Medicare Fee-For-Service (FFS) Hospital Readmissions: Q2 2015–Q1 2016 State of Arizona

Please contact Barb Averyt via email at [email protected] or by phone at 602.801.6902 for additional information

This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. AZ-11SOW-C.3- 12062016-01

Arizona Overview Table 1: 30-Day All-Cause Readmission Rates—Q2 2015–Q1 2016 1

Arizona

Baseline (CY 2013) 25,963/160,061 16.2%

Q2 2015 6,413/39,094 16.4%

Q3 2015 5,835/35,656 16.4%

Current Q4 2015 Q1 2016 6,088/38,961 6,981/44,871 15.6% 15.6%

Nation1

Q2 2015 to Q1 2016 25,317/158,582 16.0% 18.5%

Table 2: Number of Emergency Department (ED) Visits—Q2 2015–Q1 2016 Q2 2015 Arizona

57,675

Q3 2015 55,840

Q4 2015

Q1 2016

61,752

71,653

Table 3: Number of Observation Stays—Q2 2015–Q1 2016 Q2 2015 Arizona

1

13,165

Q3 2015 12,570

Q4 2015

Q1 2016

13,799

14,969

National data are obtained from the Integrated Care for Populations and Communities (ICPC) Quarterly Scorecard and the most recent data available are through December 31, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 4: All-Cause Average Readmissions Rates by Region Region

Average Rate

Western Arizona

17.1%

East Valley

16.8%

Central Valley

16.4%

West Valley

15.9%

Southern Arizona

15.5%

Northern Arizona

12.7%

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Figure 1: Arizona and National Outpatient ED Visits, Observation Stays, and Inpatient Admissions 2,3

2

3

ED visits and observation stays resulting in an inpatient stay are not included in this calculation. National data are obtained from the Integrated Care for Populations and Communities (ICPC) Quarterly Scorecard and the most recent data available are through December 31, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 5: Discharge Distribution after Inpatient Hospitalization for All Causes—Q2 2015–Q1 2016 4

Group

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days

Home 14.8% 93,625 SNF* 19.2% 25,047 HHA** 18.8% 21,272 Arizona Hospice 2.2% 6,150 Other 20.2% 12,488 Total 16.0% 158,582 *Skilled Nursing Facility **Home Health Agency

13,852 4,800 4,004 136 2,525 25,317

30-Day Readmits to Same Hospital N

%

9,548 3,218 2,983 86 1,454 17,289

68.9% 67.0% 74.5% 63.2% 57.6% 68.3%

30-Day Readmits to Different Hospital N 4,304 1,582 1,021 50 1,071 8,028

Days to Readmission

%

0-3 Days N %

4-7 Days N %

8-14 Days N %

15-21 Days N %

22-30 Days N %

31.1% 33.0% 25.5% 36.8% 42.4% 31.7%

2,579 673 731 27 623 4,633

2,633 815 753 24 404 4,629

3,376 1,283 1,062 37 525 6,283

2,674 962 723 26 500 4,885

2,590 1,067 735 22 473 4,887

18.6% 14.0% 18.3% 19.9% 24.7% 18.3%

19.0% 17.0% 18.8% 17.6% 16.0% 18.3%

24.4% 26.7% 26.5% 27.2% 20.8% 24.8%

19.3% 20.0% 18.1% 19.1% 19.8% 19.3%

18.7% 22.2% 18.4% 16.2% 18.7% 19.3%

Figure 2: 30-Day All-Cause Readmission Rates 5

4 5

An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. National data are obtained from the Integrated Care for Populations and Communities (ICPC) Quarterly Scorecard and the most recent data available are through December 31, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 6: Discharge Distribution after Inpatient Hospitalization for Acute Myocardial Infarction (AMI)—Q2 2015–Q1 2016 6

Group

Arizona

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days Home SNF HHA Hospice Other Total

