ANGEL MEDICAL CENTER PRESS CONFERENCE PACKET. Friday, April 28, :00am

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1 ANGEL MEDICAL CENTER PRESS CONFERENCE PACKET Friday, April 28, :00am

2 SPEAKERS Ronald A. Paulus, MD President and CEO, Mission Health Karen Gorby, RN, MSN, MBA, CENP, FACHE President and Chief Nursing Officer, Angel Medical Center Jill Hoggard Green, PhD, RN COO, Mission Health and President, Mission Hospital

3 OVERVIEW PRESS CONFERENCE PRESS RELEASES Angel Investment Press Release Angel Board Statement ABOUT ANGEL MEDICAL CENTER Angel Medical Center Overview Angel Medical Center Financial Overview New Angel Medical Facility Overview Mission Health Overview SUPPORTING PRESS RELEASES Top 15 Release Top 100 CAH Release Angel Acute Stroke Press Release

4 PRESS CONFERENCE MATERIALS

5 F O R I M M E D I A T E R E L E A S E Contact: Rowena Buffett Timms Mission Health (828) Mission Health and Angel Medical Center Announce Plans for Unprecedented Investment in Macon County Community Through New Healthcare Facility FRANKLIN, N.C. (April 28, 2017) Mission Health, a not-for-profit health system based in Asheville, North Carolina and Angel Medical Center (AMC), a not-for-profit Mission Health member hospital located in Franklin, North Carolina announced today their plan for a $43 million investment in a new, state-of-the-art replacement hospital for Macon County and surrounding community. Following the approval of the Angel Medical Center Board, on Thursday April 25, the Mission Health Board of Directors approved the planned $43 million investment to replace Angel Medical Center s current hospital. This extraordinary contribution to the health and well-being of our community is the single largest investment in the history of Macon County. The new, state-of-the-art AMC facility is a key part of Mission Health s Mission Future Ready initiative, an exceptional plan investing more than half a billion dollars region-wide to meet the future health needs of western North Carolina. To learn more about Mission Future Ready, please visit: This is an incredibly exciting time for Angel Medical Center and Macon County. There has never been more change than in today s healthcare environment from federal policy, to care delivery to technology and the ever growing demands on our facilities. It s our responsibility as Board leadership to be thoughtful, adapt to meet the needs of our valued communities and ensure sustainability for decades to come, said Angel Medical Center Board Chair Jane Kimsey. Our remarkable investment in this new facility supports our vision to deliver the highest quality services and an exceptional patient, family and team ember experience for the long term benefit of Macon County s patients and families. As the largest healthcare provider in the region, Mission Health is committed to investing in the health and wellbeing of our communities throughout our 18-county region. Our goal is to help each and every resident of western North Carolina Be Well, Get Well and Stay Well. Our unprecedented investment in Macon County s Angel Medical Center is just one example of our relentless commitment to delivering the best care in state-of-the-art facilities to serve the needs of our patients and families, said Mission Health President and CEO Ronald A. Paulus, MD during a press conference announcing the planned investment in Asheville Friday morning. Mission Health and AMC leadership underwent a comprehensive strategic master facility planning consultation for evaluation and assessment of Angel Medical Center where it was determined that construction of a new facility designed to meet the needs of the community for decades to come, rather than renovation of the current, outdated structure was clearly in the best interest of the community. -CONTINUTED-

