ࡱ>    !"#$%&'()*+,-./012345678:;<Root EntryFlx9@PerfectOffice_MAIN& pSummaryInformation((PerfectOffice_OBJECTS,lxlxt Days Medicare -Managed/MPatient Days Medi-Cal - Traditional %OPatient Days Medi-Cal-ManagedEQPatient Days County Indigent Programs - Traditional & Managed6SPatient Days Other Third Parties - Traditional2UPatient Days Other Third Parties - Managed#WPatient Days Other Indigent!YPatient Days Other Payors[Patient Days Total]adj pat days_mcar t adj dayamcar mc adj daycmcal t adj dayemcal mc adj daygco adj dayithird t adj daykthird mc adj daymoth ind adj dayooth adj day)qDischarges Medicare - Traditional%sDischarges Medicare - Managed)uDischarges Medi-Cal - Traditional%wDischarges Medi-Cal - ManagedCyDischarges County Indigent Programs - Traditional & Managed4{Discharges Other Third Parties - Traditional0}Discharges Other Third Parties - Managed!Discharges Other IndigentDischarges Other PayorsDischarges Total5Licensed Beds and Utilization by Type of CareLicensed Beds Acute!Licensed Beds Psychiatric"Licensed Beds Chemical Dep$Licensed Beds Rehabilitation$Licensed Beds Long-term Care9Licensed Beds Residential & Other Daily Servicesacute bed dayspsych bed dayschem bed daysrehab bed daysLtc bed daysres bed daysPatient Days Acute Patient Days Psychiatric!Patient Days Chemical Dep#Patient Days Rehabilitation#Patient Days Long-term Care% Itc days7Patient Days Residential & Other Daily ServicesDischarges AcuteDischarges PsychiatricDischarges Chemical Dep!Discharges Rehabilitation!Discharges Long-term Care5Discharges Residential & Other Daily ServicesNursery InformationNursery BassinetsNursery DaysNursery Discharges"Outpatient Visits by Payor0Outpatient Visits Medicare - Traditional,Outpatient Visits Medicare - Managed0Outpatient Visits Medi-Cal - Traditional,Outpatient Visits Medi-Cal - ManagedJOutpatient Visits County Indigent Programs - Traditional & Managed;Outpatient Visits Other Third Parties - Traditional7Outpatient Visits Other Third Parties - Managed(Outpatient Visits Other Indigent&Outpatient Visits Other PayorsOutpatient Visits Total1Ambulatory and Referred Outpatient VisitsVisits Emergency RoomVisits ClinicVisits Home Health Care"Visits Referred Outpatient)Managed Care Contract Utilization Purchased Inpatient Days2Surgery and Selected Ancillary InformationOperating Rooms#Operating Minutes Inpatient$Operating Minutes OutpatientSurgeries InpatientSurgeries Outpatient Summary Income Statement#Gross Patient Revenue Total%Deductions from Revenue Totalded rev + dsh(Total Capitation Premium Revenue!Net Patient Revenue Totalnet rev - dshOther Operating Revenuetotal op rev total op rev - dsh Total OperatingLMQ/3$ ArialZ34Z3$ArialZ34Z3$ ArialZ34Z3$ ArialZ34Z3@ Normal Comma Currency Percent Fixed DateHeading 1Heading 2 Total Comma0 Currency0033@ R033@ 2033@ B033@ 033@  033@ 033@ 033@ 0 33@ P033@ 0033@ 033@ @033@ @033@ @P033@ @033@ 0033@ @833@ 833@ 833@ 833@ 833@ 0033@ @P033@ @dBY!_d<  ? `Y($$  A   ?       wY@W swW H H H (p lwwwwwwwwgt?ww@ H H H (p lwwwwwwwGpY@W swW X H X p lwwwwwwwwwwwwwwwwwwwwwwww>>w7 7 wwwwgpQpvww7 7 wwwwg!pQpvwwwwwwwG!pQpvwwwwwwwwwwwwwwww'!pQpvwgpwwwww lwwwwwH(%pww lww'ww'///////////////////o8pwww7|*`*``۞sYAqwwwG!pQpvwg"x ZZuwxzxZ r'| z|sx|'OjUEhHZ HZ XMLhJ LLH OOh |wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwڂ*'""" "    $ $       Tq  d2X, X1Axis?  