12.9% 22.9% 17.6% 4.2% 25.4% 14.9%

2,944 442 426 167 276 4,255

381 101 75 7 70 634

30-Day Readmits to Same Hospital N

% 267 67 56 4 40 434

30-Day Readmits to Different Hospital N

70.1% 66.3% 74.7% 57.1% 57.1% 68.5%

% 114 34 19 3 30 200

29.9% 33.7% 25.3% 42.9% 42.9% 31.5%

Days to Readmission 0-3 Days N % 103 15 17 0 19 154

27.0% 14.9% 22.7% 0.0% 27.1% 24.3%

4-7 Days N % 62 23 18 3 12 118

16.3% 22.8% 24.0% 42.9% 17.1% 18.6%

8-14 Days N % 75 22 17 3 16 133

19.7% 21.8% 22.7% 42.9% 22.9% 21.0%

15-21 Days N % 78 20 9 0 14 121

20.5% 19.8% 12.0% 0.0% 20.0% 19.1%

22-30 Days N % 63 21 14 1 9 108

16.5% 20.8% 18.7% 14.3% 12.9% 17.0%

Figure 3: 30-Day AMI Readmission Rates 7

6 7

An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are through June 30, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 7: Discharge Distribution after Inpatient Hospitalization for Heart Failure (HF)—Q2 2015–Q1 2016 8

Group

Arizona

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days Home SNF HHA Hospice Other Total

22.1% 24.8% 25.2% 5.1% 33.1% 22.5%

3,693 918 1,149 396 302 6,458

815 228 290 20 100 1,453

30-Day Readmits to Same Hospital N 582 160 212 12 57 1,023

%

30-Day Readmits to Different Hospital N

71.4% 70.2% 73.1% 60.0% 57.0% 70.4%

% 233 68 78 8 43 430

28.6% 29.8% 26.9% 40.0% 43.0% 29.6%

Days to Readmission 0-3 Days N % 127 35 35 7 27 231

15.6% 15.4% 12.1% 35.0% 27.0% 15.9%

4-7 Days N % 152 44 59 4 9 268

18.7% 19.3% 20.3% 20.0% 9.0% 18.4%

8-14 Days N % 205 53 77 1 25 361

25.2% 23.2% 26.6% 5.0% 25.0% 24.8%

15-21 Days N % 155 52 52 5 21 285

19.0% 22.8% 17.9% 25.0% 21.0% 19.6%

22-30 Days N % 176 44 67 3 18 308

21.6% 19.3% 23.1% 15.0% 18.0% 21.2%

Figure 4: 30-Day HF Readmission Rates 9

8 9

An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are through June 30, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 8: Discharge Distribution after Inpatient Hospitalization for Coronary Artery Bypass Graft (CABG)—Q2 2015–Q1 2016 10

Group

Arizona

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days Home SNF HHA Hospice Other Total

9.3% 20.3% 12.9% 0.0% 19.0% 13.7%

419 202 309 2 137 1,069

39 41 40 0 26 146

30-Day Readmits to Same Hospital N

% 30 25 25 0 16 96

30-Day Readmits to Different Hospital N

76.9% 61.0% 62.5% ND 61.5% 65.8%

% 9 16 15 0 10 50

23.1% 39.0% 37.5% ND 38.5% 34.2%

Days to Readmission 0-3 Days N % 9 7 6 0 4 26

23.1% 17.1% 15.0% ND 15.4% 17.8%

4-7 Days N % 6 12 11 0 6 35

15.4% 29.3% 27.5% ND 23.1% 24.0%

8-14 Days N % 15 6 11 0 5 37

38.5% 14.6% 27.5% ND 19.2% 25.3%

15-21 Days N % 7 8 6 0 7 28

17.9% 19.5% 15.0% ND 26.9% 19.2%

22-30 Days N % 2 8 6 0 4 20

5.1% 19.5% 15.0% ND 15.4% 13.7%

Figure 5: 30-Day CABG Readmission Rates 11

10 11

An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are through June 30, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 9: Discharge Distribution after Inpatient Hospitalization for Pneumonia (PNE)—Q2 2015–Q1 2016 12

