In the aftermath of the 1994 Northridge earthquake, legislatures moved swiftly to establish strict standards to regulate the safety of hospitals. The idea was to ensure that medical facilities would withstand future quakes and remain open to treat injured people. Buildings would be examined and those that didn’t pass muster would have to be fixed or torn down and replaced. It would be a building program on massive scale an estimated $50 billion overall all the while medical facilities would stay open. It would also be against the clock, with a hard deadline of 2030, not to mention the threat of a future quake looming large at every turn. It is an ambitious plan, and as of last year, $10 billion in hospital planning and construction were underway statewide, according to the Office of Statewide Health Planning and Facilities Development Division, the state agency supervising the transitions. There’s just one problem: not a penny of that $50 billion comes from the state. Instead, facilities have been forced to come up with the cash or face shutting down. “The cost of unfunded mandates such as the earthquake retrofitting in the state of California is billions of dollars,” said Kerry Carmody, administrator for the 254-bed Providence Holy Cross Medical Center in Mission Hills. “We have to pay for it.” A history of quakes Ever since the Long Beach earthquake of 1933 sent buildings tumbling and killed 115 people, the California State Legislature and various municipal governments have rushed legislation to require certain seismic standards in public buildings. The Field Act, passed after the Long Beach quake, set standards for schools and public buildings. After the 1971 Sylmar earthquake in which a hospital collapsed, the legislature passed the Alfred E. Alquist Hospital Seismic Safety Act, which requires new hospitals to withstand major earthquakes. Old buildings, however, were grandfathered in and the legislature amended the Alquist Act in 1994 following the Northridge earthquake. The new rule required that every hospital building in the state be inspected for structural deficiencies. In response, officials from the state’s 442 acute care facilities in the late 1990s used an 11-article evaluation procedure to scrutinize more than 2,000 campus buildings for structural stability and safety issues. Because hospitals often grow in spurts with new buildings rising alongside dated buildings still in use, many campuses had structures deemed perfectly safe right beside dangerous buildings threatening to fall over. Thirty-seven percent of buildings examined were found to pose significant risk to the public and could collapse; some 175 hospital buildings were safe, but could pose a threat in a big quake. To fix the problems, the state established a series of deadlines. The first deadline was Jan. 1, 2002, in which all hospital emergency systems had to meet code. That meant upgrading communication, power, gas and alarm systems. The second will be in 2008 and requires the hospitals with significant risk to meet certain seismic standards and structural bracing, such as ducts and elevators, with some extensions available to as late as 2013. It essentially stipulates that all hospital buildings have structural integrity and will not collapse in a temblor. The final deadline is 2030, in which all of the standards, regardless of extensions, must be met in other words that all hospitals both remain in tact and operational after a major quake. A bill passed by the legislature this fall would allow some hospitals that have started retrofits but fell short because of delays or material shortages an extension to 2015. Fix it or risk it? The staggered deadlines have caused a rift in the medical world about how to tackle the issues: fix an existing building, build a new one, risk closure or hope that the state will change the deadlines. Already every hospital in the Valley has asked for extensions. Others are struggling to find money. “To continue running, we’ll have to find ways to finance it,” said Carmody the administrator for Holy Cross, which is “99 percent” compliant with state standards, save for a few upgrades of the hospital’s physical plant. Still, as part of the Providence Health System chain, which also owns Providence St. Joseph Medical Center in Burbank, funding wasn’t as large of an issue for Holy Cross than if it were a small medical facility. The hospital is bond financed and is helped by philanthropy. Such community donations paid for the hospital’s new $7.5 million emergency room. It also helped fund the fixes at Providence St. Joseph Medical Center, which is tearing down its faded hospital building on the northeast side of its campus at Alameda Avenue and Buena Vista Street and replacing it with a $71 million patient care tower. For the rest of the campus, crews have been working to bring the existing building up to regulations, said hospital spokesman Dan Boyle. “Right now, we’re completely up to standards.” Officials at Kaiser Permanente are taking a similar tact for its aging facility in Panorama City, which is being replaced by a new, 400,000-square-foot hospital, said Virginia Baca, a hospital spokeswoman. Seismic concerns have also prompted Northridge Hospital Medical Center to retrofit one of its structures and replace two others. The $26 million project includes adding concrete walls in the basement and sheets of steel to its primary diagnostics and core building, which houses the radiology, surgical, pharmacy and surgery department, said Ron Rozanski, vice president of operations. The construction, which started in July 2005, will bring the structure up to the state-required seismic standards when it opens in December 2007, Rozanski said. The hospital is also poised to replace two buildings that do not meet seismic standards. Rozanski said it was determined to be far cheaper to build a new structure versus fixing the old ones. “In strengthening an old building, it really is quite costly,” he said. “Then you have the second problem of disrupting your hospital activities.” Rozanski, who has worked in the healthcare industry for 30 years, said one of the major challenges of the current retrofitting work is coordinating the crews to minimize impact on the existing facility. “I’m having to constantly relocate departments when we get in their area,” he said. “It’s like a checker game.” It’s much easier to just build a new facility. Early plans call for 130 beds, although specifics still have to be hammered out, he said. The preliminary budget is $120 million, although it will all but certainly balloon, Rozanski said. Crews could break ground as soon 2009 and finish by 2013. “If the state stays with the 2013 rule, it’ll have to be built by 2013,” he said. Glendale Adventist Medical Center has also met all standards to date and received an extension until 2013 to upgrade structural components on existing buildings, said Alicia Gonzalez, a spokeswoman for the hospital. The hospital is also opting to build anew, and is erecting a seven-story patient tower, medical office building, ambulatory surgical center and parking structure. It’s costing well over $100 million, much of it generated through an active foundation. Others are not as lucky to have deeppocketed donors, forcing some hospital administrators to wait out the deadlines in hopes that the state will either pony up the money for the fixes or loosen standards. Other costs The issue is mainly about cash, a fact complicated by the high overhead, high nurse-to-patient ratios and insurance woes hospitals have been grappling for decades. The California Healthcare Association, a trade group representing hospitals statewide, found that 54 percent of hospitals in the state are operating in the red, which makes securing money to finance construction projects difficult. High tech hospital projects also tend to cost more, both in materials and labor, but also specialized architects and engineers. Even more challenging is that retrofits are not as financially beneficial or eyecatching as a new cancer center or maternity ward, said California Healthcare Association spokeswoman Jan Emerson. “Seismic retrofitting is purely a bricks and mortar activity that will not bring in any new patients to help pay for the construction,” she said. For many hospitals, that’s a hard pill to swallow. “It always comes down to finances,” said Lisa Knapp, a spokeswoman for Verdugo Hills Hospital in Glendale. She said hospital officials so far haven’t decided when, how or if it will fix its facilities, and doesn’t expect to make a decision before the end of the year. “We’re always looking at what options make sense financially,” Knapp said. “We’re still receiving plans and figuring out which one makes sense.” West Hills Hospital is taking a similar approach, said spokeswoman Jill Dolan. “As most other hospitals have done, we have requested extension of the 2008 deadline which extends it to 2013. We continue to evaluate the most feasible way to retrofit,” she said. Valley Presbyterian Hospital is also at compliance it just built a 188-bed patient tower but the hospital is struggling to figure out how to meet the 2013 deadline for the existing 1951 facility, said hospital Chief Human Resource Officer Gregg Yost. The issue is “the dollar value associated with it and whether the hospital can afford it,” he said. For Valley Pres, the money simply isn’t there. “Right now I don’t believe we’ve gotten to the funding portion,” he said. In the end, hospitals like Valley Pres will be faced with a difficult choice: fix it or risk it all while the price tag zooms past the estimated $50 billion it will cost statewide. The California Healthcare Association thinks that budget will at least double in coming years. “Keep in mind that the budget for the state of California is slightly more than $100 billion,” Emerson said. “The cost of compliance is continuing to skyrocket.”