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M$ArialArial "]Z  %&'( @@0d  $ Arial ZZ$ Arial ZZ  LB  %&'( 0d  $ Arial ZZ$ Arial ZZ  B           ^  ddư>   ?&  Mb@?   #       f  g    i2      -./g  0d    #566DATA2C$u<7~v7!;QQQ)Santa Clara Valley Medical Center&DISCLOSURE REPORT INFORMATION OSHPD Facility NumberFacility DBA Name Report Period Begin Date Report Period End Date Days in Report Period$GENERAL HOSPITAL INFORMATIONCounty NameHSA NumberHFPA NumberType of ControlSYSTEM (>3 HOSP)Type of HospitalType of Care(Teaching or Small/Rural Hospital!DSH hosp #OWNER%lic bed size'Itc range )Phone Number+Street Address -city/Zip Code1Chief Executive Officer$3ER Trauma Center Designation6UTILIZATION DATA%8Licensed Beds (End of Period):lic bed days  <Available Beds (Average)>avail bed days@Staffed Beds (Average)Bocc bedsDadj occ beds&GINPATIENT UTILIZATION BY PAYOR+IPatient Days Medicare - Traditional&KPatien ExpensesNet from Operationsnet op - dsh Non-Operating RevenueNon-Operating Expenses"Provision for Income TaxesExtraordinary ItemsNet Incomenet inc - dsh#PATIENT REVENUE INFORMATION(!Gross Inpatient Revenue by Payor6#Gross Inpatient Revenue Medicare - Traditional2%Gross Inpatient Revenue Medicare - Managed6'Gross Inpatient Revenue Medi-Cal - Traditional2)Gross Inpatient Revenue Medi-Cal - ManagedP+Gross Inpatient Revenue County Indigent Programs - Traditional & ManagedA-Gross Inpatient Revenue Other Third Parties - Traditional=/Gross Inpatient Revenue Other Third Parties - Managed.1Gross Inpatient Revenue Other Indigent,3Gross Inpatient Revenue Other Payors%5Gross Inpatient Revenue Total(8Gross Inpatient Revenue by Payor7:Gross Outpatient Revenue Medicare - Traditional3<Gross Outpatient Revenue Medicare - Managed7>Gross Outpatient Revenue Medi-Cal - Traditional3@Gross Outpatient Revenue Medi-Cal - ManagedQBGross Outpatient Revenue County Indigent Programs - Traditional & ManagedBDGross Outpatient Revenue Other Third Parties - Traditional=FGross Outpatient Revenue Other Third Parties- Managed/HGross Outpatient Revenue Other Indigent-JGross Outpatient Revenue Other Payors&LGross Outpatient Revenue TotalODeductions from Revenue6QContractual Adjustments Medicare - Traditional2SContractual Adjustments Medicare - Managed6UContractual Adjustments Medi-Cal - Traditional2WContractual Adjustments Medi-Cal - ManagedPYDisproportionate Share Payments for Medi-Cal (SB 855) (negative amount)Q[Contractual Adjustments County Indigent Programs - Traditional & ManagedA]Contractual Adjustments Other Third Parties - Traditional=_Contractual Adjustments Other Third Parties - ManagedaProvision for Bad DebtscCharity-Hill-BurtoneCharity-OtherNgRestricted Donations and Subsidies for Indigent Care (negative amount))iAll Other Deductions from Revenue"lCapitation Premium Revenue+nCapitation Premium Revenue Medicare+pCapitation Premium Revenue Medi-Cal;rCapitation Premium Revenue County Indigent Programs6tCapitation Premium Revenue Other Third Parties$wNet Patient Revenue by Payor2yNet Patient Revenue Medicare - Traditional.