Hospital

UNIVERSITY HEALTH SYSTEM

CCN: 450213 · SAN ANTONIO, TX 78229 · BEXAR County

Bottom quartile Middle Top quartile Percentile badges compare this hospital to all 5,426 hospitals nationally.

Overview

Address
4502 MEDICAL DR, SAN ANTONIO, TX 78229
Phone
(210) 358-2637
Hospital Type
Acute Care
Ownership
Government (District)
Emergency Services
Yes
Birthing Friendly
Yes
3 /5
★★★★★
CMS Overall Rating
p30
Acute Care — General medical and surgical hospital participating in Medicare IPPS. Subject to CMS quality reporting and payment adjustment programs (VBP, HRRP, HAC).

CMS Star Rating — Quality Domain Breakdown

CMS computes the overall star rating from five quality domains. Each domain compares this hospital's measures against national benchmarks.

Mortality 7 of 7 measures reported
7
Better No different Worse
30-day death rates for heart attack, heart failure, pneumonia, COPD, stroke, CABG, and kidney disease.
Safety of Care 7 of 8 measures reported
4
3
Better No different Worse
Healthcare-associated infections and patient safety indicators (PSI-90 composite).
Readmission 10 of 11 measures reported
10
Better No different Worse
30-day unplanned readmission rates for heart attack, heart failure, pneumonia, COPD, hip/knee replacement, and CABG.
Patient Experience 8 of 8 measures reported
8 measures reported (comparative data not available for this domain)
HCAHPS survey scores — patient-reported experience with communication, responsiveness, cleanliness, and discharge planning.
Timely & Effective Care 10 of 12 measures reported
10 measures reported (comparative data not available for this domain)
Process-of-care measures including flu immunization, blood clot prevention, and appropriate use of imaging.

Readmissions — Hospital Readmissions Reduction Program

The Excess Readmission Ratio (ERR) compares this hospital's 30-day readmission rate to expected, adjusting for patient mix. An ERR of 1.0 means readmissions are as expected; > 1.0 triggers a Medicare payment penalty (up to 3%).

⚠ This hospital has excess readmissions in at least one condition and is subject to HRRP payment reduction.
Acute Myocardial Infarction (Heart Attack)
0.9608 p24
Heart Failure 164 discharges
1.0345 p72
Pneumonia 152 discharges
0.9853 p43
COPD
0.9650 p20
Hip/Knee Replacement
— Not reported
CABG Surgery
1.0159 p56
Expected (1.0) National median

Value-Based Purchasing

The Hospital VBP Program adjusts Medicare payments based on clinical quality. The Total Performance Score (TPS) is a weighted composite of four domains, each worth 25%. This hospital's TPS is below the national median, suggesting a negative payment adjustment.

28.4 p46
Total Performance Score
National median: 29.5
Clinical Outcomes 25% weight
6.0 p57
Nat'l median: 5.0
Measures mortality rates for conditions like heart attack, heart failure, pneumonia, and COPD. Based on 30-day risk-standardized mortality.
Safety 25% weight
12.9 p68
Nat'l median: 10.0
Patient safety measures including healthcare-associated infections (CLABSI, CAUTI, SSI, MRSA, C. diff) and perioperative complications.
Person & Community Engagement 25% weight
7.0 p35
Nat'l median: 8.8
Based on HCAHPS patient experience survey results — communication with nurses and doctors, hospital cleanliness, pain management, discharge information.
Efficiency & Cost Reduction 25% weight
2.5 p43
Nat'l median: 2.5
Based on Medicare Spending Per Beneficiary (MSPB). Measures episode-of-care costs from 3 days before admission through 30 days after discharge.

CMS Payment Programs

Three Medicare programs adjust hospital payments based on quality performance. Hospitals can be penalized under multiple programs simultaneously.

Readmissions (HRRP)
Penalized
Worst ERR: 1.0345
Value-Based Purchasing
28.4 TPS
Below national median
HAC Reduction
No Reduction
HAC Score: -0.2147

Complications & Deaths

30-day mortality rates, patient safety indicators, and complication rates. "Better" means statistically significantly better than the national rate.

