5100	0	5100	0	None	1TZ511	N	CA00563752	D	SFY2018-19
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-09-26 00:00:00	060014434	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2018-03-21 00:00:00	2018-03-21 00:00:00	No	2018-10-17 00:00:00	None	FTR AE	None	800	800	0	800	0	None	FVZC11	N	CA00581016	D	SFY2018-19
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-09-27 00:00:00	060014437	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2018-07-10 00:00:00	2018-07-10 00:00:00	No	2018-10-18 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	6YU511	N	CA00596917	D	SFY2018-19
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-02-11 00:00:00	060015717	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2019-11-10 00:00:00	2019-11-10 00:00:00	No	2020-03-03 00:00:00	None	FTR AE	None	2100	2100	0	2100	0	None	XWT311	N	CA00667887	D	SFY2019-20
630011745	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - IRVINE	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-03-23 00:00:00	060015816	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2020-01-14 00:00:00	2020-01-14 00:00:00	No	2020-04-13 00:00:00	None	FTR AE	None	4800	4800	0	4800	0	None	ZDQX11	N	CA00679713	B	SFY2019-20
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-04-10 00:00:00	060015844	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-01-23 00:00:00	2020-01-23 00:00:00	No	2020-05-01 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	UTUX11	N	CA00675873	D	SFY2019-20
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-09-11 00:00:00	060016029	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-04-26 00:00:00	2020-04-26 00:00:00	No	2020-10-02 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	MFQ811	N	CA00688651	D	SFY2020-21
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-09-11 00:00:00	060016030	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-05-25 00:00:00	2020-05-25 00:00:00	No	2020-10-02 00:00:00	None	FTR AE	None	1800	1800	0	1800	0	None	PWCS11	N	CA00693128	D	SFY2020-21
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2022-05-02 00:00:00	060017612	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2022-01-10 00:00:00	2022-01-10 00:00:00	No	2022-05-23 00:00:00	None	FTR AE	None	600	600	0	600	0	None	89JM11	N	CA00771713	D	SFY2021-22
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2022-06-01 00:00:00	060017670	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2021-12-27 00:00:00	2021-12-27 00:00:00	No	2022-06-22 00:00:00	None	AP NON-IJ	None	15675	15675	0	15675	0	None	091O11	N	CA00769620	B	SFY2021-22
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2022-06-27 00:00:00	060017738	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2022-05-01 00:00:00	2022-05-01 00:00:00	No	2022-07-19 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	588R11	N	CA00785119	D	SFY2021-22
060000017	KINDRED HOSPITAL WESTMINSTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2022-07-12 00:00:00	060017771	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2022-04-26 00:00:00	2022-04-26 00:00:00	No	2022-08-02 00:00:00	None	FTR AE	None	1500	1500	0	1500	0	None	6U2Y11	N	CA00785134	D	SFY2022-23
630013929	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM	Non-LTC	GACH	General Acute Care Hospital	Orange	2023-05-19 00:00:00	060018775	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE01 - Surgery performed on a wrong body part	None	2022-12-22 00:00:00	2022-12-22 00:00:00	No	2023-06-12 00:00:00	None	FTR AE	None	5100	5100	0	5100	0	None	S8RX11	N	None	None	SFY2022-23
060001360	KINDRED HOSPITAL BREA	Non-LTC	GACH	General Acute Care Hospital	Orange	2023-07-20 00:00:00	060018977	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2023-06-06 00:00:00	2023-06-06 00:00:00	No	2023-08-10 00:00:00	None	FTR AE	None	2500	2500	0	2500	0	None	EULW11	N	CA00847068	D	SFY2023-24
630013929	KAISER FOUNDATION HOSPITAL - ORANGE COUNTY - ANAHEIM	Non-LTC	GACH	General Acute Care Hospital	Orange	2023-08-16 00:00:00	060019063	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2023-02-03 00:00:00	2023-02-03 00:00:00	No	2023-09-07 00:00:00	None	FTR AE	None	15900	15900	0	15900	0	None	T8V911	N	CA00852184	B	SFY2023-24
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2007-07-23 00:00:00	070004109	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2007-02-07 00:00:00	2007-02-07 00:00:00	No	2007-08-13 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	2XXM11	Y	CA00108314	B	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2007-10-11 00:00:00	070004558	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-09-19 08:00:00	2007-09-19 08:00:00	No	2007-11-01 00:00:00	None	FTR AE	None	900	900	0	900	0	None	D72011	N	CA00128317	A	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-01-07 00:00:00	070004562	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-04 08:00:00	2007-12-04 08:00:00	No	2008-01-29 00:00:00	None	FTR AE	None	100	100	0	100	0	None	7C2D11	N	CA00134442	B	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-01-07 00:00:00	070004564	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-06 08:00:00	2007-12-06 08:00:00	No	2008-01-29 00:00:00	None	FTR AE	None	800	800	0	800	0	None	7C2D11	N	CA00135478	B	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-02-26 00:00:00	070004717	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-01-31 08:00:00	2008-01-31 08:00:00	No	2008-03-18 00:00:00	None	FTR AE	None	200	200	0	200	0	None	Y9LE11	N	CA00140347	B	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-04-09 00:00:00	070004859	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2008-03-06 00:00:00	2008-03-06 00:00:00	No	2008-04-30 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	45EC11	N	CA00143985	B	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-04-04 00:00:00	070004860	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2008-03-06 08:00:00	2008-03-06 08:00:00	No	2008-04-25 00:00:00	None	FTR AE	None	700	700	0	700	0	None	45EC11	N	CA00143985	B	SFY2007-08
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-07-15 00:00:00	070005238	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-05-15 08:00:00	2008-05-15 08:00:00	No	2008-08-05 00:00:00	None	FTR AE	None	2700	2700	0	2700	0	None	MDK611	N	CA00153433	B	SFY2008-09
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-11-17 00:00:00	070005618	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2008-09-12 08:00:00	2008-09-12 08:00:00	No	2008-12-10 00:00:00	None	FTR AE	None	1500	1500	0	1500	0	None	CFZB11	N	CA00165255	B	SFY2008-09
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2008-11-17 00:00:00	070005619	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE01 - Surgery performed on a wrong body part	None	2008-06-30 08:00:00	2008-06-30 08:00:00	No	2008-12-10 00:00:00	None	FTR AE	None	9300	9300	0	9300	0	None	009L11	N	CA00165531	B	SFY2008-09
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2011-02-22 00:00:00	070007959	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2011-01-05 08:00:00	2011-01-05 08:00:00	No	2011-03-15 00:00:00	None	FTR AE	None	1500	1500	0	1500	0	None	CDNF11	N	CA00256906	C	SFY2010-11
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2012-04-05 00:00:00	070009210	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2011-03-29 08:00:00	2011-03-29 08:00:00	No	2012-04-26 00:00:00	None	FTR BR	None	100	100	0	100	0	None	499B11	None	CA00296792	C	SFY2011-12
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2012-04-06 00:00:00	070009211	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2012-02-03 08:00:00	2012-02-03 08:00:00	No	2012-04-27 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	PJ4411	N	CA00300410	C	SFY2011-12
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2012-08-28 00:00:00	070009461	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2012-07-26 08:00:00	2012-07-26 08:00:00	No	2012-09-19 00:00:00	None	FTR BR	None	1400	1400	0	1400	0	None	S2TQ11	None	CA00321968	C	SFY2012-13
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2012-12-27 00:00:00	070009690	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2012-01-11 08:00:00	2012-01-11 08:00:00	No	2013-01-18 00:00:00	None	FTR RES	None	200	200	0	200	0	None	2Y8T11	None	None	None	SFY2012-13
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2014-02-20 00:00:00	070010558	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2012-10-02 00:00:00	2012-10-02 00:00:00	No	2015-11-09 00:00:00	None	AP BR	None	42500	42500	0	42500	0	None	FN7O11	None	None	None	SFY2013-14
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2014-08-13 00:00:00	070010934	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2014-03-29 00:00:00	2014-03-29 00:00:00	No	2014-09-04 00:00:00	None	FTR BR	None	200	200	0	200	0	None	2Y5W11	None	CA00394466	C	SFY2014-15
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2014-08-13 00:00:00	070010935	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2014-03-29 00:00:00	2014-03-29 00:00:00	No	2014-09-04 00:00:00	None	FTR RES	None	200	200	0	200	0	None	2Y5W11	None	CA00394466	C	SFY2014-15
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2015-02-03 00:00:00	070011256	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE03 - Wrong surgical procedure performed on a patient	None	2014-04-23 00:00:00	2014-04-23 00:00:00	No	2015-02-25 00:00:00	None	FTR AE	None	2000	2000	0	2000	0	None	GUL611	N	CA00402885	C	SFY2014-15
