🏥 Mark Twain Medical Center

Calaveras County · HCAI 106050932

768 MOUNTAIN RANCH ROAD, SAN ANDREAS 95249

Open · Hospital facility · roster 2026-10-01

Hospital Snapshot

The available data, together. Tap a section to open its history and sources.

↑ Increasing · ↓ Decreasing · → Stable · Provisional = filing still in process

Read the arrows

Trends: ↑ increasing, ↓ decreasing, → stable over the dates shown. Provisional means a filing is still in process.

CMS / CDPH comparisons: ↑ above, ↓ below, ↔ equal to the national number or the source reports no difference. The label identifies which comparison is shown.

—: no matched comparison.

👩‍⚕️ RN staffing

Reporting-unit RN hours / patient day: — UNDER REVIEW
Productive RN hours: 164,122
RN-only FTEs · productive, calculated: 78.9

History & details →

✈️ Travelers / agency

Contract RN hours / reported nursing hours: 2.1%↓
Contract RN hours: 4,212

History & details →

🛏️ Beds & capacity

🏥 Reported licensed beds: 25
🛏️ Reported staffed beds: 9—
⚙️ Operational beds: — UNKNOWN
🛏️ Reported available beds: 25
❤️ Licensed ICU beds: 8
👶 Licensed NICU beds: 0
🤰 Licensed perinatal beds: 0
🚑 ED treatment stations: 8

History & details →

🚑 ED & hospital pressure

🚑 ED encounters · admitted + non-admitted: 11,446
🛏️ ED admissions: 846
⏱️ Median ED stay · excludes psych / transfers: 123 min↓
⏱️ Psychiatric / mental-health ED stay · median: 205 min↓
⏱️ ED stay before transfer · median: 406 min↑
🚑 Left before being seen: 1%↓
⏱️ Ambulance offload · 90th percentile: 7.3 min
🚨 Ambulance diversion reported: No
⏱️ Boarding / wait time: — UNKNOWN

History & details →

🔄 Services & changes

Documented service changes: Service review not documented

History & details →

👥 Turnover & working conditions

Acute-hospital RN turnover: — UNKNOWN
RN vacancies: — UNKNOWN

Pay, overtime, orientation and contract records →

History & details →

💬 Patient experience

Nurses communicated well · Always: 90%↑
Help as soon as wanted · Always · legacy measure: 82%↑

History & details →

🦠 Infections · CMS ratios

Central-line bloodstream infections · CLABSI · SIR: — UNKNOWN
Catheter-associated urinary infections · CAUTI · SIR: — UNKNOWN
MRSA bloodstream infections · SIR: — UNKNOWN
C. diff infections · SIR: 0.000↔
Surgical-site infections · colon surgery · SIR: — UNKNOWN
Surgical-site infections · hysterectomy · SIR: — UNKNOWN

History & details →

🏥 Readmissions & mortality

30-day readmissions

Heart attack: — UNKNOWN
Heart failure: 21.2%↓
Pneumonia: 16.8%↓
COPD: 19.8%↓
Coronary bypass surgery: — UNKNOWN
Hip/knee replacement: — UNKNOWN

30-day mortality

Heart attack: — UNKNOWN
Heart failure: 10%↓
Pneumonia: 17.9%↑
COPD: 9.3%↑
Coronary bypass surgery: — UNKNOWN
Stroke: — UNKNOWN

History & details →

📈 Workload & complete records

Patient days, discharges, care mix and workload history.

🔎 All sources →History & details →

Explore history & sources

Before you take the job

Open details

Charge-nurse patient assignment — UNKNOWN · charge availability affects every nurse’s backupIs the charge nurse free of a patient assignment on this unit? If not, is it a partial or full assignment, how many patients, and how often? What dedicated RN/LVN support is provided, and who covers charge duties during emergencies?Source →

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👥 Turnover & working conditions

Open details

Who stays? Who leaves?

Acute-hospital RN turnover: — UNKNOWN
RN vacancies: — UNKNOWN

Pay, overtime, orientation & contract

RN overtime: UNKNOWN — no matched RN-specific hours
Current RN wage scale: UNKNOWN — no matched current scale
Orientation: UNKNOWN — no matched unit policy
Contract provisions: UNKNOWN — no executed local contract reviewed

↑ Back to snapshot

📈 Workload & patient demand

Open details

📈 Workload, Staffing & Capacity

2022–2024: ED encounters increased from 10,849 to 11,446.