Measure Score vs. National Denominator
COMP_HIP_KNEE — Number of Cases Too Small —
Hybrid_HWM 4.20 No Different Than the National Rate 1,239
MORT_30_AMI 13.40 No Different Than the National Rate 73
MORT_30_CABG 2.60 No Different Than the National Rate 43
MORT_30_COPD 8.60 No Different Than the National Rate 38
MORT_30_HF 11.10 No Different Than the National Rate 145
MORT_30_PN 14.00 No Different Than the National Rate 146
MORT_30_STK 12.80 No Different Than the National Rate 147
PSI_03 0.93 No Different Than the National Rate 6,250
PSI_04 150.43 No Different Than the National Rate 136
PSI_06 0.15 No Different Than the National Rate 6,576
PSI_08 0.21 No Different Than the National Rate 6,682
PSI_09 1.78 No Different Than the National Rate 2,029
PSI_10 2.22 No Different Than the National Rate 678
PSI_11 6.56 No Different Than the National Rate 778
PSI_12 2.61 No Different Than the National Rate 2,071
PSI_13 5.58 No Different Than the National Rate 759
PSI_14 2.12 No Different Than the National Rate 509
PSI_15 0.75 No Different Than the National Rate 1,792
PSI_90 0.97 No Different Than the National Value —

Patient Experience (HCAHPS)

Hospital Consumer Assessment of Healthcare Providers and Systems — standardized patient survey measuring satisfaction with care.

