CMS Manual System

Pub. 100-20 One-Time Notification Centers for Medicare & Medicaid Services (CMS)

Transmittal 82 Date: May 14, 2004

CHANGE REQUEST 3214 NOTE: This transmittal replaces Pub.100-20, transmittal 72, dated April 16, 2004. The attached OTN was revised to delete the old Business Requirement 3214.6 in the original issuance of the CR and renumber the remaining requirements. After the CR was issued we became aware that MMA had done away with standardized amount reclassifications for the future so it was no longer necessary to add in the business requirements. All other information remains the same. I. SUMMARY OF CHANGES: This One-Time Notification clarifies the Policy and Business Requirements in Transmittal 30 (CR3015) for determining rural status of hospitals for Transitional Outpatient Payments. NEW/REVISED MATERIAL - EFFECTIVE DATE: January 1, 2004 and October 1, 2004

*IMPLEMENTATION DATE: June 1, 2004 and October 4, 2004

Disclaimer for manual changes only: The revision date and transmittal number apply only to the red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will only receive the new/revised information, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (R = REVISED, N = NEW, D = DELETED R/N/D CHAPTER/SECTION/SUBSECTION/TITLE N/A

III. FUNDING: *Medicare contractors only:

These instructions should be implemented within your current operating budget. IV. ATTACHMENTS: Business Requirements Manual Instruction Confidential Requirements X One-Time Notification

Recurring Update Notification

Attachment - One-Time Notification Pub. 100-20 Transmittal: 82 Date: May 14, 2004 Change Request 3214

NOTE: This OTN replaces Pub 100-20, transmittal 72, dated April 16, 2004. This OTN was revised to delete the old Business Requirement 3214.6 in the original issuance of the CR and renumber the remaining requirements. After the CR was issued we became aware that MMA had done away with standardized amount reclassifications for the future so it was no longer necessary to add in the business requirements. All other information remains the same. SUBJECT: Changes in Determining Rural Status of Hospitals for Transitional

Outpatient Payments (TOPs) for 2004

I. GENERAL INFORMATION

A. Background: This notification clarifies the Policy and Business Requirements in Transmittal 30 (CR 3015) relating to changes in the hospital Outpatient Prospective Payment System (OPPS) for services furnished during calendar years 2004 and 2005. All changes to Transmittal 30 are indicated in bold print. B. Policy: As of January 1, 2004, TOPs are being discontinued for all community mental health centers (CHMCs) and all hospitals except rural hospitals having 100 or fewer beds, sole community hospitals (SCHs) (section 1886 (d) (5) (D)(iii) of the Act) which are located in rural areas, and cancer hospitals and children’s hospitals as described in sections 1886(d)(1)(B) (iii) and (v) of the Act. The interim TOP payments for these hospitals shall be calculated as 85% of the hold harmless amount (the amount by which the provider’s charges multiplied by its cost-to-charge ratio(CCR) then multiplied by its payment-to-cost ratio (PCR) exceeds the provider’s OPPS payments.) Be advised that for the CMHCs and hospitals for which TOPs will be discontinued, interim TOPs will be paid for services furnished through December 31, 2003. Fiscal intermediaries (FIs) are responsible for permanently continuing hold harmless TOP interim payments for cancer hospitals and children’s hospitals in accordance with the provisions of the Statute. Hold harmless TOPs shall continue for services rendered through December 31, 2005, for rural hospitals having 100 or fewer beds, in accordance with the provisions of The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). In addition, hold harmless TOPs shall apply to SCHs that are located in rural areas, with respect to services furnished during the period that begins with the provider’s first cost reporting period beginning on or after January 1, 2004, and ends on December 31, 2005, in accordance with the provisions of the MMA. NOTE: If a qualifying SCH has a cost reporting period that begins on a date other than January 1, TOPs and interim TOP payments will not be paid for services furnished after December 31, 2003 and before the beginning of provider’s next cost reporting period. If a hospital qualifies as both a rural hospital having 100 or fewer beds and as a SCH located in a rural

area, for purposes of receiving TOPs and interim TOPs, the hospital will be treated as a rural hospital having 100 or fewer beds. For purposes of TOPs, a hospital is considered rural if it is geographically rural, reclassified to rural for wage index purposes, or reclassified to rural for the standardized amount. For example, a hospital that is geographically rural is always considered rural for TOPs, even if it is reclassified to urban for the wage index and/or standardized amount. A hospital that is geographically urban, but reclassified to rural for the wage index and/or standardized amount is considered rural for purposes of TOPs. Transmittal 30 instructed Standard System Maintainers (SSM) to set the Payment-to-Cost Ratio (PCR) to zero for all hospitals that no longer qualify for TOPs. Transmittal 30 instructed SSMs to refer to certain fields in the Outpatient Provider Specific File (OPSF) to determine rural eligibility for TOPs purposes. The OPSF does not contain a field indicating if a provider is reclassified for purposes of its Standardized amount. Therefore, this revised instruction requires FIs to use the Inpatient Provider Specific File (IPSF), not the OPSF, to determine if a hospital is rural. We are also instructing the intermediaries to ensure that all qualified rural hospitals have a PCR entered in their OPSF and receive interim TOPs payments. As stated above, small rural hospitals will receive interim TOPs payments from January 1, 2004, but rural SCHs with greater than 100 beds should not have a PCR in the OPSF until the provider’s first cost reporting period beginning on or after January 1, 2004. Rural SCHs with fewer than 100 beds are treated as small rural hospitals and receive interim TOPs payment retroactive to January 1, 2004. If the FI identifies additional hospitals that are eligible for TOPs payments, the FI shall make appropriate interim payments retroactive to January 1, 2004 for small rural hospitals and retroactive to the provider’s first day of the cost reporting period beginning on or after January 1, 2004 for rural SCHs having greater than 100 beds. C. Provider Education: A provider education article related to this instruction will be available at www.cms.hhs.gov/medlearn/matters shortly after the CR is released. You will receive notification of the article release via the established "medlearn matters" listserv. Contractors shall post this article, or a direct link to this article, on their Web site and include information about it in a listserv message within one week of the availability of the provider education article. In addition, the provider education article must be included in your next regularly scheduled bulletin. II. BUSINESS REQUIREMENTS

“Shall" denotes a mandatory requirement "Should" denotes an optional requirement

Requirement # Requirements Responsibility 3214.1 Using the Inpatient Provider Specific File for

reference, FIs shall verify that there is a PCR in the Outpatient Provider Specific File for:

1) Rural hospitals having 100 or fewer beds—designated as rural in one or more of the following fields in the IPSF:

• Geographic/Actual MSA (position 59-62)

• Wage Index MSA (position 63-66)

• Standardized MSA (position 67-70)

and

• bedsize 100 or less (position 97-101)

NOTE: Small rural hospitals will receive interim TOPs payments from January 1, 2004.