🚑 ED activity · ↑ 5.5%

ED history & measures → · 🔎 Sources →

↑ Back to snapshot

👩‍⚕️ RN Staffing

Open details

Annual RN labor inputs · all retained years

Annual financial reporting unit · source-reported inputs
Reporting period	Productive RN hours	Contract RN hours	Patient days	Filing status	Source
2021-07-01–2022-06-30	78,623	10,878	3,266	Audited	Preserved fileAPI record ID 239
2022-07-01–2023-06-30	81,951	2,943	2,928	Audited	Preserved fileAPI record ID 239
2023-07-01–2024-06-30	164,122	4,212	2,426	Audited	Preserved fileHADR 01-01-2024 to 12-31-2024 row 237

Full source records & reporting scope →

🔎 Records & complete history →

Reporting-unit RN hours / patient day: — UNDER REVIEW; Outlier · review pending
164,122 RN hours ÷ 2,426 patient days
6.6 patient days per reporting day
Productive RN hours: 164,122
RN-only FTEs · productive, calculated: 78.9

📈 RN hours per patient day · annual reports

RN hours per patient day · annual reports · RN hours / patient day
Period	RN hours / patient day
2022	24.07
2023	27.99
2024	67.65

2022–2024 pattern: RN hours per patient day went from 24.07 to 67.65.

↑ Back to snapshot

✈️ Travelers / Agency Nursing

Open details

🔎 Records & complete history →

Contract RN hours / reported nursing hours: 2.1%
Contract RN hours: 4,212

📈 Contract RN share of nursing hours · annual reports

Contract RN share of nursing hours · annual reports · % of nursing hours
Period	% of nursing hours
2022	10.19
2023	2.84
2024	2.11

2022–2024 pattern: contract RN share went from 10.2% to 2.1%.

2018–2019 baseline: 0.5%.

↑ Back to snapshot

🛏️ Beds & Capacity

Open details

Which kind of bed capacity is reported?

What do these bed counts mean?

🏥 Licensed: Authorized bed capacity under the facility license.
🛏️ Staffed: Beds the hospital reports having personnel to operate during the reporting period.
⚙️ Operational: Beds open and equipped for patient care at a stated time.
📋 Reported available: The source’s available-bed count for its dated reporting period. Live availability means an empty, staffed bed ready to accept a patient now.

🔎 Records & complete history →

🏥 Reported licensed beds: 25
🛏️ Reported staffed beds: 9
⚙️ Operational beds: — UNKNOWN
🛏️ Reported available beds: 25
❤️ Licensed ICU beds: 8
👶 Licensed NICU beds: 0
🤰 Licensed perinatal beds: 0
🚑 ED treatment stations: 8

📈 Licensed specialty-bed history

Licensed beds · annual utilization
Licensed beds	2022	2023	2024
❤️ ICU	8	8	8
👶 NICU	0	0	0
🤰 Perinatal	0	0	0

📈 ED treatment stations · December 31

ED treatment stations · December 31 · Stations
Period	Stations
2022	8
2023	8
2024	8

↑ Back to snapshot

🚑 ED & Hospital Pressure

Open details

🔎 Records & complete history →

🚑 ED encounters · admitted + non-admitted: 11,446
🛏️ ED admissions: 846
⏱️ Median ED stay · excludes psych / transfers: 123 min↓
⏱️ Psychiatric / mental-health ED stay · median: 205 min↓
⏱️ ED stay before transfer · median: 406 min↑
🚑 Left before being seen: 1%↓
⏱️ Ambulance offload · 90th percentile: 7.3 min
🚨 Ambulance diversion reported: No
⏱️ Boarding / wait time: — UNKNOWN

📈 Ambulance offload · 90th percentile · Oct 2024–Mar 2025

Ambulance offload · 90th percentile · Oct 2024–Mar 2025 · Minutes
Period	Minutes
Oct 2024	10
Nov 2024	7
Dec 2024	9.9
Jan 2025	9
Feb 2025	10
Mar 2025	7.3

📈 ED encounters · admitted + non-admitted

ED encounters · admitted + non-admitted · Encounters
Period	Encounters
2022	10,849
2023	10,653
2024	11,446

↑ Back to snapshot

🔄 Services & Changes

Open details

Service review not documented

All documented service changes →↑ Back to snapshot

💬 Patient experience, infections & outcomes

Open details

Patient Experience & Outcomes

CMS reporting unit 051332 · MARK TWAIN MEDICAL CENTER

Patients who answered “Always”

Nurses communicated well: 90%↑Above national rate 80% · numerical comparison
Received help as soon as wanted: 82%↑Above national rate 67% · numerical comparison

Infections · standardized infection ratio (SIR)

Central-line bloodstream infections · CLABSI: — UNKNOWN
Catheter-associated urinary infections · CAUTI: — UNKNOWN
MRSA bloodstream infections: — UNKNOWN
C. diff infections: 0.000↔CMS: no different from national benchmark
Surgical-site infections · colon surgery: — UNKNOWN
Surgical-site infections · hysterectomy: — UNKNOWN