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2015-06-11 00:00:00	070011554	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2015-02-24 00:00:00	2015-02-24 00:00:00	No	2015-07-02 00:00:00	None	AP BR	None	7500	7500	0	7500	0	None	ZE7611	None	CA00435091	C	SFY2014-15
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2015-07-21 00:00:00	070011628	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE26 - Sexual assault on a patient	None	2014-11-15 00:00:00	2014-11-15 00:00:00	Yes	2015-08-11 00:00:00	2016-02-19 00:00:00	FTR AE	None	2400	2400	0	2400	0	None	THV111	N	CA00423865	B	SFY2015-16
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2017-10-24 00:00:00	070013567	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2016-10-18 00:00:00	2016-10-18 00:00:00	No	2017-11-15 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	CLJ511	N	CA00511486	C	SFY2017-18
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2018-05-29 00:00:00	070014161	Open	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2018-04-05 00:00:00	2018-04-05 00:00:00	No	2018-06-19 00:00:00	None	AP NON-IJ	None	4750	4750	0	0	4750	None	VHGU11	N	CA00582269	A	SFY2017-18
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2018-12-05 00:00:00	070014631	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2017-04-14 00:00:00	2017-04-14 00:00:00	No	2018-12-27 00:00:00	None	AP NON-IJ	None	11925	11925	0	11925	0	None	JG3K11	N	CA00607084	B	SFY2018-19
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2019-01-25 00:00:00	070014766	Open	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE03 - Wrong surgical procedure performed on a patient	None	2018-04-25 00:00:00	2018-04-25 00:00:00	No	2019-02-15 00:00:00	None	AP NON-IJ	None	11812.5	11812.5	0	0	11812.5	None	7I2I11	N	CA00607088	B	SFY2018-19
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2019-03-27 00:00:00	070014916	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-01-19 00:00:00	2017-01-19 00:00:00	No	2019-04-17 00:00:00	None	FTR AE	None	600	600	0	600	0	None	WTEB11	N	CA00617423	C	SFY2018-19
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2019-05-07 00:00:00	070014917	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-01-16 00:00:00	2017-01-16 00:00:00	No	2019-05-28 00:00:00	None	FTR AE	None	900	900	0	900	0	None	TG8F11	N	CA00617422	C	SFY2018-19
070001355	KAISER FOUNDATION HOSPITAL-SANTA CLARA	Non-LTC	GACH	General Acute Care Hospital	San Jose	2019-07-16 00:00:00	070015233	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2019-03-09 00:00:00	2019-03-09 00:00:00	No	2019-08-06 00:00:00	None	FTR AE	None	5600	5600	0	5600	0	None	NZDB11	N	CA00637046	C	SFY2019-20
070000150	KAISER FOUNDATION HOSPITAL-SAN JOSE	Non-LTC	GACH	General Acute Care Hospital	San Jose	2019-08-21 00:00:00	070015332	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2016-11-18 00:00:00	2016-11-18 00:00:00	No	2019-09-11 00:00:00	None	FTR AE	None	1900	1900	0	1900	0	None	M3MO11	N	CA00616699	B	SFY2019-20
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2008-12-13 00:00:00	080005699	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-09-19 09:00:00	2008-09-19 09:00:00	No	2009-01-09 00:00:00	None	FTR AE	None	3100	3100	0	3100	0	None	0CNL11	N	CA00166231	B	SFY2008-09
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2007-09-12 00:00:00	080008014	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2007-08-15 00:00:00	2007-08-15 00:00:00	No	2007-10-03 00:00:00	None	FTR AE	None	700	700	0	700	0	None	TGOZ11	N	None	None	SFY2007-08
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2011-05-05 00:00:00	080008219	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2010-12-18 00:00:00	2010-12-18 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	NDLD11	N	CA00253183	B	SFY2010-11
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2011-07-27 00:00:00	080008426	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-06-16 09:26:00	2011-06-16 09:26:00	No	2011-08-17 00:00:00	None	FTR AE	None	800	800	0	800	0	None	4ONK11	N	CA00274603	B	SFY2011-12
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2011-12-12 00:00:00	080008811	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2009-04-28 00:00:00	2009-04-28 00:00:00	Yes	2012-06-22 00:00:00	2012-06-12 00:00:00	AP IJ	AP IJ	50000	30000	0	30000	0	None	VIJR11	N	CA00241706	B	SFY2011-12
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2012-03-01 00:00:00	080009057	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2011-12-07 13:30:00	2011-12-07 13:30:00	No	2012-03-22 00:00:00	None	FTR BR	None	700	700	0	700	0	None	OO2F11	None	CA00293701	E	SFY2011-12
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2014-11-07 00:00:00	080011119	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2013-10-31 00:00:00	2013-10-31 00:00:00	Yes	2015-06-09 00:00:00	2015-05-27 00:00:00	AP IJ	AP IJ	75000	57500	0	57500	0	None	L5BR11	N	CA00374224	B	SFY2014-15
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2016-07-12 00:00:00	080012386	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2014-11-18 00:00:00	2014-11-18 00:00:00	No	2016-08-02 00:00:00	None	AP NON-IJ	None	12600	12600	0	12600	0	None	LYZZ11	N	CA00422658	B	SFY2016-17
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2016-10-26 00:00:00	080012682	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE22 - Death associated with a fall	None	2016-03-24 00:00:00	2016-03-24 00:00:00	No	2016-11-17 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	I5S011	N	CA00482418	B	SFY2016-17
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2018-03-23 00:00:00	080014057	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach of IT system theft/loss of edevice/med rec	None	2016-09-16 00:00:00	2016-09-16 00:00:00	No	2018-04-13 00:00:00	None	AP BR	None	0	0	0	0	0	None	BKSM11	None	CA00505775	D	SFY2017-18
090000048	KINDRED HOSPITAL - SAN DIEGO	Non-LTC	GACH	General Acute Care Hospital	San Diego	2009-04-07 00:00:00	090006054	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-01-19 12:00:00	2009-01-19 12:00:00	No	2009-04-28 00:00:00	None	FTR AE	None	300	300	0	300	0	None	ERY611	N	CA00175928	B	SFY2008-09
080000144	KAISER FOUNDATION HOSPITAL - ZION	Non-LTC	GACH	General Acute Care Hospital	San Diego	2022-06-17 00:00:00	100019334	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2018-07-20 00:00:00	2018-07-20 00:00:00	No	2023-12-20 00:00:00	None	AP BR	None	12500	12500	0	12500	0	None	KSZC11	None	CA00598984	D	SFY2021-22
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2008-04-22 00:00:00	110004948	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-01-23 13:30:00	2008-01-23 13:30:00	No	2008-05-15 00:00:00	None	FTR AE	None	200	200	0	200	0	None	8B8T11	N	CA00139407	B	SFY2007-08
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2008-07-25 00:00:00	110005259	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-12 15:00:00	2007-12-12 15:00:00	No	2008-08-15 00:00:00	None	FTR AE	None	300	300	0	300	0	None	4EU511	N	CA00135475	B	SFY2008-09
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2009-01-28 00:00:00	110005788	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-03-01 10:21:00	2008-03-01 10:21:00	No	2009-02-23 00:00:00	None	FTR AE	None	1900	1900	0	1900	0	None	M54J11	N	CA00144835	B	SFY2008-09
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2009-02-17 00:00:00	110005882	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-08-25 15:30:00	2008-08-25 15:30:00	No	2009-03-12 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	UE3911	N	CA00163142	C	SFY2008-09
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2009-05-14 00:00:00	110006191	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2008-11-07 00:00:00	2008-11-07 00:00:00	No	2009-09-23 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	5TF011	N	CA00171025	B	SFY2008-09
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2009-07-08 00:00:00	110006376	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2009-03-03 11:59:00	2009-03-03 11:59:00	No	2009-07-29 00:00:00	None	FTR AE	None	400	400	0	400	0	None	4J8G11	N	CA00180919	C	SFY2009-10
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2009-09-03 00:00:00	110006529	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2009-03-24 11:30:00	2009-03-24 11:30:00	No	2009-09-25 00:00:00	None	FTR BR	None	1100	1100	0	1100	0	None	ZNJ911	None	CA00184285	C	SFY2009-10
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2010-12-22 00:00:00	110007711	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE01 - Surgery performed on a wrong body part	None	2009-04-28 00:00:00	2009-04-28 00:00:00	No	2011-09-29 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	59SC11	N	CA00187028	B	SFY2010-11
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2010-12-22 00:00:00	110007721	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2009-04-28 00:00:00	2009-04-28 00:00:00	No	2011-01-12 00:00:00	None	FTR AE	None	100	100	0	100	0	None	59SC11	N	CA00187028	B	SFY2010-11
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-06-16 00:00:00	110007822	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2009-02-05 00:00:00	2009-02-05 00:00:00	No	2011-07-08 00:00:00	None	FTR AE	None	2300	2300	0	2300	0	None	HJ8S11	N	CA00180083	B	SFY2010-11