2) Sole community hospitals (SCHs) which are located in rural areas—Those providers listed on Attachment A (revised) that are also designated as rural in one or more of the following fields in the IPSF:

• Geographic/Actual MSA (position 59-62)

• Wage Index MSA (position 63-66)

• Standardized MSA (position 67-70)

NOTE: Rural SCHs having greater than 100 beds should not have a PCR in the OPSF until the beginning of the provider’s first cost reporting period beginning on or after January 1, 2004. Rural SCHs with 100 or fewer beds are treated as small rural

FI

hospitals, for purposes of TOPs, and will receive interim TOPs payments retroactive to January 1, 2004.

NOTE: Rural hospitals are identified by MSAs that begin with “_ _”(blank blank) followed by a two digit state code (e.g. _ _21 is a rural hospital in Maryland).

3214.2 No later than June 1, 2004, FIs shall re-enter a PCR for rural hospitals and sole community hospitals that are eligible for TOPs payment but had their PCRs set to zero and begin making monthly interim TOPs payments as appropriate.

FI

3214.3 No later than July 1, 2004 FIs shall make retroactive payments to account for any TOPs interim payments that are due to the providers identified in requirement 3214.2 retroactively to January 1, 2004 for small rural hospitals or to the first day of the cost reporting period beginning on or after January 1, 2004 for sole community hospitals having more than 100 beds.

FIs

3214.4 The following requirement has is the same as in Transmittal 30, except for a correction in the last sentence.

In addition to TOPS payments for cancer and children’s hospitals, TOP interim payments shall be calculated for: 1)services furnished on or after January 1, 2004 through December 31, 2005 for rural hospitals having 100 or fewer beds; and 2) services furnished during the period that begins with the provider’s first cost reporting period beginning on or after January 1, 2004 and ends on December 31, 2005 for SCHs located in rural areas. The interim TOP payments for these hospitals shall be calculated the same way as payments are calculated for cancer and children’s hospitals. That is, 85% of the hold harmless amount (the amount by which the provider’s charges x CCR x PCR exceeds the provider’s OPPS payments.)

SSM

3214.5 The following requirement has not changed from the version in Transmittal 30.

FIs

FIs shall maintain a record of all PCRs that have been deleted and set to zero. These PCRs must be maintained so that they will be available in the event that future legislation restores TOPs to certain other provider types.

3214.6 No later than January 1, 2005, FIs shall populate the Geographic/Actual MSA and Wage Index MSA in the OPSF using data from the inpatient regulations that are effective on and after October 1, 2004. These fields shall continue to be updated, as needed, for future changes to the provider information contained in these fields. NOTE: Change to wage index reclassifications that apply to the Inpatient PPS on October 1 of any year do not apply to the OPPS until January 1 of the next year.

FI

3214.7 Beginning January 1, 2005, FIs shall use the OPSF bed size and MSA fields to determine number of beds and whether a hospital is considered to be rural for purposes of TOPs payments.

FI

III. SUPPORTING INFORMATION & POSSIBLE DESIGN CONSIDERATIONS

A. Other Instructions: N/A X-Ref Requirement # Instructions

B. Design Considerations: N/A

X-Ref Requirement # Recommendation for Medicare System Requirements

C. Interfaces: N/A D. Contractor Financial Reporting /Workload Impact: N/A E. Dependencies: N/A F. Testing Considerations: N/A IV. SCHEDULE, CONTACTS, AND FUNDING Effective Date: These instructions shall be

January 1, 2004 and October 1, 2004 Implementation Date: June 1, 2004 for business requirements 3214.1, 3214.2, 3214.4 and 3214.5 July 1, 2004 for business requirement 3214.3 January 1, 2005 for business requirements 3214.6 and 3214.7 Pre-Implementation Contact(s): Tamar Spolter (410)786-4709 or Janet Wellham (410-786-4510) Post-Implementation Contact(s): Tamar Spolter (410)786-4709 or Janet Wellham (410-786-4510)

implemented within your current operating budget.

Attachment

SOLE COMMUNITY HOSPITALSUpdate = July 5, 2003g:\dac\files\mgcrb\FY2004\2004reclass-ALL.xls

PROVIDERNUMBER HOSPITAL NAME CITY ST

01-0012 Baptist Medical Center/Dekalb Fort Payne AL01-0061 Jackson County Hospital Scottsboro AL01-0069 Lakeview Community Hospital Eufaula AL01-0089 Walker Baptist Medical Center Jasper AL01-0102 J. Paul Jones Hospital Camden AL01-0109 Pickens County Medical Center Carrollton AL01-0110 Bullock County Hospital and Nursing Home Union Springs AL01-0112 Bryan W. Whitfield Memorial Hospital Demopolic AL01-0115 Red Bay Hospital Red Bay AL01-0120 Monroe County Hospital Monroeville AL01-0122 Southwest Alabama Regional Medical Center Butler AL01-0125 Carraway Burdick West Medical Center Haleyville AL02-0002 Sitka Community Hospital Sitka AK02-0004 Ketchikan General Hospital Ketchikan AK02-0005 Norton Sound Regional Hospital Nome AK02-0006 Valley Palmer Hospital Palmer AK02-0007 Wrangell General Hospital Wrangell AK02-0008 Barlett Memorial Hospital Juneau AK02-0009 Petersburg General Hospital Petersburg AK02-0010 Cordova Community Hospital Cordova AK02-0011 Seward General Hospital Seward AK02-0012 Fairbanks Memorial Hospital Fairbanks AK02-0013 Kodiak Island Hospital Kodiak AK02-0014 South Peninsula Hospital Homer AK02-0024 Central Peninsula General Hospital Soldotna AK02-0025 Valdez Community Hospital Valdez AK03-0004 Sage Memorial Hospital Ganado AZ03-0007 Marcus J. Lawrence Memorial Cottonwood AZ03-0012 Yavapai Hospital Prescott AZ03-0013 Yuma Regional Medical Center Yuma AZ03-0023 Flagstaff Community Hospital Flagstaff AZ03-0027 Copper Queen Bisbee AZ03-0033 Payson Regional Medical Center Payson AZ03-0040 Holy Cross Hospital Health Center Nogales AZ03-0043 Sierra Vista Community Hospital Sierra Vista AZ03-0044 Winslow Memorial Hospital Winslow AZ03-0055 Kingman Regional Medical Center Kingham AZ03-0060 Cogre Valley Community Hospital Claypool AZ03-0062 Navapache Hospital Show Low AZ03-0067 Parker Community Hospital Parker AZ03-0068 Mount Graham Community Hospital Safford AZ03-0069 Havasu Regional Hospital Lake Havasu AZ03-0099 White Mountain Community Hospital Springerville AZ04-0011 Chambers Memorial Hospital Danville AR04-0015 Wilhelmina Medical Center Mena AR

