Exhibit 10.56


 






***  Confidential Information Omitted and filed separately
with the Securities and Exchange Commission.


 


CONTRACT
FOR HOSPITAL INPATIENT SERVICES


 


	
  Contract No.:

  	
  00-83123

  
	
   

  	
   

  
	
  Hospital:

  	
  ALTA HOLLYWOOD HOSPITALS, INC.

  dba:  HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD

  
	
   

  	
   

  
	
  Address:

  	
  6245 De Longpre Avenue

  Hollywood, CA 90028

  
	
   

  	
   

  
	
   

  	
  AND

  
	
   

  	
   

  
	
  Hospital:

  	
  ALTA HOLLYWOOD HOSPITALS, INC.

  dba:  HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS

  
	
   

  	
   

  
	
  Address:

  	
  14433 Emelita Street

  Van Nuys, CA 91401

  
	
   

  	
   

  
	
  Provider No.:

  	
  HSC 30135H – Hollywood Comm. Hosp,
  Hollywood

  HSC 30135H – Hollywood Comm. Hosp, Van Nuys

  



 


	
   

  	
  TERMS OF THIS CONTRACT AMENDMENT MUST
  REMAIN CONFIDENTIAL AND NOT SUBJECT TO PUBLIC DISCLOSURE UNTIL:

  
	
   

  	
   

  	
   

  
	
   

  	
  SERVICES:

  	
  09-14-01

  
	
   

  	
   

  	
   

  
	
   

  	
  PER DIEM RATE:

  	
  09-14-04

  
					



 


 


CONFIDENTIAL

DO NOT RELEASE

Exempt From Public Records Act

Government Code Section 6254(q)


 

















 


TABLE
OF CONTENTS


 


	
  ARTICLE
  1 

  	
  FORMATION

  
	
   

  	
  1.1

  	
  Identification
  of Parties

  
	
   

  	
  1.2

  	
  Specification
  of State’s Authority and Instrumentalities

  
	
   

  	
  1.3

  	
  Declaration
  that Beneficiaries under the Medi-Cal Program Are Not Third Party
  Beneficiaries under this Contract

  
	
   

  	
  1.4

  	
  Declaration
  of Present Contractual Intent

  
	
  ARTICLE
  2 

  	
  DEFINITIONS

  
	
   

  	
  2.1

  	
  General
  Meaning of Words and Terms

  
	
   

  	
  2.2

  	
  Acute
  Administrative Day

  
	
   

  	
  2.3

  	
  Beneficiary

  
	
   

  	
  2.4

  	
  Department

  
	
   

  	
  2.5

  	
  Fiscal
  Intermediary

  
	
   

  	
  2.6

  	
  Inpatient
  Services

  
	
   

  	
  2.7

  	
  May

  
	
   

  	
  2.8

  	
  Shall

  
	
  ARTICLE
  3 

  	
  PERFORMANCE
  PROVISIONS

  
	
   

  	
  3.1

  	
  General
  Agreement

  
	
   

  	
  3.2

  	
  Licensure
  and Certification as Conditions Precedent to State’s Payment Obligation

  
	
   

  	
  3.3

  	
  Utilization
  Controls: Compliance by Provider as Condition Precedent to Maturing State’s
  Payment Obligation

  
	
   

  	
  3.4

  	
  Appointment
  of Liaisons and Agency Status of Provider ‘s Liaison

  
	
   

  	
  3.5

  	
  Service
  Location

  
	
   

  	
  3.6

  	
  Quality
  of Care

  
	
   

  	
  3.7

  	
  Open
  Staff

  
	
   

  	
  3.8

  	
  Assumption
  of Risk by Provider

  
	
   

  	
  3.9

  	
  Delegation
  of Provider’s Duties: When Permitted

  
	
   

  	
  3.10

  	
  Patient
  Rights

  
	
   

  	
  3.11

  	
  Beneficiary
  Evaluation of Provider’s Services

  
	
   

  	
  3.12

  	
  Grievance
  Procedure

  
	
  ARTICLE
  4 

  	
  PAYMENT
  PROVISIONS

  
	
   

  	
  4.1

  	
  Rate
  Structure; Contingent Liability of State

  
	
   

  	
  4.2

  	
  Rate
  Inclusive of Physician, Transportation and Certain Prior Patient Services

  
	
   

  	
  4.3

  	
  Billing
  Procedures as Express Conditions Precedent to State’s Payment Obligation

  
	
   

  	
  4.4

  	
  Cost
  Reports

  
	
   

  	
  4.5

  	
  Recovery
  of Overpayments to Provider, Liability for Interest

  
	
   

  	
  4.6

  	
  Customary
  Charges Limitation

  
	
   

  	
  4.7

  	
  Assumption
  of Debts, Liabilities, and respective Other Obligations Deriving from
  Contract No. 96-83089

  
	
  ARTICLE
  5 

  	
  RECORDS
  AND AUDIT PROVISIONS

  
	
   

  	
  5.1

  	
  Onsite
  Reviews

  
	
   

  	
  5.2

  	
  Records
  to be Kept; Audit or Review: Availability; Period of Retention

  
				



 

















 


	
  ARTICLE
  6 

  	
  GENERAL
  PROVISIONS

  
	
   

  	
  6.1

  	
  Integration
  Clause

  	 

	
   

  	
  6.2

  	
  Performance
  Obligations; Effective Date and Term of this Waiver of Provider’s Right to
  Administrative Hearing

  	 

	
   

  	
  6.3

  	
  Headings
  – The headings of articles and paragraphs contained in this Contract are for
  reference purposes only and shall not affect in any way its meaning or
  interpretation.

  	 

	
   

  	
  6.4

  	
  Governing
  Authorities

  	 

	
   

  	
  6.5

  	
  Conformance
  with Federal Regulations

  	 

	
   

  	
  6.6

  	
  Application
  for Termination in the Face of a Declaration or Finding of Partial Invalidity

  	 

	
   

  	
  6.7

  	
  Restriction
  on Provider’s Freedom to Assign Benefits Only under this Contract or to
  Engage in Organic Change

  	 

	
   

  	
  6.8

  	
  Contract
  Officer - Delegation of Authority

  	 

	
   

  	
  6.9

  	
  Notice

  	 

	
   

  	
  6.10

  	
  Status
  as Independent Contractors

  	 

	
   

  	
  6.11

  	
  Informal
  Amendments Ineffective, Toleration of Deviation from Terms of Contract Not to
  be Construed as Waiver

  	 

	
   

  	
  6.12

  	
  Beneficiary
  Eligibility

  	 

	
   

  	
  6.13

  	
  Indemnification

  	 

	
   

  	
  6.14

  	
  Limitation
  of State Liability

  	 

	
   

  	
  6.15

  	
  Termination
  Without Cause

  	 

	
   

  	
  6.16

  	
  Termination
  for Default

  	 

	
   

  	
  6.17

  	
  Disputes

  	 

	
   

  	
  6.18

  	
  Conflict
  of Interest

  	 

	
   

  	
  6.19

  	
  Confidentiality
  of Information

  	 

	
   

  	
  6.20

  	
  Confidentiality
  of Contractual Provisions

  	 

	
   

  	
  6.21

  	
  Additional
  Provisions

  	 

	
   

  	
   

  	
   

  	 

	
  APPENDIX A

  	 

	
   

  	
   

  	 

	
  APPENDIX B

  	 

						



 

















 


ARTICLE
1

FORMATION


 


1.1                                 Identification of Parties


 


This Contract is between the State of
California, hereinafter designated “the State,” and ALTA HOLLYWOOD HOSPITALS,
INC., doing business as HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD and HOLLYWOOD
COMMUNITY HOSPITAL OF VAN NUYS, hereinafter designated “the Provider.”


 


1.2                                 Specification
of State’s Authority and Instrumentalities


 


The Provider hereby recognizes that this
Contract is formed under the authority of Sections 14081, et seq. of the
Welfare and Institutions Code and the regulations adopted pursuant thereto which
authorize the Department of Health Services to contract for provision of
inpatient hospital services to beneficiaries eligible for such services under
the Medi-Cal program in accordance with the rates, terms and conditions
negotiated by the California Medical Assistance Commission.


 


1.3                                 Declaration
that Beneficiaries under the
Medi-Cal Program Are Not Third Party Beneficiaries under this Contract


 


Notwithstanding mutual recognition that
services under this agreement will be rendered by the Provider to beneficiaries
under the Medi-Cal program, as more fully defined in Paragraph 2.3, it is not
the intention of either the State or Provider that such individuals occupy the
position of intended third party beneficiaries of the obligations assumed by
either party to this Contract.


 


1.4                                 Declaration of
Present Contractual Intent


 


The State and the Provider, in
consideration of the covenants, conditions, stipulations, terms and warranties
hereinafter expressed, presently contract as follows.


 


1

















 


ARTICLE
2

DEFINITIONS


 


2.1                                 General Meaning
of Words and Terms


 


The words and terms used in this Contract
are intended to have their usual meanings unless a particular or more limited
meaning is associated with their usage in Sections 14000, et seq. of the
Welfare and Institutions Code, or Title 22 of the California Code of
Regulations pertaining to the rendition of health care or unless specifically
defined in this Article or otherwise in this Contract.


 


2.2                                 Acute
Administrative Day


 


“Acute Administrative Day” means those
days approved in an acute inpatient facility which provides a higher level of
care than that currently needed by the patient (22 California Code of
Regulations Section 51173).


 


2.3                                 Beneficiary


 


“Beneficiary” means a person certified,
pursuant to Sections 14016 and 14018 of the Welfare and Institutions Code, as
eligible for Medi-Cal, except that beneficiary shall not include Medi-Cal
beneficiaries enrolled in Prepaid Health Plans or other organized health
systems which contract with the Department under the provisions of Sections
14000, et seq. of the Welfare and Institutions Code, and the regulations and
definitions adopted under Title 22 of the California Code of Regulations.  A beneficiary also includes that person whose
eligibility was not determined until after the rendition of inpatient
services.  Medi-Cal beneficiaries who are
also eligible for Medicare hospital benefits under the provisions of Title
XVIII of the Social Security Act, and who have not exhausted those benefits,
are not considered beneficiaries within the meaning of this Contract.  Beneficiary does not include those
individuals receiving skilled nursing facility or long term care services or
acute administrative day care.


 


2

















 


2.4                                 Department


 


“Department” means the State Department
of Health Services.


 


2.5                                 Fiscal
Intermediary


 


“Fiscal Intermediary” means that person
or entity who has contracted, as specified in Section 14104.3 of the
Welfare and Institutions Code, with the Department to perform fiscal
intermediary services related to this Contract.


 


2.6                                 Inpatient
Services


 


“Inpatient Services” includes, but is not
limited to, the following services when rendered in accordance with Sections
14133 and 14133.1 of the Welfare and Institutions Code, and Section 51327
of Title 22 of the California Code of Regulations to a Medi-Cal beneficiary:


 


(a)              Bed
and board;


 


(b)             Medical,
nursing, surgical, pharmacy and dietary services;


 


(c)              All
diagnostic and therapeutic services required by the beneficiary, including
physicians’ services, except as noted in Appendix A which is incorporated
herein by this reference;


 


(d)             Use
of hospital facilities, medical social services furnished by the hospital, and
such drugs, including takehome drugs, biologicals, supplies, appliances and
equipment, as are required by the beneficiary.