6 Both Boards decisions were based on the outcomes of this facility assessment as well as a 10-year review of the community, based on demographics and the long-term healthcare needs of the population. AMC and Mission Health will share more information about the new facility and incorporate community feedback in the months to come. ABOUT ANGEL MEDICAL CENTER # # # Angel Medical Center, a member of Mission Health, is a full-service, not-for-profit community hospital serving Macon and the surrounding counties. Located in Franklin, N.C., Angel Medical Center is a Top 100 Critical Access Hospital offering inpatient services that include a women s and children s health unit, an intensive care unit, and a medical and surgical unit. Outpatient services include a wound clinic, chemotherapy services, a full laboratory, digital mammography, CT, MRI, nuclear medicine, rehab therapy, as well as surgical and endoscopy services. The hospital also operates My Care Now and CarePartners Home Health & Hospice. For more information, please visit angelmed.org. ABOUT MISSION HEALTH Mission Health, based in Asheville, North Carolina, is the state s sixth-largest health system. For the fifth time in the past six years, Mission Health has been named one of the nation s Top 15 Health Systems by Truven Health Analytics, an IBM Company and part of IBM Watson Health in We are the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, post- acute care provider CarePartners, long-term acute care provider Asheville Specialty Hospital, and the region s only dedicated Level II trauma center. With approximately 12,000 team members and 2,000 volunteers, Mission Health is dedicated to improving the health and wellness of the people of western North Carolina. For more information, please visit mission-health.org

7 F O R I M M E D I A T E R E L E A S E Contact: Rowena Buffett Timms Mission Health (828) Please attribute statement to: Jane Kimsey, Chair, and the Angel Medical Center Board Members FRANKLIN, NC (April 28, 2017) Angel Medical Center s Board of Directors issued the following statement today: On behalf of the Angel Medical Center (AMC) Board of Directors, we would like to share with the community that our Board s support for management s recommendation to modify women s services at AMC was a very difficult one that was painstakingly considered. None of us wanted to lose labor and delivery services in Franklin. Unfortunately, we need to find ways to make Angel Medical Center break even financially over the long run or it is possible we would not have any hospital in our community. Angel Medical Center will continue to offer women s and children s services including pre-natal visits and all follow-up appointments after delivery. Our goal is to continue to have OB-GYN doctors in Franklin for those services as well as all women s needs outside of delivery. Pediatric services will also remain. In addition, we are collaborating with other providers including DLP Harris, MAHEC and Mission Hospital to ensure that Macon County has the coverage and highest quality care for expectant mothers. We recognize that the recommendation came as a shock to the community and we wish there was an easier way. Unfortunately, the overall services required to offer labor and delivery at AMC lose well over $1 million every year, which the hospital cannot absorb. Our population in Macon County is generally older, lower income, and more likely to either have no insurance or use Medicare or Medicaid. In fact, 77% of AMC patients have Medicare, Medicaid or no insurance at all. In addition, a significant number of children in Macon County are born at either Mission Hospital or DLP Harris. State and Federal legislators continue to cut funding to Medicare and Medicaid, meaning the hospital receives less and less money for all of the services that we provide. The losses only continue to grow with no way to reverse the trend no matter how much we improve. The decision to discontinue labor and delivery services was very difficult, but we are extremely pleased and excited by the commitment from Mission Health to fund a $43 million replacement hospital in Franklin. Mission Health is very committed to Macon County as evidenced by previous investments in the Cancer Center, additional ambulance coverage and enhancements to our current campus all totaling more than $13 million to date. Mission Health is making sure that we have a state of the art facility 1

8 providing the services that Angel currently offers outside of labor and delivery. As we start that process, we are excited that the community will be involved in the design of the new facility. In closing, the Board of Directors would like to express our gratitude to Mission Health for their support and leadership, and most importantly as we look to the future for healthcare in Macon County, for their unparalleled investment, not just in Franklin but across WNC. ABOUT ANGEL MEDICAL CENTER ### Angel Medical Center, a member of Mission Health, is a full-service, not-for-profit community hospital serving Macon and the surrounding counties. Located in Franklin, N.C., Angel Medical Center is a Top 100 Critical Access Hospital offering inpatient services that include a women s and children s health unit, an intensive care unit, and a medical and surgical unit. Outpatient services include a wound clinic, chemotherapy services, a full laboratory, digital mammography, CT, MRI, nuclear medicine, rehab therapy, as well as surgical and endoscopy services. The hospital also operates the Angel Urgent Care Center and Angel Home Health & Hospice. For more information, please visit angelmed.org. ABOUT MISSION HEALTH Mission Health, based in Asheville, North Carolina, is the state s sixth-largest health system and was recognized as one of the nation s Top 15 Health Systems from by Truven Health Analytics, formerly Thomson Reuters, becoming the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, postacute care provider CarePartners, long-term acute care provider Asheville Specialty Hospital, and the region s only dedicated Level II trauma center. With approximately 12,000 team members and 2,000 volunteers, Mission Health is dedicated to improving the health and wellness of the people of western North Carolina. For more information, please visit mission-health.org