Turns out, starting your very own hospital isn’t all that difficult. All it takes these days is lots of money, knowledgeable and trustworthy doctors and someone who knows how to set up an outpatient clinic. “Everybody can get in and compete directly with the acute care hospital,” said Kerry Carmody, administrator for Providence Holy Cross Medical Center in Mission Hills and Providence St. Joseph Medical Center in Burbank. And compete they have. Dozens of outpatient or ancillary clinics have opened in recent years in the San Fernando Valley area. The proliferation is largely the result of low start-up costs and advancements in affordable and easy-to-use technology that allows simple or cosmetic surgical procedures to be done far from a traditional hospital room. That may be good news for patients, but it’s no surprise that medical institutions are feeling the pinch. And that’s hurting their already painful bottom line. “It hurts every hospital economically,” quipped Dale A. Surowitz CEO of Encino-Tarzana Regional Medical Center, who called the new clinics a “phenomenon” in the San Fernando Valley over the past five or so years. “In one sense it’s a concern, but in another it’s just the way things are in today’s world,” he said. Michael L. Wall, president of Northridge Hospital Medical Center, went so far as to say that the increased competition from outpatient surgery center hurts patients because it impinges on how traditional hospitals perform. “The more you have siphoning off revenues that were in the community hospitals, the more pressure that puts on the institution,” he said. To those involved with creating new clinics, those concerns are nothing new. “We’re in 20 states; we hear it every time we go into a new city,” said Hilary Hellman, one of the founders of Ancillary Care Solutions, an Arizona-based consulting firm that helps doctors’ groups create outpatient clinics, including 12 in Southern California. “They don’t want to lose money; they don’t want to lose docs.” The benefits For doctors, the clinics are attractive because they are usually vastly less expensive to construct (or, more commonly, add to an existing office building) than a hospital structure and can often bring quick returns. In the late 1990s, for example, almost 40 doctors paid $25 million to create the 87,000-square-foot, ground-up Thousand Oaks Surgical Hospital. Compare that to the single patient care tower at Glendale Adventist Medical Center, which carries a price tag of more than $100 million. The costs can also be kept low because the clinics are often highly specialized and usually offer only one category of procedure radiology centers, dialysis centers, heart centers and cancer centers are among the most popular. Doctors can also keep supply costs low, since the same types of procedures are being done over and over again. As a result, clinics don’t need a large number of surgery or recovery rooms, since they are scheduling a certain number of procedures a day. And because the clinics usually don’t offer overnight stays, weekend and night staffs are minimal or nonexistent. “It’s far less expensive to provide that care. There’s no overhead. It’s streamlined,” Hellman said, adding later that it all adds up to a lucrative situation for doctors. “It makes it effective financially because they’re capturing what that patient is generating,” she said. “If the patient doesn’t have to spend a ton of time in the emergency room or the patient’s not having to go to specialist to specialist or place to place, over time if it’s managed well its going to cut down on delivering the service.” A colonoscopy performed in an outpatient center, for example, costs around $500. The same procedure at a hospital costs at least $6,000, according to the insurance company Blue Cross of California. Not having extra services also streamlines the process for patients, who would prefer not to deal with navigating a massive hospital to have a simple procedure, Hellman said. “If the therapist and the MRI are with the physician, the information exchange is real time. So you don’t have this guessing or calling the doc or waiting four days to come back. You’ve got it immediately,” she said. “There are efficiencies there that aren’t available with a hospital system.” Taking cues Of course, the logical thing would be for hospitals to take some of the clinic techniques and apply it at their facilities. In fact some hospitals have jumped on the outpatient clinic bandwagon. Providence Holy Cross recently opened an outpatient clinic in Santa Clarita and similar clinics have opened at West Hills Medical Center, Glendale Adventist Memorial Hospital and Mission Community Hospital. Wall said it makes good business sense. “What you’re seeing then is hospitals trying to partner with their physicians and share some of that revenue stream rather than losing it,” he said. But Hellman said that’s not always possible because of institutional resistance to the clinics and they way they go about doing business. “They could adopt them (but) it’s not who they are,” she said. State regulations also limit how doctors profit from care. Essentially, the clinics have to be formally owned by a physician’s group. In the end, the development of outpatient and multi-doctor practice groups may be part of another trend changing how hospitals operate in the future. Albert L. Greene, president and CEO of Valley Presbyterian Hospital in Van Nuys, said that an increasing number of medical residents who don’t go on for fellowship training are turning to multi-specialty group practices, generally defined as having 25 or more doctors. For them, the practices, like clinics, are more appealing than running their own office by themselves, he said. “They don’t want to have to manage a practice. They don’t want to deal with insurance companies. They want someone else to manage the business of the practice,” he said. “The day of the solo or small-group practitioner in the country is dying rapidly.”