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-03-07 00:00:00	110007885	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2009-07-22 00:00:00	2009-07-22 00:00:00	No	2011-03-28 00:00:00	None	FTR BR	None	200	200	0	200	0	None	0RWS11	None	CA00196844	C	SFY2010-11
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-03-25 00:00:00	110007940	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-06-19 00:00:00	2009-06-19 00:00:00	No	2011-04-18 00:00:00	None	FTR AE	None	300	300	-300	0	0	None	T4XC11	N	CA00193233	B	SFY2010-11
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-03-24 00:00:00	110007945	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-06-19 00:00:00	2009-06-19 00:00:00	No	2011-04-15 00:00:00	None	FTR AE	None	300	300	0	300	0	None	T4XC11	N	CA00193233	B	SFY2010-11
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-04-26 00:00:00	110007971	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2010-09-03 00:00:00	2010-09-03 00:00:00	No	2012-10-04 00:00:00	None	AP BR	None	250000	250000	-62500	187500	0	None	DOWG11	None	CA00207226	C	SFY2010-11
110000944	KAISER FOUNDATION HOSPITAL - SAN RAFAEL	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-04-08 00:00:00	110008054	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2009-08-13 08:40:00	2009-08-13 08:40:00	No	2011-04-29 00:00:00	None	FTR BR	None	2300	2300	-575	1725	0	None	JCVZ11	None	CA00201515	A	SFY2010-11
110000946	KENTFIELD HOSPITAL	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-06-16 00:00:00	110008268	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2010-08-02 19:00:00	2010-08-02 19:00:00	Yes	2011-07-08 00:00:00	2011-06-22 00:00:00	FTR AE	FTR AE	1600	900	0	900	0	None	G49311	N	CA00240128	C	SFY2010-11
110000944	KAISER FOUNDATION HOSPITAL - SAN RAFAEL	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-08-27 00:00:00	110008500	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-07-07 00:00:00	2010-07-07 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	RFUY11	N	CA00244476	B	SFY2011-12
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2011-09-07 00:00:00	110008547	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2010-02-01 10:00:00	2010-02-01 10:00:00	No	2011-09-29 00:00:00	None	FTR AE	None	2100	2100	0	2100	0	None	UNE411	N	CA00219927	C	SFY2011-12
110000946	KENTFIELD HOSPITAL	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2012-05-09 00:00:00	110009288	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	FTR/AE Stage III P/U	2011-05-25 00:00:00	2011-05-25 00:00:00	No	2012-05-31 00:00:00	None	FTR AE	None	400	400	0	400	0	None	FB4X11	N	CA00271623	B	SFY2011-12
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2012-08-22 00:00:00	110009396	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2012-01-26 00:00:00	2012-01-26 00:00:00	No	2012-09-13 00:00:00	None	FTR AE	None	5200	5200	0	5200	0	None	GJGN11	N	CA00304045	C	SFY2012-13
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2012-09-08 00:00:00	110009479	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2011-07-25 00:00:00	2011-07-25 00:00:00	No	2012-09-28 00:00:00	None	FTR BR	None	800	800	0	800	0	None	MFZ811	None	CA00289900	D	SFY2012-13
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2015-02-11 00:00:00	110009710	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-10-24 00:00:00	2010-10-24 00:00:00	No	2016-02-19 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	5B0511	N	CA00247797	B	SFY2014-15
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2015-05-13 00:00:00	110010943	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-09-18 00:00:00	2013-09-18 00:00:00	No	2015-06-04 00:00:00	None	FTR BR	None	2600	2600	-650	1950	0	None	564611	None	CA00374178	E	SFY2014-15
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2015-05-13 00:00:00	110010944	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2013-09-18 00:00:00	2013-09-18 00:00:00	No	2015-06-04 00:00:00	None	FTR RES	None	2900	2900	-725	2175	0	None	564611	None	CA00374178	E	SFY2014-15
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-07-03 00:00:00	110012106	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	AE report to the Dept.	2014-09-19 00:00:00	2014-09-19 00:00:00	No	2018-07-25 00:00:00	None	FTR AE	None	900	900	0	900	0	None	X0TC11	N	CA00415616	B	SFY2018-19
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-06-14 00:00:00	110012482	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2014-07-22 00:00:00	2014-07-22 00:00:00	No	2018-07-06 00:00:00	None	FTR RES	None	100	100	0	100	0	None	0ZS511	None	CA00412592	E	SFY2017-18
630012364	KAISER FOUNDATION HOSPITAL - VACAVILLE	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-07-02 00:00:00	110013830	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2013-03-21 00:00:00	2013-03-21 00:00:00	No	2019-04-12 00:00:00	None	AP BR	None	7500	7500	-1875	5625	0	None	WBQV11	None	CA00350262	B	SFY2018-19
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-04-19 00:00:00	110013831	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2014-01-01 00:00:00	2014-01-01 00:00:00	No	2018-05-10 00:00:00	None	FTR BR	None	800	800	0	800	0	None	VZT211	None	CA00390486	C	SFY2017-18
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-03-07 00:00:00	110013884	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	Physical Care	2017-01-25 00:00:00	2017-01-25 00:00:00	No	2018-03-28 00:00:00	None	FTR AE	None	1600	1600	0	1600	0	None	NRZ011	N	CA00522971, CA00522971	B, B	SFY2017-18
110000946	KENTFIELD HOSPITAL	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-03-16 00:00:00	110013916	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2017-10-20 00:00:00	2017-10-20 00:00:00	No	2018-04-06 00:00:00	None	FTR BR	None	3100	3100	0	3100	0	None	MPED11	None	CA00565821	E	SFY2017-18
630012364	KAISER FOUNDATION HOSPITAL - VACAVILLE	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2018-05-24 00:00:00	110014105	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2016-04-14 00:00:00	2016-04-14 00:00:00	No	2018-06-15 00:00:00	None	AP NON-IJ	None	16500	16500	0	16500	0	None	WTQ811	N	CA00491366	B	SFY2017-18
110000011	KAISER FOUNDATION HOSPITAL & REHAB CENTER - VALLEJO	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2019-10-15 00:00:00	110015453	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2016-02-01 00:00:00	2016-02-01 00:00:00	No	2019-11-05 00:00:00	None	AP NON-IJ	None	12600	12600	0	12600	0	None	FZ0U11	N	CA00475470, CA00475470	A, A	SFY2019-20
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2020-03-16 00:00:00	110015763	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2015-10-27 00:00:00	2015-10-27 00:00:00	No	2020-04-06 00:00:00	None	AP NON-IJ	None	4000	4000	0	4000	0	None	BYEJ11	N	CA00463891	B	SFY2019-20
110000508	KAISER FOUNDATION HOSPITAL - SANTA ROSA	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2020-10-14 00:00:00	110015770	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2019-03-04 00:00:00	2019-03-04 00:00:00	No	2020-11-04 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	ZMO811	N	CA00628822, CA00628822, CA00628822, CA00628822	B, B, B, B	SFY2020-21
110000946	KENTFIELD HOSPITAL	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2021-02-03 00:00:00	110016255	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2016-10-14 00:00:00	2016-10-14 00:00:00	No	2021-02-25 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	096K11	N	CA00511191	B	SFY2020-21
630012364	KAISER FOUNDATION HOSPITAL - VACAVILLE	Non-LTC	GACH	General Acute Care Hospital	Santa Rosa	2021-11-16 00:00:00	110017079	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2020-05-21 00:00:00	2020-05-21 00:00:00	No	2021-12-09 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	T83011	Y	CA00691332, CA00691332, CA00691341, CA00691341, CA00691345	A, A, A, A, A	SFY2021-22
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2007-08-20 00:00:00	120004201	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2007-08-14 00:00:00	2007-08-14 00:00:00	No	2007-09-11 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	JBX111	Y	CA00123066	A	SFY2007-08
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2008-09-15 00:00:00	120005403	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-12-12 00:00:00	2007-12-12 00:00:00	No	2008-10-06 00:00:00	None	FTR AE	None	400	400	0	400	0	None	SRV611	N	CA00135523	B	SFY2008-09
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2008-09-15 00:00:00	120005404	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-11-16 00:00:00	2007-11-16 00:00:00	No	2008-10-06 00:00:00	None	FTR AE	None	3000	3000	0	3000	0	None	SRV611	N	CA00135523	B	SFY2008-09
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2008-11-17 00:00:00	120005558	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-07-05 00:00:00	2008-07-05 00:00:00	No	2008-12-10 00:00:00	None	FTR AE	None	700	700	0	700	0	None	Y43811	N	CA00157022	B	SFY2008-09
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2008-11-17 00:00:00	120005562	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-08-27 00:00:00	2008-08-27 00:00:00	No	2008-12-10 00:00:00	None	FTR AE	None	300	300	0	300	0	None	G3VZ11	N	CA00162128	B	SFY2008-09
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2009-02-06 00:00:00	120005845	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-08-21 00:00:00	2008-08-21 00:00:00	No	2009-03-03 00:00:00	None	FTR AE	None	200	200	0	200	0	None	E73511	N	CA00161494	B	SFY2008-09