9 ABOUT ANGEL MEDICAL CENTER

10 Angel Medical Center Overview Located in Franklin, NC $73.3 million in annual economic impact $7.2 million in financial assistance $7.9 million in community benefits 25 beds 46,000+ outpatient visits per year 18,600+ emergency department visits per year 358 employees Facts About the Hospital Full-service, not-for-profit critical access hospital that serves the residents of Macon County and surrounding communities The third largest employer in Macon County and the second largest employer in Franklin A Critical Access Hospital (CAH), which is certified under a set of Medicare Conditions of Participation (CoP), which are structured differently than the traditional acute care hospital Requirements for CAH certification include: Having no more than 25 inpatient beds Maintaining an annual average length of stay of no more than 96 hours for acute inpatient care Offering 24/7 emergency care Being located in a rural area that is at least 35 miles away from any other hospital or CAH) History Angel Medical Center can be traced back to 1923 when Dr. Furman Angel returned home to set up a clinic in the old Cunningham Building in historic downtown Franklin. Significant Awards Acute Stroke Ready Certified by the Joint Commission Top 100 Critical Access Hospital for two years in a row Charity Care and Community Benefit Costs Mission Health Mission Health provided community benefit services of $148m in FY14, $151m in FY15, and $184m in FY16. Of this, charity care comprised $40m in FY14, $28m in FY15, and $30m in FY16. Angel Medical Center Angel Medical Center provided community benefit services of $2.9m in FY14, $0m in FY15, and $3.4m in FY16. Of this, charity care comprised $2.9m in FY14, $2.1m in FY15, and $2.1m in FY16.

11 Angel Medical Center Planning Process Overview SMFP Objective Systematically review facility needs across Mission to ensure capital investments align with the organization s strategic direction and the transformation of healthcare delivery. SMFP Schedule YEAR ONE YEAR TWO YEAR THREE YEAR FOUR YEAR FIVE (FY 2017): TRH and Angel Medical Center (AMC) Mission Hospital and Central (Buncombe, Henderson, and Haywood) Highlands- Cashiers Hospital (HCH) and Jackson County CarePartners Blue Ridge Regional Hospital and McDowell Hospital Committee Structure Executive Steering Committee Site Presidents, President of Regional Member Hospitals, Strategy, Quality, CFO, COO Role: Approve and recommend the preferred plan to the board Meetings: Three times during the process at the midpoint, recommendation, and end to review preferred and final option AMC Site Leadership Team President, Executive Team, Board, Additional Physician Leaders TRH Site Leadership Team President, Executive Team, Board, Additional Physician Leaders Role: Develop the preferred plan; report out to the board, as needed Meetings: Four times during the process at each site; meetings included core team members SMFP Core Team System Functional Leads, Site Designees Role: Support the process, vet materials, ensure consistency, and update the Mission Executive Team on progress Meetings: Biweekly conference call and site leadership team meetings Building Plan Overview 1st Floor 2nd Floor Approximately 115,000 to 125,000 SF Total BGSF Source: Ewing Cole analysis