It’s not a popular job, but somebody’s got to do it: managing a hospital. With under-funded state mandates, skyrocketing premiums and caring for the uninsured, it’s a position that faces unique and daunting challenges each day. To gauge what’s happening in today’s local hospitals, the Business Journal brought together a group of five CEOs from facilities large and small: Beverly Gilmore, president and CEO of West Hills Hospital and Medical Center; Michael L. Wall, president of Northridge Hospital Medical Center; Heidi Lennartz, CEO of Mission Community Hospital in Panorama City; Kerry Carmody, administrator for Providence Holy Cross Medical Center in Mission Hills and Providence St. Joseph Medical Center in Burbank; Albert L. Greene, president and CEO of Valley Presbyterian Hospital in Van Nuys. Most of the time, these executives are rivals, competing for the same nurses, doctors and, increasingly, patients. At the same time, they often deal with the same intricate issues and face strikingly similar joys and struggles. Q: This group probably has one of most complicated jobs in the country: managing a hospital. A lot of people wouldn’t want to be in your position. But what’s the best part? And what’s the most challenging? Beverly Gilmore, West Hills Hospital and Medical Center: You have to enjoy the people you work with. That’s what gets you there every day. Whatever the challenges are, you know the people you work with can get through it. I think the most challenging part is more challenges in California. The costs keep going up. That makes it challenging to survive and grow. Mike Wall, Northridge Hospital Medical Center: I’ll start with the best part. I think the best part is we’re in a profession where we go to work and we make a difference. We have the potential to impact thousands of lives, whether it’s life-in through our OB program, or whether it’s dealing with the end stages of life. How we go about work is really fulfilling. I think there (are many) challenging parts: the cost of technology and keeping current; the indigent care that you’ve got to provide coverage for; the physicians who are your customers and your competitors. There’s just so much variety; you’re never going to get bored. Gilmore: That’s actually one of the good things: never being bored. Everyday has issues you’ve never thought of. It’s very varied what you do in a day. Heidi Lennartz, Mission Community Hospital: And I think tangentially, you actually can experience the difference you make with the patients. Even as a CEO, you can go to that level with the patients and talk with them and see the difference that we can make on a day-to-day basis. A: Is there anything that would make your jobs easier day-to-day? Wall: If they could teach us a class in graduate school in how to herd cats, it’d be good. (Laughs.) Lennartz: It is like herding cats. You’re balancing and trying to control and manage a variety of forces. And that’s the art. Q: A major issue facing local hospitals and the healthcare industry in general is the nursing shortage. There simply aren’t enough nurses to meet state-mandated ratios. How are your hospitals dealing with that? Kerry Carmody, Providence Health System: We’re dealing with it through the Nurse Collaborative (a nursing education program at College of the Canyons in Valencia). We have not gone out to foreign countries to look for nurses, which has become more difficult. There are a lot of nurses in the state of California. They just don’t all want to work for us. So the idea is how to get them to work for the organizations represented here. And that’s part of every one of our days. It’s the employee’s choice because every employee from housekeeping up through your pharmacists and your nurses everyone’s a free agent. Anybody at Holy Cross can get a job the same day at any of the hospitals represented here. And people do. But you can’t afford to lose those key individuals. Albert L. Greene, Valley Presbyterian Hospital: I think a big part of the problem we have in the state is we’re not graduating enough nurses. So one of the things we’re doing at Valley Pres. is we’re working with the local colleges to expand the programs. We’ve been working pretty closely with both Mission and Valley (community colleges) to assist them in expanding. We’re paying for faculty. We’re using our facility for training. Twenty-five percent of all the nurses that are licensed in the state of California are not working anywhere. They’re not working in a hospital or home care or nursing home. They’re not engaged at all. (So we’ve) focused on those nurses who perhaps have been out of the profession raising a family for the last 10 to 20 years (and created) programs geared to bring them back to the workforce. Special residency programs to try to bring that 25 percent back into the workforce. Q: As a lay person, it would seem sponsoring foreign nurses would be a logical way to go about reducing the nursing shortage. Is that correct? Wall: I think there’s things you have to consider. You have to consider culture. You have to consider competency. I think you want to consider the moral and ethical considerations. If nurses are scarce and we’re taking nurses out of other countries or if there’s over-supply that’s one situation. But I think there are a whole host of questions. Greene: First off, the federal government isn’t making it easy. You’ve got to sponsor these nurses and from the day you sponsor till they show up could be several years. So it’s a major investment. Very long lead time. The problem that most of the public doesn’t understand is a nurse isn’t a nurse isn’t a nurse. A nurse who works in critical care can’t work in pediatrics. A nurse in pediatrics can’t working the operating room. The OR nurse can’t work the emergency room. The list goes on and on and on. So to try to project two to three years out (and say), “Gee, here comes a nurse that’s a med-surg nurse, will I have that vacancy in med-surg? Maybe all my vacancies are in labor and delivery or OB or (pediatrics),” you can’t project that far out. It makes it very difficult to bring in foreign nurses because of the long lead time. And then, as Mike said, you’ve got the cultural issues. You’ve got language barriers. Carmody: When you talk about education, at College of the Canyons a tremendous nursing program that many of us are involved in with the Collaborative I know somebody who’s on the list to get into class. She’s No. 340. So she’s two, three years before being accepted into the program. It’s a five-year wait to get into nursing school. So we’ve created this tremendous demand every one of us. The average nursing salary coming right out school we’re all competitive is around $48,000, $50,000 a year, plus benefits. So there’s a lot of interest in becoming a nurse for all the right reasons. It’s a calling. It’s a career. It’s flexible scheduling. It’s all of those things. They just can’t get in. And they’re extremely frustrated. Greene: And the problem with the universities is, even if they have the spots, they don’t have the faculty. They don’t have the trained people to do it. Q: So if there are so many problems locally, why not import nurses? Do the risks still outweigh the benefits? Wall: I don’t think it’s a quick fix solution. I think it’s na & #271;ve for people to think that will solve it. All of us in different ways are working to support the education process to get more (nurses) in the pipeline. In the meantime, boy, you’ve got to hold onto the ones you’ve got. It’s a highly competitive workplace where workload and those kind of things are factored, particularly here in the Valley. One-point-eight million people, 28 miles radius. People can move from institution to institution. They don’t have to move their families. They don’t have to do anything. Where other communities, you’re talking about moving families. That’s not the case here. It’s a very mobile workforce, very competitive and a great shortage. Greene: The other problem is nursing is still dominantly a female profession. And what happens is, just by how society operates, women will enter a 10 to 20 year period when they raise kids (and) leave the job market either on a full-time basis or a part-time basis. It exacerbates the shortage. A big portion of their lifetime is not in the workforce but out raising kids. Q: How is West Hills addressing the shortage? Gilmore: I think we have multiple strategies. We do a little bit of all these things. We are looking at sponsoring some nurses from India. We do have scholarships for nurses at Pierce and Moorpark (colleges). We do specialized training for nurses that have been on our staff for a while and want to be specialized nurse. I think all of us try every trick in the book. And usually, if you’re all like we are, the turnover is in those nurses that are a year or two. And they’re the ones that jump around. We’ve