04-0017 North Arkansas Medical Center Harrison AR04-0019 Baptist Memorial Hospital Forrest City AR04-0024 Ashley Memorial Hospital Crossett AR04-0027 Baxter County Regional Hospital Mountain Home AR04-0028 Booneville City Hospital Booneville AR04-0035 Fulton County Hospital Salem AR04-0044 Stone County Mountain View AR04-0050 Ouachita County Hospital Camden AR04-0053 Delta Memorial Hospital Dumas AR04-0060 Van Buren County Memorial Hospital Clinton AR04-0064 Dewitt City Hospital Dewitt AR04-0066 Baptist Medical Center Arkadelphia AR04-0067 Magnolia City Hospital Magnolia AR04-0071 Jefferson Regional Medical Center Pine Bluff AR04-0072 Stuttgart Memorial Hospital Stuttgart AR04-0085 Helena Regional Medical Center Helena AR04-0088 Medical Center of South Arkansas El Dorado AR04-0090 Dallas County Hospital Fordyce AR04-0091 Medical Park Hospital Hope AR04-0107 DeQueen Regional Medical Center DeQueen AR04-0109 Carroll Regional Medical Center Berryville AR04-0119 White River Medical Center Batesville AR05-0015 Northern Inyo Bishop CA05-0042 St. Elizabeth Community Hospital Redbluff CA05-0148 Plumas District Hospital Quincy CA05-0189 George L. Mee Memorial Hospital Kings City CA05-0217 Siskiyou General Hospital Yreka CA05-0251 Lassen Memorial Hospital Susanville CA05-0279 Hi-Desert Medical Center Joshua Tree CA05-0333 Seneca Hospital District Chester CA05-0352 Barton Memorial Hospital South Lake Tahoe CA05-0355 Sierra Valley District Hospital Loyalton CA05-0366 Mark Twain Hospital District San Andreas CA05-0379 Westside District Hospital Taft CA05-0392 Trinity Hospital Weaverville CA05-0397 Coalinga District Hospital Coalinga CA05-0417 Sutter Coast Hospital Crescent City CA05-0419 Mercy Medical Center Mount Shasta CA05-0423 Palo Verde Hospital Blythe CA05-0430 Modoc Medical Center Alturas CA05-0433 Indian Valley Hospital Greenville CA05-0434 Colusa Community Hospital Colusa CA05-0435 Fallbrook Hospital District Fallbrook CA05-0448 Ridgecrest Community Hospital Ridgecrest CA05-0469 Needles Desert Community Hospital Needles CA05-0476 Lakeside Community Hospital Lakeport CA05-0478 Santa Ynez Valley Hospital Solvang CA05-0494 Tahoe Forest Hospital Truckee CA05-0528 Los Banos Community Hospital Los Banos CA05-0539 Redbud Community Hospital Clearlake Highland CA05-0542 Kern Valley Hospital District Lake Isabella CA05-0569 Mendocino Coast Hospital Fort Bragg CA

05-0618 Bear Valley Community Hospital Big Bear Lake CA06-0001* North Colorado Medical Center Greeley CO06-0006 Montrose Memorial Hospital Montrose CO06-0007 Prowers Medical Center Lamar CO06-0008* San Luis Valley Regional Medical Center Alamosa CO06-0013 Mercy Medical Center Durango CO06-0016 St. Thomas More Hospital Canon City CO06-0018 Southwest Memorial Hospital Cortez CO06-0023 St. Mary's Hospital Grand Junction CO06-0029 St. Vincent General Hospital Leadville CO06-0033 Mount San Raphael Hospital Trinidad CO06-0036 Arkansas Valley Medical Center La Junta CO06-0037 Kit Carson County Memorial Hospital Burlington CO06-0041 Pioneers Hospital of Rio Blanco Meekers CO06-0042 Clagett Memorial Hospital Rifle CO06-0043 Cheyenne County Hospital Cheyenne Wells CO06-0044 Colorado Plains Medical Center Fort Morgan CO06-0046 Memorial Hospital Craig CO06-0047 Weisbrod Memorial County Eads CO06-0049 Routt County Memorial Steamboat Springs CO06-0050 Salida Hosptial Salida CO06-0052 Sedgewick County Hospital Julesburg CO06-0056 Yuma Hospital District Hospital Yuma CO06-0062 Lincoln Community Hospital Hugo CO06-0066 Huerfano County Hospital Walsenburg CO06-0070 Gunnison County Public Hospital Gunnison CO06-0073 Rangely District Rangely CO06-0075 Valley View Hospital Glenwood Springs CO06-0076 Sterling Hospital Sterling CO06-0085 Southwest Colorado Hospital Springfield CO06-0090 Kremmling Memorial Hospital Kremmling CO06-0096 Vail Valley Medical Center Vail CO10-0004 Madison County Memorial Hospital Madison FL10-0024 Fishermen's Hospital Marathon FL10-0106 Doctor's Memorial Hospital Perry FL10-0150 Depoo Memorial Hospital Key West FL10-0160 Mariner's Hospital Tavernier FL10-0175 DeSoto Memorial Hospital Arcadia FL10-0232 HCA Putnam Community Hospital Palatka FL10-0252 HCA Raulerson Okeechobee FL11-0002 Upson Regional Medical Center Thomaston GA11-0003 Satilla Regional Medical Center Waycross GA11-0025 Southeast Georgia Regional Medical Center Brunswick GA11-0032 Stephens County Hospital11-0051 Union General Hospital Blairsville GA11-0063 Liberty Regional Medical Center Hinesville GA11-0086 Memorial Hospital of Washington County Sandersville GA11-0089 Coffee Regional Medical Center Douglas GA11-0100 Jefferson Hospital Louisville GA11-0104 Crisp Regional Hospital Cordele GA11-0105 Colquitt Regional Medical Center Moultrie GA11-0109 Emanuel Medical Center Swainsboro GA

