Finance Board and Full Board of Directors Meetings Thursday, September 28, :00 p.m.

Transcription

1 Finance Board and Full Board of Directors Meetings Thursday, September 28, :00 p.m. Lee Memorial Health System Board of Directors

2 BOARD OF DIRECTORS OFFICE FAX: DOCTORS WAY #190 FT MYERS, FLORIDA CAPE CORAL HOSPITAL GULF COAST MEDICAL CENTER HEALTHPARK MEDICAL CENTER LEE MEMORIAL HOSPITAL GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA THE REHABILITATION HOSPITAL LEE PHYSICIAN GROUP LEE CONVENIENT CARE BOARD OF DIRECTORS DISTRICT ONE Stephen R. Brown, M.D. Therese Everly, BS, RRT DISTRICT TWO Donna Clarke Nancy M. McGovern, RN, MSM DISTRICT THREE Sanford N. Cohen, M.D. David Collins DISTRICT FOUR Diane Champion Chris Hansen DISTRICT FIVE Jessica Carter Peer Stephanie Meyer, BSN, RN AGENDA FINANCE AND FULL BOARD OF DIRECTORS MEETINGS September 28, 2017 at 1:00 p.m. Gulf Coast Medical Center Boardroom (Medical Office Building) Doctors Way, Ft. Myers, FL CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) The Board of Lee Memorial Health System, doing business as Lee Health, Gulf Coast Medical Center & Lee Memorial Hospital/HealthPark Medical Center and the Board of Directors of its subsidiary corporations, including but not limited to Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc. 2. INVOCATION & PLEDGE OF ALLEGIANCE (Chaplain Susan Crowley, MA, BCC) 3. PUBLIC INPUT Agenda Items: Any Public Input is limited to three minutes and a Request to Address the Board of Directors card must be completed and submitted to the Board Staff prior to meeting. Individuals wishing to address the Board on a Non Agenda item must notify the Board Staff of the subject matter at least three (3) days prior to the meeting. 4. PRESIDENT S REPORT (Larry Antonucci, MD, MBA, President & CEO) 1. Hurricane Irma Update (Lisa Sgarlata, Chief Patient Care & Nursing Officer) (Connie Bowles, Coordinator Emergency MGMT/Disaster Preparedness) 5. DYAD DEFINITION & FUNCTION (Scott Nygaard, Chief Medical & Clinical Integration Officer) 6. EMPLOYEE ENGAGEMENT RESULTS (Kristy Rigot, System Director, Recruitment & Employee Relations) 7. LEGISLATIVE PRIORITIES (Approve) (Michael Nachef, Director, Government Relations) FINANCE PORTION - David Collins, Finance Liaison 8. CONSENT AGENDA (Approve) 1. Financial and Statistical Reports ending July 31, FY2018 BUDGET (Approve) (Ben Spence, Chief Financial & Business Services Officer) 1. FY2018 Operating Budget 2. FY2018 Capital Budget 3. FY2018 Room Rates 10. FINANCIAL AND STATISTICAL REPORTS OF AUGUST 31, 2017 (Ben Spence, Chief Financial & Business Services Officer) (Accept) LEE HEALTH BUSINESS Sanford Cohen, M.D., BOARD CHAIRMAN 11. FULL BOARD MEETING MINUTES OF 8/24/17 (Approve) Lee Memorial Health System Board of Directors

3 AGENDA (Page 2 of 2) FINANCE AND FULL BOARD OF DIRECTORS MEETINGS September 28, 2017 at 1:00 p.m. BOARD OF DIRECTORS OFFICE FAX: DOCTORS WAY #190 FT MYERS, FLORIDA CAPE CORAL HOSPITAL GULF COAST MEDICAL CENTER HEALTHPARK MEDICAL CENTER LEE MEMORIAL HOSPITAL GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA THE REHABILITATION HOSPITAL LEE PHYSICIAN GROUP LEE CONVENIENT CARE Gulf Coast Medical Center Boardroom (Medical Office Building) Doctors Way, Ft. Myers, FL MEDICAL STAFF RECOMMENDATIONS (Approve) 1. Lee Memorial Hospital 2. Cape Coral Hospital 3. Gulf Coast Medical Center 4. HealthPark Medical Center 5. Golisano Children s Hospital of SWFL 13. OLD BUSINESS 14. NEW BUSINESS 15. BOARD MEETING CRITIQUE 16. BOARD OF DIRECTORS REPORTS 17. Date of the next Meeting: October 12, 2017 at 1:00 p.m. Planning Board and Full Board of Directors Gulf Coast Medical Center Boardroom Doctors Way, Ft. Myers, FL BOARD OF DIRECTORS DISTRICT ONE Stephen R. Brown, M.D. Therese Everly, BS, RRT 18. ADJOURN (Sanford Cohen, M.D., Board Chairman) DISTRICT TWO Donna Clarke Nancy M. McGovern, RN, MSM DISTRICT THREE Sanford N. Cohen, M.D. David Collins DISTRICT FOUR Diane Champion Chris Hansen DISTRICT FIVE Jessica Carter Peer Stephanie Meyer, BSN, RN Lee Memorial Health System Board of Directors

4 BOARD OF DIRECTORS Invocation & Pledge of Allegiance Lee Memorial Health System Board of Directors

5 BOARD OF DIRECTORS PUBLIC INPUT AGENDA ITEMS: Any public input pertaining to items on the Agenda is limited to three minutes and a Request to Address the Board of Directors card must be completed and submitted to the Board Staff prior to meeting. Refer to Board Policy: 10:15G: Public Addressing the Board Non-Agenda Item: Individuals wishing to address the Board on an item NOT on the Agenda, the Board office must be notified of subject matter at least three (3) days prior to the meeting to allow staff time to prepare and to insure the matter is within the jurisdiction of the Board. Lee Memorial Health System Board of Directors

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7 BOARD OF DIRECTORS PRESIDENT S REPORT Larry Antonucci, MD, MBA, President & CEO 1. Hurricane Irma Update (Lisa Sgarlata, Chief Patient Care & Nursing Officer) (Connie Bowles, Coordinator Emergency MGMT/Disaster Preparedness) Lee Memorial Health System Board of Directors