 


(e)              Transportation
services subsequent to admission required in providing inpatient services under
this Contract.


 


(f)                All
other services provided to hospital inpatients except as noted in Appendix A.


 


(g)             Services
rendered by the Provider within 24 hours prior to the beneficiary’s admission
as an inpatient, such as outpatient or emergency services which are related to
the condition for which the beneficiary is admitted as an inpatient.


 


3

















 


(h)                             Administrative
services required in providing inpatient services under this Contract.


 


2.7                                 May


 


“May” is used to indicate a permissive or
discretionary term of function.


 


2.8                                 Shall


 


“Shall” is used to introduce a covenant
of either the State or the Provider, and is mandatory.


 


4

















 


ARTICLE
3

PERFORMANCE PROVISIONS


 


3.1                                 General
Agreement


 


(a)                             Provider
agrees to render inpatient services (Paragraph 2.7) to any eligible beneficiary
(Paragraph 2.3) in need of such services and assumes full responsibility for
provision of all inpatient services, either directly, or as otherwise provided
in this Contract.  Provider agrees to
accept as payment in full for these inpatient services payment from the
Department as provided in Article 4 of this Contract.  The Department agrees to pay the Provider for
such services rendered in accordance with the terms and under the express
conditions of this Contract.


 


(b)                            Provider
shall, at its own expense, provide and maintain facilities and professional,
allied and supportive paramedical personnel to provide all necessary and
appropriate inpatient services.


 


(c)                             Provider
shall, at its own expense, provide and maintain the organizational and
administrative capabilities to carry out its duties and responsibilities under
this Contract and all applicable statutes and regulations pertaining to
Medi-Cal providers.


 


(d)                            For
the purpose of (a) of this Paragraph “any eligible beneficiary” means any
individual who meets the criteria established in Paragraph 2.3 of this Contract
without reference to residence, domicile or any other geographic factor.


 


(e)                             For
the purpose of (a) of this Paragraph “all inpatient services” means those
services defined in Paragraph 2.7 of this Contract unless expressly excluded in
Appendix A of this Contract.


 


3.2                                 Licensure and
Certification as Conditions Precedent to State’s Payment Obligation


 


(a)                             Provider
hereby represents and warrants that it is currently, and for the duration of
this Contract shall remain,


 


5

















 


licensed as a general acute care hospital
in accordance with Sections 1250 et seq. of the Health and Safety Code and the
licensing regulations contained in Title 22 and Title 17 of the California Code
of Regulations.


 


(b)                             Provider
hereby represents and warrants that it is currently, and for the duration of
this Contract shall remain, certified under Title XVIII of the Federal Social
Security Act.


 


(c)                              Provider
agrees that compliance with its obligations to remain licensed as a general
acute care hospital as provided in (a) of this Paragraph, and certified
under the Federal Social Security Act as provided in (b) of this Paragraph
shall be express conditions precedent to maturing the State’s payment
obligations under Paragraph 3.1(a) and Article 4 of this Contract.


 


3.3                                 Utilization
Controls: Compliance by Provider as Condition Precedent to Maturing State’s
Payment Obligation


 


As express conditions
precedent to maturing the State’s payment obligation under the terms of this
Contract the Provider shall adhere to all utilization controls and obtain prior
authorization for services in accordance with the statutes and, except for
those provisions waived by the Director of the Department of Health Services,
regulations and Provider Bulletins governing the Medi-Cal program (Paragraph
6.4 [a] [1]).


 


3.4                                 Appointment of
Liaisons and Agency Status of Provider ‘s Liaison


 


(a)                              Provider
shall designate in writing a person to act as liaison to the Department.  Such person shall coordinate all
communications between the parties.  The
written designation of such person shall constitute the conferral of full
agency powers to bind the Provider as principal in all dealings with the
Department.


 


(b)                             The
Department shall designate a liaison in conformity with the procedures and with
such authority as specified in Paragraph


 


6

















 


6.8 of this Contract.  Communications to the Department shall be
submitted to its liaison at the following address:


 


Contract
Officer

Medi-Cal Operations Division

P.O. Box 942732

Sacramento, CA 94234-7320


 


3.5                               Service Location


 


Inpatient services rendered pursuant to
this Contract shall be rendered at the following facilities:


 


	
   

  	
  HOLLYWOOD COMMUNITY
  HOSPITAL 

  OF HOLLYWOOD

  6245 De Longpre Avenue

  Hollywood, CA  90028

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  HOLLYWOOD COMMUNITY
  HOSPITAL 

  OF VAN NUYS

  14433 Emelita Street

  Van Nuys, CA  91401

  	
   

  



 


3.6                               Quality of Care


 


As express conditions
precedent to maturing the State’s payment obligation under the terms of this
Contract, the Provider shall:


 


(1)                                Assure
that any and all eligible beneficiaries receive care as required by Sections
51207 (a) (4) and 70703 (a) of Title 22 of the California Code
of Regulations.


 


(2)                                Take
such action as required by Provider’s Medical Staff Bylaws against medical
staff members who violate those bylaws, as the same may be from time to time
amended.


 


(3)                                Provide
inpatient services in the same manner to beneficiaries as it provides to all
patients to whom it renders inpatient services.


 


(4)                                Not
discriminate against Medi-Cal beneficiaries in any manner, including admission
practices, placement in special or separate wings or rooms, provision of
special or separate meals, or waiting time for surgical procedures.


 


3.7                               Open Staff


 


Provider
shall not deny medical staff membership or clinical


 


7

















 


privileges for reasons other than a
physician’s individual qualifications as determined by professional and ethical
criteria, uniformly applied to all medical staff applicants and members.  Determination of medical staff membership or
clinical privileges shall not be made upon the basis of:


 


(1)                                The
existence of a contract with the Provider or with others;


 


(2)                                Membership
in or affiliation with any society, medical group or teaching facility or upon
the basis of any criteria lacking professional justification, such as sex,
race, creed or national origin.


 


3.8                               Assumption of Risk by
Provider


 


The Provider shall bear total risk for
the cost of all inpatient services rendered to each beneficiary covered by this
Contract.  As used in this Paragraph “risk”
means that the Provider covenants to accept as payment in full for any and all
inpatient services (Paragraph 2.6) payments made by the State pursuant to Article 4
of this Contract.  Such acceptance shall
be made irrespective of whether the cost of such services, transportation and
related administrative expenses shall have exceeded the payment obligation of
the State matured under the conditions set forth in this Contract.  The term “risk” also includes, but is not
limited to the cost for all inpatient services for illness or injury which
results from or is contributed to by catastrophe or disaster which occurs
subsequent to the effective date of this Contract, including but not limited to
acts of God, war or the public enemy.


 


3.9                               Delegation of Provider’s
Duties: When Permitted


 


The Provider and State recognize that the
inpatient hospital services covered by this Contract are personal and
non-delegable.  Any attempt by the
Provider to delegate or otherwise vest responsibility for performance of its
duties in any manner shall constitute a present material breach of this
Contract.


 


3.10                         Patient Rights


 


The Provider shall adopt and post in a
conspicuous place a


 


8

















 


written policy on patient’s rights in
accordance with Section 70707 of Title 22 of the California Code of
Regulations.  Procedures for resolving a
beneficiary’s complaint involving patients’ rights may be combined with the
grievance procedure in Paragraph 3.12. 
Complaints by beneficiaries with regard to substandard conditions may be
instigated by the Department’s Licensing and Certification Division or by the
Joint Commission on Accreditation of Healthcare Organization, or such other
agency, as required by law or regulation.


 


3.11                         Beneficiary Evaluation of
Provider’s Services


 


The Provider shall provide a written
questionnaire to the beneficiary at the time of the beneficiary’s
admission.  The questionnaire shall be
approved by the Department and offer the beneficiary the opportunity to
evaluate the care given.  It shall be
collected at the time of discharge and maintained in the Provider’s file for
four years, and shall be made available to agents of the Department.


 


3.12                         Grievance Procedure


 


The Provider shall establish and maintain
a procedure for resolving beneficiary grievances.  Such procedure shall be approved by the
Department prior to implementation.  The
grievance procedure shall include:


 


(1)                                Immediate
recording of all grievances received, including information sufficient to
identify the grievant, date of receipt, nature of the problem, date and
resolution or disposition of the grievance. 
Such records and related documents shall be open to inspection by the
Department and the Federal Department of Health and Human Services for a period
of four years.


 


(2)                                A
finding of fact and resolution within 30 days of receipt of the grievance.


 


(3)                                In
those cases where the grievant is not identifiable, or when the problem cannot
be resolved, entry of notations to that effect in the record, including the
reasons why the grievance could not be resolved


 


9

















 


and the individual responsible for that
decision.


 


(4)                                  If
the grievant is identifiable, transmittal of a copy of the finding of fact, and
an explanation of the resolution or disposition of the grievance to the
grievant and the Department within five days of the decision.


 


(5)                                  If
the grievant is identifiable, notification to the grievant regarding a right to
appeal the disposition of the grievance in the form of a complaint with the
Department’s liaison designated under Paragraph 6.8.


 


(6)                                  A
grievance coordinator.


 


10














 


ARTICLE
4

PAYMENT PROVISIONS


 


4.1           Rate Structure;
Contingent Liability of State


 


Provided
that there shall first have been a submission of claims in accordance with
Paragraph 4.3 of this Contract, the Provider shall be paid at the all-inclusive
rate per patient per day of *** for inpatient services provided to
beneficiaries.


 


4.2           Rate Inclusive of
Physician, Transportation and Certain Prior Patient Services


 


The
rate structure under Paragraph 4.1 of this Contract is intended by both the
State and Provider to be inclusive of all inpatient services rendered by the
Provider and to constitute the State I s only financial obligation under this
Contract.  As nonlimiting examples:


 


(a)           There
shall be no separate billing by either the Provider or physicians for inpatient
services rendered by physicians to beneficiaries covered by this Contract,
except for those inpatient services set forth in Appendix A previously
incorporated by reference as part of this Contract.


 


(b)           There
shall be no separate billing for any transportation services required in
providing inpatient services under this Contract.


 


(c)           There
shall be no separate billing for any services rendered by the Provider within a
24-hour period prior to the beneficiary’s admission as an inpatient, such as
outpatient or emergency services, which are related to the condition for which
the beneficiary is admitted as an inpatient. 
Such prior services shall be deemed inpatient services and included in
the rates set under Paragraph 4.1.


 


4.3           Billing Procedures
as Express Conditions Precedent to State’s Payment Obligation


 


(a)           As
an express condition precedent to maturing the State’s payment obligation under
Paragraph 4.1 of this Contract, the Provider


 


11

















 


shall
determine that inpatient services rendered directly are not covered, in whole
or in part, under any other state or federal medical care program or under any
other contractual or legal entitlement, including, but not limited to, a
private group indemnification or insurance program or workers’
compensation.  To the extent that such
coverage is available, the State’s payment obligation pursuant to paragraph 4.1
shall be reduced.


 


(b)           As
a further express condition precedent to maturing the State is payment obligation
under Paragraph 4.1 of this Contract, the Provider shall submit claims to the
fiscal intermediary for all services rendered under the terms of this Contract,
in accordance with the applicable billing requirements contained in Title 22 of
the California Code of Regulations.