{Net Patient Revenue Medicare - Managed2}Net Patient Revenue Medi-Cal - Traditional.Net Patient Revenue Medi-Cal - Managednetmcalt-dshnetmcalmc-dshLNet Patient Revenue County Indigent Programs - Traditional & Managed=Net Patient Revenue Other Third Parties - Traditional9Net Patient Revenue Other Third Parties - Managed*Net Patient Revenue Other Indigent(Net Patient Revenue Other Payors Selected Financial Items?Dispro Share Funds Transferred to Related Public EntityIntercompany Transfers"Unrestricted ContributionsIncomes#District Assessment RevenueCounty AppropriationsEXPENSE INFORMATION,Direct Expenses by Cost Center Group(Expenses Daily Hospital Services$Expenses Ambulatory Services#Expenses Ancillary Services-Expenses Purchased Inpatient Services.Expenses Purchased Outpatient ServicesResearchEducationGeneral ServicesFiscal ServicesAdministrative ServicesUnassigned Costs*Expenses by Natural ClassificationSalaries and WagesEmployee Benefits#Physician Professional FeesOther Professional FeesSuppliesPurchased ServicesDepreciationLeases and Rentals9Insurance - Hospital and Professional Malpractice,Interest - Working Capital and OtherAll Other Expenses!Balance Sheet InformationAssetsCurrent Assets#Assets Whose Use Is LimitedNet Property Construction-in-Progress$Investments and Other AssetsIntangible AssetsTotal AssetsLiabilities and EquityCurrent LiabilitiesDeferred CreditsNet Long-term DebtEquity$Total Liabilities and Equity!Other Balance Sheet Items Cash"Buildings and ImprovementsEquipmentTotal Property Accumulated DepreciationMortgages PayableBonds Payable9Intercompany Receivables(Current and Non-Current)6Intercompany Payables(Current and Non-Current)*LABOR AND PRODUCTIVITY INFORMATION& Hospital Personnel Information Total Productive HoursTotal Paid Hours3Productive Hours by Employee ClassificationHOSP-FTESTDNT-FTE"Management and Supervision Technical and SpecialistRegistered Nurses"Licensed Vocational NursesAides and Orderlies)!Clerical and Other Administrative'#Environmental and Food Services$%All Other Salaries and Wages0(Contracted Labor Hours by Classification*Registry Nurses!,Other Contracted Services3/Total Productive Hours by Cost Center Group31Total Productive Hours by Cost Center Group3Daily Hospital Services5Ambulatory Services7Ancillary Services9Education and Research;General Services=Fiscal Services=?Administrative Services (including Employee Benefits)Ashort mcare trCshort mcare mcEshort mcal trGshort mcal mcIshort cipKshort 3rd trMshort 3rd mcOshort other indQshort otherFAC-NOFAC-NAMEBEG-DATE END-DATE DAY-PERCOUNTY name HSA HFPATYPE-CNTRLSYSTEM (>3 HOSP)TYPE-HOSPTYPE-CARETEACH-RURL!DSH hosp #OWNER%lic bed size'Itc range  )PHONE+ADDRESS -CITY/ZIP-CODE 1CEO3ER-DESIG8BED-LIC:lic bed days <BED-AVL>avail bed days@BED-STFBocc bedsDadj occ bedsIDAY-MCAR-TRKDAY-MCAR-MCMDAY-MCAL-TRODAY-MCAL-MCQDAY-CNTYSDAY-THRD-TRUDAY-THRD-MCWDAY-OTH-INDYDAY-OTH[DAY-TOT]adj pat days_mcar t adj dayamcar mc adj daycmcal t adj dayemcal mc adj daygco adj dayithird t adj daykthird mc adj daymoth ind adj dayooth adj dayqDIS-MCAR-TRsDIS-MCAR-MCuDIS-MCAL-TRwDIS-MCAL-MCyDIS-CNTY{DIS-THRD-TR}DIS-THRD-MCDIS-OTH-INDDIS-OTHDIS-TOTBED-ACUTEBED-PSYCHBED-CHEMBED-REHABBED-LTCBED-RESDNTacute bed dayspsych bed dayschem bed daysrehab bed daysLtc bed daysres bed daysDAY-ACUTEDAY-PSYCHDAY-CHEMDAY-REHABDAY-LTC% Itc daysDAY-RESDNTDIS-ACUTEDIS-PSYCHDIS-CHEMDIS-REHABDIS-LTCDIS-RESDNTBAS-NURSRYDAY-NURSRYDIS-NURSRYVIS-MCAR-TRVIS-MCAR-MCVIS-MCAL-TRVIS-MCAL-MCVIS-CNTYVIS-THRD-TRVIS-THRD-MCVIS-OTH-INDVIS-OTHVIS-TOTVIS-ERVIS-CLINVIS-HOMEVIS-REF-OPDAYS-PIPSOP-ROOMOP-MIN-IPOP-MIN-OPSURG-IPSURG-OPGR-PT-REVDED-FR-REVded rev + dshTOT-CAP-REVNET-PT-REVnet rev - 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