Was this hospital in operation at any time during the year?
Yes
10.
Operation Open From:
1/1/2013
11.
Operation Open To:
12/31/2013
12.
Name of Parent Corporation:
The Regents of the University of California
13.
Corporate Business Address:
1111 Franklin Street, 8th Floor
14.
City:
Oakland
15.
State:
CA
16.
Zip:
94619 -
17.
Person Completing Report:
Cameron Steadman
18.
Report Preparer's Phone No.:
619-471-0536
19.
Fax No.:
619-543-3730
20.
E-mail Address:
csteadman@ucsd.edu
30.
Submitted by:
csteadman
31.
Submitted Date and Time:
2/18/2014 7:00:31 PM
32.
Corrected by:
denarduy
33.
Corrected Date and Time:
2/24/2014 10:00:23 AM
Section 2 - Hospital Description
LICENSE CATEGORY (TYPE) (Completed by OSHPD.)
Line No.
(1)
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 (the type of organization that owns the license) from the list below:
University of California
PRINCIPAL SERVICE TYPE
Line No.
(1)
25.
Select the category that best describes the type of service provided to the majority of your patients. (The type or service is usually consistant with majority of, or mix of reported patient days.)
General Medical / Surgical
Section 3 - Inpatient Services
INPATIENT BED UTILIZATION - DO NOT INCLUDE NORMAL NEWBORNS IN BED UTILIZATION DATA
Line No.
Bed Classification and Bed Designation
(1)
Licensed Beds as of 12/31
(2)
Licensed Bed Days
(3)
Hospital Discharges (including deaths)
(4) Intra-hospital Transfers
(5)
Patient (Census) Days
GAC Bed Designations
1.
Medical / Surgical (include GYN)
209
76,893
11,441
55,031
2.
Perinatal (exclude Newborn / GYN)
40
14,600
2,337
5,678
3.
Pediatric
0
0
0
0
4.
Intensive Care
32
11,680
1,301
2,136
9,961
5.
Coronary Care
13
4,745
479
824
4,343
6.
Acute Respiratory Care
7
2,555
138
166
1,527
7.
Burn
8
2,920
141
211
2,260
8.
Intensive Care Newborn Nursery
49
17,885
540
263
13,415
9.
Rehabilitation Center
0
0
0
0
15.
Subtotal - GAC
358
131,278
16,377
92,215
16.
Chemical Dependency Recovery Hospital
0
0
0
0
17.
Acute Psychiatric
32
11,680
1,165
9,264
18.
Skilled Nursing
0
0
0
0
0
19.
Intermediate Care
0
0
0
0
20.
Intermediate Care / Developmentally Disabled
0
0
0
0
25.
Total (Sum of lines 15 thru 20)
390
142,958
17,542
101,479
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 Services
0
0
0
31.
Acute Psych - Chemical Dep Recovery Svcs
0
0
0
* 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 Infants
(5) Nursery Days
35.
Newborn Nursery
3
1,784
4,112
* Nursery Infants are the "normal" newborn nursery equivalent to discharges from licensed beds.
Skilled Nursing Swing Beds (Completed by OSHPD.)
Line No.
(1)
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.
Locked
14
44.
Open
7
45.
Acute Psychiatric Total*
21
Acute Psychiatric Patients By Age Category on December 31
Line No.
(1) Number of Patients
46.
0 - 17 Years
0
47.
18 - 64 Years
14
49.
65 Years and Older
7
50.
Acute Psychiatric Total*
21
Acute Psychiatric Patients By Primary Payer on December 31
Line No.
(1) Number of Patients
51.
Medicare - Traditional
6
52.
Medicare - Managed Care
3
53.
Medi-Cal - Traditional
10
54.
Medi-Cal - Managed Care
0
55.
County Indigent Programs
0
56.
Other Third Parties - Traditional
1
57.
Other Third Parties - Managed Care
0
58.
Short-Doyle (includes Short-Doyle Medi-Cal)
0
59.
Other Indigent
0
64.
Other Payers
1
65.
Acute Psychiatric Total*
21
* 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 Care
No
73.
Skilled Nursing (SN)
No
74.
Intermediate Care (IC)
No
PALLIATIVE CARE PROGRAM
Line No.
(1)
80.
Did your hospital have an inpatient palliative care program during the report period?
Yes
PALLIATIVE CARE PROGRAM - An interdisciplinary team that sees patient, identifies needs, makes treatment recommendations, facilitaties patient and /or family decision making, and/or directly provides palliative care for patients with serious illness and their families.
If 'yes' on line 80, Please answer the questions below.
Line No.
(1)
81.
How many Advanced Practice Nurses(APN)Registered Nurses(RN) are on the inpatient palliative care team?
1
82.
How many of these APN/RNs are board certified by the National Board for Certification for Hospice and Palliative Nursing?
1
83.
How many Physicians are on the inpatient palliative care team?
1
84.
How many of these Physicians are board certified by the American Board of Medical Specialties?
1
85.
How many Social Workers are on the inpatient palliative care team?
1
86.
How many of these Social Workers hold an Advanced Certified Hospice and Palliative Social Worker credential from the National Association of Social Worker?
0
87.
How many Chaplains are on the inpatient palliative care team?
0
*Staffing data should only reflect inpatient palliative care team.
Line No.
(1)
90.
Did your hospital have outpatient palliative care services during the report period?