12 Mission Health About Mission Health Mission Health, based in Asheville, North Carolina, is the state s sixth-largest health system. For the fifth time in the past six years, Mission Health has been named one of the nation s Top 15 Health Systems by Truven Health Analytics in Mission Health is the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, post-acute care provider CarePartners, long-term acute care provider Asheville Specialty Hospital, and the region s only dedicated Level II trauma center. Mission Health is in the midst of a robust plan to meet the future health needs of western North Carolina as part of its Mission Future Ready initiative. Collectively, Mission Health is investing nearly half a billion dollars region-wide by far the largest investment ever made in the history of the region, a marker of the caring and confidence of Mission Health s community Board to help everyone in our region Be Well, Get Well and Stay Well. Overview Only non-profit, locally owned, locally governed health system in western North Carolina. Licensed for 1,059 beds Annual economic impact of more than $1 billion State s largest employer west of Charlotte with 10,700 employees Investments in Our Region Blue Ridge Regional Hospital Building...$7.5 million Highlands-Cashiers Hospital ER Expansion...$6.7 million McDowell Hospital Replacement Project...$45 million Transylvania Regional Hospital ED Expansion...$7.8 million Information Technology... $7 million Community Benefit Grants at Work...$1.1 million Working Together to Achieve Better Health Estimated Costs of Treating Charity Care Patients...$29.5 million Unreimbursed Medical Education and Research Costs...$4.9 million Other Direct Community Benefit Costs...$74 million Estimated Unreimbursed Costs of Treating Medicare patients... $64 million Estimated Unreimbursed Costs of Treating Medicaid patients...$10.8 million Total Community Benefit Costs and Unreimbursed Costs of Government Healthcare Programs...$183 million Mission Health Member Hospitals Mission Hospital Angel Medical Center Blue Ridge Regional Hospital McDowell Hospital Transylvania Regional Hospital Highlands-Cashiers Hospital CarePartners

13 PRESS RELEASES

14 F O R I M M E D I A T E R E L E A S E Contact: Rowena Buffett Timms Mission Health (828) Mission Health Named a Top 15 Health System in the Nation by Truven Health Analytics ASHEVILLE, NC (April 22, 2017) For a remarkable fifth time in the past six years, Mission Health has been named once again one of the nation s Top 15 Health Systems by Truven Health Analytics, an IBM Company and part of IBM Watson Health. The Truven Health study identifies the nation s 15 best health systems based upon objective care quality standards and is the only study that aggregates both individual hospital and health system-level performance to allow health system leaders and consumers to identify and compare true leaders in clinical quality and efficiency. Receiving this recognition for an unprecedented fifth time in six years recognizes our unwavering commitment to exceptional care, clinical excellence and evidence-based, standardized care and, most importantly, our dedication to the community we are so privileged to serve, said Ronald A. Paulus, President and CEO of Mission Health. Our physicians, nurses and other team members are simply extraordinary. Each strives to exceed our patients expectations and to improve every aspect of the care we provide to the people across western North Carolina. Our relentless focus on quality, safety and compassion has resulted in outstanding care for our patients and the ongoing pursuit of our BIG(GER) Aim: to get each person to their desired outcomes, first without harm, also without waste and always with an exceptional experience for each person, family and team member. The winning health systems were announced in the April 22 edition of Modern Healthcare magazine. Mortality rates at the top-performing systems were 13.4% lower than their peers and complication rates were 8.5% lower. The average length of stay was 10.2% shorter and wait times in the emergency department were 17.5% shorter compared with the benchmark. Mission Health has consistently outperformed other local, regional and national providers by saving more lives and causing fewer complications, following industry-recommended standards of care more closely, making fewer patient safety errors and scoring better on overall patient satisfaction. The Truven Health analysis is an objective, quantitative IBM Watson study that identifies 15 health systems with the highest achievement on clinical performance, efficiency and patient satisfaction based on Truven s 100 Top Hospitals National Balanced Scorecard methodologies. For the 2017 rankings, Mission Health was part of 337 health systems in the study almost every U.S. system with two or more acute-care member hospitals, including critical access hospitals. Truven s researchers analyze 1

