Table: health_facilities_state_enforcement_actions_1997_2023_data_file , facility_name like U*

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
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2002-07-05 00:00:00	010001962	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2002-03-22 00:00:00	2002-03-22 00:00:00	No	2002-07-08 00:00:00	None	B	None	1000	1000	-350	650	0	010015507	A99999	N	None	None	SFY2002-03
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2003-05-15 00:00:00	010002030	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2003-04-24 00:00:00	2003-04-24 00:00:00	No	2003-06-06 00:00:00	None	B	None	750	750	-262.5	487.5	0	010016573	A99999	N	None	None	SFY2002-03
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2003-08-15 00:00:00	010002048	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2003-01-30 00:00:00	2003-03-18 00:00:00	Yes	2003-09-08 00:00:00	2003-08-22 00:00:00	B	B	750	750	0	750	0	010016586	A99999	N	None	None	SFY2003-04
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2003-11-17 00:00:00	010002070	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2003-08-10 00:00:00	2003-08-10 00:00:00	No	2003-12-10 00:00:00	None	B	None	800	800	-280	520	0	010016973	A99999	N	None	None	SFY2003-04
100001676	UNIVERSITY RETIREMENT COMMUNITY AT DAVIS	LTC	SNF	Skilled Nursing Facility	Sacramento	2009-03-19 00:00:00	030005992	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2008-01-10 00:00:00	2008-01-10 00:00:00	No	2009-04-13 00:00:00	None	B	None	1000	1000	-350	650	0	None	1VTJ11	N	CA00137765	B	SFY2008-09
100000002	UNIVERSITY POST-ACUTE REHAB	LTC	SNF	Skilled Nursing Facility	Sacramento	2012-12-27 00:00:00	030009682	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2012-03-02 00:00:00	2012-03-02 00:00:00	No	2013-01-18 00:00:00	None	B	None	1000	1000	-350	650	0	None	D47L11	N	CA00331664	E	SFY2012-13
100000002	UNIVERSITY POST-ACUTE REHAB	LTC	SNF	Skilled Nursing Facility	Sacramento	2024-01-25 00:00:00	030019626	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-11-17 00:00:00	2023-11-17 00:00:00	No	2024-02-15 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	H0DU11	N	CA00870839	A	SFY2023-24
090000046	UNIVERSITY CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Diego	2006-12-20 00:00:00	090003589	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2006-11-03 00:00:00	2006-11-03 00:00:00	No	2007-01-12 00:00:00	None	B	None	1000	1000	-350	650	0	None	3OI811	N	CA00097803	B	SFY2006-07
090000046	UNIVERSITY CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Diego	2008-02-15 00:00:00	090004698	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2007-11-18 00:00:00	2007-11-18 00:00:00	No	2008-03-10 00:00:00	None	B	None	600	600	-210	390	0	None	QWT511	N	CA00132560	C	SFY2007-08
100000002	UNIVERSITY POST-ACUTE REHAB	LTC	SNF	Skilled Nursing Facility	Sacramento	2000-01-11 00:00:00	100001993	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	1999-10-12 00:00:00	None	No	2000-02-04 00:00:00	None	B	None	1000	3200	0	3200	0	100013790	A99999	N	None	None	SFY1999-00
100000002	UNIVERSITY POST-ACUTE REHAB	LTC	SNF	Skilled Nursing Facility	Sacramento	2000-01-11 00:00:00	100001994	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	1999-11-12 00:00:00	None	Yes	2000-02-03 00:00:00	2000-08-21 00:00:00	A	A	10000	8200	-200	8000	0	100013791	A99999	N	None	None	SFY1999-00
100001676	UNIVERSITY RETIREMENT COMMUNITY AT DAVIS	LTC	SNF	Skilled Nursing Facility	Sacramento	2000-08-15 00:00:00	100002033	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2000-07-15 00:00:00	2000-07-15 00:00:00	Yes	2000-09-08 00:00:00	2000-08-30 00:00:00	A	A	4000	4000	0	4000	0	100014412	A99999	N	None	None	SFY2000-01
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2006-12-08 00:00:00	110003523	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2006-01-07 00:00:00	2006-01-07 00:00:00	No	2007-01-02 00:00:00	None	B	None	900	900	-315	585	0	None	ZV7T11	N	CA00070004	B	SFY2006-07
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2006-12-27 00:00:00	110003524	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2005-02-21 00:00:00	2005-02-21 00:00:00	No	2007-01-18 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	69QS11	N	CA00040592	B	SFY2006-07
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2007-12-12 00:00:00	110004503	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2007-04-27 00:00:00	2007-04-27 00:00:00	No	2008-01-04 00:00:00	None	B	None	800	800	-280	520	0	None	O9S611	N	CA00113569	A	SFY2007-08
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2008-10-29 00:00:00	110005472	Closed	Citation	Citation B (HSC 1424)	Dietary	None	2008-08-28 00:00:00	2008-08-28 00:00:00	No	2008-11-20 00:00:00	None	B	None	900	900	-315	585	0	None	RU0K11	N	CA00160425	B	SFY2008-09
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2009-03-27 00:00:00	110005771	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2008-12-18 00:00:00	2008-12-18 00:00:00	No	2009-04-20 00:00:00	None	B	None	1000	1000	-350	650	0	None	QSMX11	N	CA00173255	B	SFY2008-09
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2010-01-22 00:00:00	110006046	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2008-12-26 00:00:00	2008-12-26 00:00:00	No	2010-02-12 00:00:00	None	B	None	1000	1000	-350	650	0	None	P9DZ11	N	CA00179496, CA00181170	B, B	SFY2009-10
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2011-08-10 00:00:00	110007800	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2010-11-26 00:00:00	2010-11-26 00:00:00	No	2011-08-31 00:00:00	None	B	None	1000	1000	-350	650	0	None	TO3K11	N	CA00250531	A	SFY2011-12
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2011-03-03 00:00:00	110007941	Closed	Citation	Citation B (HSC 1424)	Physical Environment	None	2009-10-13 00:00:00	2009-10-13 00:00:00	No	2011-03-24 00:00:00	None	B	None	1000	1000	-350	650	0	None	EHFQ11	N	CA00204791	A	SFY2010-11
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2014-10-01 00:00:00	110010928	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2014-06-09 00:00:00	2014-06-09 00:00:00	No	2014-10-22 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	VXL911	N	CA00401525	B	SFY2014-15
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2016-09-22 00:00:00	110012051	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2015-07-09 00:00:00	2015-07-09 00:00:00	No	2016-10-13 00:00:00	None	B	None	1000	1000	0	1000	0	None	8SSQ11	N	CA00475759	C	SFY2016-17
010000080	UKIAH POST ACUTE	LTC	SNF	Skilled Nursing Facility	Santa Rosa	2019-12-17 00:00:00	110015496	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2019-01-10 00:00:00	2019-01-10 00:00:00	No	2020-01-07 00:00:00	None	B	None	2000	2000	-700	1300	0	None	KWOZ11	N	CA00623470	C	SFY2019-20
220000049	UNIVERSITY CONVALESCENT HOSPITAL	LTC	SNF	Skilled Nursing Facility	San Francisco	2002-02-26 00:00:00	220001500	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2001-07-20 00:00:00	None	No	2002-05-31 00:00:00	None	A	None	6000	6500	-6500	0	0	220010521	A99999	N	None	None	SFY2001-02
220000049	UNIVERSITY CONVALESCENT HOSPITAL	LTC	SNF	Skilled Nursing Facility	San Francisco	2002-06-07 00:00:00	220001516	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2001-05-23 00:00:00	None	No	2002-07-03 00:00:00	None	A	None	16000	17400	-17400	0	0	220010610	A99999	N	None	None	SFY2001-02
220000049	UNIVERSITY CONVALESCENT HOSPITAL	LTC	SNF	Skilled Nursing Facility	San Francisco	2002-09-30 00:00:00	220001529	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2001-07-19 00:00:00	None	No	2002-10-21 00:00:00	None	B	None	1000	1000	-1000	0	0	220010522	A99999	N	None	None	SFY2002-03
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2004-10-12 00:00:00	240001825	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2003-09-23 00:00:00	2003-09-23 00:00:00	Yes	2004-11-02 00:00:00	2004-10-22 00:00:00	A	None	10000	10000	-10000	0	0	240018908	A99999	N	None	None	SFY2004-05
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2005-03-16 00:00:00	240001851	Closed	Citation	Citation B (HSC 1424)	Staffing	None	2005-01-26 00:00:00	2005-01-26 00:00:00	Yes	2005-04-07 00:00:00	2005-04-04 00:00:00	B	None	1000	1000	-350	650	0	240019998	A99999	N	CA00037205	C	SFY2004-05
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2009-02-23 00:00:00	240005895	Closed	Citation	Citation B (HSC 1424)	Administration	None	2007-07-15 00:00:00	2007-07-15 00:00:00	No	2009-03-16 00:00:00	None	B	None	1000	1000	-350	650	0	None	4FPE11	N	CA00120551	B	SFY2008-09
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2009-03-09 00:00:00	240005942	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-08-03 00:00:00	2007-08-03 00:00:00	No	2009-03-30 00:00:00	None	B	None	1000	1000	-350	650	0	None	81OF11	N	CA00124908	B	SFY2008-09
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2009-04-08 00:00:00	240006061	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-12-26 00:00:00	2007-12-26 00:00:00	No	2009-04-29 00:00:00	None	B	None	1000	1000	-350	650	0	None	9BTV11	N	None	None	SFY2008-09
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2009-04-08 00:00:00	240006062	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2008-01-05 00:00:00	2008-01-05 00:00:00	No	2009-04-29 00:00:00	None	B	None	1000	1000	-350	650	0	None	9KMF11	N	CA00137233	C	SFY2008-09
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2011-02-24 00:00:00	240007671	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2007-08-01 00:00:00	2007-08-01 00:00:00	No	2011-03-17 00:00:00	None	B	None	1000	1000	0	1000	0	None	ZX6E11	N	CA00122380	B	SFY2010-11
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2011-06-27 00:00:00	240008335	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2008-08-02 00:00:00	2008-08-02 00:00:00	No	2011-07-19 00:00:00	None	B	None	1000	1000	0	1000	0	None	8RQE11	N	CA00161739	B	SFY2010-11
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2012-01-04 00:00:00	240008877	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2008-01-23 00:00:00	2008-01-23 00:00:00	No	2012-01-26 00:00:00	None	A	None	20000	20000	-7000	13000	0	None	7TT111	N	CA00154084	B	SFY2011-12
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2012-01-12 00:00:00	240008902	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2011-07-30 00:00:00	2011-07-30 00:00:00	No	2012-02-03 00:00:00	None	B	None	1000	1000	0	1000	0	None	401N11	N	CA00277978	B	SFY2011-12
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2012-01-18 00:00:00	240008919	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2010-05-31 00:00:00	2010-05-31 00:00:00	No	2012-02-08 00:00:00	None	B	None	1000	1000	0	1000	0	None	0KX811	N	CA00231051	D	SFY2011-12
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2012-03-09 00:00:00	240009054	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2007-06-01 00:00:00	2007-06-01 00:00:00	No	2012-03-30 00:00:00	None	B	None	1000	1000	0	1000	0	None	Z31911	N	CA00140104	C	SFY2011-12
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2014-08-04 00:00:00	240010904	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2014-03-25 00:00:00	2014-03-25 00:00:00	Yes	2014-08-25 00:00:00	2014-08-14 00:00:00	B	B	1500	1500	0	1500	0	None	L9TE11	N	CA00392778	B	SFY2014-15
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2015-08-21 00:00:00	240011656	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2014-06-30 00:00:00	2014-06-30 00:00:00	No	2015-09-14 00:00:00	None	B	None	2000	2000	-700	1300	0	None	3R6011	N	CA00407184	B	SFY2015-16
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2016-08-01 00:00:00	240012418	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2015-10-04 00:00:00	2015-10-04 00:00:00	Yes	2016-08-22 00:00:00	2016-08-01 00:00:00	B	B	10000	10000	0	10000	0	None	1SD911	N	None	None	SFY2016-17
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2016-10-05 00:00:00	240012618	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2015-10-13 00:00:00	2015-10-13 00:00:00	No	2016-10-26 00:00:00	None	B	None	2000	2000	0	2000	0	None	1SD911	N	None	None	SFY2016-17
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2017-03-16 00:00:00	240013056	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2016-07-23 00:00:00	2016-07-23 00:00:00	No	2017-04-07 00:00:00	None	B	None	2000	2000	-700	1300	0	None	BNTN11	N	CA00496997	A	SFY2016-17
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2017-12-07 00:00:00	240013671	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-10-08 00:00:00	2017-10-08 00:00:00	No	2017-12-29 00:00:00	None	A	None	10000	10000	-3500	6500	0	None	64U711	N	CA00556559	A	SFY2017-18