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2009-04-07 00:00:00	120005917	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE11 - Suicide/attempted suicide	None	2008-12-06 00:00:00	2008-12-06 00:00:00	Yes	2009-09-28 00:00:00	2009-09-18 00:00:00	AP IJ	AP IJ	25000	16250	0	16250	0	None	V7Z011	N	CA00171339	A	SFY2008-09
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2010-02-04 00:00:00	120006809	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2009-07-27 15:50:00	2009-07-27 15:50:00	No	2010-02-25 00:00:00	None	FTR AE	None	400	400	0	400	0	None	4XC011	N	CA00197569	B	SFY2009-10
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2010-09-23 00:00:00	120006892	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2009-09-15 00:00:00	2009-09-15 00:00:00	No	2010-12-15 00:00:00	None	AP BR	None	60000	60000	-15000	45000	0	None	2BWN11	None	CA00200065	B	SFY2010-11
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2010-09-23 00:00:00	120007268	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach of IT system theft/loss of edevice/med rec	None	2009-10-31 00:00:00	2009-10-31 00:00:00	No	2010-10-14 00:00:00	None	AP BR	None	250000	250000	-62500	187500	0	None	WOYN11	None	CA00209743	B	SFY2010-11
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2010-05-28 00:00:00	120007270	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach of IT system theft/loss of edevice/med rec	None	2009-10-31 00:00:00	2009-10-31 00:00:00	No	2010-06-21 00:00:00	None	FTR RES	None	2000	2000	-500	1500	0	None	WOYN11	None	CA00209743	B	SFY2009-10
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2011-07-21 00:00:00	120008400	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE14 - Maternal death/disab due to labor/del/post	None	2010-12-17 00:00:00	2010-12-17 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	E81511	Y	CA00253068	C	SFY2011-12
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2011-07-21 00:00:00	120008406	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE15 - Death/disability directly related to hypoglycemia	None	2011-04-18 00:00:00	2011-04-18 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	81GR11	N	CA00267654	C	SFY2011-12
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2015-06-08 00:00:00	120011533	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2014-04-16 00:00:00	2014-04-16 00:00:00	No	2015-06-29 00:00:00	None	AP NON-IJ	None	5000	5000	0	5000	0	None	9O8411	N	CA00437543	B	SFY2014-15
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2015-09-17 00:00:00	120011727	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2011-12-04 00:00:00	2011-12-04 00:00:00	No	2015-10-08 00:00:00	None	FTR AE	None	2700	2700	0	2700	0	None	SVN211	N	CA00295152	B	SFY2015-16
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2016-01-11 00:00:00	120011848	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2014-12-07 00:00:00	2014-12-07 00:00:00	Yes	2016-02-02 00:00:00	2018-01-18 00:00:00	AP BR	AP BR	7500	5625	0	5625	0	None	NB6U11	None	CA00423333	B	SFY2015-16
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2016-09-27 00:00:00	120012587	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE01 - Surgery performed on a wrong body part	None	2016-06-22 00:00:00	2016-06-22 00:00:00	No	2016-10-20 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	2RIF11	N	CA00493273	B	SFY2016-17
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2017-06-05 00:00:00	120013253	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	Surgical Error - RFO	2017-02-04 00:00:00	2017-02-04 00:00:00	No	2017-06-26 00:00:00	None	AP NON-IJ	None	12375	12375	0	12375	0	None	TQQO11	N	CA00529170	B	SFY2016-17
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2018-07-10 00:00:00	120014229	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE27 - Death/injury from a physical assault	None	2018-02-27 00:00:00	2018-02-27 00:00:00	No	2018-12-28 00:00:00	None	AP IJ	None	51975	51975	0	51975	0	None	3JEQ11	N	CA00576420	A	SFY2018-19
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2018-12-28 00:00:00	120014695	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2018-04-03 00:00:00	2018-04-03 00:00:00	No	2019-04-11 00:00:00	None	AP IJ	None	34650	34650	0	34650	0	None	SE7U11	N	CA00584143	B	SFY2018-19
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2019-07-01 00:00:00	120015210	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2018-10-15 00:00:00	2018-10-15 00:00:00	No	2019-07-22 00:00:00	None	AP NON-IJ	None	15000	15000	0	15000	0	None	D1NZ11	N	CA00609147	A	SFY2019-20
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2019-09-30 00:00:00	120015423	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2019-02-26 00:00:00	2019-02-26 00:00:00	No	2020-10-19 00:00:00	None	AP IJ	None	44400	44400	0	44400	0	None	Q4UT11	N	CA00631677	B	SFY2019-20
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2022-10-13 00:00:00	120018077	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2020-07-01 00:00:00	2020-07-01 00:00:00	No	2022-11-03 00:00:00	None	AP IJ	None	49500	49500	0	49500	0	None	Y37B11	N	CA00774271	B	SFY2022-23
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-05-26 00:00:00	120018798	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2022-09-13 00:00:00	2022-09-13 00:00:00	No	2023-06-19 00:00:00	None	AP IJ	None	44887.5	44887.5	0	44887.5	0	None	QFMO11	N	CA00805322	B	SFY2022-23
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-08-28 00:00:00	120019103	Open	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2023-02-24 00:00:00	2023-02-24 00:00:00	No	2023-09-20 00:00:00	None	AP NON-IJ	None	16500	16500	0	0	16500	None	UV3L11	N	CA00828339	B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-10-06 00:00:00	120019236	Closed	Administrative Penalty	None	A1 - Critical Care	None	2023-06-02 00:00:00	2023-06-02 00:00:00	Yes	2023-10-16 00:00:00	2023-11-27 00:00:00	NP	None	15000	15000	0	15000	0	None	F12L11	N	CA00845493, CA00848660, CA00848768	B, B, B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-10-17 00:00:00	120019259	Closed	Administrative Penalty	None	A1 - Critical Care	None	2023-06-10 00:00:00	2023-06-10 00:00:00	Yes	2023-10-27 00:00:00	2023-11-27 00:00:00	NP	None	30000	30000	0	30000	0	None	W4B211	N	CA00846765, CA00846767, CA00848717, CA00853168	B, B, B, B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-10-31 00:00:00	120019322	Closed	Administrative Penalty	None	A1 - Critical Care	None	2023-06-28 00:00:00	2023-06-28 00:00:00	Yes	2023-11-10 00:00:00	2023-11-27 00:00:00	NP	None	30000	30000	0	30000	0	None	NU4Q11	N	CA00848210, CA00848214	B, B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-11-03 00:00:00	120019340	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2023-07-22 00:00:00	2023-07-22 00:00:00	Yes	2023-11-29 00:00:00	2023-11-27 00:00:00	AP IJ	None	30000	30000	0	30000	0	None	GBN111	N	CA00851870	B	SFY2023-24
120001444	KAWEAH HEALTH MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-11-08 00:00:00	120019343	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2023-04-18 00:00:00	2023-04-18 00:00:00	No	2023-12-04 00:00:00	None	AP NON-IJ	None	14250	14250	0	14250	0	None	4WS711	N	CA00837559	B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-11-17 00:00:00	120019384	Closed	Administrative Penalty	None	A1 - Critical Care	None	2023-04-09 00:00:00	2023-04-09 00:00:00	Yes	2023-11-27 00:00:00	2023-11-27 00:00:00	NP	None	30000	30000	0	30000	0	None	QOFM11	N	CA00835679	B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-11-17 00:00:00	120019386	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2023-01-09 00:00:00	2023-01-09 00:00:00	Yes	2023-12-12 00:00:00	2023-11-27 00:00:00	AP NON-IJ	AP NON-IJ	16500	14850	0	14850	0	None	VHCW11	N	CA00829272	B	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-11-28 00:00:00	120019413	Closed	Administrative Penalty	None	A1 - Critical Care	None	2023-07-13 00:00:00	2023-07-13 00:00:00	Yes	2023-12-08 00:00:00	2023-12-01 00:00:00	NP	None	30000	30000	0	30000	0	None	G84211	N	CA00849532, CA00851652, CA00851652	B, A, A	SFY2023-24
120000342	KERN MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Bakersfield	2023-12-08 00:00:00	120019455	Closed	Administrative Penalty	None	A5 - Combined Labor/Delivery/Postpartum	None	2023-07-01 00:00:00	2023-07-01 00:00:00	Yes	2023-12-18 00:00:00	2023-12-11 00:00:00	NP	None	30000	30000	0	30000	0	None	BIS911	N	CA00849540	B	SFY2023-24
930000089	KINDRED HOSPITAL - LA MIRADA	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-05-04 00:00:00	150012223	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2015-09-04 00:00:00	2015-09-04 00:00:00	No	2016-05-25 00:00:00	None	AP NON-IJ	None	12500	12500	0	12500	0	None	YJHE11	N	CA00457624	B	SFY2015-16
220000010	KAISER FOUNDATION HOSPITAL - REDWOOD CITY	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-03-19 00:00:00	220005008	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE22 - Death associated with a fall	None	2008-01-21 00:00:00	2008-01-21 00:00:00	No	2008-04-10 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	EDOK11	N	CA00140040	A	SFY2007-08
220000010	KAISER FOUNDATION HOSPITAL - REDWOOD CITY	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-07-10 00:00:00	220005223	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-10-04 00:00:00	2007-10-04 00:00:00	No	2008-07-31 00:00:00	None	FTR AE	None	15600	15600	0	15600	0	None	2TOH11	N	None	None	SFY2008-09
