# Redlands Community Hospital — Market Leakage / Patient-Origin Analysis

**Subject facility:** Redlands Community Hospital (RCH) · HCAI/OSHPD facility ID 106361308 · CCN 050272 · 350 Terracina Blvd, Redlands CA 92373 · San Bernardino County
**Data year:** Calendar Year **2024** (latest available)
**Prepared:** 2026-06-07 — for USC HMGT 570 strategic-management group project (data compilation only; no SWOT/analysis beyond descriptive findings)

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## Data source & methodology

**Primary source.** California Department of Health Care Access and Information (HCAI), *Patient Origin / Market Share (Pivot Profile) — Inpatient, Emergency Department, and Ambulatory Surgery*, on the CHHS Open Data Portal:
- Dataset: https://data.chhs.ca.gov/dataset/patient-origin-market-share-pivot-profile-inpatient-emergency-department-and-ambulatory-surgery
- Resource used: **2024 Patient Origin/Market Share (Pivot Profile).xlsx** (`.../resource/940326be-d80f-4e2b-9cba-1f9e3b912cd7/download/2024-patient-origin-market-share.xlsx`)
- The workbook's **"Data" sheet** is a record-level table (410,617 rows; ~19.5M encounters statewide) with one row per facility × patient-type × patient-ZIP × discharge count. All figures below are computed directly from that raw table, not from the pre-built pivot views, so the methodology is transparent and reproducible.

**Secondary source (utilization comparison).** HCAI *Hospital Annual Utilization Report*, 2024 final (desk-audited) file:
- Dataset: https://data.chhs.ca.gov/dataset/hospital-annual-utilization-report
- Resource: **2024 Hospital Annual Utilization (October 2025)** (`.../resource/e4f70066-c0ca-40f9-8f54-0ea033f900d9/download/hosp24_util_data_final.xlsx`)

**Definitions used.**
- **Inpatient discharges** = HCAI patient types `Inpatient` + `Inpatient from ED` (a discharge that was admitted through the ED is still an inpatient discharge).
- **ED visits (treat-and-release)** = HCAI patient type `ED Only` (ED encounters not resulting in admission). Reported separately from inpatient.
- **Ambulatory surgery** = HCAI patient type `AS Only`.
- **Market share for a ZIP** = (discharges from that ZIP going to facility X) ÷ (all discharges originating in that ZIP, to any California hospital).
- **Leakage for a ZIP** = 1 − (RCH's share of that ZIP) = the share of the ZIP's patients captured by every hospital other than RCH.
- Patients who left California or went to a federal/VA/military hospital are not in this dataset; "leakage" here means leakage to other California-licensed hospitals.

**Service-area ZIPs** (per project definition): Redlands 92373/92374/92375; Loma Linda 92354; Mentone 92359; Yucaipa 92399; Calimesa 92320; Highland 92346; Grand Terrace 92313; Colton 92324; San Bernardino 92404/92405/92408/92410/92411; Beaumont/Cherry Valley 92223; Banning 92220. (92375 is a small Redlands ZIP; Cherry Valley shares 92223 with Beaumont.)

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## RCH volume profile, 2024 (all origins)

| Encounter type | RCH volume (2024) |
|---|---|
| Inpatient discharges (Inpatient + Inpatient-from-ED) | **11,162** |
| ED visits, treat-and-release (ED Only) | **46,799** |
| Ambulatory surgery cases (AS Only) | **5,812** |

Top inpatient origin ZIPs for RCH: 92399 Yucaipa (2,212; 19.8% of RCH IP), 92373 Redlands (1,543; 13.8%), 92374 Redlands (1,315; 11.8%), 92223 Beaumont/Cherry Valley (839; 7.5%), 92346 Highland (838; 7.5%). Full ZIP-by-ZIP origin detail is in `rch_patient_origin.csv`.

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## Market share & leakage — two ways to read it

The project's service-area list spans **two distinct submarkets**, and RCH's position differs sharply between them. Both are reported so the team can choose the framing.

### A. Core draw area (Redlands · Yucaipa · Mentone · Calimesa — ZIPs 92373/92374/92375/92399/92359/92320)

This is where RCH is the home hospital.