 


(c)           A
day of service shall be billed for each beneficiary who occupies an inpatient
bed at 12:00 midnight in the facilities of the Provider.  However, a day of service may be billed if
the beneficiary is admitted and discharged during the same day provided that
such admission and discharge is not within 24 hours of a prior discharge.  Only one patient day of service may be billed
for mother and newborn child (children) when both mother and newborn child
(children) are inpatients of the hospital.


 


4.4           Cost Reports


 


Although
they shall not be used for payment purposes under this Contract, as an express
condition precedent to maturing the State’s payment obligation under Paragraph
4.1 of this Contract the Provider shall complete and file Medi-Cal cost reports
in accordance with the requirements in effect during the terms of this
Contract.


 


4.5           Recovery of
Overpayments to Provider, Liability for Interest


 


(a)           When
an audit performed by the Department, the State Controller’s Office, or any other
State agency discloses that the Provider has been overpaid under this Contract,
or where the total payments exceed


 


12

















 


the
total liability under this Contract, the Provider covenants that any such overpayment
or excess payments over liability may be recouped by the Department withholding
the amount due from future payments, seeking recovery by payment from the
Provider, or a combination of these two methods.


 


(b)           Overpayments
determined as a result of audits of periods prior to the effective date of this
Contract may be recouped by the Department withholding the amount due from what
would otherwise be the State’s liability under this Contract, seeking recovery
by payment from the Provider, or a combination of those two methods.


 


(c)           When
the Department seeks recoupment or recovery under (a) of this Paragraph
the Provider may appeal according to applicable procedural requirements of
Sections 51016-51047 of Title 22 of the California Code of Regulations, with
the following exceptions:


 


(1)           There
shall be no informal hearing.


 


(2)           The
recovery or recoupment shall commence sixty (60) days after issuance of account
status or demand resulting from an audit or review and shall not be deferred by
the filing of a request for hearing pursuant to Section 51022 of Title 22
of the California Code of Regulations.


 


(3)           The
Provider’s liability to the State for any amount recovered under this Paragraph
shall be as provided in Sections 14171 and 14171.5 of the Welfare and Institutions
Code and regulations adopted pursuant thereto.


 


4.6           Customary Charges
Limitation


 


(a)           No
provision in this Contract withstanding, the State’s total liability to the
Provider shall not exceed the Provider’s total customary charges for like
services during each hospital fiscal year or part thereof, in which this
Contract is in effect.  The Department
may recoup any excess of total payments above such total customary charges
under Paragraph 4.5.


 


13

















 


(b)           As
used in (a) of this Paragraph “customary charges” is defined in conformity
with 42 USC Section 1395(f) and the regulations promulgated pursuant
thereto.


 


4.7           Assumption of Debts,
Liabilities, and respective Other Obligations Deriving from Contract No. 96-83089


 


The
parties hereby agree to assume all their respective debts, liabilities, and
other obligations related to or deriving from Contract No.  96-83089
between HOLLYWOOD HOSPITAL MEDICAL CENTER, INC., A CALIFORNIA LIMITED
PARTNERSHIP doing business as HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD, and
the Department of Health Services.


 


14

















 


ARTICLE
5

RECORDS AND AUDIT PROVISIONS


 


5.1           Onsite Reviews


 


(a)           Agents
of the Department shall conduct periodic audits or reviews, including onsite
audits or reviews, of performance under this Contract.  These audits or reviews may evaluate the
following:


 


(1)           Level
and quality of care, and the necessity and appropriateness of the services
provided.


 


(2)           Internal
procedures for assuring efficiency, economy and quality of care.


 


(3)           Grievances
relating to medical care and their disposition.


 


(4)           Financial
records when determined necessary by the Department to protect public funds.


 


(b)           The
Provider shall make adequate office space available for the review team or
auditors to meet and confer.  Such space
must be capable of being locked and secured to protect the work of the review
team or auditors during the period of their investigation.


 


(c)           Onsite
reviews and audits shall occur during normal working hours with at least
72-hour notice, except that unannounced onsite reviews and requests for
information may be made in those exceptional situations where arrangement of an
appointment beforehand is clearly not possible or clearly inappropriate to the
nature of the intended visit.


 


5.2           Records to be Kept;
Audit or Review: Availability; Period of Retention


 


The
Provider covenants that:


 


(1)           It
shall maintain books, records, documents, and other evidence, accounting
procedures, and practices sufficient to reflect properly all direct and
indirect costs of whatever nature claimed to have


 


15

















 


been
incurred in the performance of this Contract.


 


(2)           The
above information shall be maintained in accordance with Medicare principles of
reimbursement and generally accepted accounting principles, and shall be
consistent with the requirements of the Office of Statewide Health Planning and
Development.


 


(3)           The
Provider shall also maintain medical records required by Sections 70747 - 70751
of the California Code of Regulations, and other records related to a
beneficiary’s eligibility for services, the service rendered, the beneficiary
to whom the service was rendered, the date of the service, the medical
necessity of the service and the quality of the care provided.  Records shall be maintained in accordance
with Section 51476 of Title 22 of the California Code of Regulations.  The foregoing constitute “records” for the
purposes of this Paragraph.


 


(4)           The
facility or office, or such part thereof as may be engaged in the performance
of this Contract, and the information specified in this Paragraph shall be
subject at all reasonable times to inspection, audits and reproduction by any
duly authorized agents of the Department, the Federal Department of Health and
Human Services and Comptroller General of the United States.  The Federal Department of Health and Human
Services and Comptroller General of the United States are intended third party
beneficiaries of this covenant.


 


(5)           Preserve
and make available its records relating to payments made under this Contract
for a period of four years from the close of the Provider’s fiscal year, or for
such longer period, required by subparagraphs (A) and (B) below.


 


(A)          If
this Contract is terminated, the records relating to the work terminated shall
be preserved and made available for a period of four years from the date of the
last payment made under the Contract.


 


(B)           If
any litigation, claim, negotiation, audit or other


 


16

















 


action
involving the records has been started before the expiration of the four year
period, the related records shall be retained until completion and resolution
of all issues arising therefrom or until the end of the four year period
whichever is later.


 


17

















 


ARTICLE
6

GENERAL PROVISIONS


 


6.1           Integration Clause


 


The
State and Provider declare that this instrument, including Appendix A and
Appendix B, contains a total integration of all rights and obligations of both
parties.  There are no extrinsic
conditions or collateral agreements or undertakings of any kind.  In regarding this instrument as the full and
final expression of their Contract it is the express intention of both the
State and the Provider that any and all prior or contemporaneous agreements,
promises, negotiations, or representations, either oral or written, relating to
the subject matter and period of time governed by this instrument which are not
expressly set forth herein are to have no force, effect, or legal consequence
of any kind.


 


6.2           Performance
Obligations; Effective Date and Term of this Waiver of Provider’s Right to
Administrative Hearing


 


Performance
obligations assumed under this Contract shall commence on the 14th
day of September 2000, and shall apply to all inpatient admissions on or
after this date.  This Contract shall
continue indefinitely subject to the provisions of Paragraph 6.14 and the
rights of termination reserved under Paragraphs 6.15, 6.16 and 6.18.  However, the terms of this Contract shall
continue to apply to any beneficiary receiving inpatient services at the date
of termination.  There shall be no
entitlement to an administrative hearing pursuant to these sections.  The Provider waives any claim it may have to
such a hearing in consideration of the covenants, conditions and provisions of
this Contract.


 


6.3           Headings – The
headings of articles and paragraphs contained in this Contract are for
reference purposes only and shall not affect in any way its meaning or
interpretation.


 


18

















 


6.4           Governing
Authorities


 


(a)           This
Contract shall be governed and construed in accordance with:


 


(1)           Part 3,
Division 9 of the Welfare and Institutions Code; Divisions 3 and 5 of Title 22
of the California Code of Regulations; and all other applicable state laws and
regulations according to their content on the effective date stipulated in
Paragraph 6.2; and


 


(2)           Titles
42 and 45 (Part 74) of the Code of Federal Regulations and all other
applicable federal laws and regulations according to their content on and after
the effective date stipulated in Paragraph 6 .2, except those provisions or
applications of those provisions waived by the Secretary of the Department of
Health and Human Services.


 


(b)           Any
provision of this Contract in conflict with the laws or regulations stipulated
in (a) of this Paragraph is hereby amended to conform to the provisions of
those laws and regulations.  Such
amendment of the Contract shall be effective on the effective date of the
statute or regulation necessitating it, and shall be binding on the parties
even though such amendment may not have been reduced to writing and formally
agreed upon and executed by the parties as provided in Paragraph 6.11.


 


6.5           Conformance with
Federal Regulations


 


The
Provider stipulates that this Contract, in part, implements Title XIX of the
Federal Social Security Act and, accordingly, covenants that it will conform to
such requirements and regulations as the United States Department of Health and
Human Services may issue from time to time, except for those provisions waived
by the Secretary of Health and Human Services.


 


6.6           Application for
Termination in the Face of a Declaration or Finding of Partial Invalidity


 


In
the event any provision of this Contract is declared null and


 


19

















 


void
by any court of law, either party may apply to that court for permission to
immediately rescind the remainder of the Contract.  In ruling upon this request the court shall
consider the impact upon the affected Medi-Cal population as well as the
relative degree of hardship which would be imposed upon either or both of the
parties if the request is denied.


 


6.7           Restriction on
Provider’s Freedom to Assign Benefits Only under this Contract or to Engage in
Organic Change


 


The
State and Provider hereby declare their mutual recognition that the subject
matter of this Contract is personal, being founded upon the State’s confidence
in the reputation, type and location of facilities, and other personal
attributes of the Provider.  For this
reason:


 


(1)           Unless
given prior written approval by the Department any attempt by the Provider to
make an assignment of the right to receive the contingent payment obligations
of the State under this contract shall operate as an express condition
subsequent to those obligations discharging the State from what may otherwise
have been a matured obligation of performance.


 


(2)           If
the Provider desires to make an assignment of rights only under this Contract
it shall submit a written application for approval to the Department.  Such an application shall identify the
proposed assignee and include a detailed explanation of the reason and basis
for the proposed assignment.  If the
Department is satisfied that the proposed assignment is consistent with the
continued receipt of satisfactory performance on the part of the Provider it
shall be approved in writing.  The
effective date of the assignment shall be the date upon which the Department
issues written approval.


 


(3)           Unless
given prior written approval by the Department any attempt by the Provider to
participate as a constituent entity in any


 


20

















 


merger,
consolidation or sale of assets other than in the regular course of business
shall operate as an express condition subsequent discharging the State from
what may otherwise have been a matured obligation of performance under this
Contract.


 


(4)           If
the Provider desires to participate as a constituent entity in any merger,
consolidation or sale of assets other than in the regular course of business it
shall submit a written application for approval to the Department.  The Department shall act upon such requests
within 30 days of the receipt of such requests.


 


(A)          If
approval is sought for participation in a merger or consolidation the
application shall identify all proposed constituent entities and disclose the
rights and preferences of all classes of stock in the resulting or surviving
entity.  In addition, the application
shall inform the Department of the licensure and certification status of the
proposed resulting or surviving entity (Paragraph 3.2), and such other
information as the Department may require.


 


(B)           If
application is sought for approval of a sale of assets other than in the
regular course of business it shall identify the purchaser; inform the
Department of licensure and certification status of the purchaser (Paragraph
3.2); and, such other information as the Department may require.