11-0114 Wills Memorial Hospital Washington GA11-0124 Wayne Memorial Hospital Jesup GA11-0128 Meadows Regional Medical Center11-0146 Gilman Hospital St. Mary's GA11-0185 Charlton Memorial Hospital Folkston GA11-0195 Stewart Webster Richland GA12-0002 Maui Memorial Hospital Maui HI12-0005 Hilo Hospital Hilo HI12-0014 G N Wilcox Memorial Hospital Kauai HI12-0016 Honokaa Hospital Honokaa HI12-0019 Kona Hospital Kona HI12-0028 North Hawaii Community Hospital13-0002 Majic Valley Reginal Hospital Twin Falls ID13-0009 Clearwater Valley Hospital Orofino ID13-0024 Bonner General Hospital Sandpoint ID13-0026 Cassia Hospital Burley ID14-0001 Graham Hospital Canton IL14-0003 Sarah D. Culbertson Hospital Rushville IL14-0005 Hardin County Roseclaire IL14-0015 Blessing Hospital Quincy IL14-0058 Passavant Hospital Jacksonville IL14-0089 McDonough District Hospital Macomb IL14-0161 St. James Hospital Pontiac IL14-0167 Iroquois Memorial Hospital Watseka IL14-0189 Sarah Bush Lincoln Health Mattoon IL15-0078 Jasper County Hospital Rensselaer IN16-0001 Marshalltown Medical and Surgical Marshalltown IA16-0013 Muscatine General Hospital Muscatine IA16-008116-0031 Shelby County Myrtue Memorial Hospital Harlan IA16-0039 Cass County Memorial Hospital Atlantic IA16-0048 Ringgold County Hospital Mount Ayr IA16-0064 North Iowa Mercy Health Center Mason City IA16-0090 Montgomery County Memorial Hospital Ged Oak IA16-0093 Virginia Gay Hospital Vinton IA16-0107 Burgess Memorial Hospital Onawa IA16-0116 Greater Community Hospital Creston IA16-0131 Horn Memorial Hospital Ida Grove IA17-0001 Newman County Hospital Emporia KS17-0006* Mount Carmel Medical Center Pittsburg KS17-0008 Citizen's Medical Center Colby KS17-0012* Salina Regional Medical Center Salina KS17-0013* Hays Regional Medical Center Hays KS17-0015 Mitchell County Hospital Beloit KS17-0019* WM Newton Memorial Hsopital Winfield KS17-0020 Hutchinson Hospital Hutchinson KS17-0022 Atchison Hospital Association Atchison KS17-0023 St. Catherine Hospital Garden City KS17-0027 Pratt Regional Medical Center Pratt KS17-0033 Central Kansas Medical Center Great Bend KS17-0041 Osborne County Memorial Hospital Osborne KS17-0045 Community Hospital, Onaga, Inc. Onaga KS

17-0052 Kingman County Hospital Kingman KS17-0054 Clay County Hospital Clay Center KS17-0063 Sheridan County Hospital Hoxie KS17-0068 Southwest Medical Center Liberal KS17-0070 Morris County Hospital Council Grove KS17-0082 Greeley County Hospital Tribune KS17-0084 Norton County Hospital Norton KS17-0090 Hodgeman County Health Center Jetmore KS17-0093 Smith County Memorial Hospital Smith Center KS17-0094 Coffey County Hospital Burlington KS17-0097 Northwest Kansas Medical Center Goodland KS17-0110 Bob Wilson Ulysses KS17-0120 Labette County Medical Center Parsons KS17-0137# Lawrence Memorial Hospital Lawrence KS17-0151 Harper District Hospital Harper KS17-0166 Morton County Hospital Elkhart KS17-0175 Humana Hospital - Dodge City Dodge City KS18-0012 Hardin Memorial Hospital Elizabethtown KY18-0028 McDowell Area Regional Hospital McDowell KY18-0041 Ohio County Hospital Hartford KY18-0043 Memorial Hospital Manchester KY18-0044 Pikeville Methodist Hospital Pikeville KY18-0093 Regional Medical Center/Hopkin County Madisonville KY18-0129 Mary Breckinridge Hospital Hyden KY18-0132 Humana Hospital - Lake Cumberland Somerset KY18-0139 Middle Kentucky River Medical Center Jackson KY19-0007 Natchitoches Parish Hospital Natchitoches LA19-0037 South Cameron Memorial Hospital Cameron LA19-0048 Lady of the Sea General Hospital Galliano LA19-0059 Pointe Coupee General Hospital New Roads LA19-0118 DeSoto Regional Health System Mansfield LA19-0156 Madison Parish Hospital Tallulah LA19-0218 Sabine Hospital Many LA19-0240 Christus Coushatta Health Care Center Coushatta LA20-0002 Miles Memorial Hospital Damariscotta ME20-0013 Waldo County General Hospital Belfast ME20-0026 Houlton Regional Hospital Houlton ME20-0027 Down East Community Hospital Machias ME20-0037 Franklin County Memorial Hospital Farmington ME20-0052 Northern Maine Medical Center Fort Kent ME20-0063 Penobscot Medical Center Rockland ME20-0066 Mayo Regional Hospital Dover-Foxcroft ME22-0012 Cape Cod Hospital Hyannis MA23-0001 Francis A Bell Hospital Ispeming MI23-0034 Community Memorial Hospital Cheboyan MI23-0036 Alpena General Hospital Alpena MI23-0054 Marquette General Hospital Marquette MI23-0055 Dickinson County Memorial Hospital Iron Mountain MI23-0058 MHSN Grayling Hospital23-0060 West Shore Hospital Manistee MI23-0081 Cadillac Mercy Hospital Cadillac MI23-0095 Tolfree Memorial Hospital West Branch MI

