Disproportionate Share (DSH) Program Final Eligibility List SFY 2019-20

Medicaid Utilization Rate Cut-Off 51.7 Mean of Medicaid Utilization Rate 31.1379 StandardStandar Deviationd Deviat iofon Medicaid of Medi Utilizationcaid Utili zRateation 20.5692 Rate 20.5692

Medicaid Low Income Inpatient Low Income Percent Utilization Rate Number (LIUR) Hospital Name OSHPD ID (MIUR) Clearlake 106171049 35.3 54.9 54 Adventist Health Hanford 106164029 37.8 34.9 34 Adventist Health Reedley 106100797 80 80.9 80 Adventist Health Tehachapi Valley 106154168 20 50.7 50 Adventist Health Tulare 106540816 30.6 100.0 100 Adventist Health Ukiah Valley 106231396 36.9 44.5 44 Adventist Health White Memorial 106190878 63.1 45.5 45 AHMC Anaheim Regional Medical Center 106301098 35.5 27.9 27 Alameda Hospital 106010735 33.7 53.7 53 Alhambra Hospital Medical Center 106190017 31.6 27.2 27 Anaheim Global Medical Center 106301188 54.3 54.4 54 106190034 43.8 37.2 37 Arrowhead Regional Medical Center 106364231 57.9 69.7 69 Aurora Charter Oak 106190163 19.4 32.9 32 Aurora Vista Del Mar Hospital 106560203 22.7 33.9 33 Bear Valley Community Hospital 106361110 9.3 42.7 42 Beverly Hospital 106190081 40.1 56.1 56 Butte County Mental Health Services 106044006 92.2 100.0 100 Hospital Medical Center - Los Angeles 106190125 72.5 70.7 70 Centinela Hospital Medical Center 106190148 38.8 32.6 32 Central Star PHF 106105125 86.6 76.2 76 Chapman Global Medical Center 106301140 13.1 36.3 36

Disproportionate Share Hospital (DSH) Program Final Eligibility List SFY 2019-20

Medicaid Low Income Inpatient Low Income Percent Utilization Rate Number (LIUR) Hospital Name OSHPD ID (MIUR) Children's Hospital of Los Angeles 106190170 60.8 55.7 55 Children's Hospital of Orange County 106300032 48.6 30.4 30 Coast Plaza Hospital 106190766 37.6 34.4 34 College Hospital Costa Mesa 106301155 89.3 66.7 66 College Medical Center 106190587 82 61.7 61 Colorado River Medical Center 106361458 40.5 39.7 39 Community Hospital of Huntington Park 106190197 56.7 55.3 55 Community Hospital of San Bernardino 106361323 63.4 65.8 65 Community Regional Medical Center-Fresno 106100717 52 38.1 38 Contra Costa Regional Medical Center 106070924 58.6 83.7 83 Delano Regional Medical Center 106150706 59.7 44.1 44 Desert Valley Hospital 106364144 32.9 26.6 26 Doctors Medical Center of Riverside 106331293 42.4 32.9 32 Doctors Medical Center 106500852 43.5 31.9 31 East Los Angeles Doctors Hospital 106190256 63.7 71.0 71 Eastern Plumas Hospital-Portola Campus 106320859 11.7 42.3 42 El Centro Regional Medical Center 106130699 42 54.5 54 Emanate Health Queen of The Valley Hospital 106190636 43 26.2 26 Encino Hospital Medical Center 106190280 12.3 26.7 26 Fairchild Medical Center 106474007 28.3 28.9 28 Fountain Valley Regional Hospital & Medical Center - Euclid 106301175 38.7 55.5 55 Garden Grove Hospital and Medical Center 106301283 30.7 33.7 33 Garfield Medical Center 106190315 32.5 40.5 40 Gateways Hospital and Mental Health Center 106190317 18.2 100.0 100 George L Mee Memorial Hospital 106270777 23.6 44.2 44 Glendale Memorial Hospital and Health Center 106190522 40.8 28.5 28