 


(5)           If
the Department is satisfied that the proposed merger, consolidation or sale of
assets other than in the regular course of business is consistent with the
continued satisfactory performance of the Provider is obligations under this
Contract it shall be approved in writing. 
The effective date of the merger, consolidation or sale of assets other
than in the regular course of business shall be no earlier than the date upon
which the Department issues written approval.


 


21














 


6.8                                 Contract
Officer - Delegation of Authority


 


The Department will administer this
Contract through a single administrator, the Contract Officer.  Until such time as the Director gives the
Provider written notice of successor appointment, the person designated above
shall make all determinations and take all actions necessary to administer this
Contract, subject to the limitations of California laws and state
administrative regulations.  No person
other than the Contract Officer or the Director shall have the power to bind
the Department relative to the rights and duties of the Contractor and the
Department under this Contract, nor shall any other person be considered to
have the delegated authority of the Contract Officer or to be acting on his
behalf unless the Contract Officer has expressly stated in writing that that
person is acting as his authorized agent.


 


6.9                                 Notice


 


Any notice required to be given pursuant
to the terms and provisions of the Contract shall be in writing and shall be
sent by certified mail, return receipt requested.  Notice to the Department shall be sent to the
following address:


 


Contract Officer

Medi-Cal Operations Division

P.O. Box 942732

Sacramento, CA 94234-7320.


 


Notice to the Provider shall be sent to
the Chief Executive Officer at the following address:


 


HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD

6245 De Longpre Avenue

Hollywood, CA 90028


 


6.10                           Status
as Independent Contractors


 


The State and Provider hereby acknowledge
that they are


 


22

















 


independent contractors to one another
and neither is an officer, agent, or employee of the other for any purpose.


 


6.11                           Informal
Amendments Ineffective, Toleration of Deviation from Terms of Contract Not to
be Construed as Waiver


 


(a)                                  It
is the express intention of both the State and Provider that the terms of this
totally integrated writing shall comprise their entire Contract and are not
subject to rescission, modification or waiver except as defined in a subsequent
written instrument executed in the same manner and with the same
authority.  In furtherance of this
agreement the State and Provider mutually covenant and request of any reviewing
tribunal that any claim of rescission, modification, or waiver predicated upon
any evidence other than a subsequent written instrument executed in the same
manner and with the same authority as this writing be regarded as void.


 


(b)                                 The
informal toleration by either party of defective performance of any independent
covenant in this Contract shall not be construed as a waiver of either the
right to performance or the express conditions which have been created in this
Contract.


 


6.12                           Beneficiary
Eligibility


 


This Contract is not intended to change
the determination of Medi-Cal eligibility for beneficiaries in any way.  However, in the event the California State
Legislature or Congress of the United States enacts a statute which redefines
Medi-Cal eligibility so as to affect the provision of inpatient services under
this Contract, this new definition shall apply to the terms of this Contract.


 


6.13                           Indemnification


 


The Provider covenants to indemnify,
defend and hold harmless the State, its officers, agents and employees from any
and all claims and losses accruing or resulting to any and all contractors,
subcontractors, materialmen, laborers or any other person, firm or corporation


 


23

















 


furnishing or supplying work, services,
materials or supplies in connection with the performance of this Contract, and
from any and all claims and losses accruing or resulting to any person, firm or
corporation who may be injured or damaged by the Provider in the performance of
this Contract.


 


6.14                           Limitation
of State Liability


 


No provision of this Contract
withstanding, the liability of the State shall not exceed the amount of funds
appropriated in the support of this Contract by the California
Legislature.  Any requirement of
performance by the Department and the Provider is dependent upon the
availability of appropriations by the Legislature for the purpose of this
Contract.


 


6.15                           Termination
Without Cause


 


The Provider or the State may terminate
this Contract without cause in accordance with this Paragraph.  Termination without cause shall be effected
by giving written notice of the termination to the other party at least 120
days prior to the effective date of the termination and stating the effective
date of the termination.


 


6.16                           Termination
for Default


 


(a)                                  The
State may terminate this Contract for default upon thirty (30) days written
notice to the Provider, except in cases where the Department determines that
the health and welfare of Medi-Cal beneficiaries is jeopardized by continuation
of the Contract, in which case the Contract may be immediately terminated.  Notification shall state the effective date
of and grounds for termination.


 


(b)                                 The
State may terminate this agreement upon thirty (30) days written notice to the
Provider in the event that: (1) The Secretary of the Department of Health
and Human Services determines that the Provider does not meet the requirements
for participation in the Medicaid


 


24

















 


program, Title XIX of the Social Security
Act; (2) The Provider has violated the conflict of interest provisions
contained in Paragraph 6.18 of this Contract; or, (3) The Department
determines that the Provider is abusing or defrauding the Medi-Cal program or
its beneficiaries.


 


6.17                           Disputes


 


(a)                                  As
an alternative to the judicial remedy available to the Provider under Section 14087.27(a) of
the Welfare and Institutions Code the Provider may appeal disputes relating to
performance under this Contract to an independent hearing examiner appointed by
the Director of the Department.  The
proceedings for review of such disputes shall be conducted by the hearing
examiner and a decision rendered pursuant to the applicable procedural
requirements of Sections 51016-51047 of Title 22 of the California Code of
Regulations regarding provider audit appeals with the following exceptions:


 


(1)                                  There
shall be no informal hearing.


 


(2)                                  All
references to a hearing officer shall apply to the independent hearing examiner
appointed by the Director of the Department.


 


(b)                                 The
State and Provider stipulate recognition that the Provider Audit Appeals provisions
referenced in (a) of this Paragraph were enacted as an administrative
mechanism for disputing audit or examination findings regarding the Provider’s
cost report.  The obligations of the
parties to this Contract are not predicated upon a reimbursement of cost basis
and, for that reason, many of the provisions of Section 51016-51047 of
Title 22 of the California Code of Regulations, such as cost reports, amended
cost reports, audit reports, amended audit reports, home office-chain
organization related entities, and informal hearings will not be applicable in
the resolution of disputes arising under this Contract.  “Applicable procedural requirements” is
employed in (a) of this Paragraph to render irrelevant such inapplicable
provisions.


 


25

















 


6.18                           Conflict
of Interest


 


(a)                                  The
Provider is subject to the terms and conditions of Section 51466 of Title
22 of the California Code of Regulations as promulgated pursuant to Sections
14022, 14124.5, 14030 and 14031 of the Welfare and Institutions Code, and must
submit a Medi-Cal Personal Disclosure Statement of Significant Beneficial
Interest form as provided by the Department.


 


(b)                                 This
Contract shall be terminated immediately if it is determined that a state officer
or state employee responsible for development, negotiation, contract
management, or supervision of this Contract has a financial interest in the
Contract as that term is defined in Section 87103 of the Government Code
and the regulations adopted pursuant thereto.


 


6.19                           Confidentiality
of Information


 


(a)                                  No
provision of this Contract withstanding, names of persons receiving public
social services are confidential and are to be protected from unauthorized
disclosure in accordance with Title 45, Code of Federal Regulations Section 205.50;
Sections 10850 and 14100.2 of the Welfare and Institutions Code; and,
regulations adopted pursuant thereto. 
For the purpose of this Contract, all information, records, and data
elements pertaining to beneficiaries shall be protected by the Provider from
unauthorized disclosure.


 


(b)                                 With
respect to any identifiable information concerning beneficiaries under this
Contract that is obtained by the Provider, the Provider:


 


(1)                                  Shall
not use any such information for any purpose other than carrying out the
express terms of this Contract;


 


(2)                                  Shall
promptly transmit to the Department all requests for disclosure of such
information;


 


26

















 


(3)                                  Shall
not disclose, except as otherwise specifically permitted by this Contract, any
such information to any party other than the Department without the Department’s
prior written authorization specifying that the information may be released
under Title 45, Code of Federal Regulations Section 205.50; Sections 10850
and 14100.2 of the Welfare and Institutions Code; and, regulations adopted
pursuant thereto; and,


 


(4)                                  Shall,
at the termination of this Contract, return all such information to the
Department or maintain such information according to written procedures sent to
the Provider by the Department for this purpose.


 


6.20                           Confidentiality
of Contractual Provisions


 


This Contract and its terms shall remain
confidential and the terms of the Contract may be disclosed by the parties only
in accordance with the disclosure time limits set out in Government Code Section 6254
(q).


 


6.21                           Additional
Provisions


 


Provider shall comply with Paragraphs 1.0
through 6.0 as set forth in “Appendix B,” attached hereto and incorporated
herein by this reference, but only to the extent that it is mandated by law
that the State incorporate and enforce such provisions in this Contract, and
the Provider reserves any and all rights it may have to seek administrative
and/or judicial review with respect to such provisions.


 


27

















 


EXECUTION


 


This Contract shall be deemed duly
executed and binding upon execution by both Parties below.


 


 


	
  Executed on September 8, 2000, at

  	
   

  	
   

  
	
  Santa Monica, CA  90405

  	
   

  	
   

  
	
  (City, State, Zip)

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Alta Healthcare System, Inc. 

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  By: 

  	
   

  
	
   

  	
   

  	
   

  	
  Signature 

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  David R. Topper, President and CEO 

  
	
   

  	
   

  	
  Type Name and Title

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Hollywood Community Hospital of

  Hollywood

  and

  Hollywood Community Hospital of Van

  Nuys

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  By: 

  	
   

  
	
   

  	
   

  	
   

  	
  Signature 

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Remy Hart, CEO 

  
	
   

  	
   

  	
  Type Name and Title

  



 


 


Executed on NOV – 2  2000, at

Sacramento, California


 


	
   

  	
  STATE OF CALIFORNIA

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  
	
   

  	
   

  	
  Diana M. Bontá, R.N., Dr. P.H.