all got signing bonuses. It’s hard for them to move around. Nurses that have been around awhile don’t seem to move around. We have travelers that come from other parts of the country. And they’re very happy to come for three months. They can make here what they made there in a year. But they don’t want to move here because of the costs. Greene: The problem we have with the state is this is the only state with mandated staff nursing ratios for hospitals. And yet we rank No. 50 in the number of nurses per 1,000 population. So there’s an absolute disconnect and the ratio and the availability of nurses. Carmody: There’s also a shortage of doctors. For all of us to be able to find the right physician is just as difficult as finding the right nurse. Because Southern California is the toughest market to recruit nurses to. They can do better outside the state of California both financially and lifestyle. Greene: Also, in medical schools in this country, 50 percent of students are female, very different from when a number of us started in this business. A lot of them will pull out of medicine for 10-15 years while they’re raising kids. So you don’t have the same accessibility and availability to physicians as a result of that. Q: Beverly, we heard so much earlier this year about the labor issues at West Hills. It’s all been resolved. How did that happen? Gilmore: There has been a contract resolution, so we have a four-year contract now. But this is a relatively new labor contract with West Hills. Their first unionization was two years ago, part of a bigger contract that (Hospital Corp. of America, the owners of West Hills) and Service Employees International Union signed. So it’s a new experience at West Hills. That’s another rather unique and intense challenge more so in California than other areas: we have pretty aggressive union organizations. Wall: Let me show you how the markets move. We’re in a collective bargaining agreement that includes the nurses. Usually when you’re negotiating these contacts, you take into account the wage and salary, the competitive package at this time. In the Valley, things move so rapidly that in the middle of a contract our wages fell behind $1.7 million. So we had to make a decision: make a mid-course correction or losing those nurses, particularly the zero-to-five years. Q: Is that the case at other facilities? Greene: We’re a non-union facility, but we operate basically as if we were a unionized facility. The market is so competitive that you’ve got to have wages and benefits that are competitive. It’s also how you treat your employees. Q: How does Mission operate? Lennartz: Virtually the same way. Because we do share most of the staff in the Valley, they might get certain needs at other facilities they don’t get at my facility. We’re compelled to provide similar benefits. But again, it comes down to a management issue. How we make ourselves available, our appeal system. Q: How would you describe all of your management styles? Carmody: I tend to be a people person, so I’m out and about. I’ve grown up in hospitals for 33 years, so I know a lot of people by name. The style of management today is probably similar for everybody: you’ve got to be inclusive; you’ve got to bring your team; you’ve got to meet a consensus; and you’ve got to be successful with your medical staff. This is a skill set that the people in this room obviously have or they wouldn’t be in the room. Gilmore: You wouldn’t last long, would you? (Laughs.) Carmody: That’s what makes the job a joy when it’s working and a challenge to make it that way. Greene: I think we all have to emulate that, but I think we would all say for us to be successful, our styles have to be eclectic. What works in one situation, one set of circumstances, one set of individuals, does not necessarily work everywhere. For those of us in this room, the reason whatever degree of success we’ve had is because we’re able to read the situation and figure out what style is the best approach. Gilmore: I don’t think there really is a class in Hospital CEO. (Laughs.) I don’t think anyone would take it anyway. You’re right about how no one would want my job I hear that three or four times a day. But you really develop a skill and experience and some confidence in that you’re going to be able to look at each situation and come up with something that works. There has to be a lot of different strategies. Wall: For me, it’s really hiring the right people and getting out of their way. That’s my management style. Al and I and Kerry and Bev, we’ve been doing this a long time. (Heidi is) the new kid on the block. With the variety and the pace and the complexity of the job, you cannot stay on top of every thing unless you want to spend hours and hours and micromanage. So you’ve got to be a good judge of talent and have the ability to hire really good people. Q: How do you get along with your boards? Lennartz: I think what’s important is to have a relationship with each individual board member and a relationship with their vision and helping them shape that vision, and the strategy and goals for the organization, both short-term and long-term. I have been around situations where that didn’t happen. And I think what can happen is that that vision starts to split apart. The CEO vision versus the board’s vision. You all have to work to the same goal. Q: Your board is an active board? Lennartz: They have to be; we’re a small, independent hospital. Q: Are there any situations where you see a rubber-stamp board? Wall: That doesn’t work either, because all of a sudden the pendulum swings and the rubber stamp board says, “We’re listening to someone else. So we have to make a change. Goodbye” Lennartz: I think they have a real sense of responsibility. As they should. They’ve been entrusted with this asset and they want to see it successful. Carmody: For Providence in the Valley, we have a single board for both Holy Cross and St. Joseph’s and really within the past three-four years the quality has been taken on. Lay people (have been) getting educated and working with the medical staff and setting targets for the management to hit and be accountable. That has really evolved. Before it was totally buildings and mortar. Now the quality is viewed just as important as finance. Q: A lot of people are using emergency rooms as their primary care providers. How is that affecting how your hospitals operate? Wall: Here’s what you should be concerned about: You’re gainfully employed (and have) wonderful insurance. Now you have a cardiac event. But we’re on bypass (a designation, also called “diversion,” when hospitals are too busy and cannot accept new patients and reroutes inbound ambulances to other facilities) because our emergency room is inundated with patients that should be at an alternative site. We can’t take you. Greene: They can’t get to their primary care physician so they come to the ER. In Los Angeles County, the average hospital is on diversion 216 hours a month. That’s 10 days a month they’re telling people, “We’re jammed. Go someplace else.” Wall: Part B is getting physicians to cover the emergency room by specialty. Even if you pay, it’s difficult. Carmody: I also think there’s a misunderstanding in the public about what the uninsured is. The uninsured are a family of four making $40,000 a year, the husband and wife work and they don’t get insurance from their company, they used to but it’s no longer there. Or they get insurance but it’s a $2,000 deductible plan, which means they come into the hospital and can’t afford the first $2,000 it becomes charity care. So these are good people; they’re all working. That hits every hospital in this Valley. Q: What do you see your jobs being like in 30 years? Greene: I think we’re going to find ourselves in a much more integrated role. Right now, the thing that differentiates American medicine is this separation of the physicians to the hospital. If we’re going to deal with cost containment, if we’re going to deal with quality issues, all of these have to be aligned and the only way you’re going to do that is through some form of integrated system. Carmody: If (the population of the San Fernando and Santa Clarita valleys are) 1.5, 1.8 million people right now, what are we going to do then? Nobody’s building any new hospitals. We’re already at capacity. So the discussion is, “What’s the next step?” Q: These are all complex issues. Greene: But, you know, I can’t think of a better career. Dealing with very bright people. You go home and say, “I made a difference.” It’s complex you just heard all the issues. So it’s an intellectual challenge. We’re dealing with community boards and people who want to do the right thing. I couldn’t imagine doing anything else. Carmody: You said earlier who would want to do this job. I can. There’s a lot of people that would want my job. (Laughs.)