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2018-08-01 00:00:00	240014293	Closed	Citation	Citation A (HSC 1424)	Patient Rights	None	2018-05-05 00:00:00	2018-05-05 00:00:00	No	2018-08-22 00:00:00	None	A	None	10000	10000	0	10000	0	None	CRN411	N	CA00585877	B	SFY2018-19
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2018-08-16 00:00:00	240014339	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-12-12 00:00:00	2017-12-12 00:00:00	No	2018-09-07 00:00:00	None	A	None	15000	15000	0	15000	0	None	YR8P11	Y	CA00579710	B	SFY2018-19
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2018-12-28 00:00:00	240014652	Closed	Citation	Citation AA (HSC 1424)	Medication	None	2018-04-01 00:00:00	2018-04-01 00:00:00	No	2019-01-18 00:00:00	None	AA	None	30000	30000	-10500	19500	0	None	G2YP11	Y	CA00583222	A	SFY2018-19
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-04-03 00:00:00	920015837	Closed	Citation	Citation B (HSC 1424)	Medication	None	2019-12-08 00:00:00	2019-12-08 00:00:00	No	2020-04-24 00:00:00	None	B	None	2000	2100	0	2100	0	None	1P9711	N	CA00670836	B	SFY2019-20
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2020-08-31 00:00:00	920016002	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2020-05-30 00:00:00	2020-05-30 00:00:00	Yes	2020-09-22 00:00:00	2020-09-21 00:00:00	A	B	20000	2000	0	2000	0	None	HIS111	Y	CA00691108	B	SFY2020-21
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-01-27 00:00:00	920016251	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2020-11-02 00:00:00	2020-11-02 00:00:00	No	2021-02-18 00:00:00	None	B	None	2000	2000	-700	1300	0	None	WQUV11	N	CA00711234, CA00711306	B, B	SFY2020-21
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-11-17 00:00:00	920017097	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2021-05-03 00:00:00	2021-05-03 00:00:00	No	2021-12-10 00:00:00	None	A	None	20000	60000	0	60000	0	None	6BTI11	N	CA00735351	B	SFY2021-22
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-03-30 00:00:00	920017534	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2022-01-18 00:00:00	2022-01-18 00:00:00	No	2022-04-21 00:00:00	None	B	None	2000	2000	0	2000	0	None	GJII11	N	CA00768209	B	SFY2021-22
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-04-04 00:00:00	920017542	Closed	Citation	Citation B (HSC 1424)	Physical Environment	None	2022-02-22 00:00:00	2022-02-22 00:00:00	No	2022-04-25 00:00:00	None	B	None	3000	3000	0	3000	0	None	CG0T11	N	CA00772309, CA00772309	B, B	SFY2021-22
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-07-28 00:00:00	920017826	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2022-03-05 00:00:00	2022-03-05 00:00:00	No	2022-08-18 00:00:00	None	A	None	25000	25700	-8750	16950	0	None	G3CR11	N	CA00786440, CA00786440, CA00786440, CA00786440, CA00786440, CA00786440	B, B, B, B, B, B	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-11-21 00:00:00	920018163	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2022-10-14 00:00:00	2022-10-14 00:00:00	No	2022-12-14 00:00:00	None	A	None	25000	76500	-26250	50250	0	None	I18H11	N	CA00807580, CA00807580, CA00807580, CA00810538, CA00810538, CA00810538	B, B, B, A, A, A	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-03-09 00:00:00	920018481	Closed	Citation	Citation B (HSC 1424)	Administration	None	2023-01-25 00:00:00	2023-01-25 00:00:00	No	2023-03-30 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	3WEL11	N	CA00822505, CA00822505, CA00822505	A, A, A	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-04-12 00:00:00	920018594	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-02-03 00:00:00	2023-02-03 00:00:00	No	2023-05-03 00:00:00	None	B	None	3000	3150	0	3150	0	None	C5HK11	N	CA00825857, CA00825857, CA00825857, CA00825857, CA00825857	B, B, B, B, B	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-04-12 00:00:00	920018617	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-02-07 00:00:00	2023-02-07 00:00:00	No	2023-05-03 00:00:00	None	B	None	3000	3000	0	3000	0	None	LGNH11	N	CA00825756	B	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-04-12 00:00:00	920018618	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2023-02-07 00:00:00	2023-02-07 00:00:00	No	2023-05-03 00:00:00	None	B	None	3000	3000	0	3000	0	None	LGNH11	N	CA00825756	B	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-08-07 00:00:00	920019035	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-06-19 00:00:00	2023-06-19 00:00:00	No	2023-08-28 00:00:00	None	B	None	3000	3000	-1050	1950	0	None	39QO11	N	CA00846568, CA00846568	B, B	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-09-01 00:00:00	920019118	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-07-18 00:00:00	2023-07-18 00:00:00	Yes	2023-09-25 00:00:00	2023-09-13 00:00:00	A	None	25000	25000	0	0	25000	None	PVH911	N	CA00851256, CA00851256, CA00851256	A, A, A	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-09-19 00:00:00	920019173	Open	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-08-09 00:00:00	2023-08-09 00:00:00	No	2023-10-10 00:00:00	None	B	None	3000	9000	-3150	5850	0	None	D17111	N	CA00856967	B	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-09-19 00:00:00	920019176	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-08-08 00:00:00	2023-08-08 00:00:00	No	2023-10-10 00:00:00	None	B	None	3000	9000	-3150	5850	0	None	D17111	N	CA00856967, CA00856967	B, B	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2023-12-05 00:00:00	920019438	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2023-10-31 00:00:00	2023-10-31 00:00:00	No	2023-12-27 00:00:00	None	B	None	3000	9000	-3150	5850	0	None	MU5P11	N	CA00866191, CA00866191	B, B	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2024-03-07 00:00:00	920019842	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2023-12-08 00:00:00	2023-12-08 00:00:00	No	2024-03-28 00:00:00	None	A	None	25000	75000	0	0	75000	None	DQ3J11	N	None	None	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2024-03-08 00:00:00	920019843	Open	Citation	Citation B (HSC 1424)	Patient Care	None	2024-01-22 00:00:00	2024-01-22 00:00:00	No	2024-03-29 00:00:00	None	B	None	3000	9000	0	0	9000	None	DQ3J11	N	CA00880645	B	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2024-03-08 00:00:00	920019847	Open	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2024-01-24 00:00:00	2024-01-24 00:00:00	No	2024-03-29 00:00:00	None	B	None	3000	3000	0	0	3000	None	DQ3J11	N	None	None	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2024-03-12 00:00:00	920019859	Open	Citation	Citation Willful Material Falsification (HSC 1424(f)(1))	Willful Material Falsification	None	2024-01-25 00:00:00	2024-01-25 00:00:00	No	2024-04-03 00:00:00	None	WF	None	20000	20000	0	0	20000	None	DQ3J11	None	None	None	SFY2023-24
930001154	USC VERDUGO HILLS HOSPITAL D/P SNF	LTC	SNF	Skilled Nursing Facility	LA Region 1	2000-01-26 00:00:00	930000315	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2000-01-03 00:00:00	None	No	2000-02-16 00:00:00	None	A	None	7000	7000	-2450	4550	0	930010611	A99999	N	None	None	SFY1999-00
930001154	USC VERDUGO HILLS HOSPITAL D/P SNF	LTC	SNF	Skilled Nursing Facility	LA Region 1	2018-11-08 00:00:00	930014574	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2018-03-26 00:00:00	2018-03-26 00:00:00	No	2018-12-04 00:00:00	None	B	None	2000	2000	0	2000	0	None	QYPX11	N	CA00579993	B	SFY2018-19
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2012-11-19 00:00:00	940009529	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2011-11-05 00:00:00	2011-11-05 00:00:00	No	2012-12-12 00:00:00	None	A	None	16000	16000	0	16000	0	None	PCS411	N	CA00290257	B	SFY2012-13
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2015-09-30 00:00:00	940011762	Closed	Citation	Citation B (HSC 1424)	Abuse/Facility Not Self Reported	None	2015-02-13 00:00:00	2015-02-13 00:00:00	No	2015-10-21 00:00:00	None	B	None	2000	2000	0	2000	0	None	6Z5X11	N	CA00431523	A	SFY2015-16
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2017-08-24 00:00:00	940013431	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-05-26 00:00:00	2017-05-26 00:00:00	No	2017-09-15 00:00:00	None	A	None	16000	16000	-5600	10400	0	None	4RQ211	N	CA00536873, CA00536873, CA00536873, CA00536873	A, A, A, A	SFY2017-18
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2017-08-24 00:00:00	940013432	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2017-05-26 00:00:00	2017-05-26 00:00:00	No	2017-09-15 00:00:00	None	A	None	16000	16000	-5600	10400	0	None	4RQ211	N	CA00536873	A	SFY2017-18
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2019-02-22 00:00:00	940014834	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2017-12-15 00:00:00	2017-12-15 00:00:00	No	2019-03-15 00:00:00	None	B	None	2000	2000	-700	1300	0	None	9GSR11	N	CA00565294	B	SFY2018-19
960001221	UNITED CARE HOMES, INC. - CAMWOOD	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2000-02-16 00:00:00	960000832	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2000-01-31 00:00:00	None	No	2000-03-09 00:00:00	None	B	None	700	700	-245	455	0	960006873	A99999	N	None	None	SFY1999-00
960001807	UNITED CARE HOMES-VALINDA	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2000-02-17 00:00:00	960000833	Closed	Citation	Citation B (HSC 1424)	Other	CLIENTS' TRUST ACCTS	2000-02-01 00:00:00	None	No	2000-03-10 00:00:00	None	B	None	1000	1250	-350	900	0	960006881	A99999	N	None	None	SFY1999-00
960001221	UNITED CARE HOMES, INC. - CAMWOOD	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2000-06-12 00:00:00	960000854	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2000-04-17 00:00:00	None	No	2000-07-03 00:00:00	None	B	None	1000	1000	-350	650	0	960007134	A99999	N	None	None	SFY1999-00
960000874	UCP SAN PEDRO HOUSE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2002-12-30 00:00:00	960000999	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2002-10-11 00:00:00	None	No	2003-01-28 00:00:00	None	A	None	10000	10000	-3500	6500	0	960008850	A99999	N	None	None	SFY2002-03
960001807	UNITED CARE HOMES-VALINDA	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2003-06-17 00:00:00	960001024	Closed	Citation	Citation B (HSC 1424)	Administration	None	2003-05-27 00:00:00	None	No	2003-07-09 00:00:00	None	B	None	800	800	-280	520	0	960009229	A99999	N	None	None	SFY2002-03
960001221	UNITED CARE HOMES, INC. - CAMWOOD	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2004-02-27 00:00:00	960001059	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2004-02-13 00:00:00	None	No	2004-04-27 00:00:00	None	B	None	1000	1000	-350	650	0	960009609	A99999	N	None	None	SFY2003-04
960000874	UCP SAN PEDRO HOUSE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2004-08-13 00:00:00	960001088	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2004-07-21 00:00:00	None	No	2004-09-28 00:00:00	None	B	None	1000	1000	-350	650	0	960009827	A99999	N	None	None	SFY2004-05
960000874	UCP SAN PEDRO HOUSE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2005-06-16 00:00:00	960001127	Closed	Citation	Citation B (HSC 1424)	Administration	None	2005-04-26 00:00:00	None	Yes	2005-07-27 00:00:00	2005-07-14 00:00:00	B	B	1000	500	0	500	0	960010185	A99999	N	None	None	SFY2004-05
960000894	UCP/SCF ICF/DD-N HATCHER HOUSE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2008-02-22 00:00:00	960004708	Closed	Citation	Citation B (HSC 1424)	Patient Rights	None	2008-02-05 00:00:00	2008-02-05 00:00:00	No	2008-03-14 00:00:00	None	B	None	1000	1000	-350	650	0	None	HMZJ11	N	CA00140111	A	SFY2007-08
960002063	UNITED CARE HOMES - KINBRAE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2009-10-07 00:00:00	960006609	Closed	Citation	Citation A (HSC 1424)	Patient Care	None	2009-07-22 00:00:00	2009-07-22 00:00:00	No	2009-10-29 00:00:00	None	A	None	5000	5000	-1750	3250	0	None	Q1NM11	N	CA00197320	C	SFY2009-10
960002063	UNITED CARE HOMES - KINBRAE	LTC	ICFDDN	Intermediate Care Facility-DD/H/N/CN/IID	LA ICF/DD/Clinics	2012-02-17 00:00:00	960009026	Closed	Citation	Citation B (HSC 1424)	Administration	None	2010-10-27 00:00:00	2010-10-27 00:00:00	No	2012-03-12 00:00:00	None	B	None	1000	1000	-350	650	0	None	C89G11	N	CA00257172	C	SFY2011-12
630014236	UNITED CARE MINFORD	LTC	CLHF	Congregate Living Health Facility	LA HHA/Hospice	2019-06-27 00:00:00	980015199	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2019-03-20 00:00:00	2019-03-20 00:00:00	No	2019-07-18 00:00:00	None	B	None	1000	1700	0	1700	0	None	QLDQ11	N	CA00636809	B	SFY2018-19