  
	
   

  	
   

  	
  Director

  
	
   

  	
   

  	
  Department of Health Services

  



 


28

















 


APPENDIX
A


 


	
   

  	
  HOSPITAL NAME:

  	
   

  	
  Hollywood Community Hospital of

  Hollywood and Hollywood Community

  Hospital of Van Nuys New Contract

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  DATE PREPARED:

  	
   

  	
  August 31, 2000

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  PREPARED BY:

  	
   

  	
  Karen A. Thalhammer

  



 


I.                                         SERVICES
NOT PROVIDED BY HOSPITAL OR ITS DELEGATE UNDER THIS CONTRACT AND NOT
REIMBURSABLE


 


	
   

  	
   

  	
  UNIVERSAL
  BILLING CODES

  
	
  INTENSIVE
  CARE, TRAUMA

  	
   

  	
  208

  
	
  INTENSIVE
  CARE, POST ICU

  	
   

  	
  206

  
	
  INTENSIVE
  CARE, PEDIATRIC

  	
   

  	
  203

  
	
  INTENSIVE
  CARE, LUNG TRANSPLANT

  	
   

  	
  083

  
	
  INTENSIVE
  CARE, HEART-LUNG TRANSPLANT

  	
   

  	
  084

  
	
  INTENSIVE
  CARE, HEART TRANSPLANT

  	
   

  	
  086

  
	
  INTENSIVE
  CARE, LIVER TRANSPLANT

  	
   

  	
  087

  
	
  INTENSIVE
  CARE, BONE MARROW TRANSPLANT

  	
   

  	
  088

  
	
  INTENSIVE
  CARE, KIDNEY TRANSPLANT

  	
   

  	
  089

  
	
  INTENSIVE
  CARE, BURN CARE IN LICENSED BURN CENTER BEDS

  	
   

  	
  207

  
	
  CORONARY
  CARE, GENERAL

  	
   

  	
  210

  
	
  CORONARY
  CARE, MYOCARDIAL INFARCTION

  	
   

  	
  211

  
	
  CORONARY
  CARE, OTHER

  	
   

  	
  219

  
	
  CORONARY
  CARE, PULMONARY CARE

  	
   

  	
  212

  
	
  CORONARY
  CARE, POST CCU

  	
   

  	
  214

  
	
  NURSERY,
  NEONATAL INTENSIVE CARE

  	
   

  	
  175

  
	
  LITHOTRIPSY

  	
   

  	
  090

  
	
  PEDIATRIC
  - PRIVATE

  	
   

  	
  113

  
	
  PEDIATRIC
  - SEMI-PRIVATE 2 BEDS

  	
   

  	
  123

  
	
  PEDIATRIC
  - SEMI-PRIVATE 3 OR 4 BEDS

  	
   

  	
  133

  
	
  PEDIATRIC
  - WARD (MEDICAL OR GENERAL)

  	
   

  	
  153

  
	
  OBSTETRIC
  - PRIVATE

  	
   

  	
  112

  
	
  OBSTETRIC
  - SEMI-PRIVATE 2 BEDS

  	
   

  	
  122

  
	
  OBSTETRIC
  - SEMI-PRIVATE 3 OR 4 BEDS

  	
   

  	
  132

  
	
  OBSTETRIC
  - WARD (MEDICAL OR GENERAL)

  	
   

  	
  152

  
	
  NURSERY
  NEWBORN, WELL BABY

  	
   

  	
  171

  
	
  NURSERY
  ACUTE WITHOUT ASSOCIATED DELIVERY

  	
   

  	
  085

  
	
  NURSERY
  NEWBORN, INELIGIBLE

  	
   

  	
  094

  
	
  MOTHER
  NURSERY ACUTE WITH ASSOCIATED DELIVERY

  	
   

  	
  095

  
	
  ADMINISTRATIVE
  DAY

  	
   

  	
  098*

  
	
  REHABILITATION
  - PRIVATE

  	
   

  	
  118

  
	
  REHABILITATION
  - SEMI-PRIVATE 2 BEDS

  	
   

  	
  128

  
	
  REHABILITATION
  - SEMI-PRIVATE 3 OR 4 BEDS

  	
   

  	
  138

  
	
  REHABILITATION
  - WARD (MEDICAL OR GENERAL)

  	
   

  	
  158

  



 


	
   

  	
   

  	
  CPT-4
  CODES

  
	
  CARDIAC
  CATHETERIZATION

  	
   

  	
  93501-93562

  
	
  CARDIOVASCULAR
  SURGERY

  	
   

  	
  33010-37799

  
	
  ABORTIONS

  	
   

  	
  59840-59857

  
	
  STERILIZATION

  	
   

  	
  55250,55450,56301,56302

  
	
  STERILIZATION

  	
   

  	
  58600,58605,58611,58615

  
	
  NEUROSURGERY

  	
   

  	
  61000-64999

  
	
  CORNEAL
  TRANSPLANTS

  	
   

  	
  65710,65730,65750,65755

  
	
  RADIATION
  THERAPY

  	
   

  	
  77261-77499,77750-77799

  
	
  THERAPEUTIC
  NUCLEAR MEDICINE

  	
   

  	
  79000-79999

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  70336,70540

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  70551-70553,71550

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  72141-72142,72146-72149

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  72156-72158,72196

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  73220-73221,73720-73721

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  74181,75552,75554-75556

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  76093-76094,76400

  
	
  HYPERBARIC
  OXYGEN

  	
   

  	
  99183

  



 






*BILLABLE ONLY OUTSIDE THE PROVISIONS OF
THE CONTRACT.


 


29

















 


APPENDIX
A (CONTINUED)


 


	
   

  	
  HOSPITAL NAME:

  	
   

  	
  Hollywood Community Hospital of

  Hollywood and Hollywood Community

  Hospital of Van Nuys New Contract

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  DATE PREPARED:

  	
   

  	
  August 31, 2000

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  PREPARED BY:

  	
   

  	
  Karen A. Thalhammer

  



 


II.            ONLY
THE FOLLOWING PHYSICIAN SERVICES ARE INCLUDED IN THE ALL-INCLUSIVE RATE AND ARE
NOT SEPARATELY BILLED:


 


NONE


 


III.           ONLY
THE FOLLOWING OTHER PROVIDER SERVICES MAY BE BILLED FEE-FOR-SERVICE BY
SUCH PROVIDER AND ARE NOT INCLUDED IN THE ALL-INCLUSIVE CONTRACT RATE:


 


NONE


 


30

















 


APPENDIX
B


 


1.0                                 Fair
Employment Practices


 


(a)                                  In
the performance of this Contract, the Provider shall not discriminate against
any employee or applicant for employment because of race, color, religion,
ancestry, sex, age, national origin, physical handicap, mental condition,
sexual orientation, or marital status. 
The Contractor shall take affirmative action to ensure that applicants
are employed and that employees are treated during employment without regard to
their race, color, religion, ancestry, sex, age, national origin, mental
condition, physical handicap, marital status, or sexual orientation.  Such action shall include, but not be limited
to the following: employment, upgrading, demotion or transfer; recruitment or
recruitment advertising, layoff or termination; rates of pay or other forms of
compensation; and selection for training, including apprenticeship.  The Contractor shall post in conspicuous
places, available to employees and applicants for employment, notices to be
provided by the State setting forth the provisions of this Fair Employment
Practices section.


 


(b)                                 The
Provider shall permit access to his records of employment, employment
advertisements, application forms, and other pertinent data and records by the
State Fair Employment and Housing Commission, or any other agency of the State
of California designated by the State, for the purposes of investigation to
ascertain compliance with the Fair Employment Practices section of this
Contract.


 


(c)                                  Remedies
for Unlawful Employment Practice:


 


(1)                                  The
State may determine an unlawful practice under the Fair Employment Practices
section of this Contract to have occurred upon receipt of a final judgment
having that effect from a court in an action to which Provider was a party, or
upon receipt of a written notice from the Fair Employment and Housing Commission
that it has investigated and determined that the Provider has violated the
provisions of the Fair Employment and Housing Act and has issued an order,
under Government Code Section 12970, which has become final.


 


(2)                                  For
unlawful practices under this Fair Employment Practices section, the State
shall have the right to terminate this Contract after a determination pursuant
to (c)(1) of this section has been made.


 


Any loss or damage sustained by the State
in securing a replacement provider to render the services contracted for under
this Contract shall be borne and paid for by the Provider and the State may
deduct from any moneys due to that thereafter may become due to the Provider,
the difference between the price named in the contract and the actual cost thereof
to the State.


 


(d)                                 Provider
agrees to comply with Title 2, Division 3, Part 2.8 (Government Code
Sections 12900 et seq.), any amendments thereto, and any regulation adopted
pursuant to that part.


 


1

















 


2.0                                 Nondiscrimination
in Services, Benefits and Facilities


 


(a)                                  The
Provider shall not discriminate in the provision of services because of race,
color, religion, national origin, sex, age, mental or physical handicap or
sexual orientation as provided by state and federal law.


 


(b)                                 For
the purposes of this Contract, distinctions on the grounds of race, color,
religion, national origin, age or mental or physical handicap or sexual
orientation include but are not limited to the following:  denying a beneficiary any service or benefit
which is different, or is provided in a different manner or at a different time
from that provided other beneficiaries under this Contract; subjecting a
beneficiary to segregation or separate treatment in any matter related to his
receipt of any service; restricting a beneficiary in any way in the enjoyment,
advantage or privilege enjoyed by others receiving any service or benefit;
treating a beneficiary differently from others in determining whether the
beneficiary satisfied any admission, eligibility, other requirement or
condition which individuals must meet in order to be provided any benefit; the
assignment of times or places for the provision of services on the basis of the
race, color, religion, national origin, age, mental or physical handicap or
sexual orientation of the beneficiaries to be served.


 


(c)                                  The
Provider shall take affirmative action to ensure that services to intended
beneficiaries are provided without regard to race, color, religion, national
origin, sex, age, mental or physical handicap or sexual orientation.


 


3.0                                 Clean
Air and Water


 


(This paragraph 3.0 applicable only if
the Contract exceeds $100,000, or the Federal Contracting Officer or State has
determined that orders under an indefinite quantity contract in anyone year
will exceed $100,000, or a facility to be used has been the subject of a
conviction under the Clean Air Act (42 USC 1857c-8 [c][l]) or the Federal Water
Pollution Control Act (33 USC 1319[c]) and is listed by EPA, or the contract is
not otherwise exempt.)


 


(a)                                  The
Provider agrees as follows:


 


(1)                                  To
comply with all the requirements of Section 114 of the Clean Air Act, as
amended (42 USC 1857, et seq., as amended by Pub.L., 91-604) and Section 308
of the Federal Water Pollution Control Act (33 USC 1251 et seq., as amended by
Pub.L., 92-500), respectively relating to inspection monitoring, entry,
reports, and information, as well as other requirements specified in Section 114
and Section 308 of the Air Act and the Water Act, respectively, and all
regulations and guidelines issued thereunder before the award of this Contract.


 


(2)                                  No
obligation required by this Contract will be performed in a facility listed on
the Environmental Protection Agency List of Violating Facilities on the date
when this contract was executed unless and until the EPA eliminates the name of
such facility or facilities from such listing.


 


2














 


(3)           To
use its best efforts to comply with clean air standards and clean water
standards at the facility in which the services are being performed.


 


(4)           To
insert the substance of the provisions of this Paragraph 3.0 into any written
delegation.


 


(b)                                 The
terms used in this Paragraph have the following meanings:


 


(1)           The
term “Air Act” means the Clean Air Act, as amended (42 USC 1857 et seq., as
amended by Pub.L., 91-604) .


 


(2)           The
terms “Water Act” means Federal Water Pollution Control Act, as amended (33 USC
1251 et seq., as amended by Pub.L., 92-500).


 


(3)           The
term “clean air standards” means any enforceable rules, regulations,
guidelines, standards, limitations, orders, controls, prohibitions, or other
which are contained in, issued under, or otherwise adopted pursuant to the Air
Act or Executive Order 11738, an approved implementation procedure or plan
under section 110(d) of the Clean Air Act (42 USC 1857c-5[d]), an approved
implementation procedure or plan under section 111(c) or section 111(d),
or an approved implementation procedure under section 112(d) of the Air
Act (42 use 1857c-7[d]).


 


(4)           The
terms “clean water standards” means any enforceable limitation, control,
condition, prohibition, standard, or other requirement which is promulgated
pursuant to the Water Act or contained in a permit issued to a discharger by
the Environmental Protection Agency or by a state under an approved program, as
authorized by Section 402 of the Water Act (33 USC 1317).


 


(5)           The
term “compliance” means compliance with clean air or water standards.  Compliance shall also mean compliance with a
schedule or plan ordered or approved by a Court of competent jurisdiction, the
Environmental Protection Agency or an air or water pollution control agency in
accordance with the requirements of the Air Act or Water Act and regulations
issued pursuant thereto.