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38 Lee Health Board of Directors Meeting September 28, 2017 President s Report Hurricane Irma Report o o Stories Family Member Note Hurricane Prep & Timeliness Hurricane Aftermath Lisa Sgarlata Incident Commander o o Staffing Explanation Employee Assistance Connie Bowles o o Emergency Preparedness Overview Hospital Incident Command System Miscellaneous o o o o FHA Board Appointment New LeeSar CEO LIP Funding Update Graham Cassidy Bill Update

39 BOARD OF DIRECTORS DYAD- DEFINITION & FUNCTION (Scott Nygaard, Chief Medical & Clinical Integration Officer)

40 DYAD LEADERSHIP MODEL WHAT, WHY AND HOW Presented by: Scott Nygaard, M.D., Chief Medical & Clinical Integration Officer September 28, 2017

41 DYADS WHAT ARE THEY? Dyad pronounced (di ad) Something that consists of two elements. A dyad model in healthcare allows administration and physicians to be equally represented in decision making and is an effort to eliminate the we/they thinking that permeates healthcare Closely partnered in a joint and shared decision making process with shared performance targets e.g. SHARED VISION (M. Keenan 2012) Have each others back

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43 PRINCIPLES: HOW DO THEY WORK? All actions/decisions are to be made with the full input of each partner in advance Mutual trust and respect for each other, appreciate views and diversity better decisions made together Takes time to mature the relationship work marriage Flexibility and adaptability between the parties mutual compromise play to each others strengths

44 THE EVIDENCE WHY? Best performing hospitals have physician leaders involved in the management of the hospital Quality scores 25% higher in physician led hospitals (Goodall 2011) McKinsey report (2009) hospitals with greater number of engaged physician leaders scored higher in overall management (e.g. HAC, readmission rates, patient experience). Also published by Press Ganey in 2017 Reduction in sepsis and ED response times (Studer 2012)

45 RESEARCH INDICATES THE FOLLOWING The measurable outcomes in safety and quality of care influence patients perceptions of their care experience. Patient experience of care and the safety and quality of care are associated with the engagement level of the workforce Both workforce engagement and patient experience of care influence organizations financial performance EXCELLENCE ACROSS THESE DOMAINS REQUIRES ALIGNED AND ACCOUNTABLE LEADERSHIP THAT CLEARLY COMMUNICATES GOALS FOR PERFORMANCE, CONTINUALLY MEASURES AND MONIOTRS PERFORMANCE AND DRIVES THE IMPROVEMENTS SHARED VISION

46 POTENTIAL FOR VALUE CREATION Understanding that our calling stated in our mission TO BE A TRUSTED PARTNER, EMPOWERING HEALTHIER LIVES THROUGH CARE AND COMPASSION To achieve this we must pursue EXCELLENCE Organizations with top quartile performance on safety and quality measures have higher patient experience scores as well a strong statistical link exists between operational excellence and service excellence. (Source Press Ganey 2017 Strategic Insights)

47 CULTURE KEY TO PERFORMANCE Not the soft stuff, but the hard thing to build, takes time part of the transformation The underlying values, beliefs and principles that serve as a foundation for an organization s management system as well as the practices and behaviors that both exemplify and reinforce those basic principles Organizations that put the patient and family first and nurture highperformance in a supportive culture defined by the following elements (Meaningful Work, Engaged Employees, Strong Leadership and Accountability) are best positioned to achieve success in today s CONSUMER DRIVEN marketplace.

48 DYADS MAKE A DIFFERENCE Key to competitive success Research has repeatedly demonstrated that a focus on the elements of Safety, Quality, Experience of Care and Caregiver Engagement contributes to Patient Centeredness. Cross domain analysis shows these elements are highly interrelated to each other and with financial outcomes and best performing and sustainable organizations achieve optimal excellence in all areas

49 SUMMARY OF BENEFITS Improves the engagement of physicians Drive clinical and organizational excellence Reduce siloes by formulating a shared vision Improve communication and consistency of message Increases transparency Improves accountability for performance and outcomes

50 ACMO & VP PATIENT CARE SERVICES DYAD Golisano Children s Hospital of Southwest Florida: Alex Daneshmand, DO, ACMO and Susan Ryckman, RN, VP Patient Care Services HealthPark Medical Center: Eric O. Appelgren, MD, ACMO and Cindy Brown, RN, VP Patient Care Services Cape Coral Hospital: Harry Alberti, MD, ACMO and VPPCS Wendy Piascik, RN, VP Patient Care Services Gulf Coast Medical Center: Jonathan A. Velez, MD, ACMO and VPPCS Holly Muller, RN, VP Patient Care Services Lee Memorial Hospital: Scott A. Wolf, DO, ACMO and VPPCS Jennifer Higgins, RN, VP Patient Care Services

51 BOARD OF DIRECTORS EMPLOYEE ENGAGEMENT RESULTS (Kristy Rigot, System Director, Recruitment & Employee Relations)

52 2017 Employee Engagement Survey Results September 28, 2017 Lee Memorial Health System Board of Directors Meeting # Rev. 10/16

53 Agenda Approach to Annual Survey System Wide Results Results Roll-out & Action Planning Process Recognition & Celebrations 1

54 Approach to Annual Survey An engaged workforce helps assure Patients get safe care and have a positive patient-customer experience Financial viability All employees have an opportunity to participate in annual Employee Engagement Survey. This feedback is extremely helpful to making Lee Health an Exceptional Healthcare Employer and winner of prestigious awards such as Employer of Choice and Forbes Best Large Employers. In addition, this type of data helps Lee Health prioritize its Caring People strategic goals as well as ensure that employees are given the tools and support by their supervisors necessary to do their best work. Our motto for our survey is You Talk, We Listen, Things Change. 2

55 System Wide Results Overall response rate= 81.2%; 10,748 employees responded Lee Health grand mean = Lee Health percentile rank = 98% Employee Engagement Index = Positive increases in scores for 19 out of 31 questions You Talk, We Listen, Things Change! 3

56 100 Lee Health Grand Mean Grand Mean

57 100 Lee Health Work Environment Index

58 100 Lee Health Job Role Index

59 100 Lee Health Leader Index

60 100 Lee Health Trifecta Index - Items I would recommend Lee Memorial Health System to friends as a good place to work. I see my job in a positive light and encourage others to consider it as a career. Overall, I am satisfied with my job.