Disproportionate Share Hospital (DSH) Program Final Eligibility List SFY 2019-20

Medicaid Low Income Inpatient Low Income Percent Utilization Rate Number (LIUR) Hospital Name OSHPD ID (MIUR) Glenn Medical Center 106110889 23.1 38.6 38 Good Samaritan Hospital-Bakersfield 106150775 34.3 35.9 35 Greater El Monte Community Hospital 106190352 55.5 65.5 65 Grossmont Hospital 106370714 38.4 25.2 25 Hazel Hawkins Memorial Hospital 106350784 39.5 49.8 49 Healthbridge Children's Hospital-Orange 106304159 71.3 76.2 76 Hemet Valley Medical Center 106331194 33.7 46.0 45 Hi-Desert Medical Center 106362041 40.8 45.9 45 Highland Hospital 106010846 67.2 79.6 79 Hollywood Presbyterian Medical Center 106190382 57.6 56.5 56 Jerold Phelps Community Hospital 106121031 32.1 43.2 43 John F Kennedy Memorial Hospital 106331216 57 30.1 30 Kaweah Delta Medical Center 106540734 41.4 35.9 35 Kedren Community Mental Health Center 106190150 16.8 49.9 49 106150736 73.8 65.9 65 Kern Valley Healthcare District 106150737 47.1 49.3 49 LAC Harbor-UCLA Medical Center 106191227 59.8 83.8 83 LAC Rancho Los Amigos National Rehab Center 106191306 65.1 100.0 100 LAC+USC Medical Center 106191228 61.1 84.7 84 Laguna Honda Hospital and Rehabilitation Center 106380865 100 93.4 93 Loma Linda University Behavioral Medicine Center 106364014 38.9 39.3 39 Loma Linda University Children's Hospital 106364502 64.8 52.2 52 Lompoc Valley Medical Center 106420491 26.8 46.2 46 Los Angeles Community Hospital 106190198 61.2 51.1 51 Los Angeles County Olive View-UCLA Medical Center 106191231 63.7 87.1 87 Mad River Community Hospital 106121002 33 26.8 26

Disproportionate Share Hospital (DSH) Program Final Eligibility List SFY 2019-20

Medicaid Low Income Inpatient Low Income Percent Utilization Rate Number (LIUR) Hospital Name OSHPD ID (MIUR) Madera Community Hospital 106201281 55 51.4 51 Marie Green Psychiatric Center - PHF 106244027 75.9 86.2 86 Martin Luther King, Jr. Community Hospital 106191230 76.7 81.1 81 Memorial Hospital Los Banos 106240924 65.8 26.7 26 Memorial Hospital of Gardena 106190521 55.1 54.2 54 MemorialCare Miller Children's & Women's Hospital Long Beach 106196168 54.5 49.8 49 Mercy Medical Center - Merced 106240942 40.2 26.2 26 Mercy San Juan Hospital 106340950 36.8 25.4 25 Methodist Hospital of Sacramento 106340951 53 39.4 39 Mission Community Hospital - Panorama Campus 106190524 50.7 43.1 43 Modoc Medical Center 106250956 14.6 48.7 48 Montclair Hospital Medical Center 106361166 44.4 44.2 44 Monterey Park Hospital 106190547 50.6 58.5 58 Mountains Community Hospital 106361266 24.3 51.5 51 106274043 60.1 27.0 26 North Bay Medical Center 106481357 34.5 25.8 25 Oak Valley Hospital District 106500967 31.4 50.7 50 Ojai Valley Community Hospital 106560501 8.1 29.6 29 Orange County Global Medical Center 106301566 49.8 56.4 56 Orchard Hospital 106040802 8.6 32.0 31 106040937 37.8 31.0 31 Pacifica Hospital of The Valley 106190696 77.3 67.2 67 Palo Verde Hospital 106331288 38.8 53.2 53 Paradise Valley Hospital 106370759 44.6 36.3 36 Pioneers Memorial Healthcare District 106130760 45.7 43.9 43 Plumas District Hospital 106320986 22.8 26.9 26