30-day readmissions & mortality · risk-standardized rates

Unplanned readmissions within 30 days

Heart attack: — UNKNOWN
Heart failure: 21.2%↓Below national rate 21.3% · numerical comparison
Pneumonia: 16.8%↓Below national rate 17.3% · numerical comparison
COPD: 19.8%↓Below national rate 20% · numerical comparison
Coronary bypass surgery: — UNKNOWN
Hip/knee replacement: — UNKNOWN

Deaths within 30 days

Heart attack: — UNKNOWN
Heart failure: 10%↓Below national rate 11.1% · numerical comparison
Pneumonia: 17.9%↑Above national rate 15.2% · numerical comparison
COPD: 9.3%↑Above national rate 8.6% · numerical comparison
Coronary bypass surgery: — UNKNOWN
Stroke: — UNKNOWN

🔎 Measure records & sources →

↑ Back to snapshot

🔎 Sources

Open details

HCAI facility roster · 2026-10-01 · source row 29 · Retained roster
Download this hospital’s retained records and history (JSON)HCAI 106050932 · dates, source locators and original values included

RN labor and workload · records & history

RN trend comparison: eligible. Contract-share trend comparison: eligible.

2022 · 2021-07-01–2022-06-30 · Audited

Download preserved source · Official source · API record ID 239

Field

Value

year

2022

begin

2021-07-01

end

2022-06-30

reportDays

365

filing

Audited

type

Comparable

sourceRecord

239

name

MARK TWAIN MEDICAL CENTER

county

Calaveras

rnHours

78623

patientDays

3266

ratio

24.07317819963258

components

Open components

Retained record fields
Field	Value
PRD_HR_RN	78623
PRD_HR_LVN	11504
PRD_HR_AID	5755
CNT_HR_RN	10878

nursingHours

106760

contractShare

0.10189209441738478

careDays

Open careDays

Retained record fields
Field	Value
DAY_ACUTE	3266
DAY_PSYCH	0
DAY_CHEM	0
DAY_REHAB	0
DAY_LTC	0
DAY_RESDNT	0

2023 · 2022-07-01–2023-06-30 · Audited

Download preserved source · Official source · API record ID 239

Field

Value

year

2023

begin

2022-07-01

end

2023-06-30

reportDays

365

filing

Audited

type

Comparable

sourceRecord

239

name

MARK TWAIN MEDICAL CENTER

county

Calaveras

rnHours

81951

patientDays

2928

ratio

27.98872950819672

components

Open components

Retained record fields
Field	Value
PRD_HR_RN	81951
PRD_HR_LVN	11425
PRD_HR_AID	7341
CNT_HR_RN	2943

nursingHours

103660

contractShare

0.028390893305035695

careDays

Open careDays

Retained record fields
Field	Value
DAY_ACUTE	2928
DAY_PSYCH	0
DAY_CHEM	0
DAY_REHAB	0
DAY_LTC	0
DAY_RESDNT	0

2024 · 2023-07-01–2024-06-30 · Audited

Download preserved source · Official source · HADR 01-01-2024 to 12-31-2024 row 237

Field

Value

year

2024

begin

2023-07-01

end

2024-06-30

reportDays

366

filing

Audited

type

Comparable

sourceRecord

237

name

MARK TWAIN MEDICAL CENTER

county

Calaveras

rnHours

164122

patientDays

2426

ratio

67.6512778235779

components

Open components

Retained record fields
Field	Value
PRD_HR_RN	164122
PRD_HR_LVN	18724
PRD_HR_AID	12132
CNT_HR_RN	4212

nursingHours

199190

contractShare

0.0211456398413575

careDays

Open careDays

Retained record fields
Field	Value
DAY_ACUTE	2426
DAY_PSYCH	0
DAY_CHEM	0
DAY_REHAB	0
DAY_LTC	0
DAY_RESDNT	0

Current CNO profile record · reported labor fields

Preserved 2024 financial workbook

Retained record fields
Field	Value
rnHours	164122
contractHours	4212
contractShare	0.02115
rnPerPatientDay	67.65128
baseline	0.00453
history	UNIQUE
filing	Audited