630013146	UNITED CARE PELONA	LTC	CLHF	Congregate Living Health Facility	LA HHA/Hospice	2019-08-01 00:00:00	980015263	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2019-02-05 00:00:00	2019-02-05 00:00:00	No	2019-08-22 00:00:00	None	B	None	1000	1150	0	1150	0	None	YXZJ11	N	CA00640059, CA00640059	B, B	SFY2019-20
630014236	UNITED CARE MINFORD	LTC	CLHF	Congregate Living Health Facility	LA HHA/Hospice	2020-03-13 00:00:00	980015802	Closed	Citation	Citation B (HSC 1424)	Patient Care	None	2020-01-16 00:00:00	2020-01-16 00:00:00	No	2020-04-03 00:00:00	None	B	None	1000	1000	0	1000	0	None	Z2FG11	N	CA00671662, CA00671662, CA00671662, CA00671662	A, A, A, A	SFY2019-20
630015635	UNITED CARE CENTER, INC.	LTC	CLHF	Congregate Living Health Facility	LA HHA/Hospice	2022-08-01 00:00:00	980017838	Open	Citation	Citation A (HSC 1424)	Patient Care	None	2022-05-18 00:00:00	2022-05-18 00:00:00	No	2022-08-22 00:00:00	None	A	None	10000	10150	0	1700	8450	None	9I1P11	N	CA00777815, CA00777815	A, A	SFY2022-23
630014236	UNITED CARE MINFORD	LTC	CLHF	Congregate Living Health Facility	LA HHA/Hospice	2023-05-11 00:00:00	980018743	Open	Citation	Citation B (HSC 1424)	Staffing	None	2023-04-27 00:00:00	2023-04-27 00:00:00	No	2023-06-02 00:00:00	None	B	None	1000	1150	0	1000	150	None	ZHNH11	N	None	None	SFY2022-23
630015635	UNITED CARE CENTER, INC.	LTC	CLHF	Congregate Living Health Facility	LA HHA/Hospice	2024-03-07 00:00:00	980019839	Closed	Citation	Citation B (HSC 1424)	Staffing	None	2024-02-22 00:00:00	2024-02-22 00:00:00	No	2024-03-28 00:00:00	None	B	None	1000	1000	0	1000	0	None	D0RH11	N	None	None	SFY2023-24
090000046	UNIVERSITY CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Diego	2023-07-18 00:00:00	100018938	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 12 - 24 Days	None	2020-07-01 00:00:00	2020-09-30 00:00:00	No	2023-08-08 00:00:00	None	AP NHPPD	None	50000	50000	0	50000	0	None	IIET11	None	None	None	SFY2023-24
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2017-01-25 00:00:00	240012885	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2015-11-17 00:00:00	2016-02-16 00:00:00	Yes	2017-02-09 00:00:00	None	AP NHPPD	APPEAL WITHDRAWN BY	15000	15000	0	15000	0	None	HU8L11	None	None	None	SFY2016-17
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2018-10-15 00:00:00	240014470	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2017-03-17 00:00:00	2017-06-16 00:00:00	No	2018-10-30 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	TPQO11	None	None	None	SFY2018-19
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2021-08-20 00:00:00	240016811	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	2021-09-04 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	6JFI11	None	None	None	SFY2021-22
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2019-10-22 00:00:00	810015457	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2018-03-17 00:00:00	2018-06-16 00:00:00	No	2019-11-06 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	C4WY11	None	None	None	SFY2019-20
090000046	UNIVERSITY CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Diego	2021-07-08 00:00:00	810016675	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	2021-07-23 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	6XZK11	None	None	None	SFY2021-22
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2022-07-13 00:00:00	810017762	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2019-07-01 00:00:00	2019-09-30 00:00:00	No	2022-07-28 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	7JUC11	None	None	None	SFY2022-23
240000289	UPLAND REHABILITATION AND CARE CENTER	LTC	SNF	Skilled Nursing Facility	San Bernardino	2022-12-15 00:00:00	810018184	Closed	Administrative Penalty	AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5)	DHPPD: 2 - 11 Days	None	2020-07-01 00:00:00	2020-09-30 00:00:00	No	2022-12-30 00:00:00	None	AP NHPPD	None	25000	25000	0	25000	0	None	7Z1N11	None	None	None	SFY2022-23
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2022-12-13 00:00:00	810018213	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	2023-01-04 00:00:00	None	AP NHPPD	None	50000	50000	0	50000	0	None	Y5NR11	None	None	None	SFY2022-23
240000029	UNIVERSITY POST ACUTE	LTC	SNF	Skilled Nursing Facility	San Bernardino	2024-06-27 00:00:00	810020361	Open	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	2024-07-19 00:00:00	None	AP NHPPD	None	25000	25000	0	0	25000	None	3KJ011	None	None	None	SFY2023-24
970000135	UNIVERSITY PARK HEALTHCARE CENTER	LTC	SNF	Skilled Nursing Facility	LA Region 2	2021-09-09 00:00:00	920016883	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	2021-09-24 00:00:00	None	AP NHPPD	None	15000	15000	0	15000	0	None	SW2911	None	None	None	SFY2021-22
140000014	UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2010-10-18 00:00:00	020007641	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2010-02-24 05:30:00	2010-02-24 05:30:00	No	2010-11-08 00:00:00	None	FTR AE	None	700	700	0	700	0	None	KEWZ11	Y	CA00220693	A	SFY2010-11
140000014	UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2011-01-13 00:00:00	020007844	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach of IT system theft/loss of edevice/med rec	None	2009-01-15 19:05:00	2009-01-15 19:05:00	No	2011-02-04 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	O23011	None	CA00176299	C	SFY2010-11
140000014	UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2011-01-13 00:00:00	020007845	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach of IT system theft/loss of edevice/med rec	None	2009-01-15 19:05:00	2009-01-15 19:05:00	No	2011-02-04 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	O23011	None	CA00176299	C	SFY2010-11
140000014	UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2011-01-13 00:00:00	020007846	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach of IT system theft/loss of edevice/med rec	None	2009-01-15 19:05:00	2009-01-15 19:05:00	No	2011-02-04 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	O23011	None	CA00176299	C	SFY2010-11
140000014	UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND	Non-LTC	GACH	General Acute Care Hospital	East Bay	2014-12-04 00:00:00	020011156	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	2014-03-03 00:00:00	2014-03-03 00:00:00	No	2014-12-26 00:00:00	None	FTR AE	None	8100	8100	0	8100	0	None	P2HJ11	N	CA00400495	C	SFY2014-15
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2008-03-26 00:00:00	030004822	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	2007-08-24 00:00:00	2007-08-24 00:00:00	No	2008-04-18 00:00:00	None	FTR AE	None	200	200	0	200	0	None	3M9L11	N	CA00125205	B	SFY2007-08
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2008-04-11 00:00:00	030004916	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	2007-08-17 00:00:00	2007-08-17 00:00:00	No	2008-05-06 00:00:00	None	FTR AE	None	1500	1500	0	1500	0	None	ZJ9311	N	CA00125584	B	SFY2007-08
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2008-04-11 00:00:00	030004917	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	2007-09-16 00:00:00	2007-09-16 00:00:00	No	2008-05-06 00:00:00	None	FTR AE	None	400	400	0	400	0	None	I0R911	N	CA00127601	B	SFY2007-08
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-11-30 00:00:00	030007739	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	2009-08-28 00:00:00	2009-08-28 00:00:00	No	2010-12-21 00:00:00	None	FTR BR	None	1600	1600	-400	1200	0	None	FD6R11	None	CA00202232	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-12-01 00:00:00	030007741	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	2009-12-21 00:00:00	2009-12-21 00:00:00	No	2010-12-22 00:00:00	None	FTR BR	None	1800	1800	-450	1350	0	None	20WM11	None	CA00214619	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-12-02 00:00:00	030007749	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	2010-07-29 00:00:00	2010-07-29 00:00:00	No	2010-12-23 00:00:00	None	FTR BR	None	2800	2800	0	2800	0	None	TP5U11	None	CA00241526	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-12-02 00:00:00	030007750	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	2010-07-29 00:00:00	2010-07-29 00:00:00	No	2010-12-23 00:00:00	None	FTR RES	None	2800	2800	-700	2100	0	None	TP5U11	None	CA00241526	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2010-12-03 00:00:00	030007753	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	2010-08-09 00:00:00	2010-08-09 00:00:00	No	2010-12-24 00:00:00	None	FTR BR	None	3500	3500	-875	2625	0	None	N7DB11	None	CA00243496	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2011-03-25 00:00:00	030008064	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	2009-05-26 00:00:00	2009-05-26 00:00:00	No	2011-04-18 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	I9HJ11	None	CA00190942	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2011-03-25 00:00:00	030008069	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	2010-09-08 00:00:00	2010-09-08 00:00:00	No	2011-04-18 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	Z40M11	None	CA00243311	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2011-03-25 00:00:00	030008071	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	2010-09-08 00:00:00	2010-09-08 00:00:00	No	2011-04-18 00:00:00	None	FTR RES	None	2100	2100	-525	1575	0	None	Z40M11	None	CA00243311	B	SFY2010-11
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2013-05-16 00:00:00	030009913	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2010-10-15 00:00:00	2010-10-15 00:00:00	No	2013-09-06 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	1K5X11	Y	CA00319646	C	SFY2012-13
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-11-04 00:00:00	030012726	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	2015-01-05 00:00:00	2015-01-05 00:00:00	No	2016-11-30 00:00:00	None	FTR AE	None	400	400	0	400	0	None	MO0711	N	CA00427163	D	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-11-17 00:00:00	030012760	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	2015-07-31 00:00:00	2015-07-31 00:00:00	No	2016-12-12 00:00:00	None	FTR AE	None	600	600	0	600	0	None	1WWI11	N	CA00454043	C	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-11-18 00:00:00	030012765	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	2010-10-19 00:00:00	2010-10-19 00:00:00	No	2016-12-13 00:00:00	None	FTR AE	None	1100	1100	0	1100	0	None	X18611	N	CA00248216	B	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2016-12-05 00:00:00	030012791	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE03 - Wrong surgical procedure performed on a patient	None	2011-07-14 00:00:00	2011-07-14 00:00:00	No	2016-12-27 00:00:00	None	FTR AE	None	1400	1400	0	1400	0	None	524L11	N	CA00277904	C	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-06-08 00:00:00	030013270	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	2015-04-10 00:00:00	2015-04-10 00:00:00	No	2017-06-29 00:00:00	None	FTR AE	None	300	300	0	300	0	None	D1CM11	N	CA00439587	E	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-06-14 00:00:00	030013282	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE03 - Wrong surgical procedure performed on a patient	None	2013-02-19 00:00:00	2013-02-19 00:00:00	No	2017-07-06 00:00:00	None	FTR AE	None	200	200	0	200	0	None	SVCX11	N	CA00345188	D	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-06-15 00:00:00	030013291	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	2013-07-03 00:00:00	2013-07-03 00:00:00	No	2017-07-07 00:00:00	None	FTR AE	None	500	500	0	500	0	None	EJ9B11	N	CA00362420	D	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-06-20 00:00:00	030013301	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	2013-09-05 00:00:00	2013-09-05 00:00:00	No	2017-07-12 00:00:00	None	FTR AE	None	300	300	0	300	0	None	0S6I11	N	CA00369915	D	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-06-21 00:00:00	030013304	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	2014-07-30 00:00:00	2014-07-30 00:00:00	No	2017-07-13 00:00:00	None	FTR AE	None	1000	1000	0	1000	0	None	7ZFK11	N	CA00409458	D	SFY2016-17
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2017-07-17 00:00:00	030013352	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	2015-07-30 00:00:00	2015-07-30 00:00:00	No	2017-08-07 00:00:00	None	FTR AE	None	300	300	0	300	0	None	I16B11	N	CA00453767	D	SFY2017-18
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2018-05-09 00:00:00	030014069	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	2014-10-31 00:00:00	2014-10-31 00:00:00	No	2018-05-30 00:00:00	None	FTR AE	None	200	200	0	200	0	None	K18L11	N	CA00431176	D	SFY2017-18