Disproportionate Share Hospital (DSH) Program Final Eligibility List SFY 2019-20

Medicaid Low Income Inpatient Low Income Percent Utilization Rate Number (LIUR) Hospital Name OSHPD ID (MIUR) Pomona Valley Hospital Medical Center 106190630 52.7 26.1 26 Providence Holy Cross Medical Center 106190385 38 25.1 25 Providence Little Company of Mary MC - San Pedro 106190680 40.9 28.3 28 Rady Children's Hospital - 106370673 48.5 39.2 39 Resnick Neuropsychiatric Hospital at UCLA 106190930 9.9 32.4 32 Riverside University Health System - Medical Center 106334487 55.2 59.9 59 Ronald Reagan UCLA Medical Center 106190796 26.3 12.0 12 San Francisco General Hospital 106380939 53.5 67.5 67 San Gabriel Valley Medical Center 106190200 28.8 36.2 36 San Gorgonio Memorial Hospital 106331326 27.6 42.6 42 San Joaquin General Hospital 106391010 55.9 56.4 56 San Leandro Hospital 106013619 36.5 48.9 48 San Mateo Medical Center 106410782 53.7 81.6 81 Santa Clara Valley Medical Center 106430883 49.8 59.5 59 Santa Monica - UCLA Medical Center and Orthopaedic Hospital 106190687 15.3 10.9 10 106370744 37.9 25.5 25 Sempervirens PHF 106124004 78.7 50.6 50 Sharp Chula Vista Medical Center 106370875 39.8 29.8 29 Shriners for Children Northern Calif. 106344114 24.4 78.4 78 Sierra View Medical Center 106540798 48.1 38.7 38 Sierra Vista Hospital 106342392 7.9 33.3 33 Silver Lake Medical Center - Downtown Campus 106190661 37.5 25.4 25 South Coast Global Medical Center 106301258 43.2 68.8 68 Southern California Hospital at Hollywood 106190380 48.9 44.2 44 Southern Inyo Hospital 106141338 100 66.8 66 St. Bernardine Medical Center 106361339 42.3 30.5 30

Disproportionate Share Hospital (DSH) Program Final Eligibility List SFY 2019-20

Medicaid Low Income Inpatient Low Income Percent Utilization Rate Number (LIUR) Hospital Name OSHPD ID (MIUR) St. Francis Medical Center 106190754 72.2 56.3 56 St. Mary Medical Center - Long Beach 106190053 48.9 47.0 46 St. Rose Hospital 106010967 42.3 32.8 32 Star View Adolescent - PHF 106194967 45.5 100.0 100 Surprise Valley Community Hospital 106250955 2.1 60.5 60 Sutter Coast Hospital 106084001 26.5 29.8 29 Sutter Solano Medical Center 106481094 36.5 27.2 27 Telecare El Dorado County PHF 106094002 95.8 74.6 74 Telecare Riverside County PHF 106334457 83.5 40.3 40 Telecare Santa Cruz PHF 106444029 36.8 46.1 46 Telecare Stanislaus County PHF 106504081 66.5 72.9 72 Telecare Willow Rock Center 106014226 67.6 88.0 88 Totally Kids Rehabilitation Hospital 106364451 94.2 97.3 97 UC San Diego Health Hillcrest - Hillcrest Medical Center 106370782 38.4 25.1 25 UCSF Benioff Children's Hospital Oakland 106010776 53 55.2 55 UCSF Medical Center 106381154 29.8 16.4 16 University of California Davis Medical Center 106341006 38.8 25.6 25 University of California Irvine Medical Center 106301279 41.7 28.9 28 Valley Children's Hospital 106204019 66.5 58.7 58 Valley Presbyterian Hospital 106190812 59.1 59.6 59 Ventura County Medical Center 106560481 54.2 37.0 36 Victor Valley Global Medical Center 106361370 44.5 57.6 57 Watsonville Community Hospital 106444013 52.3 28.4 28 West Anaheim Medical Center 106301379 24.4 29.0 29 Whittier Hospital Medical Center 106190883 37.9 34.9 34