61 Lee Health Employee Engagement Index - Items Aggregate score I feel comfortable discussing issues or problems with leaders in my department. I have input in making decisions that affect my job. Work processes are designed in a way that allows me to do my work effectively.

62 98% Percentile Rank Based on Overall Grand Mean Raw Score 10

63 Overall, Lee Health has created an extraordinary culture, now measuring in the 98 th percentile. This result is extremely difficult to achieve. Finding another organization this size that has created a culture this healthy would not be easy. The dominant contributing factor in creating a culture this healthy at Lee Health is exceptional leadership and management. This is also the primary driver of employee engagement, patient satisfaction and loyalty. At this high level, as I have cautioned in recent years, the tendency would be to grow complacent. That has not happened at Lee Health, another indication of their leadership effectiveness. Lee Health has increased strategic focus on leadership effectiveness for high degree of difficulty functions known as H3 * departments. These departments have High spans of responsibility (people), High revenue responsibility (financial results) and High patient responsibility (quality and safety). They represent a smaller number of the total departments in the health system, but contribute a significant amount of the total revenue, and are some of the most important departments to improve the overall patient experience for Lee Health. In healthcare, creating and sustaining a culture this healthy is extremely difficult. Results like what we are seeing at Lee Health makes other goals easier to attain because the workforce is highly engaged, yielding more willing participants working towards strategic goals. Tom Olivo, President of Success Profiles and Healthcare Performance Solutions *H3 Examples Emergency Departments, Critical Care Nursing, Surgical Services, Pharmacy, Labs, Radiology, Respiratory, Labor & Delivery, etc. 11

64 Results Roll-out & Action Planning Process Each year, Senior Leaders communicate survey results and expectations for department leader action planning and follow-up: Share results of the survey with all employees Demonstrate a commitment to actions that will follow from identified areas needing improvement Created appropriate action plans with employee input Provide on-going communication with employees regarding action planning implementation 12

65 Results Roll-out & Action Planning Process cont. Increase focus on the H3 areas and support and strengthen these functions to achieve the health system s desired outcomes - quality, safety, service and financial management. Utilize employee engagement survey results and key business performance indicators to prioritize areas of focus. Celebrate successes as improvements occur. 13

66 Recognition & Celebrations Leadership Recognition President Circle Honorees Greatest Improvement Winners Departments with at least 80% response rate get a pizza party Lee Health s commitment to employee engagement is evident through our 98% National Percentile Rank Overall Grand Mean score for 2017 Survey. Leaders are focused on results and make it a top priority to be the best health care system for our employees, patients and the communities we serve. 14

67 Questions or comments Thank you! # Rev. 10/16

68 BOARD OF DIRECTORS LEGISLATIVE PRIORITIES (Michael Nachef, Director, Government Relations)

69 BOARD OFF DIIREECTTORS RECOMMENDED FOR BOARD ACTION (Action includes Acceptance, Approval, Adoption, etc) Keep form to one page, to: by Noon Eight (8) days PRIOR to presenting. DATE: September 28, 2017 LEGAL SERVICE REVIEW? YES NO_X_ SUBJECT: 2018 Legislative Priorities REQUESTOR & TITLE: Michael A. Nachef, Director, Government Relations Mary Andrews, System Director, Government and Community Relations PREVIOUS BOARD ACTION ON THIS ITEM (IF ANY) (justification and/or background for recommendations internal groups which support the recommendation) Board approves the annual Legislative Priorities each fall for the next cycle of state legislative session. These priorities are presented to the annual legislative delegation hearings in the 5-county area by Lee Health staff. SPECIFIC PROPOSED MOTION: Approve the 2018 Lee Health Legislative Priorities. FINANCIAL IMPLICATIONS Budgeted Account _X_ Non-Budgeted (Annual Project Budget and Total Project Budget) All current state law, funding and regulations are budgeted for state fiscal year Final decisions on all Medicaid, trauma, and other funding for next state fiscal year (July 2018-June 2019) will be influenced by these priorities. STAFFING & OPERATIONAL IMPLICATIONS (including FTEs, facility needs, etc.) All budgetary adjustments to the reduction in DSH funding and increases in LIP funding for state fiscal year are in the process of being finalized based on LIP final amounts. New IGT commitments will track these changes. Implications for the next fiscal year will be determined by legislative action. PURPOSE/REASON FOR RECOMMENDATION The Legislative Priorities provide a framework to educate legislators and their staff on current issues. This foundation also provides a framework for ongoing review of legislation, amendments, and legislative action. SUMMARY (including alternatives considered, Pros and Cons) The 2018 Lee Health Legislative Priorities Include: Fully fund Hospital Medicaid reimbursement rates and allow optimal flexibility in Medicaid 1115 waiver to cover unforeseen needs. Further Improve special terms and conditions for the Florida Low Income Pool (LIP) to allow maximum amount of federal funds to be drawn down. Extend health care coverage to the low income uninsured even if the Affordable Care Act (ACA) is to be repealed and replaced. Continue state funding of trauma programs and promote regulations that support patient safety and security, consistent with Trauma System Advisory Council collaboration and recommendations. Fund and support Graduate Medical Education (GME) including new or expanded residency programs. Support telemedicine and encourage reimbursement of those services. Fund and support initiatives to address mental health/substance abuse issues in our community. The pros to this recommendation include having a board approved legislative platform which our advocates can utilize to educate legislators. There are no cons to this recommendation. Lee Memorial Health System Board of Directors Updated 3/2/17