23-0097 Munson Medical Center Traverse City MI23-0100 Tawas St. Joseph Hospital Tawas City MI23-0101 St. Francis Hospital Escanba MI23-0105 Northern Michigan Hospital Petoskey MI23-0110 Memorial Medical Center/West Michigan Ludington MI23-0124 Charlevoix Area Hospital Charlevoix MI23-0133 Otsego Memorial Hospital Gaylord MI23-0143 Grand View Hospital Ironwood MI23-0149 Iron County Hospital Iron River MI23-0222 Midland Hospital Midland MI23-0239 Chippewa County/War Memorial Sault St. Marie MI24-0016 St. Joseph's Area Health Services Park Rapids MN24-0017 Northwestern Hospital Services Thief River Falls MN24-0029 St. Francis Medical Center Breckenridge MN24-0044 Community Memorial Hospital Winona MN24-0064 Itasca Memorial Hospital Grand Rapids MN24-0100 North Country Hospital Bemidji MN24-0139 Mille Lace Hospital Onamia MN25-0005 Perry County General Hospital Richton MS25-0010 Tippah County Hospital Ripley MS25-0012 Holly Springs Memorial Hospital Holly Springs MS25-0015 Grenada Lake Medical Center Grenada MS25-0029 S E Lackey Memorial Hospital Forest MS25-0030 Leake Memorial Hospital Carthage MS25-0035 Franklin County Memorial Hospital Meadville MS25-0036 George County Hospital Lucedale MS25-0058 South Central Regional Medical Center Laurel MS25-0076 Kemper Community Hospital Dekalb MS25-0077 Wayne General Hospital Waynesboro MS25-0079 Sharkey-Issaquena Hospital Rolling Rock MS25-0083 Univ. Hospitals & Clinics-Holmes Co. Lexington MS25-0088 Field Memorial Community Hospital Centreville MS25-0089 H. C. Watkins Memorial Hospital Quitman MS25-0095 South Sunflower County Hospital Indianola MS25-0098 Humphreys County Memorial Hospital Belzoni MS25-0107 Walthall County General Hospital Tylertown MS25-0119 King's Daughters Hospital Yazoo City MS25-0148 Stone County Hospital Wiggins MS26-0004 Cooper County Memorial Hospital Boonville MO26-0006# Heartland Regional Medical Center Saint Joseph MO26-0009 Bothwell Regional Health Center Sedalia MO26-0017 Phelps County Regional Medical Center Rolla MO26-0018 St. Francis/Mountain View Mountain View MO26-0022 Northeast Regional Medical Center Kirksville MO26-0024 Texas County Memorial Hospital Houston MO26-0025 Hannibal Regional Hospital Hannibal MO26-0034 Bates County Memorial Hospital Butler MO26-0044 Hedrick Medical Center Hedrick MO26-0050 St. Francis Hospital Maryville MO26-0058 Hermann Area District Hospital Hermann MO26-0059 Breech Medical Center Lebanon MO26-0064 Audrain Medical Center Mexico MO

s

26-0067 Carroll County Memorial Hospital Carrollton MO26-0073 Barton County Memorial Hospital Lamar MO26-0074 Moberly Regional Hospital Moberly MO26-0078 Ozark Medical Center West Plains MO26-0086 Gentry County Memorial Hospital MO26-0094 Skaggs Community Hospital Branson MO26-0097 Western Missouri Medical Center Warrensburg MO26-0113 Missouri Delta Community Hospital Lebanon MO26-0127 Pike County Memorial Hospital Louisiana MO26-0142 Fitzgibbon Hospital Markshall MO26-0147 Sec-Osage Hospital Osceola MO26-0158 Hermann Area District Hospital Hermann MO26-0172 Salem Memorial District Hospital Salem MO26-0175 Golden Valley Memorial Hospital Clinton MO26-0186 Lake of the Ozarks General Hospital Osage Beach MO26-0195 Citizens Memorial Hospital Bolivar MO27-0002 Holy Rosary Hospital Miles City MT27-0003 St. Peter's Hospital Helena MT27-0006 Broadwater Community Hospital Townsend MT27-0007 Stillwater Community Hospital Columbus MT27-0009 Community Hospital/Anaconda Anaconda MT27-0011 Central Montana Hospital Lewiston MT27-0012 Great Falls Consolidated Hospital Great Falls MT27-0016 Rosebud Community Hospital Forsythe MT27-0017 St. James Community Hospital Butte MT27-0021 Community Memorial Hospital Sidney MT27-0024 Trinity Hospital Wolf Point MT27-0026 Toole Community Hospital Shelby MT27-0027 Liberty County Hospital Chester MT27-0028 Barrett Hospital Dillon MT27-0029 Carbon County Memorial Hospital Red Lodge MT27-0030 Sweet Grass Community Hospital Big Timber MT27-0031 Teton Medical Center Choteau MT27-0032 Northern Montana Harve MT27-0033 Wheatland Memorial Hospital Harlowton MT27-0035 St. John's Lutheran Hospital Libby MT27-0036 Daniels Memorial Hospital Scobey MT27-0039 Pondera Medical Center Conrad MT27-0041 Powell County Hospital Deerlodge MT27-0044 Frances Mahon Deaconess Hospital Glasgow MT27-0046 Phillips County Hospital Malta MT27-0048 Glendive Medical Center Glendive MT27-0050 Marcus Daly Memorial Hospital Corporation Hamilton MT27-0052 Fallon Memorial Hospital Baker MT27-0053 Big Sandy Hospital Big Sandy MT27-0057 Bozeman Deaconess Hospital Bozeman MT27-0058 Sheridan Memorial Hospital Plentywood MT27-0059 Ruby Valley Hospital Sheridan MT27-0060 Poplar Community Hospital Poplar MT27-0063 Madison Valley Hospital Ennis MT27-0067 Roosevelt Memorial Hospital Culbertson MT27-0068 Mountainview Memorial Hospital Wht Sulphur Spring MT

s

27-0072 Chouteau County District Hospital Fort Benton MT27-0073 Mineral County Hospital Superior MT27-0079 Big Horn County Memorial Hospital Hardin MT27-0080 Livingston Memorial Hospital Livingston MT27-0081 Roundup Memorial Hospital Roundup MT27-0082 Glacier County Medical Center Cut Bank MT27-0083 Clark Fork Valley Hospital Plains MT28-0021 Community Hospital McCook NE28-0054 Beatrice Community Hospital Wymore NE28-0057 Jennie M. Melham Memorial Medical Center Broken Bow NE28-0061 West Nebraska General Hospital Scottsbluff NE28-0065 Great Plains Regional Medical Center North Platte NE28-0108 Phelps Memorial Hospital Holdrege NE28-0111 Columbus Community Hospital Columbus NE28-0117 Tri-County Hospital Lexington NE28-0118 Box Butte General Hospital Alliance NE28-0125 Faith Regional Health Services Norfolk NE29-0002 South Lyon Health Center Yearington NV29-0006 Churchill Regional Medical Center Fallon NV29-0008 Elko General Hospital Elko NV29-0016 Humboldt General Hospital Winnemucca NV29-0019 Carson Tahoe Hospital Carson City NV29-0020 Nye General hospital Tonopah NV29-0027 Grover C. Dils Medical Center Caliente NV30-0006 Huggins Hospital Wolfboro NH30-0010 Speare Memorial Hospital Plymouth NH30-0015 Memorial Hospital North Conway NH30-0022 Androscoggin Valley Hospital Berlin NH32-0002 Saint Vincent Hospital Santa Fe NM32-0003 Northeastern Regional Hospital Las Vegas NM32-0004 Gerald Champion Hospital Alamogordo NM32-0005 San Juan Regional Hospital Farmington NM32-0006 Eastern New Mexico Medical Center Roswell NM32-0011 Esponola General Hospital Esponola NM32-0012 Dr. Dan C. Trigg Memorial Hospital Tucumcari NM32-0013 Holy Cross Hospital Taos NM32-0014 Mimbres Memorial Hospital Deming NM32-0016 Gila Regional Medical Center Silver City NM32-0018 Memorial General Hospital Las Cruces NM32-0022 Plains Reg. Med. Ctr. Clovis NM32-0030 Artesia General Hospital Artesia NM32-0031 De Baca General Hospital Fort Sumner NM32-0032 Socorro General Hospital Socorro NM32-0033 Los Alamos Hospital Los Alamos NM32-0035 Sierra Vista Hospital Truth/Consequence NM32-0037 Cibola General Hospital Grants NM32-0038 McKinley Hospital Gallup NM32-0046 Ruidoso Hondo Hospital Ruidoso NM32-0048 Union County General Hospital Clayton NM32-0063 Guadalupe Medical Center Carlsbad NM32-0065 Lea Regional Hospital Hobbs NM32-0067 Guadalupe County Hospital Santa Rosa NM