Group

Arizona

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days Home SNF HHA Hospice Other Total

15.3% 22.4% 22.9% 1.9% 23.7% 17.1%

6,401 1,863 1,625 799 655 11,343

977 417 372 15 155 1,936

30-Day Readmits to Same Hospital N 724 294 299 9 96 1,422

%

30-Day Readmits to Different Hospital N

74.1% 70.5% 80.4% 60.0% 61.9% 73.5%

% 253 123 73 6 59 514

25.9% 29.5% 19.6% 40.0% 38.1% 26.5%

Days to Readmission 0-3 Days N % 184 57 74 0 43 358

18.8% 13.7% 19.9% 0.0% 27.7% 18.5%

4-7 Days N % 184 68 68 2 30 352

18.8% 16.3% 18.3% 13.3% 19.4% 18.2%

8-14 Days N % 231 111 93 6 28 469

23.6% 26.6% 25.0% 40.0% 18.1% 24.2%

15-21 Days N % 191 78 62 3 25 359

19.5% 18.7% 16.7% 20.0% 16.1% 18.5%

22-30 Days N % 187 103 75 4 29 398

19.1% 24.7% 20.2% 26.7% 18.7% 20.6%

Figure 6: 30-Day PNE Readmission Rates 13

12

The method for identifying PNE visits was modified; therefore, the data may not be comparable to previous reports. An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. 13 National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are through June 30, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 10: Discharge Distribution after Inpatient Hospitalization for Chronic Obstructive Pulmonary Disease (COPD)—Q2 2015–Q1 2016 14

Group

Arizona

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days Home SNF HHA Hospice Other Total

18.7% 25.3% 23.4% 5.0% 24.5% 19.8%

3,538 574 755 219 249 5,335

661 145 177 11 61 1,055

30-Day Readmits to Same Hospital N

% 514 102 139 10 41 806

30-Day Readmits to Different Hospital N

77.8% 70.3% 78.5% 90.9% 67.2% 76.4%

% 147 43 38 1 20 249

22.2% 29.7% 21.5% 9.1% 32.8% 23.6%

Days to Readmission 0-3 Days N % 117 20 37 3 22 199

17.7% 13.8% 20.9% 27.3% 36.1% 18.9%

4-7 Days N % 116 23 15 1 9 164

17.5% 15.9% 8.5% 9.1% 14.8% 15.5%

8-14 Days N % 171 34 47 3 7 262

25.9% 23.4% 26.6% 27.3% 11.5% 24.8%

15-21 Days N % 129 30 50 2 13 224

19.5% 20.7% 28.2% 18.2% 21.3% 21.2%

22-30 Days N % 128 38 28 2 10 206

19.4% 26.2% 15.8% 18.2% 16.4% 19.5%

Figure 7: 30-Day COPD Readmission Rates 15

14 15

An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are through June 30, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Table 11: Discharge Distribution after Inpatient Hospitalization for Total Hip/Knee Replacement (THA/TKA)—Q2 2015–Q1 2016 16

Group

Arizona

30-Day Readmits to Same Hospital

Readmits Setting 30-Day Within Discharged To Readmit Rate Discharges 30 Days Home SNF HHA Hospice Other Total