70 2018 Legislative Priorities Lee Health Lee Health Lee Health is a public non-profit health care services organization committed to the well-being of every individual we serve. Our goal is to promote healthy living and robust health for the people of Southwest Florida. Lee Health has nearly 2 million patient contacts per year. We are Southwest Florida s largest employer with more than 13,000 full-time employees, as well as 4,500 volunteers and auxilians. Every dollar we collect is reinvested back into our community to improve facilities, add services and extend care to those who need it most. Important to note is that all of this is done without receiving any local tax support. Lee Health is the largest public health system in the nation not benefiting from a direct local tax and we are proud of that fact. Despite significant challenges in the ever changing health care industry, we continue to provide the best care possible for our community. We are caring people, inspiring health. Medicaid Funding In FY 2016, Lee Health directly contributed more than the federal government and four times what the State funded for local Medicaid patients served. The total cost of Lee Health providing Medicaid services to the people of Southwest Florida in 2016 was $221.6 million. The total is represented by 43 percent ($94.4 million) being funded by the federal government, 11 percent ($25.5 million) being funded by state government, and 46 percent ($101.7 million) being funded by Lee Health. Lee Health s share is funded through hospital taxes imposed by the state known as Public Medical Assistance Trust Fund (PMATF), local revenues sent by Lee Health to Tallahassee to draw down the federal match known as Intergovernmental Transfers (IGTs), and local funds utilized to cover the Medicaid shortfall. Florida ranks 48 out of 50 in overall Medicaid funding for children, pregnant women, low-income families, elderly, and the disabled. 1

71 Additionally, IGTs benefit all qualifying hospitals regardless of whether local public funds are contributed on their behalf. Historically, federal guidelines have allowed mechanisms under managed care to recognize and fund those hospitals that are providing significant services at a loss for Medicaid patients. We support these guidelines and encourage the federal government to again authorize this practice. We support fully funding hospital services reimbursed by Medicaid, including the Medically Needy and Aged/Disabled programs. Our shortfall in Medicaid reimbursement for FY 2016 was $58.4 million, a 40percent increase above the 2015 shortfall. Changing from a fee-for-service to a Diagnosis-Related Group (DRG) methodology has further reduced reimbursement, and recent transition to statewide managed care reduced our reimbursement even more. During the 2017 Session, the Florida Legislature cut Medicaid funding to hospitals by $521 million dollars. Dramatic reductions in rate reimbursements for all types of government and commercial insurance create a tremendous burden to health systems trying to provide care for uninsured or underinsured patients. Lee Health supports transparency, increased accountability, and improved efficiency in managed care. Medicaid 1115 Waiver Extended for Five Years Last year, Lee Health supported a continuation of the federal 1115 Medicaid Healthcare Transformation Waiver. The Waiver has been extended for a period of five years. The 1115 Medicaid waiver allows states optimal flexibility to design and improve their programs that promote the objectives of the Medicaid and CHIP programs. This significant flexibility allows for CMS to waive Medicaid statutory requirements or permit federal match for activities not specifically authorized by statute. This gives CMS significant discretion for approval or denial of these waivers. The federal budget neutrality requirement provides the opportunity to fund creative programs such as the Low Income Pool (LIP). Budget neutrality means that federal expenditures must be at or below what they would be without the waiver. The opportunity to bridge funding now while improving services may lead to future Medicaid innovation waivers. The Low Income Pool (LIP) provides government support to providers for the costs of uncompensated charity care for low-income individuals who are uninsured. Uncompensated care includes charity care for the uninsured but does not include uncompensated care for insured individuals, bad debt, or Medicaid and Children s Health Insurance Program (CHIP) shortfall. 2

72 Low Income Pool The reduction of federal LIP in FY from $2 to $1 billion encouraged State lawmakers in the 2016 legislative session to dedicate $400 million in general revenue to help offset substantial losses to community, safety net, and teaching hospitals, which provide the significant share of healthcare services for the under and uninsured in Florida. The Legislature offset the loss of federal dollars with state general revenue including increases to Medicaid rates that helped to make hospitals whole when combined with the remaining $1 billion LIP program for FY LIP was further reduced to only $608 million for FY and with the funding formula dramatically changed to a new definition of charity care, many hospitals saw great reductions in state reimbursement, including Lee Health hospitals. During the 2017 Session, the State and CMS agreed to again increase LIP funding authorization to $1.5 billion. As a public hospital, Lee Health benefits from new LIP special terms and conditions that create a tier specifically to fund public hospitals that see disproportionately higher volumes of Medicaid and uninsured patients. In previous years, Disproportionate Share Hospital (DSH) payments had been redefined in Florida in order to help offset substantial losses in LIP. In the 2017 Session, DSH payments were cut substantially with the promise of additional LIP funds. Medicaid DSH payments are statutorily required payments intended to offset hospitals uncompensated care costs to improve access for Medicaid and uninsured patients as well as the financial stability of safety-net hospitals. States have broad flexibility in determining which hospitals receive DSH payments and in determining how the payments are calculated. Historically Florida has been disadvantaged compared to other large states with our DSH allocation being around $200 million compared to more than $1 billion for states like Texas and California. Lee Health encourages HHS to use its authority for flexibility to redistribute DSH to appropriately reflect individual states needs. When Congress passed the ACA in 2010, statutory cuts were built into DSH payments assuming that more patients would be insured and less uncompensated care would be occurring. This has not been the case in Florida and safety-net hospitals have been forced to lobby for DSH cut delays. Congress contemplated removing DSH cuts for ACA non-expansion states and increasing DSH rates for traditionally low DSH states, like Florida, during the ACA repeal and replace debate. Lee Health supports delaying or repealing DSH cuts and maintaining state flexibility in DSH payment distribution. 3