The Pacoima area has been included in the expanded boundaries of the Los Angeles Central/Hollywood enterprise zone, the governor’s office announced Monday. The move preserves an area of the San Fernando Valley in which businesses located within the boundaries receive tax incentives for hiring local residents. Gov. Arnold Schwarzenegger credited working with the city and Mayor Antonio Villaraigosa and his staff for reconfiguring the enterprise zone to include Pacoima. “The addition of the Pacoima area strengthens the region’s economic development activities and allows incentives to remain in place to promote business expansion and job growth,” Schwarzenegger said in a prepared statement. The governor understood why the enterprise zone is so critical to economic development in the Valley and the city, said Bruce Ackerman, president and chief executive officer of the Economic Alliance of the San Fernando Valley. “Carving it down to a smaller manageable piece which keeps a bulk of where the real need is is going to make it a lot better and a lot easier to manage as well,” Ackerman said. In November, business leaders in the Valley were taken by surprise when the Northeast Valley Enterprise Zone was not renewed by the state. The zone was created in 1986 and renewed in 2001. The boundaries included much of Pacoima and portions of Sun Valley and Panorama City. Businesses within the boundaries were eligible for local tax incentives, the most popular being an employee tax credit of $31,000 per employee over a five-year period. About 165 businesses use that tax credit. Others include a rebate on sales tax for certain equipment and parts purchases; a business expense deduction capped at $20,000; and a five-year subsidy from the L.A. Department of Water and Power.

At the end of last month, Debi Schultze, a district representative for state Assemblyman Dr. Keith S. Richman, found herself without a job. Richman, who represented Santa Clarita, Glendale, Simi Valley and the northern half of the San Fernando Valley in Sacramento since 2000, was termed out and staff members like Schultze were sent packing. “That was all of our last days,” she said. But it didn’t take long for Schultze, a longtime political consultant and Simi Valley resident, to find work. She started Dec. 1 as president and CEO of the nonprofit United Chambers of Commerce of the San Fernando Valley, replacing Sarah Finn Haskell. “I got a call from the executive board out of the blue,” Schultze said. “I hadn’t sent out resumes or anything.” The position continues a long line of appointments for Schultze, who has served as everything from the CEO of the SACC Assistive Technology Center at Simi Valley Hospital and assistant executive director of Boys and Girls Club of Simi Valley to assistant to Ventura County Supervisor Vicky Howard, administrator for CMC Medical Associates and director of the Rancho Simi Recreation and Park District. Schultze is also a licensed vocational nurse; has a real estate license and a paralegal certificate; and founded Freedom Tree, which plants trees in honor of the men and women in the armed forces. Before moving to Richman’s office, she was also chair of the Simi Valley Chamber of Commerce, where Schultze helped improve membership and programs. With such a varied resume, Schultze jumped at the chance to lead the United Chambers, which represents 21 member chambers and 5,000 businesses in the Valley. “I really like the opportunity to watch the organization grow,” Schultze said. One goal she already has is to build sponsorships and bring more members on to the board. “The business is dedicated to advocating for businesses,” she said. For now, Schultze is concentrating on learning the members and the issues. She says her background in policy will serve her well. “I had worked with a lot of them on the campaign trail,” she said. “It is challenging as far as using all of my expertise in different areas. It’s a lot to take in at first.”

To understand the looming demand on hospitals in northern Los Angeles County in coming years, consider these numbers: In 2000, the combined population of the Antelope and Santa Clarita valleys was around 500,000 residents. In just six short years, however, dozens of new residential developments in the region have driven that number exponentially higher. By 2025, the amount is expected to grow to 1.2 million, an addition of 700,000 residents about the population of North Dakota according to the Southern California Association of Governments. For hospitals and medical providers, that type of unfettered growth translates into an astounding demand for health care only worsened by the fact north L.A. County is already home to relatively few full-service, acute-care medical centers. All told, the areas are vastly underserved especially Palmdale, which has the unusual distinction of being the largest city in California without a hospital, after Lost Desert Palms Hospital closed in 1996. It’s a situation that is all but certain to get worse in coming years. “This is a continuing issue,” said Sue Albert, a registered nurse and dean of Allied Health at College of the Canyons in Valencia. “We have a huge population growth here.” The expansion is especially pronounced in the Santa Clarita Valley, which has just one acute care and trauma center Henry Mayo Newhall Memorial Hospital. When the 217-bed facility opened in 1975, it was designed to care for about 18,000 patients a year. That number has been steadily rising as the population grows, registering a 4 percent jump last year in the number of occupied beds. It is expected to keep rising. “We are really looking at a shortage within 18 months,” said Andie Bogdan, a spokeswoman for the hospital. But Mayo is also in a unique situation. Bogdan explained that in most cases the demand for additional medical space is driven by the age of those in the hospital’s coverage area. That usually means areas with a large elderly population, for example, will require a hospital with acute care services. Younger population But since Santa Clarita is a relatively new area, the population is mostly young families or middle aged adults. “We have a younger population,” she said. “The real capacity needs are driven by seniors.” As a result, the most demand at Mayo has been directed at the maternity ward and emergency room, where 23 percent of patients have been under the age of 14, Bogdan said. In response to that need, work began last year on a $13.6 million expansion of the 8,000-square-foot emergency room that will double it and add 11 beds and rooms for cardiac care and pediatrics. The project is about halfway complete, with completion slated for next fall. Mayo is also considering a plan to turn a 27-bed transitional care unit used by the elderly and recovering patients into an acute care ward to treat emergencies. Plans are also in the work to add a new office building and parking structure on the property. While those services should serve the younger population for now, hospital officials are already preparing for when they get older, Bogdan said. A 2,500-square-foot cardiac catheterization laboratory to treat heart attack victims is slated to open next year. Currently, the closest cath lab is in the Valley, Bogdan said. “This population is large enough and getting old enough to need to have that service locally,” Bogdan said. All told, Bogdan said Mayo has to act quickly to handle the increases. “We have to start building now to make sure we don’t run out of beds for the next 25 years,” she said. A growing Antelope Valley It’s a similar story in Antelope Valley, the fastest growing area in L.A. County. Like the Santa Clarita Valley, the growth is putting pressure on the region’s two acute care facilities, Lancaster Community Hospital and Antelope Valley Hospital. While the Antelope Valley has two to Santa Clarita’s one hospital, the facilities together cover a much larger area just north of Santa Clarita well into Kern County. “We only have two hospitals in our market and both are extremely busy,” said Bob Trautman, chief executive of Lancaster Community. “As a result, a lot of people have to leave the area for hospitalization and medical care. It’s a community problem.” Antelope Valley Hospital’s coverage area is an astounding 3,000 square miles; its emergency room in 2004-2005 handled 98,000 visits, making it the second busiest emergency department in Los Angeles County. In response, the board of directors for the 379-bed facility