15 public information, including Medicare cost reports, Medicare Provider Analysis and Review (MedPAR) data, and core measures and patient satisfaction data from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website. Previously, Mission Health has received this esteemed recognition for the four consecutive year period of 2012, 2013, 2014, and No other health system in America has achieved this recognition in four consecutive years. ABOUT MISSION HEALTH ### Mission Health, based in Asheville, North Carolina, is the state s sixth-largest health system and was recognized as one of the nation s Top 15 Health Systems for five years by Truven Health Analytics, becoming the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, post-acute care provider CarePartners, longterm acute care provider Asheville Specialty Hospital, and the region s only dedicated Level II trauma center. With approximately 12,000 team members and 2,000 volunteers, Mission Health is dedicated to improving the health and wellness of the people of western North Carolina. For more information, please visit mission-health.org ABOUT TRUVEN HEALTH ANALYTICS Truven Health Analytics is dedicated to delivering the answers their clients need to improve healthcare quality and reduce costs. They are a healthcare analytics company with unmatched data assets and advanced analytic expertise that have served the global healthcare industry for more than 30 years. These strengths combine with their unique perspective from across the entire healthcare industry to give hospitals, clinicians, employers, health plans, government agencies, life sciences researchers and policymakers the confidence they need to make the right decisions, right now, every time. With their healthcare-specific expertise and tools for managing complex and disparate data, Truven Health Analytics understands how to implement and integrate tailored analytics that drive improvement. Truven Health has its principal offices in Ann Arbor, Mich.; Chicago; and Denver. For more information, please visit truvenhealth.com.

16 F O R I M M E D I A T E R E L E A S E Contact: Rowena Buffett Timms Mission Health (828) Mission Health s Angel Medical Center and Transylvania Regional Hospital Named 2017 Top 100 Critical Access Hospitals ASHEVILLE, NC (February 10, 2017) Two Mission Health member hospitals recently earned coveted places on 2017 s Top 100 Critical Access Hospital list, which is created annually by the National Rural Health Association s Rural Health Policy Institute, ivantage Health Analytics, and the Chartis Center for Rural Health. Franklin s Angel Medical Center and Transylvania Regional Hospital, located in Brevard, were recognized, and are the only North Carolina honorees. The list was published by Becker s Hospital Review, a top hospital and health system industry news and analysis publication. Critical Access Hospitals are rural community hospitals with twenty-five or fewer beds that serve as vital safety net institutions, crucial to preserving the health of rural communities. Those communities are often populated by older, sicker, and more complex populations, as is the case with the communities that Angel Medical Center and Transylvania Regional Hospital serve. The Top 100 Critical Access Hospitals list is informed by comprehensive research performed by The Chartis Group, a national advisory services firm that works to improve healthcare delivery by providing a host of consulting services to the country s most prominent healthcare providers. The firm conducted the 2017 Rural Relevance Study: Vulnerability to Value, a detailed and objective examination of the special challenges that currently face rural healthcare providers, which was the primary source used to assess and select awardees. Over 2,000 hospitals were included in the analysis, with only 100 selected for the entire United States. We are proud to see the work of our amazing caregivers recognized, said Kathleen Culhane Guyette, MSN, RN, NEA-BC, Senior Vice President of Patient Care Services and President of Regional Member Hospitals, and see this acknowledgement as an affirmation of the compassion and excellence that we provide our community members, who inspire us to keep striving to provide the most advanced regional care. The Vulnerability to Value study examined Critical Access Hospital performance to determine which institutions excelled as care providers in The Chartis Group considered a diverse range of factors, including each hospital s ability to successfully manage risk and operate at a lower cost than their peers, proficiency in providing superior care, history of earning increased patient satisfaction, and reputation for enjoying consistently positive patient outcomes. Both Angel Medical Center and Transylvania Regional Hospital struck a balance between these often competing factors. Ronald A. Paulus, MD, President and CEO of Mission Health, expressed pride in the caregivers and leaders of Angel Medical Center and Transylvania Regional Hospital. This ranking is given to hospitals that earn

17 high marks in clinical excellence, consistent fiscal competence, and maintaining agility within a constantly and rapidly shifting healthcare landscape. These achievements echo Mission Health s BIG(GER) AIM: to get every person to their desired outcome, first without harm, also without waste and always with an exceptional experience for each person, family and team member, he said. ABOUT MISSION HEALTH ### Mission Health, based in Asheville, North Carolina, is the state s sixth-largest health system and was recognized as one of the nation s Top 15 Health Systems from by Truven Health Analytics, formerly Thomson Reuters, becoming the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, post- acute care provider CarePartners, long-term acute care provider Asheville Specialty Hospital, and the region s only dedicated Level II trauma center. With approximately 12,000 team members and 2,000 volunteers, Mission Health is dedicated to improving the health and wellness of the people of western North Carolina. For more information, please visit mission-health.org