32-0069 Miner's Colfax Medical Center Raton NM33-0008 Wyoming County Hospital Warsaw NY33-0079 Adirondack Medical Center Saranac Lake NY33-0084 Alice Hyde Hospital Malone NY33-0085 A. O. Fox Memorial Hospital Oneonta NY33-0096 Jones Memorial Hospital Wellsville NY33-0136 Mary Imogene Bassett Hospital Cooperstown NY33-0151 St. James Mercy Hospital Hornell NY33-0175 Cortland Memorial Hospital Cortland NY33-0177 E. J. Noble-Gouverneur Gouverneur NY33-0179 Clifton Fine Hospital Ogdensburg NY33-0197 Canton-Potsdam Hospital33-0211 A. Barton Hepburn Ogdensburg NY33-0213 Lewis County General Lowville NY33-0223 Massena Memorial Hospital33-0250 Champlain Valley Physicians Plattsburgh NY33-0263 Carthage Area Hospital Carthage NY33-0386 Community General/Sullivan Hospital Harris NY34-0011* Spruce Pine Community Hospital Spruce Pine NC34-0027 Lenior Memorial Hospital Kinston NC34-0042 Onslow Memorial Hospital Jacksonville NC34-0044 Alleghany Memorial Hospital Sparta NC34-0050 Southeastern General Hospital Lumberton NC34-0072 Ashe Memorial Hospital Jefferson NC34-0099 Roanoke-Chowan Hospital34-0131 Craven Regional Medical Center New Bern NC34-0142* Carteret County Hospital Morehead City NC34-0151* Halifax Memorial Hospital Roanoke Rapids NC34-0177 The Outerbanks Hospital NC35-0001 Garrison Memorial Hospital Garrison ND35-0003 St. Joseph's Hospital Dickinsen ND35-0006 Trinity Hospital Minot ND35-0007 St. Andrew's Hospital Bottineau ND35-0008 Carrington Health Center Carrington ND35-0009 Jamestown Hospital Jamestown ND35-0010 Good Samaritan Hospital Rugby ND35-0012 Oakes Community Hospital Oakes ND35-0013 Mercy Hospital Valley City ND35-0014 Towner County Memorial Hospital Cando ND35-0017 Mercy Hospital Williston ND35-0018 St. Aloisius Medical Center Harvey ND35-0019 United Hospital Grand Forks ND35-0021 St. Luke's Hospital Crosby ND35-0023 St. Luke's Tri-State Hospital Bowman ND35-0024 Presentation Medical Center Rolla ND35-0025 McKenzie County Memorial Hospital Watford City ND35-0027 Hillsboro Community Hospital Hillsboro ND35-0029 Stanley Community Hospital Stanley ND35-0030 Mercy Hospital Devils Lake ND35-0033 Union Hospital Mayville ND35-0034 Tioga Community Hospital Tioga ND35-0035 Kenmare Community Hospital Kenmare ND

35-0036 Renville-Bottineau Memorial Hospital Mohall ND35-0038 Pembina County Memorial Hospital Cavlier ND35-0039 Sakakawea Medical Center Hazen ND35-0041 Community Memorial Hospital Lisbon ND35-0044 Jacobson Memorial Hospital Elgin ND35-0049 Ashley Medical Center Ashley ND35-0050 Turtle Lake Community Memorial Hospital Turtle Lake ND35-0051 Wishek Community Hospital Wishek ND35-0053 Griggs County Hospital Cooperstown ND35-0055 Community Hospital/Nelson County McVille ND35-0056 Cavalier County Memorial Hospital Langdon ND35-0058 Linton Hospital Linton ND35-0061 West River Regional Medical Center Hettinger ND35-0065 Dickey County Memorial Hospital Ellendale ND36-0006 Hood River Memorial Hospital OH36-0109 Coshocton County Memorial Hospital Coshocton OH37-0002 Woodward Hospital Woodward OK37-0004 Baptist Regional Health Center Miami OK37-0007 Newman Memorial Hospital Shattuck OK37-0020 Valley View Regional Hospital Ada OK37-0022 Jackson County Memorial Hospital Altus OK37-0023 Duncan Regional Hospital Duncan OK37-0034 McAlester Regional Health Center McAlester OK37-0036 Harmon Memorial Hospital Hollis OK37-0040 Eastern Oklahoma Medical Center Poteau OK37-0046 Lindsay Municipal Hospital Lindsay OK37-0048 McCurtain Memorial Hospital Idabel OK37-0049 Stillwater Medical Center Stillwater OK37-0051 Tillman County Memorial Hospital Frederick OK37-0054 Grady Memorial Hospital Chickasha OK37-0064 Carnegie Tri-County Municipal Hospital Carnegie OK37-0065 Craig General Hospital Vinita OK37-0079 Kingfisher Regional Hospital Kingfisher OK37-0080 Share Memorial Hospital Alva OK37-0082 Beaver County Memorial Hospital Beaver OK37-0084 Haskell County Hospital Stigler OK37-0085 Mary Hurley Hospital Coalgate OK37-0089 Tahlequah City Hospital Tahlequah OK37-0108 Harper County Community Hospital Buffalo OK37-0113 Grove General Hospital Grove OK37-0125 Mangum City Hosptial Mangum OK37-0138 Guyman Memorial Hospital Guyman OK37-0139 Perry Memorial Hospital Perry OK37-0146 Cimmaron Memorial Hospital Boise City OK37-0156 Pauls Valley General Hospital Pauls Valley OK37-0165 Jefferson County Hospital Waurika OK37-0177 Seiling Municipal Hospital Seiling OK37-0178 Stilwell Memorial Hospital Stilwell OK38-0001 Mid Columbia Medical Center The Dalles OR38-0003 Pacific Communities Hospital Newport OR38-0011 St. Elizabeth Community Hospital Baker OR38-0013 Peace Harbor Hospital Florence OR