220000009	KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-07-14 00:00:00	220005229	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-04-12 00:00:00	2008-04-12 00:00:00	Yes	2008-08-04 00:00:00	2008-07-21 00:00:00	FTR AE	None	3600	3600	0	3600	0	None	C8D311	N	CA00153572	B	SFY2008-09
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-06-09 00:00:00	220007288	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2009-01-01 00:00:00	2009-01-01 00:00:00	No	2011-06-24 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	RTK611	N	CA00173737	B	SFY2009-10
220000009	KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-08-16 00:00:00	220007416	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2009-08-24 00:00:00	2009-08-24 00:00:00	No	2011-12-30 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	XMV011	N	None	None	SFY2010-11
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-21 00:00:00	220007960	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-02-06 00:00:00	2010-02-06 00:00:00	No	2012-06-22 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	K96B11	N	CA00217978	C	SFY2011-12
220000010	KAISER FOUNDATION HOSPITAL - REDWOOD CITY	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2007-08-30 00:00:00	220008033	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2007-08-16 08:00:00	2007-08-16 08:00:00	No	2007-09-21 00:00:00	None	FTR AE	None	700	700	0	700	0	None	SWFX11	N	CA00124772	C	SFY2007-08
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-03-28 00:00:00	220008051	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE15 - Death/disability directly related to hypoglycemia	None	2010-06-12 00:00:00	2010-06-12 00:00:00	No	2012-09-20 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	KLLX11	Y	CA00235034	B	SFY2010-11
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-03-22 00:00:00	220008055	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2010-06-12 08:00:00	2010-06-12 08:00:00	No	2011-04-13 00:00:00	None	FTR AE	None	2200	2200	0	2200	0	None	KLLX11	N	CA00235034	B	SFY2010-11
220000009	KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-06-14 00:00:00	220008309	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-08-30 00:00:00	2010-08-30 00:00:00	No	2012-09-21 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	XO0N11	N	CA00258737	B	SFY2010-11
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-11-04 00:00:00	220011819	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2014-11-17 00:00:00	2014-11-17 00:00:00	No	2015-11-30 00:00:00	None	FTR BR	None	2900	2900	-725	2175	0	None	YUPG11	None	CA00424740	D	SFY2015-16
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-09-07 00:00:00	220012544	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE07 - Use of device other than as intended	None	2015-12-06 00:00:00	2015-12-06 00:00:00	No	2017-05-11 00:00:00	None	AP IJ	None	47025	47025	0	47025	0	None	083D11	N	CA00471877	B	SFY2016-17
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-12-23 00:00:00	220012842	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2016-04-12 00:00:00	2016-04-12 00:00:00	No	2017-05-11 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	J0DX11	Y	CA00484762, CA00493807	C, C	SFY2016-17
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-12-28 00:00:00	220012850	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2016-04-04 00:00:00	2016-04-04 00:00:00	No	2017-01-20 00:00:00	None	AP NON-IJ	None	12750	12750	0	12750	0	None	NY0W11	N	CA00483599	C	SFY2016-17
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2017-05-31 00:00:00	220013238	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2016-07-15 00:00:00	2016-07-15 00:00:00	No	2017-06-21 00:00:00	None	FTR BR	None	1000	1000	0	1000	0	None	E78Y11	None	CA00499261	E	SFY2016-17
220000010	KAISER FOUNDATION HOSPITAL - REDWOOD CITY	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2017-06-01 00:00:00	220013246	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2014-11-01 00:00:00	2014-11-01 00:00:00	No	2017-06-22 00:00:00	None	FTR BR	None	4100	4100	0	4100	0	None	56VR11	None	CA00425544	E	SFY2016-17
220000008	KAISER FOUNDATION HOSPITAL - SAN FRANCISCO	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2017-07-12 00:00:00	220013339	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE07 - Use of device other than as intended	None	2015-12-06 00:00:00	2015-12-06 00:00:00	No	2017-08-02 00:00:00	None	FTR AE	None	11700	11700	0	11700	0	None	SUIM11	N	CA00483304	C	SFY2017-18
220000010	KAISER FOUNDATION HOSPITAL - REDWOOD CITY	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2019-10-31 00:00:00	220015501	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2018-02-06 00:00:00	2018-02-06 00:00:00	No	2019-11-21 00:00:00	None	AP NON-IJ	None	4750	4750	0	4750	0	None	1L0W11	N	CA00647387, CA00647387	C, C	SFY2019-20
220000010	KAISER FOUNDATION HOSPITAL - REDWOOD CITY	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2020-03-03 00:00:00	220015728	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2019-05-03 00:00:00	2019-05-03 00:00:00	No	2020-03-24 00:00:00	None	AP NON-IJ	None	13320	13320	0	13320	0	None	9OCE11	N	CA00637830	B	SFY2019-20
240000040	KINDRED HOSPITAL ONTARIO	Non-LTC	GACH	General Acute Care Hospital	San Bernardino	2009-07-03 00:00:00	240006313	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2008-04-22 00:00:00	2008-04-22 00:00:00	No	2009-07-24 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	9B1T11	N	CA00147759	C	SFY2009-10
240000024	KAISER FOUNDATION HOSPITAL FONTANA	Non-LTC	GACH	General Acute Care Hospital	San Bernardino	2009-12-22 00:00:00	240006804	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE21 - Death/disability due to a burn	None	2008-09-16 00:00:00	2008-09-16 00:00:00	Yes	2010-01-14 00:00:00	2010-04-20 00:00:00	AP IJ	None	25000	25000	0	25000	0	None	59SQ11	N	CA00167812	E	SFY2009-10
240000024	KAISER FOUNDATION HOSPITAL FONTANA	Non-LTC	GACH	General Acute Care Hospital	San Bernardino	2014-09-03 00:00:00	240010978	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE22 - Death associated with a fall	None	2014-05-08 00:00:00	2014-05-08 00:00:00	No	2016-02-19 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	0ZUN11	Y	CA00398884	B	SFY2014-15
240000024	KAISER FOUNDATION HOSPITAL FONTANA	Non-LTC	GACH	General Acute Care Hospital	San Bernardino	2023-11-28 00:00:00	240020137	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2022-08-18 00:00:00	2022-08-18 00:00:00	No	2024-06-19 00:00:00	None	AP BR	None	20000	20000	-5000	15000	0	None	62OG11	None	CA00811990	D	SFY2023-24
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2008-03-17 00:00:00	250004891	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2008-01-11 00:00:00	2008-01-11 00:00:00	No	2008-04-08 00:00:00	None	FTR AE	None	900	900	0	900	0	None	B9XZ11	N	CA00139016	C	SFY2007-08
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2010-07-16 00:00:00	250007399	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2008-12-02 00:00:00	2008-12-02 00:00:00	No	2010-08-09 00:00:00	None	FTR AE	None	1200	1200	0	1200	0	None	41GT11	N	CA00172529	C	SFY2010-11
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2010-07-21 00:00:00	250007415	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2009-06-29 00:00:00	2009-06-29 00:00:00	No	2010-08-11 00:00:00	None	FTR AE	None	200	200	0	200	0	None	K9H811	N	CA00194167	C	SFY2010-11
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2011-06-14 00:00:00	250008305	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2010-09-28 00:00:00	2010-09-28 00:00:00	No	2011-07-06 00:00:00	None	FTR AE	None	100	100	0	100	0	None	3LS811	N	CA00244986	C	SFY2010-11
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2013-05-01 00:00:00	250009869	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2009-07-31 00:00:00	2009-07-31 00:00:00	No	2013-05-22 00:00:00	None	FTR AE	None	600	600	0	600	0	None	G8JE11	N	CA00198214	C	SFY2012-13
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2013-05-01 00:00:00	250009870	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2009-07-31 00:00:00	2009-07-31 00:00:00	No	2013-05-22 00:00:00	None	FTR BR	None	500	500	0	500	0	None	G8JE11	None	CA00198214	C	SFY2012-13
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2013-10-09 00:00:00	250010056	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach to person/entity outside facility/hc system	None	2013-02-11 00:00:00	2013-02-11 00:00:00	No	2013-10-30 00:00:00	None	FTR BR	None	200	200	0	200	0	None	HJCI11	None	CA00344111	C	SFY2013-14
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2013-10-09 00:00:00	250010194	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2013-02-11 00:00:00	2013-02-11 00:00:00	No	2013-10-30 00:00:00	None	FTR RES	None	300	300	0	300	0	None	HJCI11	None	CA00344111	C	SFY2013-14
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2014-05-07 00:00:00	250010712	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2011-04-29 00:00:00	2011-04-29 00:00:00	Yes	2014-08-15 00:00:00	2014-08-01 00:00:00	AP IJ	Drop>Deficiency	50000	15000	0	15000	0	None	MH3U11	N	CA00268068	C	SFY2013-14
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2014-10-24 00:00:00	250011088	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2009-02-04 00:00:00	2009-02-04 00:00:00	No	2014-11-17 00:00:00	None	FTR BR	None	15000	15000	-3750	11250	0	None	4XMO11	None	CA00194629	C	SFY2014-15
