Annual Utilization Report of Hospitals
Facility Name:GOOD SAMARITAN HOSPITAL-SAN JOSE
OSHPD ID:106430779Report Status:Submitted
License Category:General Acute Care HospitalReport Year:2005
Table of Content
Click on any of the links listed below to view the corresponding section.
Section 1 - General Information
Section 2 - Hospital Description
Section 3 - Inpatient Services
Section 4 - Emergency Medical Services (EMS)
Section 5 - Surgery and Related Services
Section 6 - Major Capital Expenditures
General Comments
View Errors and Warnings
Section 1 - General Information
1.Facility Name:GOOD SAMARITAN HOSPITAL-SAN JOSE
2.OSHPD ID Number:106430779
3.Street Address:2425 SAMARITAN DRIVE
4.City:SAN JOSE
5.Zip:95124
6.Facility Phone No.:( 408 ) 559 - 2011 ext.
7.Administrator Name:William K. Piche
8.Administrator E-mail Address:william.piche@hcahealthcare.com
9.Was this hospital in operation at any time during the year?:Yes
10.Operation Open From:1/1/2005
11.Operation Open To:12/31/2005
12.Name of Parent Corporation:HCA
13.Corporate Street Address:1 Park Plaza
14.City:Nashville
15.State:TN
16.Zip:37203 -
17.Person Completing Report:Amy Guardino
18.Phone No.:408-559-2515
19.Fax No.:408-559-2490
20.E-mail Address:amy.guardino@hcahealthcare.com
30.Submitted by:vzk6688
31.Submitted Date and Time:2/15/2006 11:36:29 AM
Section 2 - Hospital Description
1.License Category:General Acute Care Hospital
LICENSEE TYPE OF CONTROL
Line
No.		(1)
5.Select the category that best describes the licensee type of control of your hospital from drop down list:Investor - Corporation
PRINCIPAL SERVICE TYPE
Line
No.		(1)
25.Select the category that best describes the type of service provided to the majority of your patients from drop down list:General Medical / Surgical
Section 3 - Inpatient Services
INPATIENT BED UTILIZATION - DO NOT INCLUDE NORMAL NEWBORNS IN BED UTILIZATION DATA
Line
No.		Bed Classification and General Acute Care (GAC) Bed Designation(1)
Licensed Beds as of 12/31		(2)
Licensed Bed Days		(3)
Hospital Discharges (including deaths)		(4)
Intra-hospital Transfers from Critical Care		(5)
Patient (Census) Days
GAC Bed Designations
1.Medical / Surgical (include GYN)13443,18611,48838,487
2.Perinatal (exclude Newborn / GYN)8628,9722,9298,180
3.Pediatric259,1251,1722,977
4.Intensive Care228,0302657954,141
5.Coronary Care217,6655007133,862
6.Acute Respiratory Care00000
7.Burn00000
8.Intensive Care Newborn Nursery5117,79946729010,358
9.Rehabilitation Center0000
15.Subtotal - GAC339114,77716,82168,005
16.Chemical Dependency Recovery Hospital0000
17.Acute Psychiatric0000
18.Skilled Nursing279,85500
19.Intermediate Care0000
20.Intermediate Care / Developmentally Disabled0000
25.Total (Sum of Lines 15 thru 20)366124,63216,82168,005
Chemical Dependency Recovery Services In Licensed GAC and Acute Psychiatric Beds*
Line
No.		Bed Classification(1)
Licensed
Beds
(3)
Hospital
Discharges


(5)
Patient
(Census)
Days
30.GAC - Chemical Dep Recovery Services0245689
31.Acute Psych - Chemical Dep Recovery Svcs000
* The licensed services data for these CDRS are to be included in lines 1 through 25 above.
Newborn Nursery Information
Line
No.		(1)
Nursery
Bassinets		(3)
Nursery
Discharges		(5)
Nursery
Days
35.Newborn Nursery292,7396,752
40.Number of licensed General Acute Care beds approved for Skilled Nursing Care:0
Complete lines 43 through 70 only if your hospital has licensed Acute Psychiatric or PHF beds. Include Chemical Dependency Recovery Services provided in licensed Acute Psychiatric beds.
