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Facility Information

Facility ID: 110000070

Register Complaint

Ukiah Valley Medical Center

275 Hospital Dr
Ukiah, Ca   95482

County:Mendocino

Phone:(707) 463-7692

Fax:(707) 463-7384

Managing District Office

Please contact the following Licensing and Certification office for any questions and/or concerns:

Santa Rosa/Redwood Coast District Office
2170 Northpoint Parkway
Santa Rosa, CA. 95407
Phone Number: (707) 576-6775

License Information

Licensee: Ukiah Adventist Hospital
275 Hospital Drive
Ukiah, Ca 95482

Licensee Type: Nonprofit Corp

License Number: 110000095

License Status: Active

License Category: General Acute Care Hospital

License Effective Date: 3/3/2016

Expiration Date: 3/2/2017

Total Bed Capacity: 68

Bed Classification/Services:

  • 68 General Acute Care

Other Approved Services:

  • Basic Emergency Medical
  • Mobile Unit - Pet/Proton Therapy
  • Nuclear Medicine
  • Outpatient Clinics - Rhc
  • Outpatient Clinics - Rhc
  • Outpatient Clinics - Rhc
  • Outpatient Clinics - Rhc
  • Outpatient Clinics - Rhc
  • Outpatient Services - Aids Clinic - Pt
  • Outpatient Services - Cancer & Infusion
  • Outpatient Services - Cardiology Services
  • Outpatient Services - Draw Station
  • Outpatient Services - Gastroenterology Clinic
  • Outpatient Services - Labratory
  • Outpatient Services - Occupational Medicine
  • Outpatient Services - Ophthalmology
  • Outpatient Services - Outpatient Clinics
    • Rural Health Clinic
      Offsite Address: Fort Bragg Rural Health Center, 850 Sequola Circle, Fort Bragg
  • Outpatient Services - Physician Services
  • Outpatient Services - Physician Services
  • Outpatient Services - Primary Care
  • Outpatient Services - Primary Care
  • Outpatient Services - Pt
  • Outpatient Services - Radiation
  • Outpatient Services - Radiology
  • Outpatient Services - Rehab.
  • Outpatient Services - Surgery Services
  • Outpatient Services - Surgery, Phlebotomy
  • Outpatient Services - Urology
  • Outpatient Services - Wound Care
  • Physical Therapy
  • Radiation Therapy
  • Respiratory Care Services

Language Assistance Policy

No Language Assistance Policy document has been uploaded for display.

Certification Information
Title 18 = Medicare
Title 19 = Medi-Cal (Medicaid)

This Hospital deemed by HFAP (AOA)

Complaints/Facility Self-Reported Incidents/Inspection Results Summary/Adverse Events


Disclaimer: Federal deficiencies that are corrected during a follow-up survey are listed on the 'Survey Findings' page but not included in the total deficiency count.
   

Year: 2016

1ComplaintsComplaints

3Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

0Survey DeficienciesSurvey Deficiencies

Year: 2015

5ComplaintsComplaints

5Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

2Survey DeficienciesSurvey Deficiencies

Year: 2014

2ComplaintsComplaints

4Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

22Survey DeficienciesSurvey Deficiencies

Year: 2013

0ComplaintsComplaints

17Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

13Survey DeficienciesSurvey Deficiencies

Year: 2012

6ComplaintsComplaints

22Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

23Survey DeficienciesSurvey Deficiencies

Year: 2011

4ComplaintsComplaints

10Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

17Survey DeficienciesSurvey Deficiencies

Year: 2010

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

5Survey DeficienciesSurvey Deficiencies

Year: 2009

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

47Survey DeficienciesSurvey Deficiencies

Year: 2008

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

2State Enforcement ActionsEnforcement Actions

17Survey DeficienciesSurvey Deficiencies

Year: 2005

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

1Survey DeficienciesSurvey Deficiencies

Year: 2004

0ComplaintsComplaints

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

3Survey DeficienciesSurvey Deficiencies

Administration Information

3/3/1980
to Present

Ukiah Adventist Hospital
Relationship to Facility: Licensee

8/4/2016
to Present

Matthews, Gwen
Relationship to Facility: Administrator

8/4/2016
to Present

Van Housen, Heather
Relationship to Facility: Director Of Nursing

6/5/2003
to Present

Ukiah Valley Medical
Relationship to Facility: Director Of Nursing

Ownership Information

None found

Operating Entities

10/22/2007
to Present

Herber, M.D., Steven C
Relationship to Facility: Board Of Directors

10/22/2007
to Present

Patzer, Jere D
Relationship to Facility: Board Of Directors

10/18/2007
to Present

Mostert, Jr, Thomas
Relationship to Facility: Board Of Directors

10/17/2007
to Present

Behrens, Berel L
Relationship to Facility: Board Of Directors

10/17/2007
to Present

Friestad, Christine E
Relationship to Facility: Board Of Directors

10/16/2007
to Present

Bradshaw, Robert
Relationship to Facility: Board Of Directors

10/16/2007
to Present

Creitz, Lynn E
Relationship to Facility: Board Of Directors

10/16/2007
to Present

Jobe, Meredith S
Relationship to Facility: Board Of Directors

10/16/2007
to Present

Livesay, Don
Relationship to Facility: Board Of Directors

10/15/2007
to Present

Carmen, Robert G
Relationship to Facility: Board Of Directors

10/15/2007
to Present

Dodds, Larry
Relationship to Facility: Board Of Directors

8/2/2002
to Present

Larose, Mark
Relationship to Facility: Board Of Directors

5/12/2008
to Present

Grainger, Rodney
Relationship to Facility: Corporate Officer