Beds and capacity · records & history

Official facility identity, campus scope & licensed beds · 2026-10-01

Official HCAI roster · Retained source · row 29

Field

Value

officialName

MARK TWAIN MEDICAL CENTER

county

Calaveras

city

SAN ANDREAS

address

768 MOUNTAIN RANCH ROAD

zip

95249

level

Parent Facility

category

General Acute Care Hospital

status

Open

statusEffective

1951-08-21

licensedBeds

erServiceLevel

Emergency - Basic

licenseNumber

030000058

rosterDate

2026-10-01

checkedOn

2026-10-12

sourceRow

officialUrl

https://data.chhs.ca.gov/dataset/licensed-healthcare-facility-listing

sourceFile

/downloads/coverage/hcai-current-20261001.json.gz

aliases

Open aliases

Record 1

MARK TWAIN MEDICAL CENTER

parentId

— UNKNOWN

parentName

— UNKNOWN

cdphFacilityType

GENERAL ACUTE CARE HOSPITAL

crosswalkRows

Open crosswalkRows

Record 1

Retained record fields
Field	Value
_id	239
LICENSED_CERTIFIED	LICENSED AND CERTIFIED
ELMS_FACID	030000120
LICENSE_NUMBER	030000058
LICENSE_STATUS_DESCRIPTION	ACTIVE
PERM_ID	10029
HCAI_ID	106050932
ASPEN_FACID	CA030000120
CCN	051332
NPI	1508968819
ASPEN_STATUS	ACTIVE
FACNAME	MARK TWAIN MEDICAL CENTER
FAC_TYPE_DESCRIPTION	GENERAL ACUTE CARE HOSPITAL
FAC_FDR	GENERAL ACUTE CARE HOSPITAL
FAC_FAC_RELATIONSHIP	Parent
ELMS_PARENT_FACID	— UNKNOWN

addedByCoverageAudit

false

Retained record fields
Field	Value
licensedBeds	25
staffedBeds	9
availableBeds	25
reportingYear	2025
scope	Workforce reporting year 2024; capacity reporting year 2025; not a same-period state assessment.

Licensed beds by care type · 2022 · 2022-01-01–2022-12-31

Preserved utilization workbook · Page 1-6 · row 35

Field

Value

year

2022

begin

2022-01-01

end

2022-12-31

operated

Yes

beds

Open beds

Retained record fields
Field	Value
acute	25
psychiatric	0
chemical	0
skilledNursing	0
intermediateCare	0
developmentalCare	0

total

sourceRow

sourceId

AUR-2022

Licensed beds by care type · 2023 · 2023-01-01–2023-12-31

Preserved utilization workbook · Page 1-6 · row 35

Field

Value

year

2023

begin

2023-01-01

end

2023-12-31

operated

Yes

beds

Open beds

Retained record fields
Field	Value
acute	25
psychiatric	0
chemical	0
skilledNursing	0
intermediateCare	0
developmentalCare	0

total

sourceRow

sourceId

AUR-2023

Licensed beds by care type · 2024 · 2024-01-01–2024-12-31

Preserved utilization workbook · Page 1-6 · row 36

Field

Value

year

2024

begin

2024-01-01

end

2024-12-31

operated

Yes

beds

Open beds

Retained record fields
Field	Value
acute	25
psychiatric	0
chemical	0
skilledNursing	0
intermediateCare	0
developmentalCare	0

total

sourceRow

sourceId

AUR-2024

ED activity, specialty beds and diversion · records & history

2022 · 2022-01-01–2022-12-31

Download preserved workbook · Official source · HCAI 106050932 · source row 35

Retained record fields
Field	Value
year	2022
begin	2022-01-01
end	2022-12-31
operated	Yes
sourceId	AUR-2022
sourceRow	35
diversionReported	No
icuLicensed	8
nicuLicensed	0
perinatalLicensed	0
edStations	8
edNonAdmitVisits	10128
edAdmissions	721
diversionHours	— UNKNOWN

2023 · 2023-01-01–2023-12-31

Download preserved workbook · Official source · HCAI 106050932 · source row 35

Retained record fields
Field	Value
year	2023
begin	2023-01-01
end	2023-12-31
operated	Yes
sourceId	AUR-2023
sourceRow	35
diversionReported	No
icuLicensed	8
nicuLicensed	0
perinatalLicensed	0
edStations	8
edNonAdmitVisits	9946
edAdmissions	707
diversionHours	— UNKNOWN

2024 · 2024-01-01–2024-12-31

Download preserved workbook · Official source · HCAI 106050932 · source row 36

Retained record fields
Field	Value
year	2024
begin	2024-01-01
end	2024-12-31
operated	Yes
sourceId	AUR-2024
sourceRow	36
diversionReported	No
icuLicensed	8
nicuLicensed	0
perinatalLicensed	0
edStations	8
edNonAdmitVisits	10600
edAdmissions	846
diversionHours	— UNKNOWN

CMS ED measures · records & history

CMS 051332 · MARK TWAIN MEDICAL CENTER · Download preserved CMS file · Official source

OP_18b · Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better · source row 17291

Retained record fields
Field	Value
value	123
raw	123
sample	359
footnote
start	2024-10-01
end	2025-09-30
sourceRow	17291
measureName	Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better

OP_18c · Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better · source row 17292

Retained record fields
Field	Value
value	205
raw	205
sample	23
footnote
start	2024-10-01
end	2025-09-30
sourceRow	17292
measureName	Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better

OP_18d · Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better · source row 17293

Retained record fields
Field	Value
value	406
raw	406
sample	16
footnote
start	2024-10-01
end	2025-09-30
sourceRow	17293
measureName	Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better

