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its both
parts is an old hospital
others are room sets
like when they spend a lot of time in a room they use a set so there is room for a camera

The locale of Sacred Heart within the fictional world of Scrubs is either a deliberate ambiguity or a well-kept secret that has been by the cast and crew of the show, who go so far as to describe the location as "San DiFrangeles" – a portmanteau of San Francisco, San Diego, and Los Angeles that is meant to encompass a large part of California. It has been indicated that the show's location in the United States was originally supposed to be a complete mystery, but location shots containing the shooting location's Californian environment made the location hard to conceal.

"We were really trying to make it like Anywhere, USA, and I think as the years passed we kind of like gave up on that idea. In some shots you see palm trees," cast member Judy Reyes remarked during the audio commentary of the episode "My T.C.W." on Disk Three of "The Complete Second Season [of] Scrubs" DVD set.

"We still call it San DiFrangeles in the writers' room," creator Bill Lawrence added during that same commentary.

"Sacred Heart" is the name for a number of medical institutions in the United States, so the name may have been chosen to add ambiguity. Another likely scenario is that it is a nod by Bill Lawrence to his wife and cast member, Christa Miller's school, Convent of the Sacred Heart in New York City. Many fans continue to speculate about where exactly the show might take place, and based on current clues, the show does seem to take place somewhere in the state of California. These clues include:

* During episodes taking place during the winter months, characters are seen wearing winter clothing such as coats, gloves, and scarves, suggesting that the climate is a less temperate one than that found in Florida or Southern California. The average winter temperatures in San Francisco/Oakland are 45-58 °F.
* In Episode 1.4, “My Old Lady,” Carla states that a third of the hospital's patients speak Spanish as a primary language, which may reflect upon the demographics of the location.
* In Episode 1.11, "My Own Personal Jesus," nearby Miller Park is an important plot element. This most likely isn't referring to real life Miller Park of Milwaukee, Wisconsin.
* In Episode 2.04, "My Big Mouth," a limo is seen with TCP registration engraved on the bumper. The CA Public Utilities Commission issues permits to operate limousines called Transportation Charter Party. Each limo has to have the letters TCP and its individually assigned number on the corners of both front and rear bumpers.
* In the early episodes of season 3, Elliot took a commuter train to visit her then-boyfriend Sean (played by Scott Foley), who worked as an animal trainer at a SeaWorld theme park. SeaWorld has locations in Orlando, San Antonio, San Diego, and, previously Cleveland. The episodes shown in season 3 were filmed at the SeaWorld in San Diego.
* In Episode 3.04, “My Lucky Night,” the front destination panel of the bus that Sean takes reads, "Redding". This may be a reference to Redding, California.
* In Episode 3.09, “My Dirty Secret,” When J.D. sis asked when a particular T.V. show is on, he says its on at 9PM Central and 8PM Mountain. It is strange that he would omit Pacific time, which is the hospital's suspected area.
* In Episode 4.01, "My Old Friend's New Friend," during the scene where J.D. thinks he's going to get a hug from Dr. Cox, the whiteboard in the background reads, "Bowling night at Kona Lanes." Kona Lanes was a landmark bowling alley in Costa Mesa, California.
* In one of the episodes the camera clearly shows the 'Riverside' street sign. In the same shot you see the 134 'Ventura' freeway located in the valley. This may indicate the hospital is in fact located in Los Angeles, California.
* In Episode 4.04, “My First Kill,” a conversation between Elliot and Dr. Molly Clock establishes that the time difference between the location of the hospital and Greenland is three hours, as Greenland is largely UTC-3 (though this varies from UTC to UTC-4), this places Sacred Heart in UTC-6, or Central Standard Time. In the same episode, Elliot asks Molly if she wants to go to the Little Tokyo district of the city with her, which could be a reference to Little Tokyo, Los Angeles, California.
* In episode 4.08, “My Last Chance,” When Molly tells Elliot that she is leaving, she says that she will be going to Milwaukee. The sad mood of Elliot implies that a trip to Milwaukee is very far, and therefore it is probably not in the Midwest region.
* In episode 4.08, “My Last Chance,” Molly is leaving in a taxi cab with a California license plate 2FAN321, which conforms to the California license-plate format of a number, followed by three letters, then by three numbers, but when Dr. Cox rides on the ambulance for his community service and he can clearly be seen wearing a N.J. State Department of Health EMT patch.
* In Episode 4.9, “My Malpractical Decision,” Turk gets the cell phone number 1-916-CALL-TURK (Its actually 1-916-CALL-TUR). 916 is the area code for the capital city of California, Sacramento.
* In Episode 4.11, "My Unicorn," J.D. visits a small local airport with a map of the San Francisco Bay Area in the control tower.
* In Episode 4.21, “My Lips Are Sealed,” J.D. sets his clock back three hours to see what it would be like to live in Honolulu, which suggests that the location is either in the Pacific or Mountain time zones, depending on Daylight Saving Time.
* In Episode 4.25, "My Changing Ways," Turk brings J.D. a pizza from Big Mama's & Papa's Pizzeria, which is available only in the Los Angeles metropolitan area.
* In Episode 5.03, "My Day at the Races," J.D. mentions swimming in the waters of the salty Pacific, which would logically would indicate a west coast setting, barring the possibility that the location is Hawaii, which, judging from the aforementioned landscape, is unlikely.
* In Episode 5.05, “My New God,” Turk is on his way home to meet Carla and stops by at a Dunkin Donuts Shop. Dunkin Donuts' are rare in California and one of the only ones in Northern California is located at 3311 Power Inn Rd Ste 101, Sacramento. Another (former) location of a Dunkin Donuts shop in Northern California is on the corner of Union and Camden Avenues in the Cambrian Park neighborhood of San Jose.
* In Episode 5.15, “My Extra Mile,” Dr. Cox says that they are giving Tastykakes away. This brand of snack cake is sold mostly around the Philadelphia metropolitan area, however it is also sold in Northern California.
* In Episode 6.04, "My House," Kim is going to Tacoma, Washington by plane, proving Sacred Heart is not in Seattle, since the cities are only 32 miles apart.
* Scenes on the rooftop depict a clear image of a hospital only four stories high and clearly on a valley floor; quite similar to the Santa Clara Valley (only 17 miles from the beach town of Santa Cruz) giving credence to the impression of Sacred Heart being located in San Jose, California or Los Angeles. The surrounding foothills can be seen in some of these episodes while in others the smog is so thick as to make it clear it is located in Los Angeles, CA.
* In several episodes, palm trees can be seen, ruling out Sacred Heart being in Oregon or Washington.
* In the episode My Road to Nowhere, J.D. takes an overnight road-trip to Tacoma, Washington, implying that it is not near Tacoma.
* In the episode My Road to Nowhere, J.D. talks about taking a $900 cab ride home from Tacoma, Washington, placing Sacred Heart somewhere in Central California
* In one episode, Carla and Turk discuss if Carla's mother will live with them when they get married, and Turk says that if she ever walked in on him in the bathroom, she would get a "trip to Flor-i-da," suggesting that Sacred Heart is in a state far from Florida.

Well My road to nowhere rules out anywhere in washington, since J.D said it's be a "strain on his scooter", and he also took a $900 dollar cab ride home. Oregon is ruled out because you can see palm trees. Which leaves somewhere in California.