73 Extension of Health Coverage Lee Health continues to advocate for implementation of a solution that will extend healthcare coverage to the most individuals possible. Florida consistently ranks in the top 5 for total number of uninsured patients in the United States. Revenues are still being taken from Floridians to cover the costs of the Affordable Care Act and we need to acknowledge that we are paying for this care, whether we allow it to be funded or not. The current federal administration may not support continuation of the ACA, but, as of now, it remains the law of the land. Lee Health supports extending health care coverage by any name to cover as many individuals as possible. The five-county region we serve in Southwest Florida has one of the highest rates of uninsured patients in the entire state of Florida. In the most recent US Census data published, four of the five counties we serve rank in the top 10 of 67 counties for the highest percentage of uninsured patients. Glades County has 26.2% (1) uninsured, Hendry County has 26.0% (2) uninsured, Collier County has 23.2% (5) uninsured, Lee County has 19.9% (10) uninsured, and Charlotte County has 16.8% (23) uninsured. Overall these numbers demonstrate about 3% more people per county being insured over last year s data. Even with these gains, our region remains one of the most uninsured in all of Florida. Only one in five patients admitted to Lee Health hospitals has commercial insurance now, and those patients and their employers receive the full burden of the hidden tax, shifting the unpaid costs of Medicaid, Medicare, and uninsured to them. This tax burden is compounded every year the state does not leverage Florida tax dollars back to Florida by extending health care coverage or working with the federal government to fund uncompensated care through Medicaid waivers. Extending healthcare coverage to the uninsured has also been supported by the Florida Chamber of Commerce Healthcare Partnership. Noted in the Chamber s Healthcare Partnership position is that one-seventh of Florida s economy is based on healthcare and a significant portion of our state budget is invested in Medicaid. Those numbers are growing and in order to address the cost shift to those who have commercial insurance, action must be taken. At the Florida Chamber, we believe Florida has an opportunity to set the national example for expanding healthcare coverage while also lowering costs on Floridians and reforming Florida s healthcare system, Mark Wilson said during the Expanding Healthcare and Ending the Cost Shift Now Business Briefing. It makes good business sense to get a return on our taxpayer s investment in order to provide quality healthcare for all Floridians. 4

74 Potential Affordable Care Act Repeal and Replacement If the ACA is to be repealed and replaced, Lee Health supports a replacement program that does not utilize substantial cuts to Medicaid in order to cut ACA taxes. In the summer of 2017, The United States House of Representatives and United States Senate debated and voted on various plans to repeal and replace the ACA. Most all of their proposals included onerous cuts to Medicaid in order to fund ACA tax cuts. These cuts amounted to nearly 1 trillion dollars in reduced Medicaid spending, along with implementation of per-capita caps that would severely limit growth in the Medicaid program. The Senate Better Care Reconciliation Act did contemplate at least some positive approaches, including removal of ACA Disproportionate Share Hospital (DSH) cuts for non-expansion states and restoration of traditionally low DSH state payments to a national average for at least a four-year period. We view these approaches as positive when not coupled with substantial cuts to the Medicaid program. Lee Health supports repealing ACA DSH cuts and increasing Florida s traditionally low DSH funding. Trauma Funding and Regulation The Lee County Trauma Services District was created by a special act of the Florida Legislature, , and is the only trauma service district in the State of Florida governed by a publicly elected board of directors, the same elected body as the Lee Health Board of Directors. The Regional Trauma Center at Lee Memorial Hospital, a State designated Level II Trauma Center, has served as a safety net to the injured patients from Lee, Collier, Charlotte, Hendry and Glades Counties for over 21 years. While the Trauma District has no taxing authority or local tax support, it has demonstrated area-wide leadership in developing an inclusive and collaborative system of injury care. This program of care is tailored to all of Southwest Florida and is guided by the needs of the residents we serve. The Regional Trauma Center at Lee Memorial Hospital received re-verification status three years ago certifying the trauma program complies with trauma care standards consistently and without exception There is no higher compliment to be had from a survey team. We are verified through June The Lee Health Board of Directors has approved a plan to move our Regional Trauma Center to our Gulf Coast Medical Center Campus by We encourage all stakeholders to support legislation that maintains the existing high performing trauma system, and funding for the existing trauma programs. Concerns exist over perceived less stringent standards being contemplated by the Florida Department of Health (DOH) and Florida Legislature which could be harmful to the quality of trauma care in our region. Data confirms that better outcomes are achieved when trauma center professionals treat a higher volume of 5

75 patients. Patient outcomes may be negatively impacted if trauma center patient populations are too far diluted by the opening of more trauma centers. It is our hope DOH will incorporate the suggestions of stakeholders to collaboratively work with providers to improve Florida s trauma system through the rulemaking process. We recommend DOH also engage the Florida Committee on Trauma, Association of Florida Trauma Coordinators and Association of Florida Trauma Program Managers to provide ongoing input from clinical professionals on such rules and standards. The American College of Surgeons (ACS) also recommended to DOH that it reconvene and work with the Florida Trauma System Advisory Council for ongoing collaboration for the best regulatory results. The Florida Trauma System Advisory Council has not been reconvened for the past several years. One of the biggest threats to optimal trauma care has been the recent insurgence of superfluous trauma centers. The findings of a recent study published in the medical journal Annals of Surgery, titled Impact of Volume Change Over Time on Trauma Mortality in the United States, reveal that the lightly regulated and poorly coordinated designation for trauma care centers in states like Florida has created an oversaturated system that dilutes patient volumes, leads to worse outcomes and generally does more harm than good. Many of these centers are charging exorbitant entry fees ( Activation Fees ) of up to $30, and moving into areas already served by an existing trauma center. Lead author of the aforementioned study, Joshua Brown, MD, a research fellow in the division of trauma and general surgery at the University of Pittsburgh School of Medicine said Siphoning of patients through unregulated growth of unnecessary trauma centers can have a profound detrimental impact on patients. GME - Statewide Medicaid Residency Program Lee Health is a qualified GME participant in the FSU Family Medicine Residency Program and supports continued funding for the GME medical residency program as well as the physician supplemental payment program. The Graduate Medical Education (GME) Statewide Medicaid Residency Program consists a state-wide pool of money used to provide funding to qualified participating hospitals involved in graduate medical education. Additionally, the GME Startup Bonus Program provides $100 million dollars to qualifying hospitals with newly approved residency positions in the statewide supply-and-demand deficit specialties. Supplemental payments are also available for physician educators within these programs. These new resident physicians will meet a critical need as a national physician shortage persists. Thus far, eight Family Practice 6