in July approved spending $5.9 million to design the first phase of a master facilities plan for the hospital. While plans are still being worked out, suggestions include expanding the emergency room by up to 9,000 square feet and increasing ER beds from 24 and building a new tower for 150 patients and additional office buildings. More than $87 million has been earmarked, on top of the $24 million the hospital just spent on the Women and Infants Pavilion that opened this summer. Across town, the 119-bed Lancaster Community Hospital also has little room to grow. “Our current facility is very old and space is very limited,” Trautman said. As a result, the hospital’s publicly-traded corporate parent, Pennsylvania-based Universal Health Services, is building a $170 million new hospital in Palmdale. Palmdale Regional Medical Center is slated to open in late 2007 and will include two medical office buildings and the 171- bed main hospital. Still, the project is at least two years from completion, which doesn’t help things at Lancaster right now. Hospitals staffers are grappling with more patients, less help and not enough space, said Trautman, who also serves as the regional head for Universal Health Services. “We’re doing some out of the box thinking,” he said. “We’re doing some things so that people get in and out quicker. That’s worked well for us.” The County Board of Supervisors has also approved constructing a $98 million, 124,000-square-foot ambulatory center on 15 acres at Avenue I and 3rd Street East in Lancaster. It could open as soon as 2010. Not surprisingly, the fervent demand has also triggered a growth of doctor-owned and outpatient clinics in the region. The most significant so far has been an 83,000-square-foot health center opened last year by Providence Holy Cross Medical Center in Mission Hills. The $40 million clinic in the Santa Clarita Valley Medical Plaza in Valencia offers outpatient surgery service, cancer care and imaging. Such projects, of course, mean more demand for nurses and other staff, something that’s been difficult in recent years given the crippling nursing shortage. Albert said College of the Canyons is bracing for even more demand. “As a school, we’re trying very hard to keep up to meet the needs of the community,” she said. Still, Trautman, the Lancaster executive, said that while the new Palmdale hospital will certainly alleviate the capacity issue, it is still only a temporary measure. The population is expected to keep growing, he said. “That’s the projection by economists,” he said. “There is a concern.”

From one end of the San Fernando Valley to the other, one finds an abundance of entertainment companies and the people working there. So it’s no surprise the Valley plays host to festivals showcasing the work of young, up-and-coming filmmakers and the veterans still reaching for the big time. With spring comes Method Fest in Calabasas and the San Fernando Valley International Film Festival in North Hollywood. In the fall it’s the Valley Film Festival at the El Portal Theatre also in North Hollywood. Come next October, Universal City enters the circuit with a festival placing an emphasis on educating filmmakers. The Universal City International Film Festival benefits a scholarship program for the New York Film Academy, a school based on the Universal Studio lot. “There are plenty of wonderful filmmakers who cannot afford to go to film school,” said film producer Suzanne DeLaurentiis. “Let’s face it, film school is very expensive and a lot of young filmmakers won’t get the opportunity or exposure because they can’t go to film school.” DeLaurentiis conceived the festival along with Dan Mackler, a staff member at the New York Film Academy, and Juliette Harris, of “It” Girl Public Relations, a firm that does work for DeLaurentiis’ production company. The Universal City/North Hollywood Chamber of Commerce has also joined in promoting the event. As a lecturer at the New York Film Academy, DeLaurentiis discussed with Mackler and Harris how her production company could assist student filmmakers and the trio came up with the festival. The one-week event features screenings at theaters at City Walk and on the Universal backlot, panel discussions and seminars run by Mackler, and after-hours events at City Walk restaurants. A black tie gala dinner at the Universal City Hilton concludes the week. The movie screenings will offer something for everyone, DeLaurentiis said. There will be a nights of student films, shorts, and feature length films. Since the festival falls on the weekend before Halloween, one night is devoted to horror films. That the festival takes place on the Universal lot should be enticing for young filmmakers, so that they experience all the “bells and whistles” of coming to the entertainment capital of the world, DeLaurentiis said. Film submissions for the festival begin in February and sponsorships are still available. For more information on the festival visit www.uciff.com. Visual Effects Training The Visual Effects Society kicked off a new training and mentoring program this month to give students a better understanding of the skills needed to get into the entertainment industry. The program is partially funded by a $5,000 grant from the Academy of Motion Picture Arts & Sciences and for its first go around the society limited it to students from three area schools with visual effects and animation programs. “This gives each student the opportunity to talk to and get advice from someone who is already doing what they want to do when they finish school,” said Pam Hogarth, co-chair of the education committee of the Encino-based VES, a trade organization of visual effects professionals from 16 countries. The program is divided into two parts with the training portion taking place on two Saturdays in December. The first Saturday featured panel discussions from those working on the visual effects side of the film, animation, broadcast and gaming industries. The second Saturday focused on honing job hunting skills and receiving one-on-one advice on what to include in a resume and demo reels and the type of work and skills that studios look for. Hogarth, the director of industry relations at Gnomon School of Visual Effects, spoke with students from the Hollywood school who attended the first session who told her it was valuable because the information presented was not available from other sources. “They also got a good idea of the cultures of each of the different industries because of the people on the panels,” Hogarth said. “I had students come back and say they would want to work at a smaller studio after seeing these people and hearing what it’s like.” The mentoring portion of the program begins in mid-January with a goal of 10 students taking part. If more VES members sign up to be mentors, however, then more students can participate and establish a rapport with professionals who can usher them from school into full-time work, Hogarth said. The secondary goal is for the mentoring program to be of value to the VES members. Working in visual effects can be a time consuming occupation but the people who do it enjoy their work and tend to enjoy imparting their knowledge on those starting out, Hogarth said. “The opportunity to reach out to share and help a student along can be very fulfilling,” Hogarth said. Subdued E3 The trade organization behind the popular Electronic Entertainment Expo (aka E3) has pulled the plug on the show’s sensory-overloading and carnival-like atmosphere. The Entertainment Software Association now wants their premier annual event to be more “business-like” in the words of its president, Douglas Lowenstein. So the expensive displays promoting new video games, the loud music, and the booth babes prevalent at this year’s expo at the Los Angeles Convention Centesr will be replaced by a more controlled environment at the Barker Hangar in Santa Monica where displays will be limited to 100-square feet to 400-square feet. The three-day event also features invitation-only meetings between ESA members and non-members with retailers, media and developer partners. San Fernando Valley game publishers Buena Vista Games, THQ, Inc., Insomniac Games, and Warner Bros. Interactive used the intense media exposure of this year’s expo to promote their upcoming games. Games based on feature films were a trend at the show. Staff Reporter Mark R. Madler can be reached at (818) 316-3126 or by e-mail at [email protected] .