Acute Psychiatric Patients By Unit on December 31
Line
No.		(1)
Number of Patients
43.Locked0
44.Open0
45.Acute Psychiatric Total*0
Acute Psychiatric Patients By Age Category on December 31
Line
No.		(1)
Number of Patients
46.0 - 17 Years0
47.18 - 64 Years0
49.65 Years and Older0
50.Acute Psychiatric Total*0
Acute Psychiatric Patients By Primary Payer on December 31
Line
No.		(1)
Number of Patients
51.Medicare - Traditional0
52.Medicare - Managed Care0
53.Medi-Cal - Traditional0
54.Medi-Cal - Managed Care0
55.County Indigent Programs0
56.Other Third Parties - Traditional0
57.Other Third Parties - Managed Care0
58.Short-Doyle (includes Short-Doyle Medi-Cal)0
59.Other Indigent0
64.Other Payers0
65.Acute Psychiatric Total*0
* Acute Psychiatric Total on lines 45, 50 and 65 must agree.
Short Doyle Contract Services
Line
No.		(1)
70.During the reporting period, did you provide any acute psychiatric care under a Short-Doyle contract?No
Inpatient Hospice Program
Line
No.		(1)
71.Did your hospital offer an inpatient hospice program during the report period?No
If 'yes' on line 71, what type of bed classification is used for this service? (Check all that apply.)
Line
No.		Bed Classification(1)
72.General Acute CareNo
73.Skilled Nursing (SN)No
74.Intermediate Care (IC)No
Section 4 - Emergency Medical Services (EMS)
EMSA Trauma Center Designation on December 31
(Completed by OSHPD from EMSA data.)
Line
No.		(1)
Designation		(2)
Pediatric
1.
Licensed Emergency Department Level
(Completed by OSHPD)
Line
No.		(1)
January 1		(2)
December 31
2.BasicBasic
Services Available on Premises
(Check all that apply.)
Line
No.		Services Available(1)
24 Hour		(2)
On-Call
11.AnesthesiologistNoYes
12.Laboratory ServicesYesNo
13.Operating RoomNoYes
14.PharmacistNoYes
15.PhysicianNoYes
16.Psychiatric ERNoYes
17.Radiology ServicesYesNo
Emergency Medical Service Visits By Type
Line
No.		EMS Visit Type*CPT Codes(1)
Total
(2)
Admitted
21.Minor992813146
22.Low/Moderate992821,02923
23.Moderate992831,228210
24.Severe without threat992841,066792
25.Severe with threat992851,3311,253
30.Total EMS Visits4,9682,284
* DO NOT INCLUDE patients who register but leave without being seen, employee physicals and scheduled Clinic-type visits.
Emergency Medical Treatment Stations on December 31
Line
No.		(1)
35.Enter the number of emergency medical treatment stations.25
Treatment Stations - A specific place within the emergency department adequate to treat one patient at a time. Do not count holding or observation beds.
Non-Emergency (Clinic) Visits Seen in Emergency Department
Line
No.		(1)
40.Enter the number of non-emergency (clinic) visits seen in EMS.0
Emergency Registrations, But Patient Leaves Without Being Seen*
Line
No.		(1)
45.Enter the number of EMS registrations that did NOT result in treatment.11
* Include patients who arrived at ED, but did not register and left without being seen (if available)
Emergency Department Closure / Ambulance Diversion Hours
Line
No.		(1)
50.Did your hospital close its ED at any time during the year, resulting in ambulance diversion? If 'yes', fill out lines 51 through 65 below.Yes
Number of Hours Emergency Department Was Closed
Line
No.		Month(1)
Hours
51.January18
52.February35
53.March12
54.April15
55.May17
56.June15
57.July18
58.August24
59.September5
60.October11
61.November16
62.December36
65.Total Hours222
Section 5 - Surgery and Related Services
Surgical Services
Line
No.		Surgical Services(1)
Surgical Operations		(2)
Operating Room Minutes
1.Inpatient5,028670,189
2.Outpatient5,426402,840
Operating Rooms On December 31
Line
No.		Operating Room Type(1)
Number
7.Inpatient Only0
8.Outpatient Only0
9.Inpatient and Outpatient13
10.Total Operating Rooms13
Ambulatory Surgical Program
Line
No.		(1)
15.Did your hospital have an organized ambulatory surgical program?Yes
Live Births
Line
No.		(1)
Number
20.Total Live Births (Count multiple births separately)*2,763
21.Live Births with Birth Weight Less Than 2500 grams (5 lbs. 8 oz.)326
22.Live Births with Birth Weight Less Than 1500 grams (3 lbs. 5 oz).102
* TOTAL LIVE BIRTHS on line 20 should approximate the number of Perinatal discharges shown in Section 3, line 2, column 3. Include LDR or LDRP births and C-Section deliveries.