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2014-10-24 00:00:00	250011089	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach by h/c worker within facility/hc system	None	2009-02-04 00:00:00	2009-02-04 00:00:00	No	2014-11-17 00:00:00	None	FTR RES	None	14400	14400	-3600	10800	0	None	4XMO11	None	CA00194629	C	SFY2014-15
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-03-03 00:00:00	250011197	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2013-05-29 00:00:00	2013-05-29 00:00:00	No	2015-03-24 00:00:00	None	FTR AE	None	1500	1500	0	1500	0	None	RFDN11	N	CA00359108	C	SFY2014-15
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-03-13 00:00:00	250011198	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2013-05-20 00:00:00	2013-05-20 00:00:00	No	2015-04-06 00:00:00	None	FTR AE	None	2400	2400	0	2400	0	None	RFDN11	N	CA00359108	C	SFY2014-15
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-05-07 00:00:00	250011457	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2014-12-03 00:00:00	2014-12-03 00:00:00	No	2015-05-29 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	29QG11	N	CA00424188	C	SFY2014-15
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-05-13 00:00:00	250011474	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2014-05-29 00:00:00	2014-05-29 00:00:00	No	2015-06-04 00:00:00	None	FTR AE	None	800	800	0	800	0	None	5MWU11	N	CA00401603	C	SFY2014-15
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-05-19 00:00:00	250011487	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-07-08 00:00:00	2011-07-08 00:00:00	Yes	2015-06-10 00:00:00	2015-06-05 00:00:00	FTR AE	FTR AE	85200	60000	0	60000	0	None	1ZI411	N	CA00376547	C	SFY2014-15
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-05-20 00:00:00	250011492	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach by h/c worker within facility/hc system	None	2015-01-08 00:00:00	2015-01-08 00:00:00	No	2015-06-11 00:00:00	None	FTR BR	None	1400	1400	-350	1050	0	None	18VJ11	None	CA00432023	C	SFY2014-15
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-05-20 00:00:00	250011498	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach by h/c worker within facility/hc system	None	2015-01-08 00:00:00	2015-01-08 00:00:00	No	2015-06-11 00:00:00	None	FTR RES	None	1400	1400	-350	1050	0	None	ZM5F11	None	CA00431363	B	SFY2014-15
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-09-29 00:00:00	250011764	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-08-13 00:00:00	2015-08-13 00:00:00	No	2015-10-20 00:00:00	None	FTR AE	None	1600	1600	0	1600	0	None	X0RO11	N	CA00454719	C	SFY2015-16
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2015-09-29 00:00:00	250011765	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2014-09-23 00:00:00	2014-09-23 00:00:00	No	2015-10-20 00:00:00	None	FTR AE	None	10200	10200	0	10200	0	None	RMKE11	N	CA00423152	C	SFY2015-16
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2016-02-24 00:00:00	250012039	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2011-03-17 00:00:00	2011-03-17 00:00:00	No	2018-01-30 00:00:00	None	AP BR	None	20000	20000	0	20000	0	None	E58F11	None	CA00266625	B	SFY2015-16
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2016-02-23 00:00:00	250012040	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-11-19 00:00:00	2015-11-19 00:00:00	No	2016-03-15 00:00:00	None	FTR AE	None	2400	2400	0	2400	0	None	YK0Y11	N	CA00469358	C	SFY2015-16
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2016-02-23 00:00:00	250012041	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-08-26 00:00:00	2015-08-26 00:00:00	No	2016-03-15 00:00:00	None	FTR AE	None	400	400	0	400	0	None	ZC3R11	N	CA00457160	C	SFY2015-16
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2016-06-22 00:00:00	250012325	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2011-09-13 00:00:00	2011-09-13 00:00:00	No	2018-01-30 00:00:00	None	AP BR	None	17500	17500	0	17500	0	None	J6EG11	None	CA00286637	C	SFY2015-16
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2016-06-22 00:00:00	250012349	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2011-06-03 00:00:00	2011-06-03 00:00:00	No	2016-07-14 00:00:00	None	FTR BR	None	2000	2000	-500	1500	0	None	J6EG11	None	CA00286637	C	SFY2015-16
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2017-06-14 00:00:00	250013290	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2016-12-15 00:00:00	2016-12-15 00:00:00	No	2017-07-06 00:00:00	None	FTR AE	None	200	200	0	200	0	None	2LUF11	N	CA00515556	C	SFY2016-17
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2017-11-13 00:00:00	250013616	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2017-05-03 00:00:00	2017-05-03 00:00:00	No	2017-12-06 00:00:00	None	AP NON-IJ	None	11812	11812	0	11812	0	None	G3I511	N	CA00534537	C	SFY2017-18
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2018-03-01 00:00:00	250013868	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2016-08-03 00:00:00	2016-08-03 00:00:00	No	2018-03-22 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	EMIL11	Y	CA00514989	C	SFY2017-18
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2018-03-08 00:00:00	250013893	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2017-10-25 00:00:00	2017-10-25 00:00:00	No	2018-03-29 00:00:00	None	FTR AE	None	800	800	0	800	0	None	GLVH11	N	CA00560034	C	SFY2017-18
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2018-05-10 00:00:00	250014074	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2018-03-04 00:00:00	2018-03-04 00:00:00	No	2018-06-01 00:00:00	None	FTR AE	None	1200	1200	0	1200	0	None	3MMT11	N	CA00579176	C	SFY2017-18
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2018-05-23 00:00:00	250014103	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-10-07 00:00:00	2017-10-07 00:00:00	Yes	2018-06-14 00:00:00	2018-06-11 00:00:00	AP NON-IJ	AP NON-IJ	15750	13388	0	13388	0	None	44ZQ11	N	CA00556071, CA00558482	C, C	SFY2017-18
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2022-01-14 00:00:00	250014222	Closed	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Breach to person/entity outside facility/hc system	None	2017-11-10 00:00:00	2017-11-10 00:00:00	No	2022-02-04 00:00:00	None	FTR RES	None	2900	2900	0	2900	0	None	8E7E11	None	CA00568406	E	SFY2021-22
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2019-03-12 00:00:00	250014872	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2018-08-20 00:00:00	2018-08-20 00:00:00	Yes	2019-04-02 00:00:00	2019-04-03 00:00:00	FTR AE	None	6100	6100	0	6100	0	None	NFZU11	N	CA00605844	B	SFY2018-19
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2019-03-12 00:00:00	250014874	Open	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2018-09-09 00:00:00	2018-09-09 00:00:00	No	2019-04-02 00:00:00	None	FTR AE	None	1400	1400	0	1400	0	None	NFZU11	N	CA00605844	B	SFY2018-19
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2019-03-12 00:00:00	250014875	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2018-09-06 00:00:00	2018-09-06 00:00:00	Yes	2019-04-02 00:00:00	2019-04-03 00:00:00	FTR AE	None	4400	4400	0	4400	0	None	NFZU11	N	CA00605844	B	SFY2018-19
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2019-06-27 00:00:00	250015206	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2019-03-18 00:00:00	2019-03-18 00:00:00	Yes	2019-07-18 00:00:00	2019-07-12 00:00:00	FTR AE	FTR AE	4700	4700	0	4700	0	None	4BV311	N	CA00633410	C	SFY2018-19
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2019-11-25 00:00:00	250015554	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2019-03-13 00:00:00	2019-03-13 00:00:00	No	2020-10-19 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	VZEI11	N	CA00624837	B	SFY2019-20
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-04-28 00:00:00	250016448	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-09-21 00:00:00	2020-09-21 00:00:00	No	2021-05-19 00:00:00	None	FTR AE	None	300	300	0	300	0	None	6WUY11	N	CA00707053	C	SFY2020-21
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-04-29 00:00:00	250016455	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-11-24 00:00:00	2020-11-24 00:00:00	No	2021-05-20 00:00:00	None	FTR AE	None	200	200	0	200	0	None	9OHW11	N	CA00714762	B	SFY2020-21
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-06-25 00:00:00	250016647	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2020-07-22 00:00:00	2020-07-22 00:00:00	No	2021-07-16 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	F8TD11	N	CA00700203	B	SFY2020-21
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-08-02 00:00:00	250016786	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2021-01-08 00:00:00	2021-01-08 00:00:00	No	2021-08-23 00:00:00	None	FTR AE	None	200	200	0	200	0	None	WIIR11	N	CA00721533, CA00721533	B, B	SFY2021-22
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-08-06 00:00:00	250016798	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-12-29 00:00:00	2020-12-29 00:00:00	No	2021-08-27 00:00:00	None	FTR AE	None	1200	1200	0	1200	0	None	UG8H11	N	CA00721536	B	SFY2021-22
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-08-18 00:00:00	250016828	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-12-25 00:00:00	2020-12-25 00:00:00	No	2021-09-09 00:00:00	None	FTR AE	None	2700	2700	0	2700	0	None	OS7P11	N	CA00722998, CA00722998	B, B	SFY2021-22