inQ has snagged a $7.75 million investment in a new round of funding led by new investors and including existing investors. inQ, an Agoura Hills-based provider of online live chat sales services founded in 1999, received $2.5 million in funding in April, the company said. The newest round, series C, was led by Emergence Capital and Partech International. Also participating were existing investors, Dolphin Equity Partners, Hudson Ventures and Vertrue. Jason Green, general partner at San Mateo-based Emergence Capital, and Vincent Worms, managing partner and co-founder of San Francisco-based Partech, will join the inQ board of directors.

Demand for healthcare is at an alltime high despite innovations in medical care, antibiotics and safety products as well as pressure for shorter hospital stays. In 2005, 13 out of the 20 largest hospitals in the San Fernando Valley reported increases in the number of patients being served each day. Encino-Tarzana Regional Medical Center led the pack with a 7.1 percent increase from 2004 to 2005 in patients, which topped 301 patients served on an average day. The facility also reported that 80 percent of its 396 rooms were full each day, compared to 75 percent in 2004. Emergency rooms are also overloaded, enough that a UCLA study in 2005 found that one in seven emergency patients in the western portion of the San Fernando Valley were diverted to another hospital because of overcrowding. The increases are due to an upswing in the area’s population to more people using hospitals as their primary care providers, jamming emergency rooms. The demand is worsened as the number of hospitals in the San Fernando Valley dwindles. Since 1989, more than a dozen local medical institutions have closed their doors, including the Granada Hills Community Hospital in 2003 and Northridge Hospital Medical Center Sherman Way facility in 2004. Hospitals are also being pressured to comply with deadlines for seismic retrofitting, required to make sure structures will withstand future temblors. Add that to complex state regulations and limited contractors available. “Those costs have just gone berserk,” Beverly Gilmore, president and CEO of West Hills Hospital and Medical Center. The budget for her new project a twostory, 47,000-square-foot expansion has skyrocketed. “Ours has gone up 50 percent in a year,” she said. “From $40 million last year. Now it’s $60 million.” Still, the blitz will continue through 2007, with nearly every medical institution tackling one project or another, be it building a new patient tower at Glendale Adventist or wing at The Jewish Home for the Aging to expanding the emergency room at Henry Mayo Newhall Hospital in Valencia. Big projects, big budgets The bulk of the attention on hospital projects has been focused on four major constructions with price tags soaring past $100 million each. One of the most extensive is a $116 million project for a 254-bed facility at Providence Holy Cross Medical Center in Mission Hills. Plans call for a ground-up four-story, 101-bed patient care tower, expansion of the intensive care unit, 12-bed neonatal intensive care unit, gastroenterology lab, surgery and other services. The hospital is also working on a 6,600- square-foot expansion of its 15-bed emergency department, constructed in 1977 to serve 15,000 patients a year. In recent years, that number has grown to 45,000 patients, including 1,600 trauma victims. Holy Cross Administrator Kerry Carmody said the increase would double the size to 34 beds and cost around $7.8 million, much of it donated. Construction is scheduled to finish by November, said spokesman Dan Boyle. Three other large projects in the region are at Glendale Adventist Medical Center, Palmdale Regional Medical Center, Kaiser Permanente Panorama City and Northridge Hospital Medical Center. At 448 beds and more than 2,100 employees, Glendale Adventist is already one of the largest hospitals in the Valley. But despite its size, the hospital is having a hard time keeping up. The facility, which first opened in 1905, saw its average daily census rise 2.7 percent to 300.9 patients from 2004 to 2005. Its occupancy rate also jumped from 64.84 percent in 2004 to 67.19 percent last year. The hospital is caring for 80 to 100 more patients today than it did four years ago. The centerpiece of the plan is a new, seven-story patient care tower that includes patient care facilities, an expanded emergency department and surgery sites, new cardiovascular center and intensive care unit, said spokeswoman Alicia Gonzalez. Next door, plans are in the works for a four-story medical office building that will house a dozen physicians and a 16,000- square-foot ambulatory surgical center, and a 500-space parking structure. Palmdale project In north L.A. County, meanwhile, Universal Health Services is moving forward with an ambitious plan for a ground-up 171- bed hospital and two-building office complex called Palmdale Regional Medical Center. Blueprints are still being worked out, but the project has a price tag of $170 million, said Bob Trautman, a Universal Health Services official. Back in the San Fernando Valley, Kaiser Permanente has launched dual multi-million projects. It’s spending $267 million to construct a six-level, 400,000-square-foot acute care facility in Panorama City. The project will include 218 beds, an inpatientcare diagnostic and treatment facility, inpatient and outpatient surgery, labor and delivery and neonatal intensive care, said Cathy Casas, director of hospital operations for Kaiser Permanente. It replaces the existing 1960s-era Kaiser facility at Woodman Avenue and Roscoe Boulevard, which does not meet state seismic standards. The facility is slated to open this summer. In the West Valley, Kaiser is also building out a portion of an unused tower on the east side of its Woodland Hills campus for medical surgical beds, Casas said. Seismic issues are also at the core of a new patient care tower being planned at Northridge Hospital Medical Center. Vice President of Operations Ron Rozanski said the 130-bed facility would replace two seismically deficient buildings, although specific plans have not been worked out. The project could break ground as soon as 2009 and finish by 2013. Northridge Hospital is also in the middle of a major, $26 million seismic upgrade of its core building slated to finish by December 2007, Rozanski said. Medium projects The massive amount of development in the Simi Valley is also forcing Simi Valley Hospital to expand its facilities, said spokesman Jeremy Brewer. “Simi and Moorpark has seen a great deal of growth over the past 10 years. We have to keep up with the healthcare needs of the community,” he said. The hospital is keeping up with a fivephase expansion project, centered on a fourstory, 146,000-square-foot patient tower with a price tag of almost $60 million. The structure, which broke ground in 2003, will include 144 private care rooms, 24 intensive care beds, eight labor and delivery rooms and 28 women and children’s rooms. It replaces two hospital wings constructed in 1968 and 1969, and part of the 1964 building. Construction