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Facility Information

Facility ID: 110000070

Register Complaint

Ukiah Valley Medical Center/Hospital Drive

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: 3/3/2014

Expiration Date: 3/2/2015

Total License Capacity: 67

Bed Classification/Services:

Other Approved Services:

  • Basic Emergency Medical
  • Mobile Unit - Pet
  • Nuclear Medicine
  • Outpatient Clinics
    • Rhc
      Offsite Address: Ukiah Valley Primary Care/Adventist Health , 487 S. Main St., Lakeport
    • Rhc
      Offsite Address: Ukiah Valley Rural Health Clinic, 1050 N. State Street, Ukiah
    • Rhc
      Offsite Address: Ukiah Valley Primary Care/Adventist Health , 260 Hospital Dr. Suite 102, 103, 107, 201, 204, & 209, Ukiah
    • Rhc
      Offsite Address: Family Practice Clinic, 487 S. Main Street, Lakeport
    • Rhc
      Offsite Address: Ukiah Valley Primary Care/Adventist Health , 1165 S. Dora St., Ste. B1, Ukiah
  • Outpatient Services
    • Cardiology Services
      Offsite Address: Heart Center - Lakeport/Ukiah Valley Medical Ctr., 475 N. Forbes, Lakeport
    • Draw Station
      Offsite Address: Phlebotomy Draw Station, 260 Hospital Dr. Suite 109, Ukiah
    • Labratory
      Offsite Address: Coast Laboratory Services, 483 Chestnut St., Fort Bragg
    • Occupational Medicine
      Offsite Address: Job Care, 232 B Hospital Drive, Ukiah
    • Ophthalmology
      Offsite Address: Uvmc- Outpatient Physician Services, 248-B Hospital Dr., Ukiah
    • Physician Services
      Offsite Address: Uvmc -Outpatient Physician Services, 246 Hospital Dr., Ukiah
    • Physician Services
      Offsite Address: Uvmc - Outpatient Physician Services, 1165 S. Dora St. Suite C-2, Ukiah
    • Primary Care
      Offsite Address: Ukiah Valley Primary Care/Adventist Health , 1165 S. Dora St. Ste. E1 & E2, Ukiah
    • Primary Care
      Offsite Address: Ukiah Valley Primary Care/Adventist Health , 1050 North State Street, Ukiah
    • Pt
      Offsite Address: Physical Therapy @ 404 East Perkins Street, Ukiah
    • Radiation
      Offsite Address: 275 Hospital Drive, Ukiah
    • Radiology
      Offsite Address: Uvmc- Outpatient Imaging Services, 1165 S. Dora St., Suite D-1, Ukiah
    • Rehab.
      Offsite Address: Outpatient Rehab. Therapy, Redwood Health Club Of Ukiah, 3101 South State Street, Ukiah
    • Surgery Services
      Offsite Address: Pavilion Surgical Services, 245 Hospital Dr. Suite 100, Ukiah
    • Surgery, Phlebotomy
      Offsite Address: Outpatient Pavilion, 245 Hospital Dr, Ukiah
    • Wound Care
      Offsite Address: Advanced Wound Center Of The Uvmc, 415 Hospital Drive, Ukiah
  • Physical Therapy
  • Radiation Therapy
  • Respiratory Care Services

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

This Hospital deemed by HFAP (AOA)

Complaints/Facility Self-Reported Incidents/Inspection Results Summary

Year: 2014

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

0Survey DeficienciesSurvey Deficiencies

Year: 2013

7Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

8Survey DeficienciesSurvey Deficiencies

Year: 2012

19Facility Self-Reported IncidentsFacility Self-Reported Incidents

1State Enforcement ActionsEnforcement Actions

23Survey DeficienciesSurvey Deficiencies

Year: 2011

17Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

15Survey DeficienciesSurvey Deficiencies

Year: 2010

2Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

5Survey DeficienciesSurvey Deficiencies

Year: 2009

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

47Survey DeficienciesSurvey Deficiencies

Year: 2008

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

2State Enforcement ActionsEnforcement Actions

17Survey DeficienciesSurvey Deficiencies

Year: 2005

0Facility Self-Reported IncidentsFacility Self-Reported Incidents

0State Enforcement ActionsEnforcement Actions

1Survey DeficienciesSurvey Deficiencies

Year: 2004

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

4/1/2007
to Present

Burns, Terry
Relationship to Facility: Administrator

3/5/2007
to Present

Chaney, Gerald
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