76 physicians who have completed their FSU residency program have stayed in the Southwest Florida community to practice. As we go forward, our goal is to retain 75% of the program s graduates in Southwest Florida. Telemedicine/Telehealth Lee Health supports the use of new technologies including telemedicine for improved patient care. Lee Health utilizes telemedicine in a multitude of care delivery scenarios. We implement telemedicine consultations in our children s hospital, home health, mental health through Lee Community Healthcare, and in our emergency departments. The use of this innovative technology allows more patients to receive better outcomes. The Florida Legislature created the Florida Telehealth Advisory Council in The Council is charged to make recommendations intended to increase the use and accessibility of services provided via telehealth. A report of these recommendations is due to the Governor, the President of the Senate, and the Speaker of the House of Representatives by October 31, Lee Health supports telemedicine legislation that requires certified clinical care being properly reimbursed. Mental Health/Substance Abuse Mental Health is a major pillar of overall health and wellbeing. Lee Health supports the use of federal, state, and local resources to address the opioid and substance abuse epidemic effecting the nation and SWFL. The substance abuse and mental health crisis has reached a problem of epidemic proportion. In FY 2016, we treated nearly 3,000 patients for substance abuse and 470 for substance overdose. Through June of 2017, we have treated 727 patients for substance overdose. Substance abuse and mental health patients create stress through utilization on our emergency departments, trauma center, and Neonatal Intensive care Unit (NICU) at the Golisano Children s Hospital of SWFL. Most auto-accident patients that arrive in our Trauma Center due to the severity of their injury are impaired. Babies born with opioid withdrawal through dependency obtained during pregnancy are treated in our NICU. Resources are needed to implement a more robust continuum of care after discharge from emergency departments. Need for stability, education, mental health treatment from licensed professionals, and medication assisted treatment are paramount to properly addressing this crisis. Community resources that currently exist must be properly coordinated to support the needs of our region. September

77 Board of Directors Legislative Update Michael Nachef Director, Government Relations Mary Andrews System Director, Government and Community Relations September 28, 2017 # Rev. 10/16

78 2018 Legislative Agenda Fully fund Hospital Medicaid reimbursement rates and allow optimal flexibility in Medicaid 1115 Waiver to cover unforeseen needs. Further Improve special terms and conditions for the Florida Low Income Pool (LIP) to allow maximum amount of federal funds to be drawn down. Extend healthcare coverage to the low income uninsured even if the ACA is to be repealed and replaced. Continue state funding of trauma programs and promote regulations that support patient safety and security, consistent with Trauma System Advisory Council collaboration and recommendations. Fund and support GME including new or expanded residency programs. Support telemedicine and encourage reimbursement of those services. Fund and support initiatives to address mental health/substance abuse issues in our community. 1

79 Fully Fund Medicaid Services Fully fund Medicaid hospital services including the Medically Needy and Aged/ Disabled Programs. FY 2015 Lee Health Medicaid Cost $158 million total $93.8 million Federal $38.8 million State $25.6 million Lee Health FY 2016 Lee Health Medicaid Cost $221.6million total $94.4 million Federal $25.5 million State $101.7 million Lee Health 2

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83 Low Income Pool (LIP) Lee Health s Final net return on LIP FY 2016/2017 $380,368 Lee Health s Projected net return on LIP for FY 2017/2018 Ranges based on AHCA and SNHAF models between $15.85 million and $20.3 million Major difference is that public hospitals were successfully secured in Tier 1 of LIP Range in projected LIP is a result of nuisances still under negotiation with the department related to IGT funding for lower tiers 6

84 Extension of Healthcare Coverage The five county region Lee Health serves in SWFL still has one of the highest rate of uninsured patients in the entire State of Florida. Four of the five counties we serve rank in the top 10 of 67 counties for the highest percentage of uninsured patients. Glades County has 26.2% (1) uninsured, Hendry County has 26.0% (2) uninsured, Collier County has 23.2% (5) uninsured, Lee County has 19.9% (10) uninsured, and Charlotte County has 16.8% (23) uninsured. It makes good business sense to get a return on Florida taxpayer s investment in order to provide quality healthcare for all Floridians. Access to comprehensive healthcare services is important for promoting and maintaining overall health. If the ACA is to be modified or repealed, modified plans should consider covering as many individuals as possible. 7

85 Potential Repeal and Replacement of the Affordable Care Act (ACA) During the summer of 2017, the US House and Senate discussed and voted on plans to repeal and replace the ACA. Whether it was the American Health Care Act or Better Care Reconciliation Act, all of their plans relied on cutting Medicaid funding by nearly $1 trillion over 10 years to offset rolling back ACA taxes. If the ACA is to be repealed and replaced, Lee Health supports a replacement program that does not utilize substantial cuts to Medicaid in order to cut ACA taxes. Lee Health supports repealing ACA Hospital Disproportionate Share Funding cuts and increasing Florida s traditionally low DSH funding. 8

86 Trauma Funding and Regulation Continue State funding of trauma programs. Promote regulations that support patient safety and security consistent with Trauma System Advisory Council recommendations on triage criteria and trauma center allocations. Discourage unnecessary and duplicative collection of patient identified data. 9

87 Telemedicine/Telehealth Lee Health supports the use of telemedicine to improve patient care and is hopeful that the Florida Legislature will enact legislation requiring that certified clinical care be properly reimbursed. The Florida Legislature created the Florida Telehealth Advisory Council in The Council is charged to make recommendations intended to increase the use and accessibility of services provided via telehealth. A report of these recommendation is due to the Governor, the President of the Senate, and the Speaker of the House of Representatives by October 31, Lee Health supports telemedicine legislation that requires certified clinical care being properly reimbursed. 10

88 Mental Health/Substance Abuse Mental Health is a major pillar of overall health and wellbeing. Lee Health supports the use of federal, state, and local resources to address the opioid epidemic and substance abuse effecting the nation and SWFL. In FY 2016, Lee Health treated nearly 3,000 patients for substance abuse and 470 for substance overdose. Through June of 2017, Lee Health treated 727 patients for substance overdose. Substance abuse and mental health patients create stress through utilization on our emergency departments, trauma center, and Neonatal Intensive care Unit (NICU) at the Golisano Children s Hospital of SWFL. Need for stability, education, mental health treatment from licensed professionals, and medication assisted therapy are paramount to properly addressing this crisis. Community resources that currently exist must be properly coordinated to support the needs of our region. 11