is slated to finish next spring. Back at Providence St. Joseph Medical Center, crews are building a $71 million patient care tower on the northeast side of its campus at Alameda Avenue and Buena Vista. Plans are also moving forward with the four-story, 55,000-square-foot Roy and Patricia Disney Cancer Center at Buena Vista Street and Alameda Avenue, which will feature new radiation and diagnosis technology, a medical library and a resource center. Los Robles Hospital & Medical Center in Thousand Oaks is also constructing a 200,000-square-foot wing with 91 beds and plans are in the works to further renovate Mission Community Hospital, which in 2003 saw a new patient care tower added to its Panorama City campus. Smaller facilities The expansion is hardly refined to large, big-budget facilities. Antelope Valley Hospital in Palmdale is also mulling over a proposal to expand its 379-bed facility, which added a $24 million Women and Infants Pavilion earlier this year. A master plan could include a larger emergency room and a new tower. The Jewish Home for the Aging in Reseda is building a new 249-bed skilled nursing facility called the Joyce Eisenberg- Keefer Center, which will also house a 10- bed geriatric psychiatric unit. That project is slated to open next year, said spokeswoman Bonnie Polishuk. Last month, Henry Mayo Memorial Hospital in Valencia opened its new and expanded emergency room, which includes 9,000 square feet of additional space, 18 new beds, nurses’ station, medication room and paramedic station. The project cost $14.1 million. Plans are also in the works to upgrade the existing 1975 emergency room, which will cost an additional $6.8 million. Also in Santa Clarita, Providence Holy Cross Medical Center recently built an 83,000-square-foot health center that has outpatient surgery service, cancer care and imaging.

‘Tis the season for e-commerce and no one knows that better than ValueClick Inc., the Westlake Village Internet company that provides banner ads to 13,000 clients. Buttressed by more shoppers turning to the Internet to shop for holiday gifts in the weeks after Thanksgiving, the eight-year-old company has seen its year-to-date earnings jump 36.1 percent as of Dec. 11, finishing the year with a market cap of $2.41 billion. Such growth has fueled a rapid expansion by ValueClick, which went public just six years ago and acquired 12 companies in that time. Today, its clients include Circuit City Stores Inc., Best Buy Co. Inc., Net Zero, Major League Baseball, Yahoo!, NBC and Verizon Wireless. In November, it joined the Standard & Poor’s MidCap 400 and this month bought the private British company Shopping.Net for $13.3 million in cash. The move boosted its toehold in Europe, where in 2004 it purchased PriceRunner.com, a comparison-shopping search engine. But its most significant expansion came Dec. 5, when the company started offering a streaming video service to compliment existing banners for client advertisers. The new system for publishers and marketers will dovetail with ValueClick’s existing ad-serving platform and offers a variety of formats, such as video, rich media and standard display ads, the company said. The sector has seen a significant amount of activity with several small providers and the behemoth Google AdSense entering the fray over the past year. But ValueClick, helmed by CEO James R. Zarley since 1999, is seen as well-positioned because of its relationships with clients already under contract. It also has the technology the company estimates it could serve 100 million streams in the first month of operation. That could make the company, which ranked as No. 32 on Fortune’s list of fastest-growing companies, well positioned for 2007, said Eric Martinuzzi, an analyst for Craig-Hallum Capital. “They benefit from bigger attention,” he said, as do the rest of the online commerce sites this time year. “They will have a strong finish for the year-end.” The most hopeful sign: online shopping during December increased 25 percent compared to last year, with the industry raking in a whopping $15.6 billion, according to a study by ComScore Networks Inc. Amgen Awaits Decision A decision by a Congressional committee could translate into a major blow for the drug maker Amgen Inc. The House Ways and Means Committee is considering whether to reduce Medicare payments for drugs that treat anemia in kidney failure and bundle payments for the drugs and kidney dialysis, which the government currently pays separately. Amgen has a stake in the decision because its anemia drugs, Epogen and Aranesp, make up more than half of the company’s $12 billion annual revenue. Any change could cut into those profits. The committee earlier this month heard testimony about the cost and quality of care. Amgen contends the increased costs are the result of tougher standards and a larger and sicker dialysis patient population. Any change, the company said, “could result in harm to patients and cost Medicare more money.” In a note to investors after the testimony, analyst Geoffrey Porges said the change could hurt Amgen. “We see no way for this to be positively construed by Amgen,” he wrote. “There is significant risk to Amgen’s earnings from these hearings.” It is the latest issue for Amgen concerning its anemia drugs. The company is locked in a patent battle alleging Roche Holding AG violated Amgen’s patent when it developed an anemia drug called Cera. Briefly David Sambol, the president and CEO of Countrywide Financial Corp., has exercised for 14,000 shares of common stock under a prearranged trading plan. Sambol exercised the shares on Nov. 30 for $14.69 each, only to turn around and sell for $41.54 the same day, according to forms filed with the Securities and Exchange Commission. Van Nuys-based uWink Inc., the newly public operator of interactive video-game-oriented restaurants, is looking to add franchises. The brainchild of Atari and Chuck E. Cheese founder Nolan Bushnell, uWink opened its first location at Westfield Promenade earlier this year. The concept is a mix of video arcade, bar and restaurant using tabletop touch screen terminals. UWink went public this fall and is now looking to expand nationally, Bushnell said in a statement. “Since the opening of our beta restaurant last month, we have been inundated with requests from potential franchisees,” he said. “With the help of our customers, we’ve spent the last month refining the uWink experience so we can expand to a national level.” Finally, Cheesecake Factory Inc. is up to date with the Securities and Exchange Commission after a review of the Calabasas restaurant operator’s stock-option grants. The company filed its restated financials for the quarters ended July 4 and Oct. 3 and fiscal year ended Jan. 3. In a SEC filing, Cheesecake said the aggregate adjustments increased net income by $400,000 for fiscal year 2005 and cut net income by $1.2 million in fiscal 2004 and $1.6 million in fiscal 2003. The company also expanded its portfolio this month, adding locations in Boise, Idaho, and Buffalo, N.Y. Staff Reporter Chris Coates can be reached at (818) 316-3124 or at [email protected] .