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-08-18 00:00:00	250016829	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2021-02-13 00:00:00	2021-02-13 00:00:00	No	2021-09-09 00:00:00	None	FTR AE	None	1200	1200	0	1200	0	None	8JQY11	N	CA00727477, CA00727477	C, C	SFY2021-22
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-08-24 00:00:00	250016848	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-12-30 00:00:00	2020-12-30 00:00:00	No	2021-09-15 00:00:00	None	FTR AE	None	1100	1100	0	1100	0	None	PWEO11	N	CA00721562	B	SFY2021-22
630011959	KAISER FOUNDATION HOSPITAL-MORENO VALLEY	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-09-08 00:00:00	250016901	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2021-01-14 00:00:00	2021-01-14 00:00:00	No	2021-09-29 00:00:00	None	FTR AE	None	300	300	0	300	0	None	604U11	N	CA00722505	C	SFY2021-22
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-12-06 00:00:00	250017157	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2021-03-09 00:00:00	2021-03-09 00:00:00	No	2021-12-27 00:00:00	None	FTR AE	None	100	100	0	100	0	None	WYDT11	N	CA00729188, CA00729188	B, B	SFY2021-22
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2022-03-17 00:00:00	250017512	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2021-09-06 00:00:00	2021-09-06 00:00:00	No	2022-04-08 00:00:00	None	FTR AE	None	1700	1700	0	1700	0	None	33Z511	N	CA00754935	B	SFY2021-22
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2022-06-21 00:00:00	250017716	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2022-01-03 00:00:00	2022-01-03 00:00:00	No	2022-07-13 00:00:00	None	FTR AE	None	900	900	0	900	0	None	T1T111	N	CA00769391, CA00769391	B, B	SFY2021-22
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2023-06-29 00:00:00	250018905	Open	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2022-10-01 00:00:00	2022-10-01 00:00:00	No	2023-07-21 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	460X11	N	CA00807775	B	SFY2022-23
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2021-03-19 00:00:00	250019171	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2017-08-09 00:00:00	2017-08-09 00:00:00	Yes	2023-10-18 00:00:00	2023-10-06 00:00:00	AP BR	AP BR	125000	62500	0	62500	0	None	NDUF11	None	CA00550534	E	SFY2020-21
250000004	KINDRED HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2024-02-14 00:00:00	250019740	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2022-06-20 00:00:00	2022-06-20 00:00:00	No	2024-03-07 00:00:00	None	FTR AE	None	14500	14500	0	14500	0	None	N93T11	N	CA00806557, CA00811849, CA00811849	B, B, B	SFY2023-24
250000707	KAISER FOUNDATION HOSPITAL RIVERSIDE	Non-LTC	GACH	General Acute Care Hospital	Riverside	2023-10-03 00:00:00	250020138	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2022-01-19 00:00:00	2022-01-19 00:00:00	No	2023-10-24 00:00:00	None	FTR BR	None	2600	2600	-650	1950	0	None	YNKK11	None	CA00812088	D	SFY2023-24
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2008-02-07 00:00:00	930004675	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-07-10 00:00:00	2007-07-10 00:00:00	No	2008-03-03 00:00:00	None	FTR AE	None	12700	12700	0	12700	0	None	TVFX11	N	None	None	SFY2007-08
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2008-02-07 00:00:00	930004676	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-10-17 00:00:00	2007-10-17 00:00:00	No	2008-03-03 00:00:00	None	FTR AE	None	2800	2800	0	2800	0	None	TVFX11	N	None	None	SFY2007-08
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2008-02-07 00:00:00	930004677	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-08-28 00:00:00	2007-08-28 00:00:00	No	2008-03-03 00:00:00	None	FTR AE	None	7800	7800	0	7800	0	None	TVFX11	N	None	None	SFY2007-08
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2008-02-07 00:00:00	930004678	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-07-11 00:00:00	2007-07-11 00:00:00	No	2008-03-03 00:00:00	None	FTR AE	None	12600	12600	0	12600	0	None	TVFX11	N	None	None	SFY2007-08
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2008-02-07 00:00:00	930004679	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-09-08 00:00:00	2007-09-08 00:00:00	No	2008-03-03 00:00:00	None	FTR AE	None	6700	6700	0	6700	0	None	TVFX11	N	None	None	SFY2007-08
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2008-02-07 00:00:00	930004680	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2007-08-01 00:00:00	2007-08-01 00:00:00	No	2008-03-03 00:00:00	None	FTR AE	None	10500	10500	0	10500	0	None	TVFX11	N	None	None	SFY2007-08
930000074	KAISER FOUNDATION HOSPITAL-DOWNEY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2009-05-14 00:00:00	930006192	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	Breach	2009-02-05 00:00:00	2009-02-05 00:00:00	Yes	2009-06-05 00:00:00	2009-05-22 00:00:00	AP BR	None	250000	250000	-62500	187500	0	None	V1TI11	None	CA00176960	A	SFY2008-09
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2009-06-11 00:00:00	930006283	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE03 - Wrong surgical procedure performed on a patient	None	2007-09-24 00:00:00	2007-09-24 00:00:00	No	2009-07-02 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	EYIJ11	N	CA00143480	C	SFY2008-09
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2009-06-26 00:00:00	930006308	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE02 - Wrong patient surgery	None	2007-09-24 00:00:00	2007-09-24 00:00:00	Yes	2009-07-17 00:00:00	2009-07-10 00:00:00	FTR AE	FTR AE	30300	19695	0	19695	0	None	5N6E11	N	CA00143480	C	SFY2008-09
930000074	KAISER FOUNDATION HOSPITAL-DOWNEY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2009-06-29 00:00:00	930006335	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	Medical Record Breach	2009-01-26 00:00:00	2009-01-26 00:00:00	No	2009-08-05 00:00:00	None	AP BR	None	187500	187500	-46875	140625	0	None	5E7211	None	CA00186764	B	SFY2008-09
930000039	KINDRED HOSPITAL SOUTH BAY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2009-12-04 00:00:00	930006751	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2008-10-25 00:00:00	2008-10-25 00:00:00	Yes	2009-12-28 00:00:00	2009-12-14 00:00:00	FTR AE	FTR AE	25300	5060	0	5060	0	None	QFQ211	N	CA00179984	E	SFY2009-10
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2010-08-17 00:00:00	930007498	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2010-02-05 00:00:00	2010-02-05 00:00:00	No	2010-09-08 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	J71311	N	CA00219553	C	SFY2010-11
930001543	KAISER FOUNDATION HOSPITAL - BALDWIN PARK	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2011-03-28 00:00:00	930008107	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2009-03-09 00:00:00	2009-03-09 00:00:00	No	2012-10-01 00:00:00	None	AP BR	None	25000	25000	-6250	18750	0	None	G6D211	None	CA00235038	C	SFY2010-11
930000072	KAISER FOUNDATION HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2011-10-15 00:00:00	930008619	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE23 - Death/disab assoc with use of restraints/bedrails	None	2010-06-19 00:00:00	2010-06-19 00:00:00	No	2012-09-20 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	RSQI11	Y	CA00233429	B	SFY2011-12
930000074	KAISER FOUNDATION HOSPITAL-DOWNEY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2011-11-10 00:00:00	930008730	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach by h/c worker within facility/hc system	None	2010-04-12 00:00:00	2010-04-12 00:00:00	No	2013-03-08 00:00:00	None	AP BR	None	42500	42500	0	42500	0	None	1LOF11	None	CA00257715	C	SFY2011-12
930000071	KAISER FOUNDATION HOSPITAL - SOUTH BAY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2011-11-08 00:00:00	930008731	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2010-07-16 00:00:00	2010-07-16 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	SSN011	Y	CA00236462	B	SFY2011-12
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2011-12-21 00:00:00	930008841	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-05-19 00:00:00	2010-05-19 00:00:00	No	2012-06-25 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	T13T11	N	CA00230939	C	SFY2011-12
930000290	KAISER FOUNDATION HOSPITAL - WOODLAND HILLS	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2014-04-23 00:00:00	930010642	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2013-05-28 00:00:00	2013-05-28 00:00:00	No	2015-03-05 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	MG8711	N	CA00357973	B	SFY2013-14
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-02-16 00:00:00	930012019	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2013-01-11 00:00:00	2013-01-11 00:00:00	No	2016-03-08 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	DRLY11	N	CA00340877	C	SFY2015-16
930000089	KINDRED HOSPITAL - LA MIRADA	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-08-26 00:00:00	930012279	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-10-05 00:00:00	2015-10-05 00:00:00	No	2016-09-19 00:00:00	None	FTR AE	None	600	600	0	600	0	None	DO2W11	N	CA00462215	B	SFY2016-17