Measure Score Star Rating
H_COMP_1_A_P: Nurses "always" communicated well 76% —
H_COMP_1_SN_P: Nurses "sometimes" or "never" communicated well 5% —
H_COMP_1_U_P: Nurses "usually" communicated well 19% —
H_COMP_1_LINEAR_SCORE: Nurse communication - linear mean score — —
H_COMP_1_STAR_RATING: Nurse communication - star rating — 3
H_NURSE_RESPECT_A_P: Nurses "always" treated them with courtesy and respect 83% —
H_NURSE_RESPECT_SN_P: Nurses "sometimes" or "never" treated them with courtesy and respect 3% —
H_NURSE_RESPECT_U_P: Nurses "usually" treated them with courtesy and respect 14% —
H_NURSE_LISTEN_A_P: Nurses "always" listened carefully 71% —
H_NURSE_LISTEN_SN_P: Nurses "sometimes" or "never" listened carefully 6% —
H_NURSE_LISTEN_U_P: Nurses "usually" listened carefully 23% —
H_NURSE_EXPLAIN_A_P: Nurses "always" explained things so they could understand 73% —
H_NURSE_EXPLAIN_SN_P: Nurses "sometimes" or "never" explained things so they could understand 5% —
H_NURSE_EXPLAIN_U_P: Nurses "usually" explained things so they could understand 22% —
H_COMP_2_A_P: Doctors "always" communicated well 78% —
H_COMP_2_SN_P: Doctors "sometimes" or "never" communicated well 5% —
H_COMP_2_U_P: Doctors "usually" communicated well 17% —
H_COMP_2_LINEAR_SCORE: Doctor communication - linear mean score — —
H_COMP_2_STAR_RATING: Doctor communication - star rating — 3
H_DOCTOR_RESPECT_A_P: Doctors "always" treated them with courtesy and respect 84% —
H_DOCTOR_RESPECT_SN_P: Doctors "sometimes" or "never" treated them with courtesy and respect 3% —
H_DOCTOR_RESPECT_U_P: Doctors "usually" treated them with courtesy and respect 13% —
H_DOCTOR_LISTEN_A_P: Doctors "always" listened carefully 77% —
H_DOCTOR_LISTEN_SN_P: Doctors "sometimes" or "never" listened carefully 6% —
H_DOCTOR_LISTEN_U_P: Doctors "usually" listened carefully 17% —
H_DOCTOR_EXPLAIN_A_P: Doctors "always" explained things so they could understand 72% —
H_DOCTOR_EXPLAIN_SN_P: Doctors "sometimes" or "never" explained things so they could understand 6% —
H_DOCTOR_EXPLAIN_U_P: Doctors "usually" explained things so they could understand 22% —
H_COMP_5_A_P: Staff "always" explained 59% —
H_COMP_5_SN_P: Staff "sometimes" or "never" explained 20% —
H_COMP_5_U_P: Staff "usually" explained 21% —
H_COMP_5_LINEAR_SCORE: Communication about medicines - linear mean score — —
H_COMP_5_STAR_RATING: Communication about medicines - star rating — 3
H_MED_FOR_A_P: Staff "always" explained new medications 71% —
H_MED_FOR_SN_P: Staff "sometimes" or "never" explained new medications 11% —
H_MED_FOR_U_P: Staff "usually" explained new medications 18% —
H_SIDE_EFFECTS_A_P: Staff "always" explained possible side effects 46% —
H_SIDE_EFFECTS_SN_P: Staff "sometimes" or "never" explained possible side effects 29% —
H_SIDE_EFFECTS_U_P: Staff "usually" explained possible side effects 25% —
H_COMP_6_N_P: No, staff "did not" give patients this information 15% —
H_COMP_6_Y_P: Yes, staff "did" give patients this information 85% —
H_COMP_6_LINEAR_SCORE: Discharge information - linear mean score — —
H_COMP_6_STAR_RATING: Discharge information - star rating — 3
H_DISCH_HELP_N_P: No, staff "did not" give patients information about help after discharge 15% —
H_DISCH_HELP_Y_P: Yes, staff "did" give patients information about help after discharge 85% —
H_SYMPTOMS_N_P: No, staff "did not" give patients information about possible symptoms 14% —
H_SYMPTOMS_Y_P: Yes, staff "did" give patients information about possible symptoms 86% —
H_CLEAN_HSP_A_P: Room was "always" clean 74% —
H_CLEAN_HSP_SN_P: Room was "sometimes" or "never" clean 7% —
H_CLEAN_HSP_U_P: Room was "usually" clean 19% —
H_CLEAN_LINEAR_SCORE: Cleanliness - linear mean score — —
H_CLEAN_STAR_RATING: Cleanliness - star rating — 4
H_QUIET_HSP_A_P: "Always" quiet at night 58% —
H_QUIET_HSP_SN_P: "Sometimes" or "never" quiet at night 10% —
H_QUIET_HSP_U_P: "Usually" quiet at night 32% —
H_QUIET_LINEAR_SCORE: Quietness - linear mean score — —
H_QUIET_STAR_RATING: Quietness - star rating — 3
H_HSP_RATING_0_6: Patients who gave a rating of "6" or lower (low) 7% —
H_HSP_RATING_7_8: Patients who gave a rating of "7" or "8" (medium) 18% —
H_HSP_RATING_9_10: Patients who gave a rating of "9" or "10" (high) 75% —
H_HSP_RATING_LINEAR_SCORE: Overall hospital rating - linear mean score — —
H_HSP_RATING_STAR_RATING: Overall hospital rating - star rating — 4
H_RECMND_DN: "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it) 5% —
H_RECMND_DY: "YES", patients would definitely recommend the hospital 74% —
H_RECMND_PY: "YES", patients would probably recommend the hospital 21% —
H_RECMND_LINEAR_SCORE: Recommend hospital - linear mean score — —
H_RECMND_STAR_RATING: Recommend hospital - star rating — 4
H_STAR_RATING: Summary star rating — 3

Healthcare Associated Infections

Standardized Infection Ratios (SIR). A SIR < 1.0 means fewer infections than predicted based on national baseline data.