No
Section 4 - Emergency Department Services (EDS)
EMSA Trauma Center Designation on December 31
(Completed by OSHPD from EMSA data.)
Line No.
(1) Designation
(2) Pediatric
1.
Level I
Licensed Emergency Department Level
(Completed by OSHPD from DHS Data.)
Line No.
(1) January 1
(2) December 31
2.
Comprehensive
Comprehensive
Services Available on Premises
(Check all that apply.)
Line No.
Services Available
(1) 24 Hour
(2) On-Call
11.
Anesthesiologist
Yes
No
12.
Laboratory Services
Yes
No
13.
Operating Room
Yes
No
14.
Pharmacist
Yes
No
15.
Physician
Yes
No
16.
Psychiatric ER
Yes
No
17.
Radiology Services
Yes
No
Emergency Department Services
Line No.
EDS Visit Type
CPT Codes
(1)
Visits not Resulting in Admission*
(2) Admitted from ED (Enter Total Only if Details not Available)
(3)
Total ED Traffic (1) + (2)
21.
Minor
99281
1,031
17
22.
Low/Moderate
99282
9,424
400
23.
Moderate
99283
20,418
5,615
24.
Severe without threat
99284
2,828
2,468
25.
Severe with threat
99285
109
218
30.
TOTAL
33,810
8,718
42,528
* DO NOT INCLUDE patients who register but left 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.
36
Treatment Station - 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 ED.
0
Emergency Registrations, But Patient Leaves Without Being Seen*
Line No.
(1)
45.
Enter the number of EDS registrations that did NOT result in treatment.
0
* Include patients who arrived at ED, but did not register and left without being seen (if available)
Emergency Department Ambulance Diversion Hours
Line No.
(1)
50.
Were there periods when the ED was unable to receive any and all ambulance patients during the year and as a result ambulances were diverted to other hospitals? If 'yes' fill out lines 51 through 62 below. Count only those hours in which the ED was unavailable TO ALL PATIENTS (see instructions).
Yes
Number of Ambulance Diversion Hours that occurred at Emergency Department
Line No.
Month
(1) Hours
51.
January
100
52.
February
69
53.
March
65
54.
April
77
55.
May
67
56.
June
72
57.
July
112
58.
August
89
59.
September
111
60.
October
48
61.
November
62
62.
December
99
65.
Total Hours
971
Section 5 - Surgery and Related Services
Surgical Services
Line No.
Surgical Services
(1) Surgical Operations
(2) Operating Room Minutes
1.
Inpatient
4,691
815,709
2.
Outpatient
3,454
327,542
Operating Rooms On December 31
Line No.
Operating Room Type
(1) Number
7.
Inpatient Only
0
8.
Outpatient Only
4
9.
Inpatient and Outpatient
11
10.
Total Operating Rooms
15
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)*
2,433
21.
Live Births with Birth Weight Less Than 2500 grams (5 lbs. 8 oz.)
252
22.
Live Births with Birth Weight Less Than 1500 grams (3 lbs. 5 oz)
48
* 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 (Outpatient) Center Information
Line No.
(1)
31.
Did your hospital have an approved alternate birthing (outpatient) program?
Yes
32.
Was your alternate setting was approved as LDR
No
33.
Was your alternate setting was approved as LDRP
Yes
Other Live Birth Data
Line No.
(1) Number
36.
How many of the live births reported on line 20 occurred in your alternative (outpatient) setting? Do not include C-Section deliveries.
301
37.
How many of the live births reported on line 20 were C-Section deliveries?
808
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.
11
Cardiovascular Surgical Operations (with and without the HEART/LUNG MACHINE*)
Line No.
(1) Cardio-Pulmonary Bypass USED*
(2) Cardio-Pulmonary Bypass NOT USED
43.
Pediatric
0
7
44.
Adult
0
3
45.
Total Cardiovascular Surgical Operations
0
10
* 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.
0
* 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.
2
Cardiac Catheterization Visits
Line No.
(1) Diagnostic
(2) Therapeutic
56.
Pediatric - Inpatient
0
0
57.
Pediatric - Outpatient
0
0
58.
Adult - Inpatient
104
57
59.
Adult - Outpatient
3
1
60.
Total Cardiac Catheterization Visits
107
58
Distribution of Procedures Performed in Catheterization Laboratory
Line No.
(1) Procedures
65.
Diagnostic Cardiac Catheterization Procedures (LHC, R & LHC)
106
66.
Myocardial Biopsy
0
71.
Permanent Pacemaker Implantation
0
711.
Other Permanent Pacemaker Procedures (Generator or Lead Replacement)
All other catheterization procedures performed in the lab
20
85.
Total Catheterization Procedures
188
Percutaneous Transluminal Balloon Valvuloplasty(PTBV) is very rarely done in these times. Those that are done are generally on pediatric patients.
AICD procedures are frequently done in the cath lab and are very similar to permanent pacemaker implants.
NOTE: Do Not Include Any Of The Following As A Cardiac Catheterization:
Defibrillation
Temporary Pacemaker Insertion
Cardioversion
Pericardiocentesis
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
Line No.
(1)
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)."
Line No.
(1)
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.
4468 Clinical Laboratory Renovation
$4,288,021
P-2012-00562
27.
28.
29.
30.
General Comments:
Correction submitted to reflect updated bed count.