3.6% 6.9% 3.8%

4,482 1,613 3,053

N

161 112 115

%

30-Day Readmits to Different Hospital N

102 76 61

63.4% 67.9% 53.0%

% 59 36 54

36.6% 32.1% 47.0%

Days to Readmission 0-3 Days N % 47 24 23

4-7 Days N %

29.2% 21.4% 20.0%

38 18 24

23.6% 16.1% 20.9%

66.7%

3

2

1

50.0%

1

50.0%

0

0.0%

0

0.0%

8.6% 4.5%

513 9,664

44 434

24 264

54.5% 60.8%

20 170

45.5% 39.2%

11 105

25.0% 24.2%

3 83

6.8% 19.1%

8-14 Days N % 35 22 27

21.7% 19.6% 23.5%

2 100.0% 2 88

4.5% 20.3%

15-21 Days N % 22 30 19

13.7% 26.8% 16.5%

22-30 Days N % 19 18 22

11.8% 16.1% 19.1%

0

0.0%

0

0.0%

18 89

40.9% 20.5%

10 69

22.7% 15.9%

Figure 8: 30-Day THA/TKA Readmission Rates 17

16 17

An entry of “ND,” or missing data point, indicates that data were unavailable for the specified time period. National data are obtained from the Hospital Compare website and are calculated using the 30-day risk adjustment standardized methodology for the CMS Hospital Readmission Reduction Program. The most recent data available are through June 30, 2015.

Arizona Readmission Report

November 2016 (Q2 2015–Q1 2016)

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Methodology and Data Source Information The dashboard provides information regarding your state’s all-cause, acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), pneumonia (PNE), chronic obstructive pulmonary disease (COPD), and total hip/knee replacement (THA/TKA) 30-day readmissions. Rates are calculated using hospital inpatient claims for Medicare Fee-For-Service (FFS) beneficiaries. Planned readmissions are excluded from this analysis. Data in this report are limited to Medicare FFS Part-A data for discharges from April 1, 2015, to March 31, 2016. 18 International Classification of Diseases (ICD)-10 codes are used to calculate rates starting from October 2015. Readmission rates in this report are not calculated using the 30-day risk standardized methodology for the Centers for Medicare & Medicaid Services (CMS) Hospital Readmission Reduction Program or found on hospitalcompare.hhs.gov. Readmission rates are updated quarterly with the most current time period’s data. The time periods illustrated in this document are examples only and may not reflect the most current data period. Pages 1 through 3 contain the following information. Summary table 1 Emergency department (ED) visits and 2 observation stays tables

3 4

Regional map Outpatient ED visits, observation stays, and inpatient admissions graphs

Example Dashboard (Pages 1 through 3)

1

2

18

The Complete Standard Analytical Table (CSAT) data file was used for this analysis. The CSAT data file is provided to HSAG by CMS. The CSAT data file includes Part A and Part B claims for FFS beneficiaries. Please note that the results obtained from CSAT may vary from your own state’s results.

Readmission Report

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3

Example Outpatient ED Visits, Observation Stays, and Inpatient Admissions Dashboard

4

Readmission Report

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1

Summary Table

The summary table contains your state’s Baseline and Current 30-day readmission rates, including the numerator and denominator for each quarter. All rates are calculated from Medicare inpatient claims for FFS beneficiaries. See page F for measure definitions. The summary table also includes the national rate. Due to availability of the data, the national rates may be calculated from a different time period.

2

ED Visits and Observation Stays Tables

The ED visits and observations stays tables provide the count of ED visits and observations stays, respectively, for each quarter in the current report period. ED visits and observation stays resulting in an inpatient stay are not included in the counts.

3

Regional Map

The state of Arizona was divided into six regions: Western Arizona (WAZ), Northern Arizona (NAZ), Southern Arizona (SAZ), West Valley Phoenix (WV Phoenix), Central Valley Phoenix (CV Phoenix), and East Valley Phoenix (EV Phoenix). Aggregate readmission rates are calculated for each region using the hospitals located in the region. The table shows regional readmission rates for each region.

4

Outpatient ED Visits, Observation Stays, and Inpatient Admissions

The two graphs depict the volume of outpatient ED visits, observation stays, and inpatient admissions for the state and the nation. The purpose of each is to monitor acute care utilization at the state and national levels. The counts are calculated for quarterly periods from Medicare acute care claims for FFS beneficiaries. Claims are classified based on hierarchy rules similar to Medicare bundled payment rules. Each encounter counts as only one of three types: (1) Inpatient admission, (2) Observation stay, or (3) ED visit. Therefore, ED visits and observation stays that result in an inpatient stay are counted as an inpatient stay. ED visits that result in an observation stay, but not an inpatient stay, are counted as an observation stay.