- Total inpatient discharges originating here: **15,513**
- RCH captures **5,712 → 36.8% inpatient market share** (leakage **63.2%**)
- Top competitors capturing the leakage:

| Rank | Facility | Discharges from core ZIPs | Share of core market |
|---|---|---|---|
| 1 (RCH) | **Redlands Community Hospital** | 5,712 | **36.8%** |
| 2 | Loma Linda University Medical Center | 2,970 | 19.1% |
| 3 | Kaiser Foundation Hospital – Fontana | 1,661 | 10.7% |
| 4 | Loma Linda University Children's Hospital | 1,447 | 9.3% |
| 5 | Arrowhead Regional Medical Center | 637 | 4.1% |
| 6 | St. Bernardine Medical Center | 530 | 3.4% |

Even in its home market, RCH keeps just over a third of inpatient discharges; the **Loma Linda system (LLUMC + LLU Children's) together pulls ~28%** of RCH's core inpatient volume, and **Kaiser Fontana ~11%** (largely Kaiser-plan members who route to a Kaiser facility regardless of geography).

### B. Broad service area (all 17 project ZIPs, including the City of San Bernardino)

This wider footprint reaches into San Bernardino city ZIPs (92404/92405/92408/92410/92411) where RCH has never been the dominant provider — those ZIPs are anchored by St. Bernardine, Community Hospital of San Bernardino, and Arrowhead Regional.

- Total inpatient discharges originating here: **67,502**
- RCH captures **9,117 → 13.5% inpatient market share** (leakage **86.5%**)
- Top capturers across the broad area:

| Rank | Facility | Discharges | Share of broad market |
|---|---|---|---|
| 1 | Loma Linda University Medical Center | 11,798 | 17.5% |
| 2 (RCH) | **Redlands Community Hospital** | 9,117 | **13.5%** |
| 3 | St. Bernardine Medical Center | 9,096 | 13.5% |
| 4 | Arrowhead Regional Medical Center | 6,802 | 10.1% |
| 5 | Kaiser Foundation Hospital – Fontana | 6,311 | 9.3% |
| 6 | Loma Linda University Children's Hospital | 6,018 | 8.9% |
| 7 | Community Hospital of San Bernardino | 5,431 | 8.0% |
| 8 | San Gorgonio Memorial Hospital | 1,761 | 2.6% |

**Interpretation note for the team:** the 13.5% "overall" figure is heavily diluted by the San Bernardino-city ZIPs, which are arguably outside RCH's realistic catchment. The 36.8% core-area figure is the more honest read of RCH's competitive standing. Per-ZIP detail for all 17 ZIPs (inpatient and ED) is in `rch_market_share_leakage.csv`.

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## Biggest leakage destinations (inpatient, who captures RCH's would-be patients)

Ranked across the **core draw area**, the patients NOT going to RCH go primarily to:

1. **Loma Linda University Medical Center** — ~19% of core-area inpatients (the regional academic/Level I trauma magnet, ~9 miles away). Combined with LLU Children's, the **LLU system takes ~28%**.
2. **Kaiser Permanente (Fontana, plus Riverside/Moreno Valley)** — ~11% in the core area; this is closed-network leakage (Kaiser members), structurally hard to recapture.
3. **Arrowhead Regional Medical Center** — ~4% (county safety-net / Level I trauma).
4. **St. Bernardine Medical Center** — ~3% (Dignity Health, San Bernardino).

Where leakage is worst by ZIP (inpatient): RCH's share is lowest in the San Bernardino-city ZIPs (92411 = 1.4%, 92410 = 2.7%, 92405 = 2.7%, 92404 = 3.2%) and in Loma Linda 92354 (6.9%, where LLUMC takes 51% — its own back yard). RCH is strongest in 92373 Redlands (42.3%), 92399 Yucaipa (39.9%), 92359 Mentone (33.9%), and 92374 Redlands (31.7%).

**Service-line note:** This dataset segments by patient type (inpatient / ED / ambulatory surgery), not by clinical service line or DRG, so service-line-level leakage (e.g., cardiac, oncology, OB) cannot be derived from this file alone. The clearest structural leakage driver visible here is **tertiary/quaternary acuity** — cases routing to LLUMC and Arrowhead, the region's two Level I trauma/academic centers, which RCH (a 211-bed community hospital with no trauma designation) does not serve.