OP_22 · Left before being seen · source row 17294

Retained record fields
Field	Value
value	1
raw	1
sample	11681
footnote
start	2024-01-01
end	2024-12-31
sourceRow	17294
measureName	Left before being seen

Ambulance offload · records & history
Mark Twain Medical Center · CEMSIS 20271 · unique normalized hospital / retained CMS name + EMS geography
Download preserved report · Official report
Record 1 · 2024-10
Retained record fields
Field Value
month 2024-10
minutes 10
offloadCount 143
countPage 33
rawTime 0:10:00
sourceId EMSA-APOT-JUNE2025
page 21
row 22
Record 2 · 2024-11
Retained record fields
Field Value
month 2024-11
minutes 7
offloadCount 122
countPage 38
rawTime 0:07:00
sourceId EMSA-APOT-JUNE2025
page 21
row 22
Record 3 · 2024-12
Retained record fields
Field Value
month 2024-12
minutes 9.9
offloadCount 142
countPage 43
rawTime 0:09:54
sourceId EMSA-APOT-JUNE2025
page 21
row 22
Record 4 · 2025-01
Retained record fields
Field Value
month 2025-01
minutes 9
offloadCount 131
countPage 48
rawTime 0:09:00
sourceId EMSA-APOT-JUNE2025
page 21
row 22
Record 5 · 2025-02
Retained record fields
Field Value
month 2025-02
minutes 10
offloadCount 140
countPage 53
rawTime 0:10:00
sourceId EMSA-APOT-JUNE2025
page 21
row 22
Record 6 · 2025-03
Retained record fields
Field Value
month 2025-03
minutes 7.3
offloadCount 148
countPage 58
rawTime 0:07:18
sourceId EMSA-APOT-JUNE2025
page 21
row 22

CMS patient experience, infection, readmission & mortality records

CMS 051332 · MARK TWAIN MEDICAL CENTER · 768 MOUNTAIN RANCH RD, SAN ANDREAS 95249 · unique normalized address + city + ZIP

Unplanned Hospital Visits - National · Preserved national benchmarks · SHA-256 42db9aba1b194c9c65cbba3db83a990ffa653795d38a037bc660f12f58fecf98
Complications and Deaths - National · Preserved national benchmarks · SHA-256 b5e488f242f3e577db0e5cc8223bf2964cf914b424464fba95976e2931d15dc6
Patient survey (HCAHPS) - National · Preserved national benchmarks · SHA-256 1168d562ee10f94eaef2d29e4e8571a9be912c6e27b8dc37b215ad4300d0d6ed
Timely and Effective Care - National · Preserved national benchmarks · SHA-256 9a9201b989acb29177312caf5c9340cf5c07bc7469f58a15b80fbc7eab3636de
HCAHPS National · November 26, 2025 archive · Preserved national benchmarks · SHA-256 4b9d43013c67022783fd5cb4fc12fb8076afb084cc774644586093d1843f04af
HCAHPS · nurse communication · released 2026-08-13 · Preserved CSV (gzip) · Release metadata
File checksums
CSV SHA-256: b70e598f29552df302e30ed649d178abd1b3d3c868ae97cf8e55453dd33898fc
Gzip SHA-256: 95684a71416b383524c79ad0c7ad112622e632df97f33dbc1d701827eeff04a9
HCAHPS · legacy responsiveness · released 2025-11-26 · Preserved CSV (gzip) · Release metadata
File checksums
CSV SHA-256: c11338a55a9ee674566493fe8abde8748d2809163e86de100bc45aaa382d8751
Gzip SHA-256: 7c48b1aefcba65ebbe26a1dba592c0319261b847cdd9bb7c58306d55466cd4f8
Healthcare-associated infections · released 2026-08-13 · Preserved CSV (gzip) · Release metadata
File checksums
CSV SHA-256: 95283bf20e66c5f9271e6b0b98969d8655487b4d5fa074dcee6e204ee4574f3d
Gzip SHA-256: f6f0f580606726171c93adad77cd1c92a4ec00a8b37563114414ff19116c39af
CMS unplanned readmissions · released 2026-09-30 · Preserved CSV (gzip) · Release metadata
File checksums
CSV SHA-256: 98cc64f5fc330ffa7e4bef97f8e86a772a1d3dfe2f7dd08976cb1ee43fad1b2d
Gzip SHA-256: 1110a7b338b17e815ee9a2e3f6e40f7c53d9fde1df7663ff452b2f82ed7bb575
CMS 30-day mortality · released 2026-09-30 · Preserved CSV (gzip) · Release metadata
File checksums
CSV SHA-256: 2f7112969e2de2a015af8574848973dc48595ca6f2fe032e5f0932c515d5f59a
Gzip SHA-256: 04b606e8f24603cc6711bd630abc02fee2ee707d81a529360c72433806b180ce

