California OSHPD Annual Disclosure Reports
California's OSHPD collects annual hospital financial, utilization, and payroll data in its Annual Disclosure Report, collected since the 1975–1976 fiscal year. Every hospital except federal hospitals is required to complete the survey annually for its own fiscal year data, and the survey responses are audited for consistency. Some hospitals are not required to complete every page of the survey; for example, state hospitals are not mandated to provide staffing data, and Kaiser hospitals did not submit staffing data until the early 2000s.
OSHPD's Hospital Disclosure Report measures employment in terms of productive hours for each of RNs, LPNs, unlicensed aides/orderlies, management and supervision, administrative and clerical, and other labor categories. Hours are reported for each revenue unit separately, with revenue units including daily services aggregated to the “divisional level” (medical–surgical inpatient, intensive care, pediatric inpatient, rehabilitation, long-term care, etc.), ancillary services (laboratory, physical therapy, operating rooms, etc.), and ambulatory services (outpatient surgery, clinics, etc.). Most hospitals use their payroll system, not their actual unit-level staffing grid, to complete the survey, and thus the data are subject to errors that might exist in any payroll system. For example, hospitals might not consistently measure hours worked by nurses normally assigned to one unit but “floated” to another. The number of patient days or services provided in each revenue unit is reported, enabling calculation of hours per patient day, hours per patient discharge, and/or hours per service provided. Unit types can be aggregated or examined separately (e.g., HPPD for medical–surgical acute care only).