Readmission Report

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Pages 4 through 10 provide the following data for all-cause and disease-specific 30-day readmissions: Discharge distribution table 5 6

Line graph

Example Dashboard (discharge distribution and line graph)

5

6

5

Discharge Distribution Table

The discharge distribution table shows the 30-day readmission rates by discharge setting, the proportion of readmissions that occurred back to your hospital or another hospital, and the number of days from discharge to readmission. Readmissions from home, skilled nursing facilities (SNFs), home health agencies (HHAs), and hospice are determined by the patient discharge status on the index hospitalization claim. All other discharge status codes are bucketed into the “Other” category. Results for the state and your hospital’s region are provided for comparison.

6

Line graph

The purpose of the readmission graph is to track readmission rates over time. The Line Graph shows your state’s improvement in relation to nation. Rates are calculated quarterly.

Readmission Report

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Measure Definitions All-Cause 30-Day Readmission Rates All-cause readmission rates are calculated as the percentage of hospital admissions that occurred within 30 days of an index admission for any condition. Each hospital admission within 30 days following an index admission is considered a readmission (e.g., a beneficiary with four readmissions in the measurement period counts as four separate readmissions). Any beneficiary who dies in the hospital or is transferred to another hospital on the same day is excluded from your facility’s calculation. Readmissions from home, SNFs, HHAs, and hospice are determined by the patient discharge status on the index hospitalization claim. Planned Readmissions A planned readmission is a readmission within 30 days of discharge from a short-term acute care hospital that is a scheduled part of the patient’s plan of care. Planned readmissions are excluded from this report. Condition-Specific 30-Day Readmission Rates When calculating disease-specific readmission rates, an admission is included if the principal diagnosis/procedure code for the admission specifies that disease (i.e., AMI, HF, CABG, PNE, COPD, and THA/TKA). Condition-specific readmissions include all-cause admissions that occur within 30 days of an index admission for the specific condition (e.g., a beneficiary with an index admission of AMI who is readmitted for a urinary tract infection (UTI) is considered an AMI readmission). Any beneficiary who dies in the hospital or is transferred to another hospital on the same day is excluded from your facility’s calculation. The following table lists the codes used to identify the discharges for AMI, HF, CABG, PNE, COPD, and THA/TKA. ED Visits and Observation Stays The following table lists the codes used to identify ED visits and observations stays. Revenue Codes ED Visits

0450, 0451, 0452, 0456, 0459, 0981

Observation Stays

0762, 0760

Readmission Report

HCPCS

AND

G0378

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Arizona Hospitals by Region Central Valley ABRAZO CENTRAL CAMPUS BANNER - UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS

ABRAZO SCOTTSDALE CAMPUS

ARIZONA STATE HOSPITAL

BANNER BEHAVIORAL HEALTH HOSPITAL

HAVEN SENIOR HORIZONS

HONORHEALTH DEER VALLEY MEDICAL CENTER

HONORHEALTH JOHN C LINCOLN MEDICAL CENTER

HONORHEALTH SCOTTSDALE OSBORN MEDICAL CENTER

HONORHEALTH SCOTTSDALE SHEA MEDICAL CENTER

HONORHEALTH SCOTTSDALE THOMPSON PEAK MEDICAL CENTER

MARICOPA MEDICAL CENTER

MAYO CLINIC HOSPITAL

OASIS HOSPITAL

PHOENIX INDIAN MEDICAL CENTER

QUAIL RUN BEHAVIORAL HEALTH

ST JOSEPH'S HOSPITAL AND MEDICAL CENTER

ST LUKE'S BEHAVIORAL HOSPITAL

ST LUKE'S MEDICAL CENTER

THE CORE INSTITUTE SPECIALTY HOSPITAL

VALLEY HOSPITAL

East Valley ARIZONA ORTHOPEDIC AND SURGICAL SPECIALITY HOSP

ARIZONA SPINE AND JOINT HOSPITAL

AURORA BEHAVIORAL HEALTHCARE-TEMPE

BANNER BAYWOOD MEDICAL CENTER

BANNER CASA GRANDE MEDICAL CENTER

BANNER DESERT MEDICAL CENTER

BANNER GATEWAY MEDICAL CENTER

BANNER GOLDFIELD MEDICAL CENTER

BANNER HEART HOSPITAL

BANNER IRONWOOD MEDICAL CENTER

CHANDLER REGIONAL MEDICAL CENTER

FLORENCE HOSPITAL AT ANTHEM, LLC MERCY GILBERT MEDICAL CENTER

GILBERT HOSPITAL

HUHU KAM MEMORIAL HOSPITAL

MOUNTAIN VISTA MEDICAL CENTER, LP

OASIS BEHAVIORAL HEALTH HOSPITAL

BANNER PAYSON MEDICAL CENTER COMMUNITY COUNSELING CTRS INC AT PINEVIEW HOSPITAL

CHINLE COMPREHENSIVE HEALTH CARE FACILITY

COBRE VALLEY REGIONAL MEDICAL CENTER

FLAGSTAFF MEDICAL CENTER

FORT DEFIANCE INDIAN HOSPITAL

HOPI HEALTH CARE CENTER

LITTLE COLORADO MEDICAL CENTER

PAGE HOSPITAL

SAGE MEMORIAL HOSPITAL

SAN CARLOS INDIAN HOSPITAL

SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER

Northern Arizona

THE GUIDANCE CENTER

TUBA CITY REGIONAL HEALTH CARE CORPORATION

VERDE VALLEY MEDICAL CENTER

WHITE MOUNTAIN REGIONAL MEDICAL CENTER

WHITERIVER PHS INDIAN HOSPITAL

WINDHAVEN PSYCHIATRIC HOSPITAL

YAVAPAI REGIONAL MEDICAL CENTER-EAST CAMPUS

YAVAPAI REGIONAL MEDICAL CENTER-WEST CAMPUS

BANNER-UNIVERSITY MEDICAL CENTER SOUTH CAMPUS

BANNER-UNIVERSITY MEDICAL CENTER TUCSON CAMPUS

BENSON HOSPITAL CARONDELET ST JOSEPH'S HOSPITAL

Southern Arizona CANYON VISTA MEDICAL CENTER

CARONDELET HOLY CROSS HOSPITAL

CARONDELET ST. MARY'S HOSPITAL

COPPER QUEEN COMMUNITY HOSPITAL

GREEN VALLEY HOSPITAL

MT GRAHAM REGIONAL MEDICAL CENTER

NORTHERN COCHISE COMMUNITY HOSPITAL

NORTHWEST MEDICAL CENTER

ORO VALLEY HOSPITAL

PALO VERDE BEHAVIORAL HEALTH

SELLS INDIAN HEALTH SERVICE HOSPITAL

SONORA BEHAVIORAL HEALTH HOSPITAL

SOUTHEAST ARIZONA MEDICAL CENTER

TUCSON MEDICAL CENTER

ABRAZO ARROWHEAD CAMPUS

ABRAZO MARYVALE CAMPUS

ABRAZO WEST CAMPUS

ARIZONA GENERAL HOSPITAL

AURORA BEHAVIORAL HEALTH SYSTEM

BANNER BOSWELL MEDICAL CENTER

BANNER DEL E WEBB MEDICAL CENTER

BANNER ESTRELLA MEDICAL CENTER

BANNER THUNDERBIRD MEDICAL CENTER

West Valley

WICKENBURG COMMUNITY HOSPITAL

Western Arizona HAVASU REGIONAL MEDICAL CENTER

KINGMAN REGIONAL MEDICAL CENTER

LA PAZ REGIONAL HOSPITAL

PARKER INDIAN HEALTH CENTER

VALLEY VIEW MEDICAL CENTER

WESTERN ARIZONA REGIONAL MEDICAL CENTER

YUMA REGIONAL MEDICAL CENTER

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