Exact CMS records · reporting unit 051332
Measure	Reported value	Period	Source / row	CMS footnotes
H_COMP_1_A_PPatients who reported that their nurses "Always" communicated well	90	2024-10-01–2025-09-30	hcahps / 40734	None
H_COMP_3_A_PPatients who reported that they "Always" received help as soon as they wanted	82	2024-01-01–2024-12-31	responsiveness / 55923	None
HAI_1_SIRCentral Line Associated Bloodstream Infection (ICU + select Wards)	Not Available	2024-10-01–2025-09-30	hai / 21571	13CMS cannot calculate
HAI_1_NUMERATORCentral Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases	0	2024-10-01–2025-09-30	hai / 21570	None
HAI_1_ELIGCASESCentral Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases	0.078	2024-10-01–2025-09-30	hai / 21569	None
HAI_1_CILOWERCentral Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21566	13CMS cannot calculate
HAI_1_CIUPPERCentral Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21567	13CMS cannot calculate
HAI_2_SIRCatheter Associated Urinary Tract Infections (ICU + select Wards)	Not Available	2024-10-01–2025-09-30	hai / 21577	13CMS cannot calculate
HAI_2_NUMERATORCatheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases	0	2024-10-01–2025-09-30	hai / 21576	None
HAI_2_ELIGCASESCatheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases	0.284	2024-10-01–2025-09-30	hai / 21575	None
HAI_2_CILOWERCatheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21572	13CMS cannot calculate
HAI_2_CIUPPERCatheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21573	13CMS cannot calculate
HAI_3_SIRSSI - Colon Surgery	Not Available	2024-10-01–2025-09-30	hai / 21583	13CMS cannot calculate
HAI_3_NUMERATORSSI - Colon Surgery: Observed Cases	0	2024-10-01–2025-09-30	hai / 21582	None
HAI_3_ELIGCASESSSI - Colon Surgery: Predicted Cases	0.421	2024-10-01–2025-09-30	hai / 21581	None
HAI_3_CILOWERSSI - Colon Surgery: Lower Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21578	13CMS cannot calculate
HAI_3_CIUPPERSSI - Colon Surgery: Upper Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21579	13CMS cannot calculate
HAI_4_SIRSSI - Abdominal Hysterectomy	Not Available	2024-10-01–2025-09-30	hai / 21589	13CMS cannot calculate
HAI_4_NUMERATORSSI - Abdominal Hysterectomy: Observed Cases	0	2024-10-01–2025-09-30	hai / 21588	None
HAI_4_ELIGCASESSSI - Abdominal Hysterectomy: Predicted Cases	0.197	2024-10-01–2025-09-30	hai / 21587	None
HAI_4_CILOWERSSI - Abdominal Hysterectomy: Lower Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21584	13CMS cannot calculate
HAI_4_CIUPPERSSI - Abdominal Hysterectomy: Upper Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21585	13CMS cannot calculate
HAI_5_SIRMRSA Bacteremia	Not Available	2024-10-01–2025-09-30	hai / 21595	13CMS cannot calculate
HAI_5_NUMERATORMRSA Bacteremia: Observed Cases	0	2024-10-01–2025-09-30	hai / 21594	None
HAI_5_ELIGCASESMRSA Bacteremia: Predicted Cases	0.067	2024-10-01–2025-09-30	hai / 21593	None
HAI_5_CILOWERMRSA Bacteremia: Lower Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21590	13CMS cannot calculate
HAI_5_CIUPPERMRSA Bacteremia: Upper Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21591	13CMS cannot calculate
HAI_6_SIRClostridium Difficile (C.Diff)	0.000	2024-10-01–2025-09-30	hai / 21601	None
HAI_6_NUMERATORClostridium Difficile (C.Diff): Observed Cases	0	2024-10-01–2025-09-30	hai / 21600	None
HAI_6_ELIGCASESClostridium Difficile (C.Diff): Predicted Cases	1.083	2024-10-01–2025-09-30	hai / 21599	None
HAI_6_CILOWERClostridium Difficile (C.Diff): Lower Confidence Limit	Not Available	2024-10-01–2025-09-30	hai / 21596	8Lower confidence limit unavailable
HAI_6_CIUPPERClostridium Difficile (C.Diff): Upper Confidence Limit	2.766	2024-10-01–2025-09-30	hai / 21597	None
READM_30_AMIAcute Myocardial Infarction (AMI) 30-Day Readmission Rate	Not AvailableCMS cohort: Not AvailableLower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	readmissions / 8396	1Too few cases to report
READM_30_HFHeart failure (HF) 30-Day Readmission Rate	21.2CMS cohort: 42Lower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	readmissions / 8399	None
READM_30_PNPneumonia (PN) 30-Day Readmission Rate	16.8CMS cohort: 117Lower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	readmissions / 8401	None
READM_30_COPDRate of readmission for chronic obstructive pulmonary disease (COPD) patients	19.8CMS cohort: 28Lower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	readmissions / 8398	None
READM_30_CABGRate of readmission for CABG	Not AvailableCMS cohort: Not AvailableLower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	readmissions / 8397	5No CMS result for this period
READM_30_HIP_KNEERate of readmission after hip/knee replacement	Not AvailableCMS cohort: Not AvailableLower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	readmissions / 8400	1Too few cases to report
MORT_30_AMIDeath rate for heart attack patients	Not AvailableCMS cohort: Not AvailableLower estimate: Not AvailableHigher estimate: Not Available	2022-07-01–2025-06-30	mortality / 11984	1Too few cases to report
MORT_30_HFDeath rate for heart failure patients	10CMS cohort: 46Lower estimate: Not AvailableHigher estimate: Not Available	2022-07-01–2025-06-30	mortality / 11987	None
MORT_30_PNDeath rate for pneumonia patients	17.9CMS cohort: 116Lower estimate: Not AvailableHigher estimate: Not Available	2022-07-01–2025-06-30	mortality / 11988	None
MORT_30_COPDDeath rate for COPD patients	9.3CMS cohort: 45Lower estimate: Not AvailableHigher estimate: Not Available	2022-07-01–2025-06-30	mortality / 11986	None
MORT_30_CABGDeath rate for CABG surgery patients	Not AvailableCMS cohort: Not AvailableLower estimate: Not AvailableHigher estimate: Not Available	2022-07-01–2025-06-30	mortality / 11985	5No CMS result for this period
MORT_30_STKDeath rate for stroke patients	Not AvailableCMS cohort: Not AvailableLower estimate: Not AvailableHigher estimate: Not Available	2023-07-01–2025-06-30	mortality / 11989	1Too few cases to report