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2018-06-14 00:00:00	030014156	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	2014-10-16 00:00:00	2014-10-16 00:00:00	No	2018-07-06 00:00:00	None	FTR AE	None	700	700	0	700	0	None	81NX11	N	CA00418878	D	SFY2017-18
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2018-07-03 00:00:00	030014214	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	2014-05-07 00:00:00	2014-05-07 00:00:00	No	2018-07-25 00:00:00	None	FTR AE	None	300	300	0	300	0	None	N4ZK11	N	CA00398747	E	SFY2018-19
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2022-08-05 00:00:00	030017874	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	2021-06-03 00:00:00	2021-06-03 00:00:00	No	2022-08-26 00:00:00	None	FTR AE	None	300	300	0	300	0	None	POCW11	N	CA00740039	C	SFY2022-23
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2022-08-12 00:00:00	030017893	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	2020-10-09 00:00:00	2020-10-09 00:00:00	No	2022-09-02 00:00:00	None	FTR AE	None	20300	20300	0	20300	0	None	FHYZ11	N	CA00736985, CA00737120	B, B	SFY2022-23
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-06-29 00:00:00	030018904	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	2023-04-24 00:00:00	2023-04-24 00:00:00	No	2023-07-21 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	VIPW11	N	CA00840542	E	SFY2022-23
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-06-30 00:00:00	030018907	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	2022-05-24 00:00:00	2022-05-24 00:00:00	No	2023-07-24 00:00:00	None	FTR AE	None	2400	2400	0	2400	0	None	TF4K11	N	CA00790031	B	SFY2022-23
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2024-05-08 00:00:00	030020055	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	2023-09-19 00:00:00	2023-09-19 00:00:00	No	2024-05-30 00:00:00	None	FTR AE	None	3000	3000	0	3000	0	None	0VW211	N	CA00866850	E	SFY2023-24
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2024-04-24 00:00:00	030020056	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	2023-09-19 00:00:00	2023-09-19 00:00:00	No	2024-05-15 00:00:00	None	FTR AE	None	100	100	0	100	0	None	J6QY11	N	CA00862444	E	SFY2023-24
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-12-19 00:00:00	030020212	Open	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2017-06-14 00:00:00	2017-06-14 00:00:00	Yes	2024-06-19 00:00:00	2024-06-07 00:00:00	AP BR	None	239700	239700	0	0	239700	None	BCH511	None	CA00652924	C	SFY2023-24
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2023-12-19 00:00:00	030020213	Open	Failure to Report Penalty	Failure to Report Breach to Resident (HSC 1280.15(b)(2))	Deliberate breach of PHI by health care worker	None	2017-06-14 00:00:00	2017-06-14 00:00:00	Yes	2024-01-11 00:00:00	2024-06-07 00:00:00	FTR RES	None	10300	10300	0	0	10300	None	BCH511	None	CA00652924	C	SFY2023-24
030000113	UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Sacramento	2024-01-09 00:00:00	030020214	Open	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2019-11-28 00:00:00	2019-11-28 00:00:00	Yes	2024-06-19 00:00:00	2024-06-07 00:00:00	AP BR	None	250000	250000	0	0	250000	None	MTW011	None	CA00694894	C	SFY2023-24
060000025	UCI HEALTH-LOS ALAMITOS	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-06-04 00:00:00	060005073	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE22 - Death associated with a fall	None	2008-02-22 00:00:00	2008-02-22 00:00:00	Yes	2008-06-25 00:00:00	2008-08-25 00:00:00	AP IJ	AP IJ	25000	15000	0	15000	0	None	D8L511	Y	CA00142374	A	SFY2007-08
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-06-20 00:00:00	060005138	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2008-04-01 00:00:00	2008-04-01 00:00:00	Yes	2008-07-17 00:00:00	2008-08-27 00:00:00	AP IJ	AP IJ	25000	15000	0	15000	0	None	SKNG11	N	CA00146510	B	SFY2007-08
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-12-19 00:00:00	060005700	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE22 - Death associated with a fall	None	2008-06-11 00:00:00	2008-06-11 00:00:00	No	2009-01-14 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	MC8G11	N	CA00153734	B	SFY2008-09
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-12-29 00:00:00	060005744	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2008-05-01 00:00:00	2008-05-01 00:00:00	Yes	2009-01-21 00:00:00	2009-03-09 00:00:00	AP IJ	AP IJ	25000	18750	0	18750	0	None	8WFQ11	N	CA00150933	A	SFY2008-09
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2008-12-30 00:00:00	060005746	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE26 - Sexual assault on a patient	None	2008-09-07 00:00:00	2008-09-07 00:00:00	No	2009-01-23 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	8RCU11	N	CA00164872	B	SFY2008-09
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2009-11-16 00:00:00	060006716	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2009-05-24 00:00:00	2009-05-24 00:00:00	No	2009-12-10 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	10I711	Y	CA00191426	B	SFY2009-10
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-02-15 00:00:00	060007930	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-06-08 00:00:00	2010-06-08 00:00:00	No	2012-09-20 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	IU0F11	N	CA00232028	B	SFY2010-11
060000062	UCI HEALTH-PLACENTIA LINDA	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-09-28 00:00:00	060008598	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE26 - Sexual assault on a patient	None	2011-03-18 08:00:00	2011-03-18 08:00:00	No	2011-10-19 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	2PIL11	N	CA00265360	B	SFY2011-12
060000062	UCI HEALTH-PLACENTIA LINDA	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-09-28 00:00:00	060008600	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE26 - Sexual assault on a patient	None	2011-03-18 08:00:00	2011-03-18 08:00:00	No	2011-10-19 00:00:00	None	FTR AE	None	1600	1600	0	1600	0	None	2PIL11	N	CA00265360	B	SFY2011-12
060000062	UCI HEALTH-PLACENTIA LINDA	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-09-28 00:00:00	060008604	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE26 - Sexual assault on a patient	None	2011-03-18 00:00:00	2011-03-18 00:00:00	Yes	2013-02-26 00:00:00	2013-02-06 00:00:00	AP IJ	AP IJ	50000	40000	0	40000	0	None	2PIL11	N	CA00265360	B	SFY2011-12
060000025	UCI HEALTH-LOS ALAMITOS	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-10-24 00:00:00	060008648	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	2010-03-01 08:00:00	2010-03-01 08:00:00	No	2011-11-15 00:00:00	None	FTR AE	None	2700	2700	0	2700	0	None	V89P11	N	CA00224443	B	SFY2011-12
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-11-10 00:00:00	060008695	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	2011-06-21 08:00:00	2011-06-21 08:00:00	No	2011-12-06 00:00:00	None	FTR BR	None	100	100	0	100	0	None	H7MV11	None	CA00274699	E	SFY2011-12
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-11-10 00:00:00	060008696	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	2011-06-21 08:00:00	2011-06-21 08:00:00	No	2011-12-06 00:00:00	None	FTR BR	None	100	100	0	100	0	None	H7MV11	None	CA00274699	E	SFY2011-12
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2011-11-08 00:00:00	060008719	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	2010-03-17 08:00:00	2010-03-17 08:00:00	No	2011-12-02 00:00:00	None	FTR BR	None	500	500	0	500	0	None	YX7M11	None	CA00224919	C	SFY2011-12
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-01-04 00:00:00	060008787	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-06-08 08:00:00	2011-06-08 08:00:00	No	2012-01-26 00:00:00	None	FTR AE	None	1800	1800	0	1800	0	None	N4CC11	N	CA00275345	B	SFY2011-12
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2012-03-14 00:00:00	060009125	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2008-07-19 00:00:00	2008-07-19 00:00:00	Yes	2012-09-20 00:00:00	2012-08-31 00:00:00	AP IJ	AP IJ	25000	17500	0	17500	0	None	FC6Q11	N	CA00186021	C	SFY2011-12
060000062	UCI HEALTH-PLACENTIA LINDA	Non-LTC	GACH	General Acute Care Hospital	Orange	2013-07-29 00:00:00	060010029	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	2011-01-19 00:00:00	2011-01-19 00:00:00	No	2013-08-19 00:00:00	None	FTR AE	None	4900	4900	0	4900	0	None	MGPW11	N	CA00264160	B	SFY2013-14
060000025	UCI HEALTH-LOS ALAMITOS	Non-LTC	GACH	General Acute Care Hospital	Orange	2013-08-02 00:00:00	060010050	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	2012-01-30 00:00:00	2012-01-30 00:00:00	No	2013-08-23 00:00:00	None	FTR AE	None	7900	7900	0	7900	0	None	9CBS11	N	CA00318865	B	SFY2013-14
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2013-10-07 00:00:00	060010184	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2011-11-05 00:00:00	2011-11-05 00:00:00	Yes	2014-02-21 00:00:00	2014-02-10 00:00:00	AP IJ	AP IJ	50000	37000	0	37000	0	None	LQXV11	Y	CA00292251	A	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2013-10-16 00:00:00	060010207	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE11 - Suicide/attempted suicide	None	2013-02-09 00:00:00	2013-02-09 00:00:00	No	2014-02-21 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	7WFH11	N	CA00354600	C	SFY2013-14
060000062	UCI HEALTH-PLACENTIA LINDA	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-02-04 00:00:00	060010426	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	2011-08-02 00:00:00	2011-08-02 00:00:00	No	2014-02-26 00:00:00	None	FTR RES	None	1000	1000	-250	750	0	None	BT4911	None	CA00283052	D	SFY2013-14
060000062	UCI HEALTH-PLACENTIA LINDA	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-02-04 00:00:00	060010427	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	2011-08-02 00:00:00	2011-08-02 00:00:00	No	2014-02-26 00:00:00	None	FTR BR	None	1000	1000	-250	750	0	None	BT4911	None	CA00283052	D	SFY2013-14
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-02-28 00:00:00	060010509	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	2012-09-27 00:00:00	2012-09-27 00:00:00	No	2014-03-21 00:00:00	None	FTR RES	None	500	500	-125	375	0	None	9GNW11	None	CA00331265	C	SFY2013-14
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-02-28 00:00:00	060010510	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	2012-09-27 00:00:00	2012-09-27 00:00:00	No	2014-03-21 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	9GNW11	None	CA00331265	C	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-03 00:00:00	060010586	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	2013-04-01 00:00:00	2013-04-01 00:00:00	No	2014-04-24 00:00:00	None	FTR RES	None	1500	1500	0	1500	0	None	WMQG11	None	CA00359972	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-03 00:00:00	060010588	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 00:00:00	2013-04-01 00:00:00	No	2014-04-24 00:00:00	None	FTR BR	None	1900	1900	0	1900	0	None	WMQG11	None	CA00359972	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-03 00:00:00	060010589	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	2013-03-06 00:00:00	2013-03-06 00:00:00	No	2014-04-24 00:00:00	None	FTR RES	None	1700	1700	0	1700	0	None	9T2T11	None	CA00359906	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-03 00:00:00	060010590	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	2013-03-16 00:00:00	2013-03-16 00:00:00	No	2014-04-24 00:00:00	None	FTR BR	None	2100	2100	0	2100	0	None	9T2T11	None	CA00359906	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-17 00:00:00	060010635	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	2013-04-18 00:00:00	2013-04-18 00:00:00	No	2014-05-08 00:00:00	None	FTR RES	None	600	600	0	600	0	None	QOJ911	None	CA00360486	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-04-17 00:00:00	060010636	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	2013-04-18 00:00:00	2013-04-18 00:00:00	No	2014-05-08 00:00:00	None	FTR BR	None	600	600	0	600	0	None	QOJ911	None	CA00360486	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-05-16 00:00:00	060010731	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	2013-03-08 00:00:00	2013-03-08 00:00:00	No	2014-06-09 00:00:00	None	FTR BR	None	600	600	0	600	0	None	6M0J11	None	CA00360731	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-05-16 00:00:00	060010732	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	2013-04-24 00:00:00	2013-04-24 00:00:00	No	2014-06-09 00:00:00	None	FTR RES	None	200	200	0	200	0	None	QPOM11	None	CA00360645	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-05-16 00:00:00	060010733	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	2013-04-24 00:00:00	2013-04-24 00:00:00	No	2014-06-09 00:00:00	None	FTR BR	None	100	100	0	100	0	None	QPOM11	None	CA00360645	E	SFY2013-14