Measure Score (SIR) vs. National
HAI_1_CILOWER 0.320 Better than the National Benchmark
HAI_1_CIUPPER 0.715 Better than the National Benchmark
HAI_1_DOPC 43683.000 Better than the National Benchmark
HAI_1_ELIGCASES 49.214 Better than the National Benchmark
HAI_1_NUMERATOR 24.000 Better than the National Benchmark
HAI_1_SIR 0.488 Better than the National Benchmark
HAI_2_CILOWER 0.199 Better than the National Benchmark
HAI_2_CIUPPER 0.535 Better than the National Benchmark
HAI_2_DOPC 26285.000 Better than the National Benchmark
HAI_2_ELIGCASES 47.554 Better than the National Benchmark
HAI_2_NUMERATOR 16.000 Better than the National Benchmark
HAI_2_SIR 0.336 Better than the National Benchmark
HAI_3_CILOWER 0.277 No Different than National Benchmark
HAI_3_CIUPPER 1.133 No Different than National Benchmark
HAI_3_DOPC 420.000 No Different than National Benchmark
HAI_3_ELIGCASES 13.410 No Different than National Benchmark
HAI_3_NUMERATOR 8.000 No Different than National Benchmark
HAI_3_SIR 0.597 No Different than National Benchmark
HAI_4_CILOWER N/A No Different than National Benchmark
HAI_4_CIUPPER 1.288 No Different than National Benchmark
HAI_4_DOPC 246.000 No Different than National Benchmark
HAI_4_ELIGCASES 2.326 No Different than National Benchmark
HAI_4_NUMERATOR 0.000 No Different than National Benchmark
HAI_4_SIR 0.000 No Different than National Benchmark
HAI_5_CILOWER 0.198 Better than the National Benchmark
HAI_5_CIUPPER 0.808 Better than the National Benchmark
HAI_5_DOPC 248693.000 Better than the National Benchmark
HAI_5_ELIGCASES 18.791 Better than the National Benchmark
HAI_5_NUMERATOR 8.000 Better than the National Benchmark
HAI_5_SIR 0.426 Better than the National Benchmark
HAI_6_CILOWER 0.287 Better than the National Benchmark
HAI_6_CIUPPER 0.464 Better than the National Benchmark
HAI_6_DOPC 216640.000 Better than the National Benchmark
HAI_6_ELIGCASES 182.106 Better than the National Benchmark
HAI_6_NUMERATOR 67.000 Better than the National Benchmark
HAI_6_SIR 0.368 Better than the National Benchmark

Timely & Effective Care

Process-of-care measures including ED wait times, treatment timeliness, and preventive care.

Measure Score Condition
EDV very high Emergency Department
GMCS — Electronic Clinical Quality Measure
GMCS_Malnutrition_Diagnosis_Documented — Electronic Clinical Quality Measure
GMCS_Malnutrition_Screening — Electronic Clinical Quality Measure
GMCS_Nutrition_Assessment — Electronic Clinical Quality Measure
GMCS_Nutritional_Care_Plan — Electronic Clinical Quality Measure
HH_HYPER — Electronic Clinical Quality Measure
HH_HYPO — Electronic Clinical Quality Measure
HH_ORAE — Electronic Clinical Quality Measure
IMM_3 99.0 Healthcare Personnel Vaccination
OP_18a 362.0 Emergency Department
OP_18b 353.0 Emergency Department
OP_18c 626.0 Emergency Department
OP_18d — Emergency Department
OP_22 2.0 Emergency Department
OP_23 — Emergency Department
OP_29 97.0 Colonoscopy care
OP_31 — Cataract surgery outcome
OP_40 — Electronic Clinical Quality Measure
SAFE_USE_OF_OPIOIDS 11.0 Electronic Clinical Quality Measure
SEP_1 81.0 Sepsis Care
SEP_SH_3HR 88.0 Sepsis Care
SEP_SH_6HR 93.0 Sepsis Care
SEV_SEP_3HR 89.0 Sepsis Care
SEV_SEP_6HR 93.0 Sepsis Care
STK_02 95.0 Electronic Clinical Quality Measure
STK_03 75.0 Electronic Clinical Quality Measure
STK_05 85.0 Electronic Clinical Quality Measure
VTE_1 — Electronic Clinical Quality Measure
VTE_2 — Electronic Clinical Quality Measure

Unplanned Hospital Visits

Readmission and ED return rates within 30 days of discharge.

Measure Score vs. National
EDAC_30_AMI -21.60 Fewer Days Than Average per 100 Discharges
EDAC_30_HF 10.80 Average Days per 100 Discharges
EDAC_30_PN 0.80 Average Days per 100 Discharges
Hybrid_HWR 15.10 No Different Than the National Rate
OP_32 13.20 No Different Than the National Rate
OP_35_ADM 10.80 No Different Than the National Rate
OP_35_ED 5.00 No Different Than the National Rate
OP_36 1.10 No Different than expected
READM_30_AMI 13.10 No Different Than the National Rate
READM_30_CABG 10.80 No Different Than the National Rate
READM_30_COPD 17.50 No Different Than the National Rate
READM_30_HF 20.30 No Different Than the National Rate
READM_30_HIP_KNEE — Number of Cases Too Small
READM_30_PN 15.50 No Different Than the National Rate

Medicare Spending Per Beneficiary

MSPB ratio: values > 1.0 mean this hospital's episode spending is higher than the national median hospital.