38-0023 Good Shepherd Community Hospital Hermiston OR38-0026 Columbia Memorial Hospital Astoria OR38-0027 Mercy Medical Center Roseburg OR38-0031 Wallowa Memorial Hospital Enterprise OR38-0040 Central Oregon District Hospital Redmond OR38-0050 Merle West Medical Center Klamath Falls OR38-0062 Pioneer Memorial Hospital Heppner OR38-0065 Lower Umpqua Hospital Reedsport OR38-0066 St. Anthony Hospital Pendleton OR38-0070 Tillamook County General Hospital Tillamook OR38-0072 Currey General Hospital Gold Beach OR38-0081 Mountain View Hospital Madras OR38-0083 North Lincoln Hospital Lincoln City OR38-0088 Lake District Hospital Lakeview OR39-0043 Soldiers & Sailors Memorial Hospital Wellsboro PA39-0104 Community Hospital Kane PA39-0113 Meadville Medical Center Meadville PA39-0117 Memorial Hospital of Bedford Everett PA39-0130 Miners Hospital of North Cambria Spangler PA39-0154 St. Mary's Regional Medical Center Saint Marys PA39-0173 Indiana Hospital Indiana PA39-0201 Pocono Medical Center East Stroudsburg PA39-0246 Charles Cole Memorial Hospital Coudersport PA42-0016 Barnwell County Hospital Barnwell SC42-0020 Georgetown Memorial Hospital Georgetown SC42-0053 Newberry County Memorial Hospital Newberry SC42-0055 Marion County Medical Center Marion SC42-0067 Beaufort Memorial Hospital Beaufort SC42-0071 Self Memorial Hospital42-0072 Hampton Regional Medical Center Varnville SC43-0005 Prairie Lakes Hospital Watertown SD43-0007 Madison Community Hospital Madison SD43-0011 Huron Regional Medical Center Huron SD43-0012 Sacred Heart Hospital Yanton SD43-001343-0014 St. Luke's Midland Regional Medical Center Aberdeen SD43-0015 St. Mary's Hospital Pierre SD43-0018 Mid Dakota Hospital Association Chamberlain SD43-0022 Marshall County Memorial Hospital Britton SD43-0024 Desmet Memorial Hospital Desmet SD43-0025 Faulk County Memorial Hospital Faulkton SD43-0026 Platte Community Memorial Hospital Platte SD43-0031 Hand County Memorial Hospital Miller SD43-0034 Redfield Community Memorial Hospital Redfield SD43-0038 Day County Hospital Webster SD43-0039 Douglas County Memorial Hospital Armour SD43-0042 Gettysburg Memorial Hospital Gettysburg SD43-0043 Baptist Hospital of Winner Winner SD43-0044 Southern Hills General Hospital Hot Springs SD43-0051 Custer Hospital Custer SD43-0056 Hans P. Peterson Memorial Hospital Philip SD43-0060 Holy Infant Hospital Hover SD

43-0064 Coteau Des Prairies Hospital Sisseton SD43-0065 Deuel County Memorial Hospital Clear Lake SD43-0066 Weskota Memorial Medical Center Wessington Springs SD43-0076 Bennet County Community Hospital Martin SD43-0079 Bowdle Hospital Bowdle SD44-0009 Cumberland Medical Center44-0010 Wayne Medical Center Waynesboro TN44-0033 Lafollette Medical Center Lafollette TN44-0052 Scott County Hospital Oneida TN44-0057 Clairborne County Hospital Tazewell TN44-0072 Methodist Healthcare-Dyersburg44-0083 Fentress County General Hospital Jamestown TN44-0180 Jellico Community Hospital Jellico TN45-0007 Sid Peterson Memorial Hospital Kerrville TX45-0050 Ward Memorial Hospital Monahans TX45-0052 Goodall-Witcher Healthcare Foundation Clifton TX45-0055 Rolling Plains Hospital Sweetwater TX45-0082 Bee County Regional Medical Center Beeville TX45-0085 Graham General Hospital Graham TX45-0092 Maverick County Memorial Hospital Eagle Pass TX45-0099 Coronado Hospital Pampa TX45-0144 Permian General Hospital Andrews TX45-0145 Refugio Memorial Hospital Refugio TX45-0146 Hansford County Hospital Spearman TX45-0154 Val Verde Memorial Hospital Del Rio TX45-0157 Hamilton Hospital Olney TX45-0163 Sphon Kleberg Memorial Hospital Kingville TX45-0165 Tri-City Community Hospital Jourdanton TX45-0177 Uvalde Memorial Hospital Uvalde TX45-0178 Pecos County Memorial Hospital Fort Stockton TX45-0185 Collingsworth General Hospital Wellington TX45-0201 Reeves County Hospital Pecos TX45-0210 Panola General Hospital Carthage TX45-0217 Hall County Hospital Memphis TX45-0219 Llano Memorial Hospital Llano TX45-0221 Memorial Hospital Dumas TX45-0246 Wagner General Hospital Palacios TX45-0264 Swisher Memorial Hospital Tulia TX45-0271 Decatur Community Hospital Decatur TX45-0283 Cozby-German Hospital Grand Saline TX45-0293 Frio Hospital Pearsall TX45-0303 Crosbyton Clinic Hospital Crosbyton TX45-0309 Medina Community Hospital Hondo TX45-0322 Iraan General Hospital Iraan TX45-0348 Falls Community Hospital Marlin TX45-0351 Harris Methodist-Erath County Stephenville TX45-0355 Coon Memorial Hospital Dalhart TX45-0362 Sheppard Memorial Hospital Burnet TX45-0369 Childress Regional Medical Center Childress TX45-0374 Cochran Memorial Hospital Morton TX45-0399 Brownfield Regional Hospital Brownfield TX45-0400 Parkview Regional Hospital Mexia TX