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-07-02 00:00:00	060010841	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	2013-04-05 00:00:00	2013-04-05 00:00:00	No	2014-07-24 00:00:00	None	FTR RES	None	1400	1400	-350	1050	0	None	XJ7D11	None	CA00360015	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-07-02 00:00:00	060010842	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	2013-04-05 00:00:00	2013-04-05 00:00:00	No	2014-07-24 00:00:00	None	FTR BR	None	1800	1800	-450	1350	0	None	XJ7D11	None	CA00360015	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-07-02 00:00:00	060010843	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	2013-04-04 00:00:00	2013-04-04 00:00:00	No	2014-07-24 00:00:00	None	FTR RES	None	1500	1500	-375	1125	0	None	JWKM11	None	CA00360007	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-07-02 00:00:00	060010845	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	2013-04-04 00:00:00	2013-04-04 00:00:00	No	2014-07-24 00:00:00	None	FTR BR	None	1900	1900	-475	1425	0	None	JWKM11	None	CA00360007	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-11-06 00:00:00	060011109	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	2012-06-09 00:00:00	2012-06-09 00:00:00	No	2014-12-02 00:00:00	None	FTR BR	None	1300	1300	0	1300	0	None	444O11	None	CA00372078	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2014-11-06 00:00:00	060011110	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	2013-04-25 00:00:00	2013-04-25 00:00:00	No	2014-12-02 00:00:00	None	FTR BR	None	500	500	0	500	0	None	SPW411	None	CA00360716	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-03-27 00:00:00	060011111	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	2013-04-23 00:00:00	2013-04-23 00:00:00	No	2015-04-20 00:00:00	None	FTR RES	None	300	300	-75	225	0	None	MJD511	None	CA00360642	E	SFY2014-15
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-02-04 00:00:00	060011254	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	2014-03-05 00:00:00	2014-03-05 00:00:00	No	2015-02-26 00:00:00	None	FTR AE	None	300	300	0	300	0	None	Z8GT11	N	CA00392024	B	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-03-27 00:00:00	060011352	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	2013-04-23 00:00:00	2013-04-23 00:00:00	No	2015-04-20 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	MJD511	None	CA00360642	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-03-27 00:00:00	060011353	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	2013-04-11 00:00:00	2013-04-11 00:00:00	No	2015-04-20 00:00:00	None	FTR RES	None	800	800	-200	600	0	None	E1OU11	None	CA00360053	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-03-27 00:00:00	060011354	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	2013-04-11 00:00:00	2013-04-11 00:00:00	No	2015-04-20 00:00:00	None	FTR BR	None	1200	1200	-300	900	0	None	E1OU11	None	CA00360053	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-04-15 00:00:00	060011392	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	2013-04-18 00:00:00	2013-04-18 00:00:00	No	2015-05-06 00:00:00	None	FTR RES	None	500	500	-125	375	0	None	S9O411	None	CA00360491	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-04-15 00:00:00	060011393	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	2013-04-18 00:00:00	2013-04-18 00:00:00	No	2015-05-06 00:00:00	None	FTR BR	None	600	600	-150	450	0	None	S9O411	None	CA00360491	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-04-15 00:00:00	060011394	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	2013-04-20 00:00:00	2013-04-20 00:00:00	No	2015-05-06 00:00:00	None	FTR RES	None	700	700	-175	525	0	None	ABUQ11	None	CA00360529	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-04-15 00:00:00	060011397	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	2013-04-20 00:00:00	2013-04-20 00:00:00	No	2015-05-06 00:00:00	None	FTR BR	None	1100	1100	-275	825	0	None	ABUQ11	None	CA00360529	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-06-15 00:00:00	060011559	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	2013-04-17 00:00:00	2013-04-17 00:00:00	No	2015-07-06 00:00:00	None	FTR RES	None	500	500	-125	375	0	None	2L2111	None	CA00360071	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-06-15 00:00:00	060011560	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	2013-04-17 00:00:00	2013-04-17 00:00:00	No	2015-07-06 00:00:00	None	FTR BR	None	600	600	-150	450	0	None	2L2111	None	CA00360071	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-06-15 00:00:00	060011561	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	2013-04-19 00:00:00	2013-04-19 00:00:00	No	2015-07-06 00:00:00	None	FTR RES	None	700	700	-175	525	0	None	227E11	None	CA00360524	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-06-15 00:00:00	060011562	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	2013-04-19 00:00:00	2013-04-19 00:00:00	No	2015-07-06 00:00:00	None	FTR BR	None	1000	1000	-250	750	0	None	227E11	None	CA00360524	E	SFY2014-15
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-09 00:00:00	060011601	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2014-05-05 00:00:00	2014-05-05 00:00:00	No	2015-07-31 00:00:00	None	AP NON-IJ	None	16500	16500	0	16500	0	None	1ZIO11	N	CA00403058	B	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-09 00:00:00	060011602	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	2014-04-30 00:00:00	2014-04-30 00:00:00	No	2015-07-30 00:00:00	None	FTR AE	None	7900	7900	0	7900	0	None	1ZIO11	N	CA00403058	B	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-28 00:00:00	060011632	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2014-08-29 00:00:00	2014-08-29 00:00:00	No	2015-08-18 00:00:00	None	AP NON-IJ	None	12600	12600	0	12600	0	None	6YQT11	N	CA00411125	B	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-27 00:00:00	060011634	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	2013-04-16 00:00:00	2013-04-16 00:00:00	No	2015-08-17 00:00:00	None	FTR RES	None	600	600	-150	450	0	None	45IS11	None	CA00360068	E	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-28 00:00:00	060011635	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	2013-04-16 00:00:00	2013-04-16 00:00:00	No	2015-08-18 00:00:00	None	FTR BR	None	700	700	-175	525	0	None	45IS11	None	CA00360068	E	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-27 00:00:00	060011636	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	2013-04-17 00:00:00	2013-04-17 00:00:00	No	2015-08-17 00:00:00	None	FTR RES	None	900	900	0	900	0	None	R6WS11	None	CA00360070	E	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-07-27 00:00:00	060011637	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	2013-04-17 00:00:00	2013-04-17 00:00:00	No	2015-08-17 00:00:00	None	FTR BR	None	800	800	0	800	0	None	R6WS11	None	CA00360070	E	SFY2015-16
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-08-31 00:00:00	060011697	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	2014-06-10 00:00:00	2014-06-10 00:00:00	No	2015-09-22 00:00:00	None	FTR AE	None	500	500	0	500	0	None	JRTP11	N	CA00451495	D	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2015-09-24 00:00:00	060011737	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2014-05-20 00:00:00	2014-05-20 00:00:00	No	2015-10-23 00:00:00	None	AP NON-IJ	None	14025	14025	0	14025	0	None	K6FQ11	N	CA00400688	B	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2016-04-06 00:00:00	060012155	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE26 - Sexual assault on a patient	None	2015-08-09 00:00:00	2015-08-09 00:00:00	No	2016-04-27 00:00:00	None	FTR AE	None	2900	2900	0	2900	0	None	PJ6J11	N	CA00457245	B	SFY2015-16
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2016-12-22 00:00:00	060012833	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach of IT system theft/loss of edevice/med rec	None	2016-04-19 00:00:00	2016-04-19 00:00:00	No	2017-01-17 00:00:00	None	FTR BR	None	300	300	0	300	0	None	CPFY11	None	CA00488802	B	SFY2016-17
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2016-12-22 00:00:00	060012835	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	2016-04-19 00:00:00	2016-04-19 00:00:00	No	2017-01-17 00:00:00	None	FTR RES	None	300	300	0	300	0	None	CPFY11	None	CA00488802	B	SFY2016-17
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2017-02-10 00:00:00	060012957	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2015-11-16 00:00:00	2015-11-16 00:00:00	No	2017-03-06 00:00:00	None	AP NON-IJ	None	13387	13387	0	13387	0	None	23M211	N	CA00466915	B	SFY2016-17
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-10-03 00:00:00	060014443	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE12 - Medication error	None	2017-11-14 00:00:00	2017-11-14 00:00:00	No	2018-10-24 00:00:00	None	FTR AE	None	2300	2300	0	2300	0	None	WQ3611	N	CA00562668	B	SFY2018-19
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-10-03 00:00:00	060014445	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2017-11-14 00:00:00	2017-11-14 00:00:00	No	2019-03-01 00:00:00	None	AP IJ	None	47025	47025	0	47025	0	None	WQ3611	N	CA00562668	B	SFY2018-19
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2018-11-27 00:00:00	060014581	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE01 - Surgery performed on a wrong body part	None	2018-05-16 00:00:00	2018-05-16 00:00:00	No	2018-12-18 00:00:00	None	AP NON-IJ	None	12375	12375	0	12375	0	None	TOXQ11	N	CA00588316	B	SFY2018-19
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2019-01-14 00:00:00	060014705	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2018-06-11 00:00:00	2018-06-11 00:00:00	No	2019-02-06 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	J5CY11	N	CA00593506	B	SFY2018-19
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-01-02 00:00:00	060015641	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2019-04-15 00:00:00	2019-04-15 00:00:00	No	2020-01-23 00:00:00	None	AP NON-IJ	None	13387.5	13387.5	0	13387.5	0	None	F8MF11	N	CA00634807, CA00634807	B, B	SFY2019-20
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2020-08-26 00:00:00	060015994	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2020-07-24 00:00:00	2020-07-24 00:00:00	No	2020-09-17 00:00:00	None	AP IJ	None	33000	33000	0	33000	0	None	G1WZ11	Y	CA00648466, CA00648466	B, B	SFY2020-21
060000025	UCI HEALTH-LOS ALAMITOS	Non-LTC	GACH	General Acute Care Hospital	Orange	2021-08-12 00:00:00	060016815	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	2021-01-21 00:00:00	2021-01-21 00:00:00	No	2021-09-02 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	5FZQ11	N	CA00724905	D	SFY2021-22
060000025	UCI HEALTH-LOS ALAMITOS	Non-LTC	GACH	General Acute Care Hospital	Orange	2021-08-12 00:00:00	060016816	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	2021-01-28 00:00:00	2021-01-28 00:00:00	No	2021-09-02 00:00:00	None	FTR AE	None	700	700	0	700	0	None	Y67Q11	N	CA00724913	D	SFY2021-22
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2021-09-01 00:00:00	060016874	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	2021-07-01 00:00:00	2021-07-01 00:00:00	No	2021-09-23 00:00:00	None	FTR AE	None	800	800	0	800	0	None	UJBW11	N	CA00744141	D	SFY2021-22
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2021-12-07 00:00:00	060017147	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2021-01-20 00:00:00	2021-01-20 00:00:00	No	2021-12-31 00:00:00	None	AP NON-IJ	None	13200	13200	0	13200	0	None	3CWV11	N	CA00725268	B	SFY2021-22
060000071	UNIVERSITY OF CALIFORNIA IRVINE MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	Orange	2022-01-04 00:00:00	060017247	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	2021-10-18 00:00:00	2021-10-18 00:00:00	No	2022-01-26 00:00:00	None	FTR AE	None	2400	2400	0	2400	0	None	S74B11	N	CA00761400	D	SFY2021-22
060000011	UCI HEALTH-FOUNTAIN VALLEY	Non-LTC	GACH	General Acute Care Hospital	Orange	2023-05-16 00:00:00	060018753	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	2023-03-14 00:00:00	2023-03-14 00:00:00	No	2023-06-07 00:00:00	None	FTR AE	None	500	500	0	500	0	None	F44H11	N	CA00833249	D	SFY2022-23