89 Federal Legislative Update Future of the ACA on hold until Congress deliberate on the debt ceiling and government shutdown. Other priorities such as tax reform and infrastructure may also be considered first despite pressure from the Whitehouse for ACA reform. Both in coordination with and irrespective of action on the ACA, Lee Health continues to advocate repeal of DSH cuts and an increase in DSH parity funding. Children s Health Insurance (CHIP) reauthorization legislation must be passed before Sept. 30. The Centers for Medicare and Medicaid Services (CMS) continue to author rules requiring action on subjects ranging from the 340B Pharmacy program to respective payment bundling structures. 12

90 State Legislative Update Strong economic growth over the past 3 years and resolution of the Seminole Compact should account for a $1.2 billion growth in general revenue for FY Medicaid base rates were cut $521 million dollars in FY 2017 and not all providers were made whole with LIP. Increasing base Medicaid funding by at least $250.4 million to account for growth in the program will be a top priority. Expect legislation again pertaining to Certificate of Need deregulation, Trauma Center deregulation, changes to scope of practice for various providers, and attempts to address the opioid and substance abuse epidemic. The damage inflicted by Hurricane Irma will cause additional strains on the state budget that had not been forecasted. 13

91 Thank You

92 Board Chairman to Finance Liaison: FINANCE BOARD OF DIRECTORS MEETING Thursday, September 28, 2017 David Collins Board Treasurer

93 BOARD OF DIRECTORS CONSENT AGENDA (Approval) 1. Financial and Statistical Reports as of July 31, 2017

94 LEE MEMORIAL HEALTH SYSTEM LEE COUNTY, FLORIDA CONSOLIDATED FINANCIAL STATEMENTS AND STATISTICAL REPORTS JULY 31, 2017

95 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS & STATISTICAL REPORTS TABLE OF CONTENTS SECTION A PAGE CONSOLIDATED SCHEDULES HIGHLIGHTS A.1 EXECUTIVE SUMMARY A.2 CONSOLIDATED STATISTICAL REPORT A.3 CONSOLIDATED INCOME STATEMENT A.4 STATEM ENT OF CASH FLOWS A.5 CONSOLIDATED BALANCE SHEET A.6 CONSOLIDATED FINANCIAL RATIOS A.7 CONSOLIDATED OPERATING RATIOS A.8 CONSOLIDATED PAYOR MIX A.9

96 Lee Memorial Health System Operating Highlights For the month ended July 31, 2017 Adjusted admits for the month ended July 31, 2017 are 11,180 which is 397 or 3.4% less than budget. Actual inpatient admits for the month are 6,052 which are 202 admits or 3.2% less than budget. Inpatient days are 31,807 or 1.4% lower than budget which resulted in a 5.26 day length of stay. Emergency room visits are 0.9% less than budget at 16,957 and outpatient surgeries of 1,701 are less than budget by 15.8%. Net patient revenue for July reflects a $5.7 million or 4.2% favorable variance to budget. The majority of this variance is due to a rate variance of $10.3 million offset by a negative volume variance $4.6 million. Net Patient Revenue per CMI adjusted admit for the month ended July 31, 2017 is $8,040 vs. budget of $7,505. Total operating expenses before depreciation and interest expense are 1.1% greater than budget. Salaries & Wages are greater than budget at $67.6 million, and above budget on a case mix adjusted admission basis by $102 as well. The majority of this variance ($1.2 million) was due to staff not flexing to the volumes. The average hourly pay rate is $34.48 which is $0.11 higher than budget. Productivity as measured by FTEs/AOB is unfavorable to budget by 3.4% (5.84 actual vs budget). Productive FTE s per adjusted daily admission were 3.9% greater than budget at vs. a budget of Supply expense is lower than budget by $0.3 million or 1.3%, while on a case mix adjusted admission basis the supply variance is unfavorable at $1,454 actual vs. $1,433 budget. Total operating costs per case mix adjusted admit are greater than budget at $7,091 actual vs. $6,824. For July 2017, the gain from operations is $3.8 million or 2.7% versus a budget of $4.5 million or 3.2%. Excess revenue over expenses is a gain of $22.3 million versus a budget of $10.2 million. The majority of this is due to investment returns being greater than expected. For the month, Cash & Investments increased by $24.5 million to $1,012.9 million. Total sources of cash from operations are $15.3 million and from investments are $16.4 million offset by uses of cash totaling $7.2 million. The majority of the uses of cash were due to cash outflows of $9.8 million for purchases of property, plant & equipment. Days in Accounts Receivable increased from 44.9 days in June to 47.2 days resulting in a $6.3 million decrease in cash. Total Notes & Bonds payable on July 31, 2017 is $681.9 million resulting in the Cash to Debt ratio of 148.5%. Page A.1