 


(6)           The
term “facility” means any building, plan, installation, structure, mine, vessel
or other floating craft, location, or site of operations, owned, leased, or
supervised by a Provider or delegate, to be utilized in the performance of a
contract of delegation.  Where a location
or site of operations contains or includes more than one building, plant,
installation, or structure, the entire location or site shall be deemed to be a
facility except where the Director, Office of Federal Activities, Environmental
Protection Agency, determines that independent facilities are collected in one
geographical area.


 


3

















 


4.0                                 Utilization
of Small Business Concerns


 


(a)           It
is the policy of the Federal Government and the State as declared by the
Congress and the State Legislature that a fair proportion of the purchases and
contracts for supplies and services for the State be placed with small business
concerns.


 


(b)           The
Provider shall accomplish the maximum amount of delegation to and purchased of
goods or services from small business concerns that the Contractor finds to be
consistent with the efficient performance of this Contract.


 


5.0                                 Utilization
of Minority Business Enterprises


 


(a)           It
is the policy of the Federal Government and the State that minority business
enterprises shall have the maximum practicable opportunity to participate in
the performance of State contracts.


 


(b)           The
Provider agrees to use its best efforts to carry out this policy in its
delegations and purchases of goods and services to the fullest extent
consistent with the efficient performance of this Contract.  As used in this Contract, the terms “minority
business enterprise” means a business, at least 50 percent of which is owned by
minority group members or, in the case of public owned business, at least 51
percent of the stock of which is owned by minority group members.  For the purpose of this definition, minority group
members are Black, Asian, Spanish-speaking/Surnamed, Filipino, Polynesian,
American Indian, or Alaskan Native. 
Non-minority women-owned firms may be included when business is 50
percent owned and operated by a woman and the co-owner is not her husband, or
51 percent (or greater) when owned and operated by a woman and the co-owner is
her husband, and/or is publicly owned. 
Providers may rely on written representations from businesses regarding
their status as minority business enterprises in lieu of an independent
investigation.


 


6.0                                 Provision
of Bilingual Services


 


(a)           When
the community potentially served by the Provider consists of non-English or
limited-English speaking persons, the Provider shall take all steps necessary
to develop and maintain an appropriate capability for communicating in any
necessary second language, including, but not limited to the employment of, or
contracting for, in public contact positions of persons qualified in the
necessary second languages in a number sufficient to ensure full and effective
communication between the non-English and limited-English speaking applicants
for, and beneficiaries of, the facility’s services and the facility’s
employees.


 


Provider may comply with this paragraph
6.0 by providing sufficient qualified translators to provide translation


 


4

















 


in any necessary second language for any
patient, caller or applicant for service, within ten minutes of need for
translation.  Provider shall maintain
immediate translation capability in the emergency room when five percent of the
emergency room patients or applicants for emergency room services are
non-English or limited-English speaking persons.


 


Provider shall provide immediate
translation to non-English or limited English speaking patients whose condition
is such that failure to immediately translate would risk serious
impairment.  Provider shall post notices
in prominent places in the facility of the availability of translation in the
necessary second languages.


 


(b)                                 As
used in this Paragraph:


 


(1)           “Non-English
or limited English speaking persons” refers to persons whose primary language
is a language other than English;


 


(2)           “Necessary
second language” refers to a language, other than English, which is the primary
language of at least five percent (5%) of either the community potentially
served by the contracting facility or of the facility’s patient population; and


 


(3)           “Community
potentially served by the contracting facility” refers to the geographic area
from which the facility derives eighty percent (80%) of its patient population.


 


(4)           “Qualified
translator” is a person fluent in English and in the necessary second language,
familiar with medical terminology, and who can accurately speak, read, write
and readily interpret in the necessary second language.


 


5

















 


CONTRACT
FOR HOSPITAL INPATIENT SERVICES


 


Amendment
No. 1


 


	
  Contract No.:

  	
   

  	
  00-83123

  
	
   

  	
   

  	
   

  
	
  Hospital:

  	
   

  	
  ALTA HOLLYWOOD HOSPITALS, INC.

  dba: HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD

  
	
   

  	
   

  	
   

  
	
  Address:

  	
   

  	
  6245 De Longpre Avenue

  Hollywood, CA 90028

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  AND

  
	
   

  	
   

  	
   

  
	
  Hospital:

  	
   

  	
  ALTA HOLLYWOOD HOSPITALS, INC.

  dba: HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS

  
	
   

  	
   

  	
   

  
	
  Address:

  	
   

  	
  Address:     14433
  Emelita Street

                     Van
  Nuys, CA 91401

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  TERMS
  OF THIS CONTRACT AMENDMENT MUST REMAIN CONFIDENTIAL AND NOT SUBJECT TO PUBLIC
  DISCLOSURE UNTIL:

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  SERVICES:   01-24-03

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  PER
  DIEM RATE:   01-24-05

  



 


CONFIDENTIAL

DO NOT RELEASE

Exempt From Public Records Act

Government Code Section 6254 [q]


 

















 


AMENDMENT NO.  1 TO CONTRACT NO. 00-83123 BETWEEN THE STATE
OF CALIFORNIA AND ALTA HOLLYWOOD HOSPITALS, INC., DOING BUSINESS AS HOLLYWOOD
COMMUNITY HOSPITAL OF HOLLYWOOD AND HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS.


 


WHEREAS, the State of California,
hereinafter designated “the State”, and ALTA HOLLYWOOD HOSPITALS, INC., doing
business as HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD and HOLLYWOOD COMMUNITY
HOSPITAL OF VAN NUYS, hereinafter designated “the Provider”, entered into a contract
(Contract No.  00-83~23) for provision of inpatient hospital services
effective, September 14, 2000;


 


NOW THEREFORE, in accordance with the
provisions for renegotiation and modification set forth in Article 6, Section 6.11
of said Contract, the Contract is amended as follows:


 


Paragraph One - Amendment of 4.1 - Rate
Structure; Contingent Liability of State


 


4.1 - Rate Structure; Contingent
Liability of State is hereby amended to read:


 


Provided that there
shall first have been a submission of claims in accordance with Paragraph 4.3
of this Contract, the Provider shall be paid at the all-inclusive rate per
patient per day of *** for inpatient services provided to beneficiaries.


 


1

















 


Paragraph Two -
Addition of 6.22 - Prohibition Against Use of State Funds to Assist, Promote,
or Deter Union Organizing


 


6.22 - Prohibition Against Use of
State Funds to Assist, Promote, or Deter Union Organizing is hereby added
as follows:


 


In accordance with
Government Code Section 16645, et seq. Contractor shall not use State
funds to assist, promote, or deter union organizing during the life of this
Contract, including any extensions or renewals of this Contract.


 


Paragraph
Three - Effective Date of Contract Amendment


 


If this Amendment is
signed by the Provider and returned to the California Medical Assistance
Commission within thirty (30) days of January 24, 2002, then the Contract
changes agreed to in this Amendment shall be effective on January 24,
2002.  If this Amendment is not signed
and returned within thirty days.  then
the Contract changes agreed to in this Amendment shall be effective on the date
the Contract is signed by both parties.


 


2

















 


Paragraph Four
- Incorporation of Contract Rights, Duties and Obligations


 


All other terms and provisions of said
Contract shall remain in full force and effect, so that all rights, duties and
obligations, and liabilities of the parties hereto otherwise remain unchanged.


 


3

















 


EXECUTION


 


This Contract shall be deemed duly
executed and binding upon execution by both Parties below.


 


 


	
  Executed on January 16, 2002, at

  	
   

  	
   

  
	
  Santa Monica, Calif. 90405

  	
   

  	
   

  
	
  (City, State, Zip)

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Alta Hollywood Hospitals, Inc.

  
	
   

  	
   

  	
  Hospital 

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  By: 

  	
   

  
	
   

  	
   

  	
   

  	
  Signature 

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  David Topper CEO 

  
	
   

  	
   

  	
  Type Name and Title

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  Executed on February 13, 2002, at

  Sacramento, California

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  STATE OF CALIFORNIA

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  By:

  	
   

  
	
   

  	
   

  	
   

  	
  Diana M. Bontá, R.N., Dr., P.H.

  
	
   

  	
   

  	
   

  	
  Director

  
	
   

  	
   

  	
   

  	
  Department of Health Services

  



 


4

















 


CONTRACT
FOR HOSPITAL INPATIENT SERVICES


 


Amendment:
No. 2


 


	
  Contract No.:

  	
   

  	
  00-83123

  
	
   

  	
   

  	
   

  
	
  Hospital:

  	
   

  	
  ALTA HOLLYWOOD HOSPITALS, INC.

  dba: HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD

  
	
   

  	
   

  	
   

  
	
  Address:

  	
   

  	
  6245 De Longpre Avenue

  Hollywood, CA 90028-8253

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  AND

  
	
   

  	
   

  	
   

  
	
  Hospital:

  	
   

  	
  ALTA HOLLYWOOD HOSPITALS, INC.

  dba: HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS

  
	
   

  	
   

  	
   

  
	
  Address:

  	
   

  	
  Address:     14433
  Emelita Street

                     Van
  Nuys, CA 91401-4213

  
	
   

  	
   

  	
   

  
	
  Provider No.:

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  TERMS
  OF THIS CONTRACT AMENDMENT MUST REMAIN CONFIDENTIAL AND NOT SUBJECT TO PUBLIC
  DISCLOSURE UNTIL:

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  SERVICES:    03-10-06

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  PER
  DIEM RATE:    03-10-09

  



 


CONFIDENTIAL

DO NOT RELEASE

Exempt From Public Records Act

Government Code Section 6254 [q]


 

















 


AMENDMENT NO. 2 TO CONTRACT NO.
00-83123 BETWEEN THE STATE OF CALIFORNIA AND ALTA HOLLYWOOD HOSPITAL, INC.,
DOING BUSINESS AS HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD AND HOLLYWOOD
COMMUNITY HOSPITAL OF VAN NUYS.


 


WHEREAS, the State of California,
hereinafter designated “the State”, and Alta Hollywood Hospital, Inc.,
doing business as Hollywood Community Hospital of Hollywood and Hollywood
Community Hospital of Van Nuys I hereinafter designated “the Provider,” entered
into a contract (Contract No. 00-83123) for provision of inpatient
hospital services effective September 14, 2000 and subsequently amended;


 


NOW THEREFORE, in accordance with the
provisions for renegotiation and modification set forth in Article 6,
Paragraph 6.11 of the Contract, the Contract is amended as follows:


 


Paragraph One
- Amendment of 3.4 - Appointment of Liaisons and Agency Status of Provider’s
Liaison


 


3.4 - Appointment of Liaisons an
Liaison is hereby amended to read:


 


1

















 


(a)           Provider
shall designate in writing a person to act as liaison to the Department.  Such person shall coordinate all
communications between the parties.  The
written designation of such person shall constitute the conferral of full
agency powers to bind the Provider as principal in all dealings with the
Department.