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2008-05-02 00:00:00	090004732	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2007-09-18 00:00:00	2007-09-18 00:00:00	No	2008-05-29 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	01Q711	N	CA00121965	B	SFY2007-08
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2008-12-10 00:00:00	090005663	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2008-06-19 00:00:00	2008-06-19 00:00:00	No	2009-01-02 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	0ELU11	N	CA00163972	B	SFY2008-09
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2009-04-10 00:00:00	090006086	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2009-01-21 00:00:00	2009-01-21 00:00:00	No	2009-05-01 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	P9GG11	N	CA00175878	B	SFY2008-09
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2009-05-28 00:00:00	090006226	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	2009-04-16 10:00:00	2009-04-16 10:00:00	No	2009-06-18 00:00:00	None	FTR AE	None	700	700	0	700	0	None	7I6C11	N	CA00186256	B	SFY2008-09
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2009-07-17 00:00:00	090006398	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	2009-05-08 00:00:00	2009-05-08 00:00:00	No	2009-08-07 00:00:00	None	FTR AE	None	700	700	0	700	0	None	HJPC11	N	CA00189042	C	SFY2009-10
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2011-12-13 00:00:00	090008816	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE28 - Adverse event or series of adverse events	None	2010-03-24 00:00:00	2010-03-24 00:00:00	No	2012-06-22 00:00:00	None	AP IJ	None	75000	75000	0	75000	0	None	BI7X11	N	CA00258021	A	SFY2011-12
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2011-12-13 00:00:00	090008817	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE11 - Suicide/attempted suicide	None	2011-02-02 00:00:00	2011-02-02 00:00:00	No	2012-11-02 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	BI7X11	Y	CA00254543	C	SFY2011-12
090000013	UC SAN DIEGO HEALTH - EAST CAMPUS MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2013-09-13 00:00:00	090009942	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE22 - Death associated with a fall	None	2012-02-05 00:00:00	2012-02-05 00:00:00	No	2013-11-14 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	C7SP11	Y	CA00298850	B	SFY2013-14
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2014-03-28 00:00:00	090010580	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE10 - Death/disability due to disappearance	None	2013-05-27 00:00:00	2013-05-27 00:00:00	No	2015-03-06 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	MLMR11	Y	CA00357013	B	SFY2013-14
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2016-06-23 00:00:00	090012315	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2015-12-13 00:00:00	2015-12-13 00:00:00	No	2016-07-15 00:00:00	None	AP NON-IJ	None	5550	5550	0	5550	0	None	FFUM11	N	CA00468924	A	SFY2015-16
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2017-02-07 00:00:00	090012951	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2015-09-08 00:00:00	2015-09-08 00:00:00	No	2017-03-01 00:00:00	None	AP IJ	None	44000	44000	0	44000	0	None	V2I611	N	CA00457925	B	SFY2016-17
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2022-01-28 00:00:00	100017266	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2016-07-28 00:00:00	2016-07-28 00:00:00	No	2022-02-22 00:00:00	None	AP BR	None	15000	15000	-3750	11250	0	None	V1FU11	None	CA00501210	D	SFY2021-22
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2021-02-05 00:00:00	100018567	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2018-02-18 00:00:00	2018-02-18 00:00:00	No	2023-05-03 00:00:00	None	AP BR	None	15000	15000	-3750	11250	0	None	6V7211	None	CA00578333	D	SFY2020-21
090000154	UC SAN DIEGO HEALTH HILLCREST - HILLCREST MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Diego	2023-12-27 00:00:00	100020135	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2022-11-24 00:00:00	2022-11-24 00:00:00	No	2024-06-19 00:00:00	None	AP BR	None	15000	15000	0	15000	0	None	DDKM11	None	CA00817497	D	SFY2023-24
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2007-11-09 00:00:00	220004453	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	Other Immediate Jeopardy (not an AE)	None	2007-09-21 00:00:00	2007-09-21 00:00:00	No	2007-12-05 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	HJ6K11	N	CA00109900, CA00118497	H, A	SFY2007-08
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-10-28 00:00:00	220005555	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	2008-08-19 08:00:00	2008-08-19 08:00:00	No	2008-11-19 00:00:00	None	FTR AE	None	300	300	0	300	0	None	099311	N	CA00161635	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-11-14 00:00:00	220005606	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	2008-08-04 08:00:00	2008-08-04 08:00:00	Yes	2008-12-09 00:00:00	2008-11-24 00:00:00	FTR AE	Drop>Deficiency	300	0	0	0	0	None	60JR11	N	CA00159999	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-11-14 00:00:00	220005607	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	2008-07-31 08:00:00	2008-07-31 08:00:00	No	2008-12-09 00:00:00	None	FTR AE	None	200	200	0	200	0	None	60JR11	N	CA00159552	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-11-14 00:00:00	220005611	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	2008-07-17 08:00:00	2008-07-17 08:00:00	Yes	2008-12-09 00:00:00	2008-11-24 00:00:00	FTR AE	FTR AE	1400	500	0	500	0	None	60JR11	N	CA00159407	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2008-12-31 00:00:00	220005753	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2008-03-31 00:00:00	2008-03-31 00:00:00	No	2009-01-23 00:00:00	None	AP IJ	None	25000	25000	0	25000	0	None	LTWW11	N	CA00145949	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2009-01-15 00:00:00	220005799	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	2008-11-17 08:00:00	2008-11-17 08:00:00	No	2009-02-06 00:00:00	None	FTR AE	None	900	900	0	900	0	None	ITNL11	N	CA00170855	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2009-01-15 00:00:00	220005800	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	2008-04-30 08:00:00	2008-04-30 08:00:00	No	2009-02-06 00:00:00	None	FTR AE	None	21800	21800	0	21800	0	None	ITNL11	N	CA00171685	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2009-01-21 00:00:00	220005814	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	2008-11-04 08:00:00	2008-11-04 08:00:00	No	2009-02-11 00:00:00	None	FTR AE	None	1200	1200	0	1200	0	None	VS0J11	N	CA00170110	B	SFY2008-09
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2009-12-16 00:00:00	220006799	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	2009-10-27 08:00:00	2009-10-27 08:00:00	No	2010-01-08 00:00:00	None	FTR BR	None	100	100	0	100	0	None	D6DY11	None	CA00206935	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-01-13 00:00:00	220006913	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	2009-11-12 08:00:00	2009-11-12 08:00:00	No	2010-02-05 00:00:00	None	FTR BR	None	3000	3000	-750	2250	0	None	61LX11	None	CA00211967	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-01-14 00:00:00	220006918	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	2009-10-08 08:00:00	2009-10-08 08:00:00	No	2010-02-08 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	B5K211	None	CA00205218	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-04-19 00:00:00	220007140	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	2010-01-04 08:00:00	2010-01-04 08:00:00	No	2010-05-10 00:00:00	None	FTR BR	None	400	400	-100	300	0	None	TSBN11	None	CA00215069	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-04-20 00:00:00	220007143	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE15 - Death/disability directly related to hypoglycemia	None	2009-05-18 08:00:00	2009-05-18 08:00:00	No	2010-05-13 00:00:00	None	FTR AE	None	2500	2500	0	2500	0	None	U8RI11	N	CA00192277	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-04-27 00:00:00	220007163	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	2008-05-21 08:00:00	2008-05-21 08:00:00	No	2010-05-18 00:00:00	None	FTR AE	None	7300	7300	0	7300	0	None	SSKO11	N	CA00160164	B	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-04-29 00:00:00	220007165	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2008-05-19 00:00:00	2008-05-19 00:00:00	Yes	2010-05-20 00:00:00	2010-11-22 00:00:00	AP IJ	AP IJ	25000	25000	0	25000	0	None	SSKO11	N	CA00160164	B	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-05-12 00:00:00	220007198	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2008-10-08 00:00:00	2008-10-08 00:00:00	Yes	2010-06-01 00:00:00	2010-11-22 00:00:00	AP IJ	AP IJ	25000	25000	0	25000	0	None	YRHG11	N	CA00166278	B	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-05-13 00:00:00	220007219	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	2009-08-24 08:00:00	2009-08-24 08:00:00	No	2010-06-07 00:00:00	None	FTR BR	None	3000	3000	-750	2250	0	None	70C911	None	CA00203283	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-05-13 00:00:00	220007220	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	2009-10-05 08:00:00	2009-10-05 08:00:00	No	2010-06-07 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	70C911	None	CA00204735	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-05-13 00:00:00	220007221	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	2009-11-19 08:00:00	2009-11-19 08:00:00	No	2010-06-07 00:00:00	None	FTR BR	None	1300	1300	-325	975	0	None	VV6K11	None	CA00210637	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-05-28 00:00:00	220007269	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	2009-03-15 08:00:00	2009-03-15 08:00:00	No	2010-06-21 00:00:00	None	FTR AE	None	1400	1400	0	1400	0	None	L6OC11	N	CA00183546	B	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-06-01 00:00:00	220007276	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	2009-12-11 08:00:00	2009-12-11 08:00:00	Yes	2010-06-22 00:00:00	2010-06-11 00:00:00	FTR BR	FTR BR	4900	4900	0	4900	0	None	O5WT11	None	CA00220643	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-06-09 00:00:00	220007306	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	2010-02-02 08:00:00	2010-02-02 08:00:00	No	2010-07-01 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	FDZS11	None	CA00218400	C	SFY2009-10
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-07-01 00:00:00	220007352	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	2010-05-15 08:00:00	2010-05-15 08:00:00	No	2010-07-22 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	FFEK11	None	CA00230550	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-07-15 00:00:00	220007386	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	2010-05-31 08:00:00	2010-05-31 08:00:00	No	2010-08-05 00:00:00	None	FTR AE	None	500	500	0	500	0	None	554U11	N	CA00231964	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-07-14 00:00:00	220007387	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	2010-05-25 08:00:00	2010-05-25 08:00:00	No	2010-08-05 00:00:00	None	FTR BR	None	800	800	-200	600	0	None	554U11	None	CA00231970	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-06-27 00:00:00	220007398	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2009-12-11 00:00:00	2009-12-11 00:00:00	Yes	2012-10-01 00:00:00	2012-09-13 00:00:00	AP BR	AP IJ	245100	95100	0	95100	0	None	O5WT11	None	CA00220643	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-08-04 00:00:00	220007467	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-02-19 00:00:00	2010-02-19 00:00:00	Yes	2011-10-03 00:00:00	2011-09-14 00:00:00	AP IJ	AP IJ	50000	37500	0	37500	0	None	UN0V11	N	CA00218897	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-09-03 00:00:00	220007519	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	2010-05-19 08:00:00	2010-05-19 08:00:00	No	2010-09-28 00:00:00	None	FTR BR	None	100	100	-25	75	0	None	Y6UY11	None	CA00230531	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-10-20 00:00:00	220007653	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	2010-07-09 08:00:00	2010-07-09 08:00:00	No	2010-11-10 00:00:00	None	FTR BR	None	3200	3200	0	3200	0	None	M3OY11	None	CA00239647	B	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-10-20 00:00:00	220007654	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	