### Emergency department leakage

RCH is a much stronger ED magnet than an inpatient magnet. Across the broad 17-ZIP area, total ED-Only (treat-and-release) visits = **248,607**, of which RCH captures **38,793 → 15.6%**. RCH ranks #2 in service-area ED volume behind St. Bernardine, ahead of San Gorgonio and Community Hospital of San Bernardino. ED capture is geographically driven (people go to the nearest open ED), so RCH's ED share holds up better than its inpatient share. Per-ZIP ED detail is in `rch_market_share_leakage.csv` (rows where `Encounter_Type = ED_Only`).

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## Capacity / utilization context (2024)

From the HCAI Annual Utilization file (full table in `hcai_utilization_comparison.csv`):

| Facility | Lic. beds | GAC discharges | ALOS (d) | GAC occ. | ED visits | Trauma |
|---|---|---|---|---|---|---|
| **Redlands Community (RCH)** | 211 | 9,320 | 4.3 | 56.6% | 61,472 | None |
| Loma Linda Univ Med Ctr | 409 | 20,805 | 6.1 | 109.3%* | 45,845 | Level I |
| LLU Children's | 364 | 17,552 | 4.8 | 63.4% | 46,083 | None |
| St. Bernardine Med Ctr | 342 | 15,485 | 4.9 | 61.2% | 84,187 | None |
| Arrowhead Regional | 456 | 17,845 | 6.4 | 85.7% | 85,453 | Level I |
| Kaiser Fontana | 450 | 19,856 | 4.4 | 53.7% | 101,937 | None |
| Community Hosp of SB | 347 | 6,541 | 3.8 | 37.2% | 66,807 | None |
| Kaiser Moreno Valley | 100 | 5,146 | 3.5 | 49.5% | 59,944 | None |
| Kaiser Riverside | 225 | 10,034 | 4.0 | 48.8% | 65,864 | None |
| San Gorgonio Memorial | 79 | 2,101 | 3.8 | 27.5% | 46,431 | None |

GAC = general acute care (med-surg + specialty acute, excludes psych/SNF/rehab). Occupancy = GAC census days ÷ (GAC licensed beds × 365).
*LLUMC GAC occupancy >100% reflects census days exceeding the GAC-licensed bed count (overflow/observation census at the region's tertiary referral and Level I trauma center); treat as "effectively at/over capacity," not a data error.

RCH runs the lowest ALOS among the larger hospitals (4.3 days) and moderate occupancy (~57%), leaving inpatient capacity headroom. The two facilities pulling RCH's tertiary leakage (LLUMC, Arrowhead) are also the two running hottest on occupancy and carry the only Level I trauma designations in the set.

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## Caveats / limitations

1. **Dilution from San Bernardino-city ZIPs.** The 13.5% "broad" market share understates RCH's real position; the 36.8% core-area figure is the truer competitive read. Use whichever framing the project intends, but state the ZIP set.
2. **No service-line / DRG detail.** This dataset cannot break leakage down by clinical service line; only patient type (IP/ED/AS).
3. **California hospitals only.** Out-of-state, VA/military, and federal facilities are excluded, so true leakage is marginally higher than shown.
4. **Patient ZIP suppression.** HCAI may suppress or roll up very small cell counts in source data; tiny ZIPs (e.g., 92375) have low totals and noisier percentages.
5. **ID note.** The project memo lists RCH's HCAI ID as 106361308; that ID is confirmed present and labeled "REDLANDS COMMUNITY HOSPITAL" in both the patient-origin and utilization files used.
6. Utilization-file figures are 2024 **final/desk-audited**; a preliminary 2025 file exists but is not yet final and was not used.

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## Files produced (this folder)

- `rch_patient_origin.csv` — every origin ZIP for RCH: inpatient, ED, and ambulatory-surgery volume + % of RCH's patients, with service-area flag. (2024)
- `rch_market_share_leakage.csv` — for each of the 17 service-area ZIPs: total discharges, RCH share, leakage %, and each major competitor's volume + share — for both Inpatient and ED-Only. Includes an `ALL_SA` roll-up row per encounter type. (2024)
- `hcai_utilization_comparison.csv` — beds, GAC discharges, ALOS, occupancy, ED visits, surgeries, births, trauma designation for RCH and 9 competitors. (2024)
- `rch_market_leakage_analysis.md` — this narrative.