Value
1.03

Financial Health (Cost Report — FY 2023)

All Data

Every labeled metric surfaced for this hospital, with national medians and percentiles where a benchmark is available.

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Source Metric Value National Median Pctl. Raw key
Cost Report Cost-to-Charge Ratio 0.29 — metrics.cost_to_charge_ratio
Cost Report Current Ratio 2.49 — metrics.current_ratio
Cost Report Employees per Bed 10.08 — metrics.employees_per_bed
Cost Report fiscal_year 2,023 — fiscal_year
Cost Report Fund Balance ($) $2,726,444,199 — metrics.fund_balance
Cost Report Net Income ($) $373,058,295 — metrics.net_income
Cost Report Net Patient Revenue ($) $1,284,463,777 — metrics.net_patient_revenue
Cost Report Total Assets ($) $5,480,615,294 — metrics.total_assets
Cost Report Total Costs ($) $1,566,830,130 — metrics.total_costs
Cost Report Total Liabilities ($) $2,754,171,095 — metrics.total_liabilities
Cost Report Total Margin (%) 11.3% — metrics.total_margin
Cost Report Uncompensated Care (%) 23.3% — metrics.uncompensated_care_pct
General Information Address 4502 MEDICAL DR — Address
General Information City/Town SAN ANTONIO — City/Town
General Information Count of Facility MORT Measures 7 — Count of Facility MORT Measures
General Information Count of Facility Pt Exp Measures 8 — Count of Facility Pt Exp Measures
General Information Count of Facility READM Measures 10 — Count of Facility READM Measures
General Information Count of Facility Safety Measures 7 — Count of Facility Safety Measures
General Information Count of Facility TE Measures 10 — Count of Facility TE Measures
General Information Count of MORT Measures Better 0 — Count of MORT Measures Better
General Information Count of MORT Measures No Different 7 — Count of MORT Measures No Different
General Information Count of MORT Measures Worse 0 — Count of MORT Measures Worse
General Information Count of READM Measures Better 0 — Count of READM Measures Better
General Information Count of READM Measures No Different 10 — Count of READM Measures No Different
General Information Count of READM Measures Worse 0 — Count of READM Measures Worse
General Information Count of Safety Measures Better 4 — Count of Safety Measures Better
General Information Count of Safety Measures No Different 3 — Count of Safety Measures No Different
General Information Count of Safety Measures Worse 0 — Count of Safety Measures Worse
General Information County/Parish BEXAR — County/Parish
General Information Emergency Services Yes — Emergency Services
General Information Facility ID 450213 — Facility ID
General Information Facility Name UNIVERSITY HEALTH SYSTEM — Facility Name
General Information Hospital overall rating 3 — Hospital overall rating
General Information Hospital overall rating footnote — — Hospital overall rating footnote
General Information Hospital Ownership Government - Hospital District or Authority — Hospital Ownership
General Information Hospital Type Acute Care Hospitals — Hospital Type
General Information Meets criteria for birthing friendly designation Y — Meets criteria for birthing friendly designation
General Information MORT Group Footnote — — MORT Group Footnote
General Information MORT Group Measure Count 7 — MORT Group Measure Count
General Information Pt Exp Group Footnote — — Pt Exp Group Footnote
General Information Pt Exp Group Measure Count 8 — Pt Exp Group Measure Count
General Information READM Group Footnote — — READM Group Footnote
General Information READM Group Measure Count 11 — READM Group Measure Count
General Information Safety Group Footnote — — Safety Group Footnote
General Information Safety Group Measure Count 8 — Safety Group Measure Count