2010-08-18 08:00:00	2010-08-18 08:00:00	No	2010-11-10 00:00:00	None	FTR BR	None	100	100	-25	75	0	None	M3OY11	None	CA00240849	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-10-28 00:00:00	220007683	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	2010-04-08 08:00:00	2010-04-08 08:00:00	No	2010-11-19 00:00:00	None	FTR AE	None	600	600	0	600	0	None	66FR11	N	CA00225884	B	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-11-03 00:00:00	220007703	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	2010-01-20 08:00:00	2010-01-20 08:00:00	No	2010-11-29 00:00:00	None	FTR BR	None	800	800	0	800	0	None	OMQ211	None	CA00217356	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2010-11-04 00:00:00	220007705	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	2010-01-20 08:00:00	2010-01-20 08:00:00	No	2010-11-30 00:00:00	None	FTR BR	None	900	900	0	900	0	None	OMQ211	None	CA00217356	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-02-04 00:00:00	220007903	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	2010-08-25 08:00:00	2010-08-25 08:00:00	No	2011-02-28 00:00:00	None	FTR BR	None	600	600	0	600	0	None	TOUM11	None	CA00244189	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-02-01 00:00:00	220007908	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2010-09-08 08:00:00	2010-09-08 08:00:00	No	2011-02-23 00:00:00	None	FTR AE	None	1600	1600	0	1600	0	None	VGPM11	N	CA00244514	B	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-08-11 00:00:00	220007923	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	2010-11-05 17:54:00	2010-11-05 17:54:00	No	2011-09-01 00:00:00	None	FTR BR	None	5300	5300	-1325	3975	0	None	MENF11	None	CA00254967	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-02-18 00:00:00	220007956	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2010-12-24 08:00:00	2010-12-24 08:00:00	No	2011-03-14 00:00:00	None	FTR AE	None	600	600	0	600	0	None	3KVS11	N	CA00254437	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-02-18 00:00:00	220007957	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2010-12-27 08:00:00	2010-12-27 08:00:00	No	2011-03-14 00:00:00	None	FTR AE	None	400	400	0	400	0	None	3KVS11	N	CA00254439	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2007-08-22 00:00:00	220008043	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2007-08-08 08:00:00	2007-08-08 08:00:00	No	2007-09-13 00:00:00	None	FTR AE	None	400	400	0	400	0	None	IXG211	N	CA00123755	B	SFY2007-08
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-05-17 00:00:00	220008249	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-03-15 08:00:00	2011-03-15 08:00:00	No	2011-06-08 00:00:00	None	FTR AE	None	100	100	0	100	0	None	R3LT11	N	CA00263199	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-05-17 00:00:00	220008252	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	2011-03-07 08:00:00	2011-03-07 08:00:00	No	2011-06-08 00:00:00	None	FTR BR	None	700	700	-175	525	0	None	R3LT11	None	CA00263204	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-05-17 00:00:00	220008253	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-03-21 09:45:00	2011-03-21 09:45:00	No	2011-06-08 00:00:00	None	FTR AE	None	400	400	0	400	0	None	R3LT11	N	CA00264320	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-06-29 00:00:00	220008345	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-03-10 08:00:00	2011-03-10 08:00:00	No	2011-07-21 00:00:00	None	FTR AE	None	600	600	0	600	0	None	CW9Y11	N	CA00263189	C	SFY2010-11
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-01 00:00:00	220008358	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2011-03-10 00:00:00	2011-03-10 00:00:00	Yes	2013-02-26 00:00:00	2013-02-07 00:00:00	AP IJ	AP IJ	100000	45500	0	45500	0	None	CW9Y11	N	CA00263189	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-08-01 00:00:00	220008397	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	2010-02-23 08:00:00	2010-02-23 08:00:00	No	2011-08-22 00:00:00	None	FTR BR	None	1400	1400	0	1400	0	None	NWDS11	None	CA00221858	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-20 00:00:00	220008399	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	2010-10-25 08:00:00	2010-10-25 08:00:00	No	2011-08-10 00:00:00	None	FTR BR	None	400	400	-100	300	0	None	N8OP11	None	CA00248523	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-21 00:00:00	220008407	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	2010-11-04 08:00:00	2010-11-04 08:00:00	No	2011-08-11 00:00:00	None	FTR BR	None	500	500	0	500	0	None	8CDC11	None	CA00249685	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-27 00:00:00	220008418	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	2011-01-31 08:00:00	2011-01-31 08:00:00	No	2011-08-17 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	DWJ111	None	CA00258604	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-26 00:00:00	220008419	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	2011-01-26 08:00:00	2011-01-26 08:00:00	No	2011-08-16 00:00:00	None	FTR BR	None	700	700	-175	525	0	None	DWJ111	None	CA00258608	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-27 00:00:00	220008421	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-02-02 08:00:00	2011-02-02 08:00:00	No	2011-08-17 00:00:00	None	FTR AE	None	200	200	0	200	0	None	DWJ111	N	CA00258611	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-27 00:00:00	220008422	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	2011-01-28 08:00:00	2011-01-28 08:00:00	No	2011-08-17 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	DWJ111	None	CA00258612	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-26 00:00:00	220008423	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	2011-01-26 08:00:00	2011-01-26 08:00:00	No	2011-08-16 00:00:00	None	FTR BR	None	700	700	-175	525	0	None	DWJ111	None	CA00258615	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-07-27 00:00:00	220008425	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-02-04 08:00:00	2011-02-04 08:00:00	No	2011-08-17 00:00:00	None	FTR AE	None	700	700	0	700	0	None	DWJ111	N	CA00259415	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2011-12-20 00:00:00	220008837	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2010-02-23 00:00:00	2010-02-23 00:00:00	No	2013-03-11 00:00:00	None	AP BR	None	25000	25000	-6250	18750	0	None	NWDS11	None	CA00221858	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-01-12 00:00:00	220008908	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2011-06-09 00:00:00	2011-06-09 00:00:00	No	2013-02-26 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	V65C11	N	CA00273112	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-03-06 00:00:00	220009080	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	2011-06-06 08:00:00	2011-06-06 08:00:00	No	2012-03-27 00:00:00	None	FTR BR	None	5400	5400	-1500	3900	0	None	E30B11	None	CA00278358	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-03-06 00:00:00	220009094	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	2011-11-05 08:00:00	2011-11-05 08:00:00	No	2012-03-27 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	ISG211	None	CA00290380	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-03-11 00:00:00	220009111	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2010-11-22 08:00:00	2010-11-22 08:00:00	No	2012-03-30 00:00:00	None	FTR AE	None	3200	3200	0	3200	0	None	E2DJ11	N	CA00253999	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-03-12 00:00:00	220009114	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2010-11-22 00:00:00	2010-11-22 00:00:00	Yes	2013-01-11 00:00:00	2012-12-20 00:00:00	AP IJ	AP IJ	75000	49500	0	49500	0	None	E2DJ11	N	CA00253999	B	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-04-10 00:00:00	220009219	Open	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2011-08-25 00:00:00	2011-08-25 00:00:00	Yes	2014-06-20 00:00:00	2014-06-09 00:00:00	AP BR	None	25000	25000	0	0	25000	None	SD4X11	None	CA00283181	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-05-21 00:00:00	220009320	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-11-22 08:00:00	2011-11-22 08:00:00	No	2012-06-12 00:00:00	None	FTR AE	None	900	900	0	900	0	None	Z8VQ11	N	CA00292018	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-05-23 00:00:00	220009331	Open	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach of IT system theft/loss of edevice/med rec	None	2011-11-05 00:00:00	2011-11-05 00:00:00	Yes	2014-06-20 00:00:00	2014-06-09 00:00:00	AP BR	None	249700	249700	0	0	249700	None	ISG211	None	CA00290380	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-05-25 00:00:00	220009341	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-02-13 08:00:00	2011-02-13 08:00:00	No	2012-06-18 00:00:00	None	FTR AE	None	1300	1300	0	1300	0	None	3VI311	N	CA00260985	C	SFY2011-12
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-07-25 00:00:00	220009419	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	2012-05-02 08:00:00	2012-05-02 08:00:00	No	2012-08-15 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	06X911	None	CA00310304	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-07-26 00:00:00	220009420	Closed	Failure to Report Penalty	Failure to Report Adverse Events to CDPH (HSC 1280.4)	AE28 - Adverse event or series of adverse events	None	2011-02-14 08:00:00	2011-02-14 08:00:00	No	2012-08-16 00:00:00	None	FTR AE	None	600	600	0	600	0	None	WBFC11	N	CA00260501	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-08-09 00:00:00	220009437	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	2012-01-31 08:00:00	2012-01-31 08:00:00	No	2012-08-30 00:00:00	None	FTR BR	None	1600	1600	-400	1200	0	None	6CDF11	None	CA00300759	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-08-13 00:00:00	220009439	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	2012-02-07 08:00:00	2012-02-07 08:00:00	No	2012-09-04 00:00:00	None	FTR BR	None	1400	1400	-350	1050	0	None	1JNV11	None	CA00301331	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-08-30 00:00:00	220009463	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	2012-04-19 08:00:00	2012-04-19 08:00:00	No	2012-09-21 00:00:00	None	FTR BR	None	4300	4300	-1075	3225	0	None	PYXY11	None	CA00314418	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2012-10-25 00:00:00	220009573	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	2012-06-18 08:00:00	2012-06-18 08:00:00	No	2012-11-16 00:00:00	None	FTR BR	None	1800	1800	-450	1350	0	None	LSOM11	None	CA00317619	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2013-06-07 00:00:00	220009941	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	2012-05-18 08:00:00	2012-05-18 08:00:00	No	2013-06-28 00:00:00	None	FTR BR	None	2800	2800	-700	2100	0	None	Q23911	None	CA00312005	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2013-06-14 00:00:00	220009952	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	2012-08-07 08:00:00	2012-08-07 08:00:00	No	2013-07-08 00:00:00	None	FTR BR	None	1600	1600	-400	1200	0	None	WDD811	None	CA00324106	D	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2013-06-14 00:00:00	220009954	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	2012-05-30 08:00:00	2012-05-30 08:00:00	No	2013-07-08 00:00:00	None	FTR BR	None	8600	8600	-2150	6450	0	None	SFHJ11	None	CA00324148	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2013-06-17 00:00:00	220009956	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	2012-08-23 08:00:00	2012-08-23 08:00:00	No	2013-07-09 00:00:00	None	FTR BR	None	1200	1200	-300	900	0	None	KJ9P11	None	CA00325336	C	SFY2012-13