CMS footnote definitions · HCAHPS survey versions

2022–2024 annual nursing history · source records & calculations

HCAI 106050932 · annual financial reporting unit
Report	Reporting period	Productive RN hours	Patient days	Contract RN hours	Nursing hours
2022	2021-07-01–2022-06-30	78,623	3,266	10,878	106,760
2023	2022-07-01–2023-06-30	81,951	2,928	2,943	103,660
2024	2023-07-01–2024-06-30	164,122	2,426	4,212	199,190

RN hours per patient day: PRD_HR_RN ÷ DAY_TOT. Contract RN share: CNT_HR_RN ÷ (PRD_HR_RN + PRD_HR_LVN + PRD_HR_AID + CNT_HR_RN).

2022 HCAI annual financial records · Preserved source · API record ID 239 · Audited · ComparableSHA-256: a79841850b69181682634b9cf5baafc9886fc80761f7ef7bd18281d87c488e8e
2023 HCAI annual financial records · Preserved source · API record ID 239 · Audited · ComparableSHA-256: 50ecefcc9e0613b9c65c7f292acbb5ea45d82205d0ec651ee7a42c153143a4ba
2024 HCAI annual financial records · Preserved source · HADR 01-01-2024 to 12-31-2024 row 237 · Audited · ComparableSHA-256: 0fcc4c3c52f335adc63699cf65d5ecbe28b94bb2d20433508cfe799e82541e26