18 Contact: Rowena Buffett TImms Mission Health (828) Angel Medical Center named acute stroke ready hospital FRANKLIN, N.C. (Aug. 9, 2016) Immediately performing life-saving care at any time of the day for people suffering from stroke is among the abilities that earned Angel Medical Center a national certification. The medical center garnered the Advanced Disease-Specific Care Certification for Acute Stroke Ready Hospital from the Joint Commission and the American Heart Association/American Stroke Association. The certification recognizes hospitals equipped to treat stroke patients with timely, evidence-based care prior to transferring them to a primary or comprehensive stroke center. Angel Medical Center underwent a rigorous onsite review to assess its compliance with the Joint Commission s Advanced Disease-Specific Care certification requirements, including: A dedicated stroke-focused program Staffing by qualified medical professionals trained in stroke care Collaboration with local emergency management agencies 24/7 ability to perform rapid diagnostic and laboratory testing Ability to administer intravenous clot-busting medications to eligible patients Availability of telemedicine technology Identifying and treating stroke quickly saves lives and improves recovery, said Karen Gorby, President and Chief Nursing Officer of Angel Medical Center. This certification is part of our goal of providing exceptional, and high quality, care to our patients close to home. The stroke program is among the broad range of services offered at Angel Medical Center, including women s and children s health, intensive care, and a medical and surgical unit. Outpatient services include a wound clinic, chemotherapy services, a full laboratory, digital mammography, CT, MRI, nuclear medicine, rehab therapy, as well as surgical and endoscopy services. The Acute Stroke Ready Hospital Certification was established in It is awarded for a two-year period to Joint Commission-accredited hospitals and critical access hospitals. Stroke is the number five cause of death and a leading cause of adult disability in the United States, according to the American Heart Association/American Stroke Association. On average, someone suffers a stroke every 40 seconds, someone dies of a stroke every four minutes and 795,000 people suffer a new or recurrent stroke each year.

19 Kathy Guyette, Mission Health Senior Vice President of Patient Care and Regional Member Hospitals, said the certification shows the commitment Angel Medical Center has to offering the best service to the community. Quickly and safely treating stroke is critical to patients in Macon County and across Western North Carolina, she said. This Joint Commission certification fits with Mission Health s BIG(GER) Aim: to get every person to their desired outcome, first without harm, also without waste and always with an exceptional experience for every person, family and team member. About Angel Medical Center Angel Medical Center, a member of Mission Health, is a full-service, not-for-profit community hospital serving Macon and the surrounding counties. Located in Franklin, N.C., Angel Medical Center is a Top 100 Critical Access Hospital offering inpatient services that include a women s and children s health unit, an intensive care unit, and a medical and surgical unit. Outpatient services include a wound clinic, chemotherapy services, a full laboratory, digital mammography, CT, MRI, nuclear medicine, rehab therapy, as well as surgical and endoscopy services. The hospital also operates the Angel Urgent Care Center and Angel Home Health & Hospice. For more information, please visit angelmed.org. About Mission Health Mission Health, based in Asheville, North Carolina, is the state s sixth-largest health system and was recognized as one of the nation s Top 15 Health Systems from by Truven Health Analytics, formerly Thomson Reuters, becoming the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, postacute care provider CarePartners, long-term acute care provider Asheville Specialty Hospital, and the region s only dedicated Level II trauma center. With approximately 10,700 employees and 2,000 volunteers, Mission Health is dedicated to improving the health and wellness of the people of western North Carolina. For more information, please visit mission-health.org About the Joint Commission Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies nearly 21,000 health care organizations and programs in the United States. About the American Heart Association/American Stroke Association The American Heart Association and the American Stroke Association are devoted to saving people from heart disease and stroke. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The American Heart Association is the nation s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. ###

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