 


(b)           The
Department shall designate a liaison in conformity with the procedures and with
such authority as specified in Paragraph 6.8 of this Contract.  Communications to the Department shall be
submitted to its liaison at the following address:


 


Contract Officer


Medi-Cal Operations Division


P.O. Box 997419


MS 4506


Sacramento, CA 95899-7419


 


Paragraph Two –
Amendment of 3.7 - Open Staffing/Exclusive Staffing Contracts


 


3.7 - Open Staffing/Exclusive Staffing
Contracts is hereby amended to read:


 


(a)           As
a Selective Provider Contracting Program contractor, the Provider shall comply
with Welfare and Institutions Code section 14087.28.


 


2

















 


(b)           Notwithstanding
Subparagraph (a) above and Welfare and Institutions Code
section 14087.28, Provider may enter into exclusive contracts for the
provision of pathology, radiology, and anesthesiology acute inpatient services,
except for consulting services requested by the admitting physician.


 


(c)           The
Parties acknowledge that although Paragraph 3.7 of this Contract and Section 14087.28
of the Welfare, and Institutions Code prohibit exclusive staffing arrangements
for Selective Provider Contracting Program hospitals, their applicability is
limited to physician staffing for acute inpatient services.  Therefore, contractual staffing arrangements
to provide outpatient services are not contrary to Paragraph 3.7 of this Contract
or Section 14087.28 of the Welfare and Institutions Code.


 


Paragraph
Three - Amendment 4.1 - Rate Structure; Contingent Liability of State


 


4.1 - Rate Structure; Contingent
Liability of State is hereby amended to read:


 


Provided that there shall first have been
a submission of claims in accordance with Paragraph 4.3 of this Contract, the
Provider shall be paid as follows:


 


3

















 


(a)           For
Inpatient Services provided to Beneficiaries, the all-inclusive rate per patient
per day of ***.


 


(b)           Commencing
March 10, 2006, for Inpatient Services provided to Beneficiaries, the
all-inclusive rate per patient per day of ***.


 


Paragraph Four
- Amendment of 4.2 - Rate Inclusive of Physician, Transportation and Certain
Prior Patient Services


 


4.2 - Rate Inclusive of Physician,
Transportation and Certain Prior Patient Services is hereby amended to
read:


 


The rate structure under Paragraph 4.1 of
this Contract is intended by both the State and Provider to be inclusive of all
Inpatient Services rendered by the Provider and to constitute the State’s only
financial obligation under this Contract. 
As nonlimiting examples:


 


(a)           There
shall be no separate billing by either the Provider or physicians for the
services specified in Appendix A, Section II, rendered by physicians to
Beneficiaries.


 


(b)           There
shall be no separate billing for any transportation services required in
providing Inpatient Services under this Contract.


 


4

















 


(c)           There
shall be no separate billing for any services rendered by the Provider within a
24-hour period prior to the Beneficiary’s admission as an inpatient, such as
outpatient or emergency services, which are related to the condition for which
the Beneficiary is admitted as an inpatient. 
Such prior services shall be deemed Inpatient Services and included in
the rates set under Paragraph 4.1.


 


Paragraph Five
- Amendment of 4.3 - Billing Procedures as Express Conditions Precedent to
State’s Payment Obligation


 


4 .3 - Billing Procedures as Express
Conditions Precedent to State’s Payment Obligation is hereby amended to
read:


 


(a)           As
an express condition precedent to maturing the State’s payment obligation under
Paragraph 4.1 of this Contract, the Provider shall determine that inpatient
services rendered are not covered, in whole or in part, under any other state
or federal medical care program or under any other contractual or legal
entitlement, including, but not limited to, a private group indemnification or
insurance program or workers I compensation. 
To the extent that such coverage is available, the State’s payment
obligation pursuant to Paragraph 4.1 shall be reduced.


 


5

















 


(b)           As
a further express condition precedent to maturing the State’s payment
obligation under Paragraph 4.1 of this Contract, the Provider shall submit
claims to the fiscal intermediary for all services rendered under the terms of
this Contract, in accordance with the applicable billing requirements contained
in Title 22 of the California Code of Regulations.


 


(c)           A
day of service shall be billed for each beneficiary who occupies an inpatient
bed at 12:00 midnight in the facilities of the Provider.  However, a day of service may be billed if
the beneficiary is admitted and discharged during the same day provided that
such admission and discharge is not within 24-hours of a prior discharge.  Only one patient day of service may be billed
for mother and newborn child (children) when both mother and newborn child
(children) are inpatients of the hospital.


 


(d)           The
State may from time to time adopt updated billing codes by means of regulation,
Medi-Cal Provider Manual, Medi-Cal Update Bulletin, or similar instruction,
which shall automatically replace the applicable billing codes expressly stated
in this Contract and/or its appendices, without the need to amend this Contract
as set forth in Paragraph 6.11.


 


6

















 


Paragraph Six
- Amendment of 6.8 - Contract Officer - Delegation of Authority


 


6.8 - Contract
Officer Delegation of Authority is hereby amended to
read:


 


The Department will administer this
Contract through a single administrator, the Contract Officer.  Until such time as the Director gives the
Provider written notice of successor appointment, the person designated above
shall make all determinations and take all actions necessary to administer this
Contract, subject to the limitations of California laws and State
administrative regulations.  No person
other than the Contract Officer or the Director shall have the power to bind
the Department relative to the rights and duties of the Contractor and the
Department under this Contract, nor shall any other person be considered to
have the delegated authority of” the Contract Officer or to be acting on his
behalf unless the Contract Officer has expressly stated in writing that that
person is acting as his authorized agent.


 


Paragraph
Seven - Amendment of 6.9 - Notice


 


6.9 - Notice is hereby
amended to read:


 


7

















 


Any notice required to be given pursuant
to the terms and provisions of the Contract shall be in writing and shall be
sent by certified mail, return receipt requested.  Department shall be sent to the following address:


 


Contract Officer


Medi-Cal Operations Division


P.O. Box 997419


MS 4506


Sacramento, CA 95899-7419


 


Notice to the Provider shall be sent to
the Chief Executive Officer at the following address:


 


Hollywood Community Hospital of Hollywood


6245 De Longpre Avenue


Hollywood, CA 90028-8253


 


Paragraph
Eight - Amendment of 6.15 - Termination Without Cause


 


6.15 - Termination Without
Cause is hereby amended to read:


 


The Provider or the State may terminate
this Contract without cause in accordance with this Paragraph.  Termination without cause shall be effected
by giving written notice of the termination to the other party on or after November 10,
2006, and at least 120 days prior to the effective date of the termination and
stating the effective date of the termination.


 


8

















 


Paragraph Nine
- Deletion of 6.22 - Prohibition Against Use of State Funds to Assist, Promote,
or Deter Union Organizing


 


6.22 - Prohibition Against
Use of State Funds to Assist, Promote, or Deter Union Organizing is hereby
deleted.


 


Paragraph Ten
- Effective Date of Contract Amendment


 


If this Amendment is signed by the
Provider and returned to the California Medical Assistance Commission within
thirty (30) days of March 10, 2005, then the Contract changes agreed to in
this Amendment shall be effective on March 10, 2005.  If this Amendment is not signed and returned
within thirty days, then the Contract changes agreed to in this Amendment shall
be effective on the date the Contract is signed by both parties.


 


Paragraph
Eleven - Incorporation of Contract Rights, Duties and Obligations


 


All other terms and provisions of said
Contract shall remain in full force and effect, so that all rights, duties and
obligations, and liabilities of the parties hereto otherwise remain unchanged.


 


9














 


EXECUTION


 


This Contract shall be deemed duly
executed and binding upon execution by both Parties below.


 


	
  Executed on March 2, 2005, at

  	
   

  
	
  Los Angeles, California

  	
   

  
	
   (City, State, Zip)

  	
   

  



 


	
   

  	
  Alta Hollywood Hospitals, Inc 

  
	
   

  	
  Hospital 

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  
	
   

  	
   

  	
  Signature 

  
	
   

  	
   

  	
   

  
	
   

  	
  David Topper, Chief Executive Officer 

  
	
   

  	
  Type Name and Title

  



 


 


Executed on 3/21/05, at

Sacramento, California


 


	
   

  	
  STATE OF CALIFORNIA 

  
	
   

  	
   

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  
	
   

  	
   

  	
  Sandra Shewry

  
	
   

  	
   

  	
  Director

  
	
   

  	
   

  	
  Department of Health Services

  



 


10

















 


CONTRACT
FOR HOSPITAL INPATIENT SERVICES


 


Amendment
No. 3


 


	
  Contract No.:

  	
   

  	
  00 - 83123

  
	
   

  	
   

  	
   

  
	
  Hospital:

  	
   

  	
  ALTA 

  	
  HOLLYWOOD HOSPITALS, INC.

  
	
   

  	
   

  	
  dba: 

  	
  HOLLYWOOD COMMUNITY HOSPITAL OF
  HOLLYWOOD

  
	
   

  	
   

  	
   

  	
   

  
	
  Address:

  	
   

  	
  6245 De Longpre Avenue

  Hollywood, CA 90028  -  8253

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
  AND

  
	
   

  	
   

  	
   

  
	
  Hospital:

  	
   

  	
  ALTA 

  	
  HOLLYWOOD HOSPITALS, INC. 

  
	
   

  	
   

  	
  dba: 

  	
  HOLLYWOOD COMMUNITY HOSPITAL OF VAN
  NUYS

  
	
   

  	
   

  	
   

  
	
  Address:

  	
   

  	
  Address:

  	
  14433 Emelita Street 

  
	
   

  	
   

  	
   

  	
  Van Nuys, CA 91401 - 4213

  
					



 


CONFIDENTIAL

DO NOT RELEASE

Exempt From Public Records Act

Government Code Section 6254 [q]


 

















 


AMENDMENT NO. 3 TO CONTRACT
NO. 00 - 83123 BETWEEN THE STATE OF CALIFORNIA AND ALTA HOLLYWOOD
HOSPITALS, INC., DOING BUSINESS AS HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD
AND HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS.


 


WHEREAS, the State of California,
hereinafter designated “the State”, and Alta Hollywood Hospitals, Inc.,
doing business as Hollywood Community Hospital of Hollywood and Hollywood
Community Hospital of Van Nuys, hereinafter designated “the Provider”, entered
into a contract (Contract No. 00 - 83123) for provision of inpatient
hospital services September 14, 2000 and subsequently amended;


 


NOW THEREFORE, in accordance with the
provisions for renegotiation and modification set forth in Article 6,
Paragraph 6.11 of the Contract, the Contract is amended as follows:


 


Paragraph One  -  Amendment of 3.5  -  Service Location


 


3 .5 – Service Location is hereby
amended to read:


 


Inpatient Services rendered pursuant to
this Contract shall be rendered at the following facilities:


 


1

















 


HOLLYWOOD COMMUNITY HOSPITAL OF HOLLYWOOD


6245 De Longpre Avenue


Hollywood, CA 90028 - 8253


 


And


 


HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS


14433 Emelita Street


Van Nuys, CA 91401 - 4213


 


Paragraph Two - Amendment of 3.7 Open
Staffing / Exclusive Staffing Contracts


 


3.7 – Open Staffing / Exclusive
Staffing Contracts is hereby amended to read:


 


Pursuant to Welfare and Institutions Code
section 14087.28, subdivision (b) , Provider is authorized to enter into
an exclusive contract for the provision of pathology, radiology, and
anesthesiology Inpatient Services, except for consulting services requested by
the admitting physician.