45-0411 Eastland Memorial Hospital Eastland TX45-0460 Tyler County Hospital Woodville TX45-0465 Matagorda General Hospital Bay City TX45-0467 Madison County Hospital Madisonville TX45-0489 Medical Arts Hospital Lamesa TX45-0498 Stephens County Hospital Breckinridge TX45-0534 Ochiltree General Hospital Perryton TX45-0559 Garza Memorial Hospital Post TX45-0574 Concho County Hospital Eden TX45-0578 Hemphill County Hospital Canadian TX45-0580 Houston County Hosptial Crockett TX45-0583 Kimble Hospital Junction TX45-0586 Seymour Hospital Seymour TX45-0587 Brownwood Regional Medical Center Brownwood TX45-0603 Culberson County Hospital Van Horn TX45-0604 Hill Country Memorial Hospital Fredericksburg TX45-0620 Dimmit County Hospital Carrizo Springs TX45-0649 Heart of Texas Memorial Hospital Brady TX45-0654 Staff County Memorial Hospital Rio Grande City TX45-0665 Otton Kaiser Memorial Hospital Kenedy TX45-0698 Lamb Healthcare Center Littlefield TX45-0700 Sabine County Hospital Hemphill TX45-0726 Brooks County Hospital Falfurrias TX45-0754 Hamilton General Hospital Hamilton TX45-0761 Muleshoe Area Medical Center Muleshoe TX45-0763 Golden Plains Community Hospital Borger TX45-0776 Coleman County Medical Center Coleman TX45-0778 Crockett County Hospital Ozona TX45-0830 Big Bend Regional Medical Center Alpine TX46-0007 Valley View Medical Center Cedar City UT46-0011 Castleview Hospital Price UT46-0014 Tooele Valley Medical Center Tooele UT46-0015 Logan Regional Hospital Logan UT46-0016 Allen Memorial Hospital Moab UT46-0018 Kane County Hospital Kanab UT46-0019 Duchesne County Hospital Roosevelt UT46-0020 San Juan Hospital Monticello UT46-0021 Dixie Memorial Hospital St. George UT46-0022 Fillmore Hospital Fillmore UT46-0024 Monument Valley Hospital Monument Valley UT46-0025 Milford Valley Hospital Milford UT46-0026 Sevier Valley Hospital Richfield UT46-0027 Delta Community Medical Center Delta UT46-0029 Sanpete Valley Hospital Mount Pleasant UT46-0030 Ashley Valley Hospital Vernal UT46-0032 Central Valley Medical Center Nephi UT46-0033 Garfield Memorial Hospital Panguitch UT46-0035 Beaver Valley Hospital Beaver UT46-0036 Wasatch County Hospital Heber UT46-0037 Gunnison Valley Hospital Gunnison UT? Buchanan General Hospital Grundy VA47-0001 Central Vermont Hospital Barre VT

47-0005 Rutland Hospital Rutland VT47-0006 Porter Medical Center Middlebury VT47-0008 North Country Hospital Newport VT47-0010 Copley Hospital Morrisville VT47-0023 Northeastern Vermont Regional Hospital St. Johnsbury VT47-0024 North Western Medical Center St. Albans VT49-0004 Rockingham Memorial Hospital Harrisonburg VA49-0012 Lee County Community Hospital Pennington GAP VA49-0013 Halifax-South Boston South Boston VA49-0018 Augusta Medical Center Fishersville VA49-0022 Mary Washington Hospital Fredericksburg VA49-0031 Stonewall Jackson Hospital Lexington VA49-0037 Shore Memorial Hospital Nassawadox VA49-0038 Smyth County Hospital49-0084 Riverside Tappahannock Hospital Tappahannock VA49-0090 Southside Community Hospital Farmville VA49-0092 Southampton Memorial Hospital Franklin VA49-0098 Community Memorial Hospital South Hills VA49-0111 Wythe County Community Hospital Wytheville VA49-0115 Twin County Community Hospital Galax VA49-0123 Rappahanock General Hospital Kilmarnock VA50-0019 Providence Hospital/Centralia Centralia WA50-0033 Samaritan Hospital Moses Lake WA50-0041 St. John's Medical Center Longview WA50-0055 Mount Carmel Hospital Colville WA50-0071 Mid-Valley Hospital Omak WA50-0072 Olympic Memorial Hospital Port Angeles WA50-0092 Lake Chelan Community Hospital Chelan WA50-0110 Kittitas Valley Hospital Ellensburg WA51-0002 Humana-Greenbrier Valley Ronceverte WV51-0006* United Hospital Center Clarksburg WV51-0015 Boone Memorial Hospital Madison WV51-0018 Jackson General Hospital Ripley WV51-0026 Grant County Hospital Petersburg WV51-0028 Moontgomery General Hospital Montgomery WV51-0030* Davis Memorial Hospital Elkins WV51-0038* Stonewall Jackson Memorial Hospital Weston WV51-0043 Pocahontas Memorial Hospital Marlinton WV51-0048* Logan General Hospital Logan WV51-0082 Summersville Memorial Hospital Summersville WV51-0086 Welch Emergency Hospital Welch WV52-0037 St. Joseph's Hospital Marshfield WI52-0039 Rusk County Memorial Hospital Ladysmith WI52-0088 St. Agnes Hospital Fon Du Lac WI52-0092 Shawano Community Hospital Shawano WI52-0109 Hess Memorial Hospital Mauston WI52-0113 Bay Area Medical Center Marinette WI52-0134 Prarie du Chien Hospital Prairie du Chien WI52-0148 Langlade Hospital Antigo WI52-0152 Door County Memorial Hospital Sturgeon Bay WI52-0173 Ashland Memorial Hospital Ashland WI53-0002 Campbell County Memorial Hospital Gillette WY

53-0003 Weston County Memorial Hospital Newcaster WY53-0004 Memorial Hospital of Hot Springs Thermopolis WY53-0005 Converse County Memorial Hospital Douglas WY53-0006 Memorial Hospital of Sheridan County Sheridan WY53-0007 Powell Hospital Powell WY53-0008 Riverton Memorial Hospital Riverton WY53-0009 Memorial Hospital of Carbon City Rawlin WY53-0011 Memorial Hospital of Sweetwater County Rock Springs WY53-0012 Memorial Hospital of Natrona County Casper WY53-0014 Memorial Hospital of Laramie County Cheyenne WY53-0015 St. John's Hospital Jackson WY53-0016 West Park Hospital Cody WY53-0017 South Lincoln Hospital Kemmerson WY53-0018 Community Hospital Torrington WY53-0019 Platte County Memorial Hospital Wheatland WY53-0022 Washakie Memorial Hospital Worland WY53-0023 Star Valley Hospital Afton WY53-0024 South Big Horn County Hospital Greybull WY53-0025 Ivinson Memorial Hospital Laramie WY53-0026 Johnson County Memorial Hospital Buffalo WY53-0027 Niobrara County Memorial Hospital Luck WY53-0029 North Big Horn Hospital Lovell WY53-0031 Crook County Memorial Hospital Sundance WY53-0032 Evanston Regional Hospital Evanston WY