Alternate Birthing Center Information
Line
No.		(1)
31.Did your hospital have an approved alternate birthing program?Yes
32.Was your alternate setting was approved as LDRYes
33.Was your alternate setting was approved as LDRPNo
Other Live Birth Data
Line
No.		(1)
Number
36.How many of the live births reported on line 20 occurred in your alternative setting? Do not include C-Section deliveries.1,708
37.How many of the live births reported on line 20 were C-Section deliveries?1,055
Licensed Cardiology and Cardiovascular Surgery Services (Completed by OSHPD.)
Line
No.
(1)
Licensure
41.Cardiovascular Surgery Services
Note: Complete lines 42 to 85 if licensed for Cardiovascular Surgery Services.
Complete lines 55 to 85 if licensed for Cardiac Catheterization only.
Licensed Cardiovascular Operating Rooms
Line
No.		(1)
42.Number of operating rooms licensed to perform cardiovascular surgery on December 31.10
Cardiovascular Surgical Operations (with and without the HEART/LUNG MACHINE*)
Line
No.		(1)
Cardio-Pulmonary
Bypass USED*		(2)
Cardio-Pulmonary
Bypass NOT USED
43.Pediatric00
44.Adult15390
45.Total Cardiovascular Surgical Operations15390
* Also refered to as Extracorporeal Bypass or "on-the-pump" (heart/lung machine).
Coronary Artery Bypass Graft (CABG) Surgeries*
Line
No.		(1)
50.Number of Coronary Artery Bypass Graft (CABG) surgeries performed.148
* Subset of cardiovascular surgeries reported on line 45 above.
Cardiac Catheterization Lab Rooms
Line
No.		(1)
55.Number of rooms equipped to perform cardiac catheterizations on December 31.3
Cardiac Catheterization Visits
Line
No.		(1)
Diagnostic
(2)
Therapuetic
56.Pediatric - Inpatient00
57.Pediatric - Outpatient00
58.Adult - Inpatient01,686
59.Adult - Outpatient0733
60.Total Cardiac Catheterization Visits02,419
Distribution of Therapeutic Cardiac Catheterization Procedures
Complete this table if Therapeutic Cardiac Catheterization Visits are reported in column 2, line 60.
Line
No.		(1)
Procedures
71.Permanent Pacemaker Implantation123
72.Percutaneous Transluminal Coronary Angioplasty (PTCA) - WITH Stent1,736
73.Percutaneous Transluminal Coronary Angioplasty (PTCA) - WITHOUT Stent440
74.Atherectomy (PTCRA - rotablator, DCA, laser, other ablation, etc.)0
75.Thrombolytic Agents (Intracoronary only)55
76.Percutaneous Transluminal Balloon Valvulopasty (PTBV)0
84.All Other (including Radiofrequency Catheter Ablation)69
85.Total Therapeutic Cardiac Catheterization Procedures2,423
NOTE: Do Not Include Any Of The Following As A Cardiac Catheterization:
Angiography - Non-coronary, Automatic Implantable Cardiac Defibrillator (AICD), Defibrillation, Cardioversion, Intra-Aortic Balloon Pump, Percutaneous Transluminal Angioplasty - Non-cardiac, Pericardiocentesis, or Temporary Pacemaker Insertion.
Section 6 - Major Capital Expenditures
Section 127285(3) of the Health and Safety Code requires each hospital to report "acquisitions of diagnostic or therapeutic equipment during the reporting period with a value in excess of five hundred thousand dollars ($500,000)."
Diagnostic and Therapeutic Equipment Acquired During The Report Period
1.Did your hospital acquire any diagnostic or therapeutic equipment that had a value in excess of $500,000? (If 'Yes', fill out lines 2 through 11, as necessary, below.)No
Diagnostic and Therapeutic Equipment Detail
Line
No.		(1)
Description of Equipment		(2)
Value		(3)
Date of Aquisition
MM/DD/YYYY		(4)
Means of Acquisition
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Building Projects Commenced During Report Period Costing Over $1,000,000
Section 127285(4) of the Health and Safety Code requires each hospital to report the "commencement of projects during the reporting period that require a capital expenditure for the facility or clinic in excess of one million dollars ($1,000,000)."
25.Did your hospital commence any building projects during the report period which will require an aggregate capital expenditure exceeding $1,000,000? (If 'Yes', fill out lines 26 through 30, as necessary, below.)Yes
Detail of Capital Expenditures
Line
No.		(1)
Description of Project		(2)
Projected Total Capital Expenditure		(3)
OSHPD Project No. (if applicable)
26.Cath Lab #4$3,928,000SS050323-0
27.
28.
29.
30.
General Comments:
Errors and Warnings