2024 HCAI selected annual financial reports · RN hours and patient-day care mix · Preserved workbook
RN comparison calculation & reporting scope
Unweighted median of hospital report ratios PRD_HR_RN / DAY_TOT. Middle 50%: inclusive linear-interpolated 25th and 75th percentiles. Same 2024 selected-report file; audited Comparable reports, 365 or 366 days, majority (>50%) patient-day care group, exact unique HCAI IDs, reconciled care-day totals and existing CNO ratio. Includes reported zero RN hours; excludes missing values. No reference for mixed care-day groups or cohorts smaller than eight.
HCAI 106050932 · HADR 01-01-2024 to 12-31-2024 · row 237 · Audited · 2023-07-01–2024-06-30
Outlier screen: ratio above the care-group upper quartile plus three interquartile ranges.
Productive RN hours: 164,122 ÷ total patient days: 2,426
- Acute care: 2,426 patient days
- Psychiatric: 0 patient days
- Chemical dependency: 0 patient days
- Rehabilitation: 0 patient days
- Long-term care: 0 patient days
- Residential: 0 patient days
Source SHA-256: 0fcc4c3c52f335adc63699cf65d5ecbe28b94bb2d20433508cfe799e82541e26
Oct 2024–Mar 2025 · EMSA ambulance offload history · page 21 · Preserved report
Offload hospital identity & source times
Mark Twain Medical Center · Mountain Counties · CEMSIS 20271 · unique normalized hospital / retained CMS name + EMS geography
- Oct 2024: 0:10:00 · 90th percentile · 143 qualifying offloads · page 21 · count page 33
- Nov 2024: 0:07:00 · 90th percentile · 122 qualifying offloads · page 21 · count page 38
- Dec 2024: 0:09:54 · 90th percentile · 142 qualifying offloads · page 21 · count page 43
- Jan 2025: 0:09:00 · 90th percentile · 131 qualifying offloads · page 21 · count page 48
- Feb 2025: 0:10:00 · 90th percentile · 140 qualifying offloads · page 21 · count page 53
- Mar 2025: 0:07:18 · 90th percentile · 148 qualifying offloads · page 21 · count page 58
CMS ED measures · reporting unit 051332 · MARK TWAIN MEDICAL CENTER · Preserved file
CMS values, dates & identity match
768 MOUNTAIN RANCH RD, SAN ANDREAS 95249 · unique normalized address + city + ZIP
- OP_18b: 123 · 2024-10-01–2025-09-30 · sample 359
- OP_18c: 205 · 2024-10-01–2025-09-30 · sample 23
- OP_18d: 406 · 2024-10-01–2025-09-30 · sample 16
- OP_22: 1 · 2024-01-01–2024-12-31 · sample 11681
Preserved hospital identities · CMS footnote definitions
2022-01-01–2022-12-31 · HCAI licensed specialty beds, ED activity & diversion · Preserved file
2023-01-01–2023-12-31 · HCAI licensed specialty beds, ED activity & diversion · Preserved file
2024-01-01–2024-12-31 · HCAI licensed specialty beds, ED activity & diversion · Preserved file
2024 contract RN share calculation
Nursing-hour denominator
Contract RN hours ÷ (productive RN + productive LVN + productive aide + contract RN hours). HCAI fields: CNT_HR_RN ÷ (PRD_HR_RN + PRD_HR_LVN + PRD_HR_AID + CNT_HR_RN).
Productive FTE calculation · hours ÷ 2,080
2024 HCAI annual financial / RN labor
2025 California capacity record

All public source collections →
Evidence standards & methodology →↑ Back to snapshot

Research record, provenance & reporting scope

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Public Record Profile · No state call

Mark Twain Medical Center

Calaveras County · HCAI 106050932

Profile statusLISTED — NOT YET REVIEWEDDescriptive profile · two source layers2024 financial filing audited2024 workforce record available2025 capacity record available

What this page can show2024 nursing labor and 2025 capacity, reported separately.

What the public record reports

What is reported?

This facility is listed, but its records have not received the additional hospital-specific review shown on reviewed profiles.

Reported RN labor164,122 productive RN hours.

164,122Hospital-wide productive RN hours · 2024

Contract RN share2.1% of reported RN labor.

2.1%Agency, registry, or contract RN share · 2024

Reported RN intensity67.7 RN hours per patient day.

67.7Hospital-wide annual proxy · 2024

Reported capacity9 staffed beds.

25 → 9Available → staffed beds · 2025

Evidence trail

Where the numbers came from.

Facility identity

CLEAR — UNIQUE ID MATCH. This page is anchored to HCAI facility ID 106050932.

Open official facility source ↗

Workforce source

2024 productive RN hours and contract-RN measures come from the HCAI hospital financial/workforce reporting layer.

Open HCAI hospital financials ↗

Capacity source

2025 licensed, available, and staffed-bed records are a separate capacity layer with its own reporting scope.

Open California health data ↗

Next evidence step

Acquire third independent audited domain before any state call.

Read CNO’s methodology →

Use the gap

What changed in patient demand, staffed capacity, and permanent RN coverage during the same reporting period—and what happened on my unit?

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Field	Value
month	2024-10
minutes	10
offloadCount	143
countPage	33
rawTime	0:10:00
sourceId	EMSA-APOT-JUNE2025
page	21
row	22

Field	Value
month	2024-11
minutes	7
offloadCount	122
countPage	38
rawTime	0:07:00
sourceId	EMSA-APOT-JUNE2025
page	21
row	22

Field	Value
month	2024-12
minutes	9.9
offloadCount	142
countPage	43
rawTime	0:09:54
sourceId	EMSA-APOT-JUNE2025
page	21
row	22

Field	Value
month	2025-01
minutes	9
offloadCount	131
countPage	48
rawTime	0:09:00
sourceId	EMSA-APOT-JUNE2025
page	21
row	22

Field	Value
month	2025-02
minutes	10
offloadCount	140
countPage	53
rawTime	0:10:00
sourceId	EMSA-APOT-JUNE2025
page	21
row	22

Field	Value
month	2025-03
minutes	7.3
offloadCount	148
countPage	58
rawTime	0:07:18
sourceId	EMSA-APOT-JUNE2025
page	21
row	22