930000089	KINDRED HOSPITAL - LA MIRADA	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-06-16 00:00:00	930012290	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-09-23 00:00:00	2015-09-23 00:00:00	No	2016-07-08 00:00:00	None	FTR AE	None	1700	1700	0	1700	0	None	CGZR11	N	CA00462180	B	SFY2015-16
930000072	KAISER FOUNDATION HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-07-18 00:00:00	930012415	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2012-05-01 00:00:00	2012-05-01 00:00:00	No	2016-08-08 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	2ID011	N	CA00309142	A	SFY2016-17
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-10-06 00:00:00	930012632	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2014-06-24 00:00:00	2014-06-24 00:00:00	Yes	2016-10-27 00:00:00	2016-10-17 00:00:00	FTR AE	FTR AE	71700	45000	0	45000	0	None	G25E11	N	CA00484548	B	SFY2016-17
930000039	KINDRED HOSPITAL SOUTH BAY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-12-07 00:00:00	930012795	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE06 -Use of contaminated drug, device, or biologic	None	2015-03-02 00:00:00	2015-03-02 00:00:00	No	2016-12-29 00:00:00	None	AP IJ	None	71250	71250	0	71250	0	None	YIF311	N	CA00433321	A	SFY2016-17
930000076	KAISER FOUNDATION HOSPITAL-WEST LA	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2017-06-15 00:00:00	930013255	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2015-11-23 00:00:00	2015-11-23 00:00:00	No	2017-07-07 00:00:00	None	FTR AE	None	200	200	0	200	0	None	Q83J11	N	CA00467263	B	SFY2016-17
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-01-04 00:00:00	930013647	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2015-11-25 00:00:00	2015-11-25 00:00:00	No	2018-01-26 00:00:00	None	AP NON-IJ	None	12600	12600	0	12600	0	None	JV9011	N	CA00468143	B	SFY2017-18
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-02-06 00:00:00	930013717	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2016-06-21 00:00:00	2016-06-21 00:00:00	No	2018-02-28 00:00:00	None	FTR AE	None	300	300	0	300	0	None	XZZ511	N	CA00493809	B	SFY2017-18
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-04-05 00:00:00	930013965	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE01 - Surgery performed on a wrong body part	None	2016-11-15 00:00:00	2016-11-15 00:00:00	No	2018-04-26 00:00:00	None	FTR AE	None	300	300	0	300	0	None	LIV211	N	CA00511801	B	SFY2017-18
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-04-10 00:00:00	930013990	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2017-11-02 00:00:00	2017-11-02 00:00:00	No	2018-05-01 00:00:00	None	FTR AE	None	700	700	0	700	0	None	R1QW11	N	CA00561032, CA00561032	B, B	SFY2017-18
930000072	KAISER FOUNDATION HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-05-03 00:00:00	930014048	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2016-01-22 00:00:00	2016-01-22 00:00:00	No	2018-05-24 00:00:00	None	AP NON-IJ	None	14250	14250	0	14250	0	None	RWLY11	N	CA00473930	B	SFY2017-18
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-07-18 00:00:00	930014183	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2016-11-14 00:00:00	2016-11-14 00:00:00	No	2018-08-08 00:00:00	None	FTR AE	None	400	400	0	400	0	None	71Y711	N	CA00511840	B	SFY2018-19
930001543	KAISER FOUNDATION HOSPITAL - BALDWIN PARK	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-07-18 00:00:00	930014185	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-11-20 00:00:00	2017-11-20 00:00:00	No	2018-08-08 00:00:00	None	FTR AE	None	200	200	0	200	0	None	NHD911	N	CA00562386	B	SFY2018-19
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-07-18 00:00:00	930014241	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2017-02-17 00:00:00	2017-02-17 00:00:00	No	2018-08-08 00:00:00	None	FTR AE	None	200	200	0	200	0	None	2N9I11	N	CA00523944	B	SFY2018-19
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-07-18 00:00:00	930014242	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2016-12-06 00:00:00	2016-12-06 00:00:00	No	2018-08-08 00:00:00	None	FTR AE	None	400	400	0	400	0	None	R88311	N	CA00514725	B	SFY2018-19
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-07-20 00:00:00	930014243	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2016-11-18 00:00:00	2016-11-18 00:00:00	No	2018-08-10 00:00:00	None	FTR AE	None	600	600	0	600	0	None	4K3011	N	CA00512249	B	SFY2018-19
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-11-30 00:00:00	930014618	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2016-03-14 00:00:00	2016-03-14 00:00:00	No	2018-12-21 00:00:00	None	AP NON-IJ	None	15675	15675	0	15675	0	None	041511	N	CA00480758	B	SFY2018-19
930000050	KAISER FOUNDATION HOSPITAL - PANORAMA CITY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2019-01-02 00:00:00	930014681	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2016-06-08 00:00:00	2016-06-08 00:00:00	No	2019-01-23 00:00:00	None	FTR AE	None	800	800	0	800	0	None	OSXS11	N	CA00492815	B	SFY2018-19
930001543	KAISER FOUNDATION HOSPITAL - BALDWIN PARK	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2019-04-25 00:00:00	930014989	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE14 - Maternal death/disab due to labor/del/post	None	2017-10-05 00:00:00	2017-10-05 00:00:00	No	2019-05-16 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	Y62711	Y	CA00557097	B	SFY2018-19
930000033	KINDRED HOSPITAL PARAMOUNT	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2019-07-23 00:00:00	930015243	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2017-06-06 00:00:00	2017-06-06 00:00:00	No	2019-08-13 00:00:00	None	FTR AE	None	400	400	0	400	0	None	EN3M11	N	CA00539823	B	SFY2019-20
930000039	KINDRED HOSPITAL SOUTH BAY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2019-08-26 00:00:00	930015348	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2019-05-01 00:00:00	2019-05-01 00:00:00	No	2019-09-17 00:00:00	None	FTR AE	None	3000	3000	0	3000	0	None	UJB311	N	CA00640497	B	SFY2019-20
930000290	KAISER FOUNDATION HOSPITAL - WOODLAND HILLS	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2020-12-04 00:00:00	930016178	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2019-07-16 00:00:00	2019-07-16 00:00:00	No	2020-12-28 00:00:00	None	FTR AE	None	1600	1600	0	1600	0	None	W6TS11	N	CA00649911	B	SFY2020-21
930000912	KECK HOSPITAL OF USC	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-04-07 00:00:00	930016395	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-01-06 00:00:00	2020-01-06 00:00:00	No	2021-04-28 00:00:00	None	FTR AE	None	8800	8800	0	8800	0	None	WDQJ11	N	CA00683946	B	SFY2020-21
930001607	KINDRED HOSPITAL - SANTA ANA	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-04-21 00:00:00	930016427	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-04-22 00:00:00	2020-04-22 00:00:00	No	2021-05-12 00:00:00	None	FTR AE	None	6400	6400	0	6400	0	None	40EP11	N	CA00694980	B	SFY2020-21
930000071	KAISER FOUNDATION HOSPITAL - SOUTH BAY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-05-12 00:00:00	930016490	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2019-10-04 00:00:00	2019-10-04 00:00:00	No	2021-06-03 00:00:00	None	FTR AE	None	700	700	0	700	0	None	M0L211	N	CA00659677	B	SFY2020-21
930000071	KAISER FOUNDATION HOSPITAL - SOUTH BAY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-05-12 00:00:00	930016492	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2019-10-04 00:00:00	2019-10-04 00:00:00	No	2021-06-03 00:00:00	None	AP NON-IJ	None	16650	16650	0	16650	0	None	M0L211	Y	CA00659677	B	SFY2020-21
930001543	KAISER FOUNDATION HOSPITAL - BALDWIN PARK	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-06-30 00:00:00	930016662	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2020-06-28 00:00:00	2020-06-28 00:00:00	No	2021-07-21 00:00:00	None	AP NON-IJ	None	17100	17100	0	17100	0	None	Q9QT11	N	CA00694972	B	SFY2020-21
930000050	KAISER FOUNDATION HOSPITAL - PANORAMA CITY	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-08-27 00:00:00	930016857	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE04 - Retention of a foreign object in a patient	None	2019-03-20 00:00:00	2019-03-20 00:00:00	Yes	2021-09-20 00:00:00	2021-09-10 00:00:00	FTR AE	FTR AE	37400	31790	0	31790	0	None	JYJP11	N	CA00683318	B	SFY2021-22
930000033	KINDRED HOSPITAL PARAMOUNT	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2021-09-14 00:00:00	930016918	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE17 - Stage 3 or 4 ulcer acquired after admission	None	2020-04-28 00:00:00	2020-04-28 00:00:00	No	2021-10-05 00:00:00	None	FTR AE	None	4700	4700	0	4700	0	None	HEJY11	N	CA00693414	B	SFY2021-22
930000088	KINDRED HOSPITAL - LOS ANGELES	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2023-12-20 00:00:00	930019196	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2023-08-03 00:00:00	2023-08-03 00:00:00	No	2024-01-11 00:00:00	None	AP IJ	None	49950	49950	0	49950	0	None	901O11	N	CA00852936, CA00853296, CA00853778	B, B, B	SFY2023-24
930001543	KAISER FOUNDATION HOSPITAL - BALDWIN PARK	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2024-03-12 00:00:00	930020290	Open	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Deliberate breach of PHI by health care worker	None	2022-10-05 00:00:00	2022-10-05 00:00:00	No	2024-04-03 00:00:00	None	FTR BR	None	1600	1600	0	0	1600	None	9U8U11	None	CA00812332	D	SFY2023-24