General Information State TX — State
General Information TE Group Footnote — — TE Group Footnote
General Information TE Group Measure Count 12 — TE Group Measure Count
General Information Telephone Number (210) 358-2637 — Telephone Number
General Information ZIP Code 78229 — ZIP Code
HAC Reduction Program fiscal_year 2,026 — fiscal_year
HAC Reduction Program measures — cauti — sir 0.39 — measures.cauti.sir
HAC Reduction Program measures — cdi — sir 0.37 — measures.cdi.sir
HAC Reduction Program measures — clabsi — sir 0.60 — measures.clabsi.sir
HAC Reduction Program measures — mrsa — sir 0.46 — measures.mrsa.sir
HAC Reduction Program measures — ssi — sir 0.71 — measures.ssi.sir
HAC Reduction Program payment_reduction No — payment_reduction
HAC Reduction Program total_hac_score -0.21 — total_hac_score
Medicare Spending per Beneficiary End Date 12/31/2024 — End Date
Medicare Spending per Beneficiary Measure ID MSPB-1 — Measure ID
Medicare Spending per Beneficiary Start Date 01/01/2024 — Start Date
Medicare Spending per Beneficiary Value 1.03 — Value
Readmissions (HRRP) Acute Myocardial Infarction (Heart Attack) — Excess readmission ratio 0.96 0.9995 p24 READM-30-AMI-HRRP.excess_readmission_ratio
Readmissions (HRRP) Acute Myocardial Infarction (Heart Attack) — Expected readmission rate 13.6% — READM-30-AMI-HRRP.expected_readmission_rate
Readmissions (HRRP) Acute Myocardial Infarction (Heart Attack) — Predicted readmission rate 13.1% — READM-30-AMI-HRRP.predicted_readmission_rate
Readmissions (HRRP) CABG Surgery — Excess readmission ratio 1.02 1.0000 p56 READM-30-CABG-HRRP.excess_readmission_ratio
Readmissions (HRRP) CABG Surgery — Expected readmission rate 10.8% — READM-30-CABG-HRRP.expected_readmission_rate
Readmissions (HRRP) CABG Surgery — Predicted readmission rate 10.9% — READM-30-CABG-HRRP.predicted_readmission_rate
Readmissions (HRRP) COPD — Excess readmission ratio 0.96 0.9969 p20 READM-30-COPD-HRRP.excess_readmission_ratio
Readmissions (HRRP) COPD — Expected readmission rate 15.5% — READM-30-COPD-HRRP.expected_readmission_rate
Readmissions (HRRP) COPD — Predicted readmission rate 14.9% — READM-30-COPD-HRRP.predicted_readmission_rate
Readmissions (HRRP) Heart Failure — Excess readmission ratio 1.03 0.9983 p72 READM-30-HF-HRRP.excess_readmission_ratio
Readmissions (HRRP) Heart Failure — Expected readmission rate 19.2% — READM-30-HF-HRRP.expected_readmission_rate
Readmissions (HRRP) Heart Failure — Number of discharges 164 — READM-30-HF-HRRP.num_discharges
Readmissions (HRRP) Heart Failure — Number of readmissions 35 — READM-30-HF-HRRP.num_readmissions
Readmissions (HRRP) Heart Failure — Predicted readmission rate 19.8% — READM-30-HF-HRRP.predicted_readmission_rate
Readmissions (HRRP) Pneumonia — Excess readmission ratio 0.99 0.9955 p43 READM-30-PN-HRRP.excess_readmission_ratio
Readmissions (HRRP) Pneumonia — Expected readmission rate 15.3% — READM-30-PN-HRRP.expected_readmission_rate
Readmissions (HRRP) Pneumonia — Number of discharges 152 — READM-30-PN-HRRP.num_discharges
Readmissions (HRRP) Pneumonia — Number of readmissions 22 — READM-30-PN-HRRP.num_readmissions
Readmissions (HRRP) Pneumonia — Predicted readmission rate 15.1% — READM-30-PN-HRRP.predicted_readmission_rate
Value-Based Purchasing Clinical Outcomes 6.00 5.00 p57 clinical_outcomes_score
Value-Based Purchasing Efficiency & Cost Reduction 2.50 2.50 p43 efficiency_score
Value-Based Purchasing Person & Community Engagement 7.00 8.75 p35 person_community_score
Value-Based Purchasing Safety 12.92 10.00 p68 safety_score
Value-Based Purchasing Total Performance Score 28.42 29.50 p46 total_performance_score
Methodology

Full methodology →