 


2

















 


Paragraph Three - Amendment of 4.1 - Rate
Structure: Contingent Liability of State


 


4.1 – Rate Structure; Contingent
Liability of State is hereby amended to read:


 


Provided that there shall first have been
a submission of claims in accordance with Paragraph 4.3 of this Contract, the
Provider shall be paid as follows:


 


(a)           For
Inpatient Services provided to Beneficiaries, the all-inclusive rate per
patient per day of ***.


 


(b)           Commencing
August 10, 2008, for Inpatient Services provided to Beneficiaries, the
all-inclusive rate per patient per day of ***.


 


Paragraph Four - Amendment of 6.15 –
Termination Without Cause


 


6.15 – Termination Without Cause
is hereby amended to read:


 


The Provider or the State may terminate
this Contract without cause in accordance with this Paragraph.  Termination without cause shall be  effected by giving written notice of the
termination to the other party on or after July 10, 2009 and at


 


3

















 


least 120 days prior to the effective
date of the termination and stating the effective date of the termination.


 


Paragraph Five - Addition of 6.30 -
Employee Education About False Claims Recovery


 


6.30 – Employee Education About False
Claims Recovery is hereby added, which reads as follows:


 


Provider shall comply with 42 USC Section 1396a(a) (68),
Employee Education About False Claims Recovery, as a condition of receiving
payments under this Contract.  Upon
request by the Department, Provider shall demonstrate compliance with this
provision, which may include providing the Department with copies of Provider’s
applicable written policies and procedures and any relevant employee handbook
excerpts.


 


Paragraph Six – Amendment of Appendix A


 


Appendix A
is hereby amended to read as attached to this amendment.


 


4

















 


Paragraph Seven – Effective Date of
Contract Amendment


 


If this Amendment is signed by the
Provider and returned to the California Medical Assistance Commission within
thirty (30) days of May 10, 2007, then the Contract changes agreed to in
this Amendment shall be effective on May 10, 2007.  If this Amendment is not signed and returned
within thirty days, then the Contract changes agreed to in this Amendment shall
be effective on the date the Contract is signed by both parties.


 


Paragraph Eight – Incorporation of
Contract Rights, Duties and Obligations


 


The terms in this Amendment shall have no
retroactive effect on any Department audit determinations or related appeals
for dates of service prior to the effective date of this Amendment.  All other terms and provisions of said
Contract shall remain in full force and effect, so that all rights, duties and
obligations, and liabilities of the parties hereto otherwise remain unchanged.


 


5

















 


EXECUTION


 


This Contract shall be deemed duly
executed and binding upon execution by both Parties below.


 


	
  Executed on May 3, 2007, at

  	
   

  
	
  Los Angeles, CA

  	
   

  
	
   (City, State, Zip)

  	
   

  



 


	
   

  	
  Hollywood Community Hospital of
  Hollywood

  
	
   

  	
  Hospital

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  
	
   

  	
   

  	
  Signature

  
	
   

  	
   

  	
   

  
	
   

  	
  David Topper, Chief Executive Officer

  
	
   

  	
  Type Name and Title

  



 


 


Executed on May 3, 2007, at


Sacramento, California


 


	
   

  	
  STATE OF CALIFORNIA

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
   

  
	
   

  	
   

  	
  Sandra Shewry

  
	
   

  	
   

  	
  Director

  
	
   

  	
   

  	
  Department of Health Services

  



 


6

















 


APPENDIX
A


 


	
   

  	
  HOSPITAL NAME:

  	
   

  	
  Hollywood Community Hospital of
  Hollywood & Van Nuys

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  CONTRACT:

  	
   

  	
  00 - 83123, A - 03

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  EFFECTIVE DATE:

  	
   

  	
  May 10, 2007

  



 


I.                                         Provider
shall provide a Medi-Cal Beneficiary his/her specific Medi-Cal benefit
Inpatient Services if Provider renders those same services to a non-Medi-Cal
beneficiary, without exception.


 


As of the effective date of this Appendix
A, the common acute and/or intensive Inpatient Services listed below are not
directly, or indirectly, provided by Provider to any patients regardless of
payor source, i.e., Medi -Cal, Medicare, private pay, commercial insurance,
third-party payor, or other payor source.


 


If any of the Inpatient Services below
are subsequently made available to non-Medi-Cal patients and are a Medi-Cal
benefit, Provider shall provide such services to Medi -Cal Beneficiaries at the
all inclusive, general acute care hospital (GACH) per diem rate(s) specified
in Paragraph 4.1 of this Contract.


 


	
   

  	
   

  	
  REVENUE CODES

  
	
  OBSTETRIC - PRIVATE

  	
   

  	
  112

  
	
  OBSTETRIC - SEMI-PRIVATE 2 BEDS

  	
   

  	
  122

  
	
  OBSTETRIC - SEMI-PRIVATE 3 OR 4 BEDS

  	
   

  	
  132

  
	
  OBSTETRIC - WARD (MEDICAL OR GENERAL)

  	
   

  	
  152

  
	
  PEDIATRIC - PRIVATE

  	
   

  	
  113

  
	
  PEDIATRIC - SEMI-PRIVATE 2 BEDS

  	
   

  	
  123

  
	
  PEDIATRIC - SEMI-PRIVATE 3 OR 4 BEDS

  	
   

  	
  133

  
	
  PEDIATRIC - WARD (MEDICAL OR GENERAL)

  	
   

  	
  153

  
	
  REHABILITATION - PRIVATE

  	
   

  	
  118

  
	
  REHABILITATION - SEMI-PRIVATE 2 BEDS

  	
   

  	
  128

  
	
  REHABILITATION - SEMI-PRIVATE 3 OR 4 BEDS

  	
   

  	
  138

  
	
  REHABILITATION WARD (MEDICAL OR GENERAL)

  	
   

  	
  158

  
	
  NURSERY, GENERAL CLASSIFICATION

  	
   

  	
  170

  
	
  NURSERY, NEWBORN LEVEL I

  	
   

  	
  171

  
	
  NURSERY, NEWBORN LEVEL II

  	
   

  	
  172

  
	
  NURSERY, NEWBORN LEVEL III

  	
   

  	
  173

  
	
  NURSERY, NEWBORN LEVEL IV

  	
   

  	
  174

  
	
  INTENSIVE CARE, PEDIATRIC

  	
   

  	
  203

  
	
  INTENSIVE CARE, INTERMEDIATE ICU

  	
   

  	
  206

  
	
  INTENSIVE CARE, BURN CARE

  	
   

  	
  207

  
	
  INTENSIVE CARE, TRAUMA

  	
   

  	
  208

  
	
  CORONARY CARE, GENERAL CLASSIFICATION

  	
   

  	
  210

  
	
  CORONARY CARE, MYOCARDIAL INFARCTION

  	
   

  	
  211

  



 


The state may
from time to time adopt updated billing codes by means of regulation, Medi-Cal
Provider Manual, Medi-Cal Update Bulletin, or similar instruction, which shall
automatically replace the applicable billing codes expressly stated in this
Contract and/or its appendices, to the extent the 


 


1

















 


service remains
a Medi-Cal benefit, without the need to amend this Contract as set forth in
Paragraph 6.11.


 


2

















 


	
  CORONARY CARE,
  PULMONARY CARE

  	
   

  	
  212

  
	
  CORONARY CARE,
  INTERMEDIATE CCU

  	
   

  	
  214

  
	
  CORONARY CARE,
  OTHER

  	
   

  	
  219

  
	
  LITHOTRIPSY,
  GENERAL CLASSIFICATION

  	
   

  	
  790

  



 


Inpatient Transplant Services


 


	
  TRANSPLANT RELATED SERVICE

  	
   

  	
  ICD-9 PROCEDURE CODE*

  
	
  BONE MARROW

  	
   

  	
  41.01, 41.02, 41.03,
  41.04, 41.05, 41.07, 41.08 or 41.09

  
	
  HEART

  	
   

  	
  37.5 or 37.51

  
	
  HEART-LUNG

  	
   

  	
  33.6

  
	
  KIDNEY

  	
   

  	
  55.61 or 55.69

  
	
  COMBINED
  KIDNEY/PANCREAS

  	
   

  	
  52.80 and 55.61 or
  55.69

  
	
  PANCREAS

  	
   

  	
  55.69

  
	
  LIVER

  	
   

  	
  50.51 or 50.59

  
	
  SMALL BOWEL

  	
   

  	
  46.97

  
	
  COMBINED LIVER/SMALL
  BOWEL

  	
   

  	
  46.97 and 50.59

  
	
  LUNG

  	
   

  	
  33.50, 33.51 or 33.52

  



 






*Billed in conjunction
with Revenue Code 201 or 203


 


 


 


	
   

  	
   

  	
  CPT-4 CODES

  
	
  CARDIAC
  CATHETERIZATION

  	
   

  	
  93501-93562

  
	
  CARDIOVASCULAR
  SURGERY

  	
   

  	
  33010-37799

  
	
  ABORTIONS

  	
   

  	
  59840-59857

  
	
  STERILIZATION

  	
   

  	
  55250,55450,56301,56302

  
	
  STERILIZATION

  	
   

  	
  58600,58605,58611,58615

  
	
  NEUROSURGERY

  	
   

  	
  61000-64999

  
	
  CORNEAL
  TRANSPLANTS

  	
   

  	
  65710,65730,65750,65755

  
	
  RADIATION
  THERAPY

  	
   

  	
  77261-77499,77750-77799

  
	
  THERAPEUTIC
  NUCLEAR MEDICINE

  	
   

  	
  79000-79999

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  70336,70540

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  70551-70553,71550

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  72141-72142,72146-72149

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  72156-72158,72196

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  73220-73221,73720-73721

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  74181,75552,75554-75556

  
	
  MAGNETIC
  RESONANCE IMAGING

  	
   

  	
  76093-76094,76400

  
	
  HYPERBARIC
  OXYGEN

  	
   

  	
  99183

  



 


The state may from time to time adopt updated billing codes by means of
regulation, Medi-Cal Provider Manual, Medi-Cal Update Bulletin, or similar
instruction, which shall automatically replace the applicable billing codes
expressly stated in this Contract and/or its appendices, to the extent the
service remains a Medi-Cal benefit, without the need to amend this Contract as set
forth in Paragraph 6.11.


 


3

















 


II.                                  Professional
physician fees, excluding technical fees, for the following services provided
during an acute and/or intensive inpatient admission are included in Provider’s
all inclusive per diem rate(s) specified in Paragraph 4.1 of this Contract
and must not be separately claimed to the Medi-Cal Program by Provider, the
physician(s) providing the service, or other claimant.  Professional physician fees for services not
listed below may be separately claimed using applicable Medi-Cal Billing and
Payment Policies for reimbursement.


 


NONE


 


III.                              The
following allied health professional services, durable medical equipment, and
other listed items provided during an acute and/or intensive inpatient stay are
not included in the all inclusive per diem rate(s) specified in Paragraph
4.1 of this Contract, and may be separately claimed.


 


NONE


 


The state may from time to time adopt updated billing codes by means of
regulation, Medi-Cal Provider Manual, Medi-Cal Update Bulletin, or similar
instruction, which shall automatically replace the applicable billing codes
expressly stated in this Contract and/or its appendices, to the extent the
service remains a Medi-Cal benefit, without the need to amend this Contract as
set forth in Paragraph 6.11.


 


4