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2013-08-26 00:00:00	220010120	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	2012-04-19 08:00:00	2012-04-19 08:00:00	No	2013-09-17 00:00:00	None	FTR BR	None	1800	1800	-450	1350	0	None	67N811	None	CA00310312	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2013-09-10 00:00:00	220010143	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	2012-11-06 08:00:00	2012-11-06 08:00:00	No	2013-10-01 00:00:00	None	FTR BR	None	700	700	-175	525	0	None	5FT911	None	CA00333808	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-05-02 00:00:00	220010695	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	2013-10-30 08:00:00	2013-10-30 08:00:00	No	2014-05-23 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	WFY011	None	CA00376326	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-05-02 00:00:00	220010696	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	2013-10-28 08:00:00	2013-10-28 08:00:00	No	2014-05-23 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	WFY011	None	CA00376330	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-05-02 00:00:00	220010697	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	2013-10-29 08:00:00	2013-10-29 08:00:00	No	2014-05-23 00:00:00	None	FTR BR	None	100	100	-25	75	0	None	WFY011	None	CA00376377	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-05-02 00:00:00	220010698	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	2013-10-30 08:00:00	2013-10-30 08:00:00	No	2014-05-23 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	WFY011	None	CA00376382	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-05-02 00:00:00	220010699	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	2013-11-01 08:00:00	2013-11-01 08:00:00	No	2014-05-23 00:00:00	None	FTR BR	None	400	400	-100	300	0	None	WFY011	None	CA00376629	C	SFY2013-14
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-07-15 00:00:00	220010867	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	2014-05-12 08:00:00	2014-05-12 08:00:00	No	2014-08-05 00:00:00	None	FTR BR	None	1000	1000	-250	750	0	None	J2QP11	None	CA00400275	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-08-13 00:00:00	220010927	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	2014-04-25 00:00:00	2014-04-25 00:00:00	No	2014-09-04 00:00:00	None	FTR BR	None	1100	1100	-275	825	0	None	THEB11	None	CA00398405	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-08-13 00:00:00	220010930	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	2014-05-19 00:00:00	2014-05-19 00:00:00	No	2014-09-04 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	THEB11	None	CA00400173	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-08-19 00:00:00	220010933	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	2013-12-04 00:00:00	2013-12-04 00:00:00	No	2014-09-10 00:00:00	None	FTR BR	None	500	500	-125	375	0	None	V29J11	None	CA00381383	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-09-24 00:00:00	220011027	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	2013-10-03 00:00:00	2013-10-03 00:00:00	No	2014-10-15 00:00:00	None	FTR BR	None	1300	1300	-325	975	0	None	KE6Z11	None	CA00374447	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-09-26 00:00:00	220011034	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE12 - Medication error	None	2011-05-09 00:00:00	2011-05-09 00:00:00	No	2015-03-06 00:00:00	None	AP IJ	None	100000	100000	0	100000	0	None	8QMY11	N	CA00281816	B	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-11-06 00:00:00	220011114	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	2014-07-16 00:00:00	2014-07-16 00:00:00	No	2014-12-02 00:00:00	None	FTR BR	None	800	800	-200	600	0	None	CYNO11	None	CA00407918	D	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-11-06 00:00:00	220011115	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	2014-01-02 00:00:00	2014-01-02 00:00:00	No	2014-12-02 00:00:00	None	FTR BR	None	1800	1800	-450	1350	0	None	6O3N11	None	CA00385420	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-12-03 00:00:00	220011149	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	2013-10-15 00:00:00	2013-10-15 00:00:00	No	2014-12-24 00:00:00	None	FTR BR	None	200	200	0	200	0	None	O0Y911	None	CA00374612	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-12-04 00:00:00	220011150	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	2013-10-15 00:00:00	2013-10-15 00:00:00	No	2014-12-26 00:00:00	None	FTR BR	None	200	200	0	200	0	None	O0Y911	None	CA00374618	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-12-04 00:00:00	220011155	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	2013-10-07 00:00:00	2013-10-07 00:00:00	No	2014-12-26 00:00:00	None	FTR BR	None	400	400	0	400	0	None	O0Y911	None	CA00373828	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-12-04 00:00:00	220011157	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	2013-10-04 00:00:00	2013-10-04 00:00:00	No	2014-12-26 00:00:00	None	FTR BR	None	400	400	0	400	0	None	H67G11	None	CA00374244	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-12-29 00:00:00	220011206	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	2014-09-05 00:00:00	2014-09-05 00:00:00	No	2015-01-21 00:00:00	None	FTR BR	None	1000	1000	-250	750	0	None	FV4P11	None	CA00414178	D	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2014-12-30 00:00:00	220011211	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	2014-08-21 00:00:00	2014-08-21 00:00:00	No	2015-01-22 00:00:00	None	FTR BR	None	800	800	0	800	0	None	KE6D11	None	CA00412923	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-02 00:00:00	220011295	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	2013-09-13 00:00:00	2013-09-13 00:00:00	No	2015-03-23 00:00:00	None	FTR BR	None	400	400	-100	300	0	None	4GQD11	None	CA00371121	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-02 00:00:00	220011298	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	2013-09-06 00:00:00	2013-09-06 00:00:00	No	2015-03-23 00:00:00	None	FTR BR	None	1200	1200	-300	900	0	None	4GQD11	None	CA00371137	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-03 00:00:00	220011299	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	2014-01-07 00:00:00	2014-01-07 00:00:00	No	2015-03-24 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	G2CM11	None	CA00384340	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-03 00:00:00	220011300	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	2014-01-07 00:00:00	2014-01-07 00:00:00	No	2015-03-24 00:00:00	None	FTR BR	None	300	300	-75	225	0	None	G2CM11	None	CA00384393	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-03 00:00:00	220011301	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	2014-01-02 00:00:00	2014-01-02 00:00:00	No	2015-03-24 00:00:00	None	FTR BR	None	400	400	-100	300	0	None	G2CM11	None	CA00383816	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-04 00:00:00	220011304	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	2013-11-25 00:00:00	2013-11-25 00:00:00	No	2015-03-25 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	EUPH11	None	CA00379613	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-10 00:00:00	220011313	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	2014-12-10 00:00:00	2014-12-10 00:00:00	No	2015-04-01 00:00:00	None	FTR BR	None	100	100	-25	75	0	None	D6DQ11	None	CA00424146	D	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-10 00:00:00	220011314	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	2014-12-09 00:00:00	2014-12-09 00:00:00	No	2015-04-01 00:00:00	None	FTR BR	None	200	200	-50	150	0	None	D6DQ11	None	CA00424151	D	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-23 00:00:00	220011356	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach by h/c worker within facility/hc system	None	2014-08-19 00:00:00	2014-08-19 00:00:00	Yes	2015-04-17 00:00:00	2018-01-16 00:00:00	AP BR	None	12500	12500	0	12500	0	None	LGNQ11	None	CA00410134	B	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-03-23 00:00:00	220011357	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach by h/c worker within facility/hc system	None	2014-06-09 00:00:00	2014-06-09 00:00:00	Yes	2015-04-17 00:00:00	2018-01-16 00:00:00	AP BR	AP BR	250000	125000	0	125000	0	None	27M311	None	CA00407173	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-06-18 00:00:00	220011571	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach of IT system theft/loss of edevice/med rec	None	2014-01-13 00:00:00	2014-01-13 00:00:00	No	2015-07-09 00:00:00	None	FTR BR	None	600	600	-150	450	0	None	II8T11	None	CA00385469	C	SFY2014-15
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-11-16 00:00:00	220011587	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	Yes	2015-12-09 00:00:00	2018-01-16 00:00:00	AP BR	None	21250	21250	0	21250	0	None	QKPO11	None	CA00406756	C	SFY2015-16
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-07-03 00:00:00	220011597	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	2013-10-15 00:00:00	2013-10-15 00:00:00	No	2015-07-24 00:00:00	None	FTR BR	None	800	800	-200	600	0	None	XLRG11	None	CA00376085	C	SFY2015-16
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2015-11-24 00:00:00	220011871	Closed	Failure to Report Penalty	Failure to Report Breach to CDPH (HSC 1280.15(b)(1))	Breach of IT system theft/loss of edevice/med rec	None	2013-09-09 00:00:00	2013-09-09 00:00:00	No	2015-12-17 00:00:00	None	FTR BR	None	1500	1500	-375	1125	0	None	OUW811	None	CA00371774	A	SFY2015-16
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-05-23 00:00:00	220012283	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	2015-07-27 00:00:00	2015-07-27 00:00:00	No	2016-06-14 00:00:00	None	FTR BR	None	1000	1000	-250	750	0	None	OEDD11	None	CA00456226	E	SFY2015-16
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-05-23 00:00:00	220012284	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach to person/entity outside facility/hc system	None	2015-07-27 00:00:00	2015-07-27 00:00:00	No	2016-06-14 00:00:00	None	AP BR	None	36000	36000	-9000	27000	0	None	OEDD11	None	CA00456226	E	SFY2015-16
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-12-14 00:00:00	220012820	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	2015-01-29 00:00:00	2015-01-29 00:00:00	No	2017-01-06 00:00:00	None	FTR BR	None	6000	6000	0	6000	0	None	RI6B11	None	CA00439776	E	SFY2016-17
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2016-12-29 00:00:00	220012851	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	2015-04-30 00:00:00	2015-04-30 00:00:00	No	2017-01-23 00:00:00	None	FTR BR	None	600	600	0	600	0	None	DOSF11	None	CA00444661	E	SFY2016-17
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2017-02-08 00:00:00	220012955	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	None	2014-04-25 00:00:00	2014-04-25 00:00:00	No	2017-03-02 00:00:00	None	AP NON-IJ	None	4000	4000	0	4000	0	None	SO9611	N	CA00398410	B	SFY2016-17
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2017-02-08 00:00:00	220012959	Closed	Administrative Penalty	AP - Non-Immediate Jeopardy (HSC 1280.3)	Other Non-Immediate Jeopardy (not an AE)	Surgical Error	2016-06-29 00:00:00	2016-06-29 00:00:00	No	2017-03-02 00:00:00	None	AP NON-IJ	None	12750	12750	0	12750	0	None	OMGR11	N	CA00495281	B	SFY2016-17
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2022-02-25 00:00:00	220018992	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach of IT system theft/loss of edevice/med rec	None	2019-06-07 00:00:00	2019-06-07 00:00:00	Yes	2023-08-30 00:00:00	2023-08-17 00:00:00	AP BR	None	250000	250000	0	250000	0	None	FYM911	None	CA00644165	C	SFY2021-22
220000031	UCSF MEDICAL CENTER	Non-LTC	GACH	General Acute Care Hospital	San Francisco	2023-06-13 00:00:00	220019425	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Deliberate breach of PHI by health care worker	None	2022-06-12 00:00:00	2022-06-12 00:00:00	No	2024-01-18 00:00:00	None	AP BR	None	10000	10000	0	10000	0	None	MZOT11	None	CA00798921	D	SFY2022-23
930000096	USC ARCADIA HOSPITAL	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2012-05-29 00:00:00	930009343	Closed	Administrative Penalty	AP - Immediate Jeopardy (HSC 1280.3)	AE04 - Retention of a foreign object in a patient	None	2010-03-24 00:00:00	2010-03-24 00:00:00	No	2013-01-11 00:00:00	None	AP IJ	None	50000	50000	0	50000	0	None	FPJ311	N	CA00240013	C	SFY2011-12
930000096	USC ARCADIA HOSPITAL	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2016-03-29 00:00:00	930012154	Closed	Administrative Penalty	AP - Breach (HSC 1280.15)	Breach by h/c worker within facility/hc system	None	2014-02-15 00:00:00	2014-02-15 00:00:00	No	2016-04-20 00:00:00	None	AP BR	None	28500	28500	0	28500	0	None	HOCU11	None	CA00389732	C	SFY2015-16
930000047	UCI HEALTH-LAKEWOOD	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2018-04-11 00:00:00	930013966	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	2015-11-29 00:00:00	2015-11-29 00:00:00	No	2018-05-02 00:00:00	None	FTR AE	None	1100	1100	0	1100	0	None	94K611	N	CA00469040, CA00469040	B, B	SFY2017-18
930000047	UCI HEALTH-LAKEWOOD	Non-LTC	GACH	General Acute Care Hospital	LA Acute/Ancillary	2019-10-22 00:00:00	930015470	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	2017-09-08 00:00:00	2017-09-08 00:00:00	Yes	2019-11-13 00:00:00	2019-10-30 00:00:00	FTR AE	FTR AE	57300	5700	0	5700	0	None	VGUK11	N	CA00552647	B	SFY2019-20