97 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED EXECUTIVE SUMMARY For the Period Ending July 31, 2017 CURRENT MONTH Budget Actual Prior Year Budget Actual Prior Year Inpatient Volumes: Admits - Adults & Peds 6,254 6,052 5, % 3.1% 67,408 67,268 66, % 1.0% Patient Days - Adults & Peds 32,247 31,807 30, % 4.9% 344, , , % 0.6% Short Stay Days 4,699 4,175 4, % -10.3% 46,901 47,713 46, % 2.7% Total Patient Days plus Short Stay Days 36,947 35,982 34, % 2.9% 391, , , % 0.9% Average Length of Stay % -1.8% % 0.4% Inpatient Surgeries 1,776 1,679 1, % 11.1% 18,310 18,467 17, % 3.5% Outpatient Volumes: Emergency Room Visits 17,108 16,957 16, % 1.8% 185, , , % 2.4% Outpatient Surgeries 2,020 1,701 1, % -5.2% 20,354 19,608 20, % -3.3% Hospital Based Physician Visits 37,971 29,035 28, % 1.1% 396, , , % -5.2% Physician Visits 74,395 72,092 63, % 12.8% 803, , , % 16.5% Home Health Visits 7,269 4,535 5, % -9.3% 71,277 56,404 56, % -0.7% Adjusted Admits 11,577 11,180 10, % 3.3% 124, , , % 3.1% (overall in/outpat volume indicator) Total Case Mix Index % 1.3% % 0.7% Operating Ratios: Net Revenue/Adj Adm CMI 7,505 8,040 7, % 9.6% 7,179 7,302 7, % 3.3% Operating Exp/Adj Adm CMI 6,824 7,091 6, % -3.0% 6,521 6,654 6, % -4.0% Supply Exp/Adj Adm CMI 1,433 1,454 1, % -5.2% 1,393 1,435 1, % -4.0% Wages/Ben - % of Net Oper Rev 55.0% 54.6% 56.9% 0.7% 4.0% 54.7% 54.1% 53.3% 1.1% -1.5% Supplies as a % of Net Oper Rev 18.6% 18.3% 18.3% 1.7% 0.3% 18.9% 19.2% 19.0% -1.5% -1.0% Charity/Bad Debt - % of Gross Rev 6.7% 7.1% 7.9% -4.9% 10.8% 6.8% 6.7% 6.5% 1.6% -1.7% FTEs/AOB % -0.6% % -2.5% Productive Hours/Adjusted Admit % -2.4% % -2.1% Average Hourly Rate % -4.3% % -4.2% Financial Ratios: Operating Margin (%) 3.2% 2.7% 1.4% -14.9% 101.1% 4.9% 4.6% 5.3% -6.2% -13.9% Excess Margin (%) 7.0% 14.1% 15.6% 101.1% -9.2% 8.5% 9.8% 10.5% 14.9% -6.3% Liquidity Ratios: Days Cash on Hand Cash to Debt (%) 157.2% 148.5% 143.8% Days in Acct Receivable Income Statement Summary (in Thousands) Total Net Operating Revenue 138, , , % 10.5% 1,426,255 1,450,241 1,356, % 6.9% Total Operating Expenses 134, , , % -9.0% 1,356,335 1,383,555 1,283, % -7.8% Consolidated Gain(Loss) from Oper 4,471 3,818 1, % 122.2% 69,920 66,686 72, % -8.0% Investment Earnings/Non Op Income 5,698 18,510 21, % -12.8% 56,656 83,830 77, % 7.9% Consolidated Excess Rev over Exp 10,169 22,328 22, % -2.7% 126, , , % 0.2% Balance Sheet Highlights (In Thousands): Cash & Investments 1,040,707 1,012,901 1,017,657 Bonds & Notes Payable 662, , ,727 Act to Bud % Variance Act to Prior % Variance YEAR-to-DATE Act to Bud % Variance Act to Prior % Variance CMI = Case Mix Index Page A.2

98 LEE HEALTH CONSOLIDATED STATISTICAL SUMMARY For the Period Ending July 31, 2017 Budget Actual Current Month Year-to-Date Prior Year % Variance % Variance Budget Actual Prior Year Act to Bud Act to PY Act to Bud Act to PY Admissions ADULTS 5,614 5,517 5, % 3.7% 60,599 61,529 60, % 2.3% PEDIATRICS % 3.9% 3,749 2,985 3, % -17.0% NICU % -10.4% % -5.3% POST ACUTE % -7.9% 2,366 2,091 2, % -3.6% Total Adult & Peds 6,254 6,052 5, % 3.1% 67,408 67,268 66, % 1.0% NEWBORNS % 8.3% 5,081 5,035 5, % -0.1% Total Admissions 6,783 6,610 6, % 3.5% 72,489 72,303 71, % 0.9% Patient Days ADULTS 24,360 24,603 23, % 5.3% 266, , , % 1.4% PEDIATRICS 1, % -4.0% 12,297 10,407 11, % -11.5% NICU 1,611 1,614 1, % 18.5% 13,925 13,902 13, % 5.5% POST ACUTE 5,191 4,691 4, % 0.9% 51,114 46,460 47, % -2.0% Total Adult & Peds 32,247 31,807 30, % 4.9% 344, , , % 0.6% NEWBORNS 1,116 1,241 1, % 4.4% 11,453 11,363 11, % -1.6% Total Patient Days 33,364 33,048 31, % 4.9% 355, , , % 0.6% Average Length of Stay ADULTS % -1.5% % 0.9% PEDIATRICS % 7.5% % -6.6% NICU % -32.2% % -11.4% POST ACUTE % -9.6% % -1.6% Total Adult & Peds % -1.8% % 0.4% NEWBORNS % 3.7% % 1.5% Total Length of Stay % -1.3% % 0.4% OP Registrations EMERGENCY ROOM 17,108 16,957 16, % 1.8% 185, , , % 2.4% OP SURGERY CASES 2,020 1,701 1, % -5.2% 20,354 19,608 20, % -3.3% Subtotal 19,128 18,658 18, % 1.1% 205, , , % 1.8% Visits HOME HEALTH VISITS 7,269 4,535 5, % -9.3% 71,277 56,404 56, % -0.8% HOSP BASED PHY VISITS 37,971 29,035 28, % 1.1% 396, , , % -5.2% PHYSICIAN VISITS 74,395 72,092 63, % 12.8% 803, , , % 16.5% TRAUMA SERVICES DISTRICT % 60.8% 11,133 9,934 10, % -4.5% Subtotal 120, ,506 98, % 8.5% 1,282,121 1,218,862 1,124, % 8.4% TOTAL OP 139, , , % 7.3% 1,488,085 1,422,912 1,324, % 7.4% Page A.3

99 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATING STATEMENT OF OPERATIONS For the Period Ending July 31, 2017 (in thousands) Current Month Year-to-Date Act to Bud % Act to Prior Budget Actual Prior Year Variance % Variance Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance INPATIENT REVENUE 323, , , % 9.5% 3,419,842 3,392,219 3,231, % 5.0% OUTPATIENT REVENUE 274, , , % 10.0% 2,900,989 2,886,472 2,627, % 9.9% TOTAL PATIENT REVENUE 598, , , % 9.7% 6,320,831 6,278,691 5,858, % 7.2% DED FROM REV-MEDICARE 253, , , % -16.2% 2,627,301 2,687,924 2,302, % -16.8% DED FROM REV-MEDICAID 72,622 69,154 55, % -25.5% 715, , , % -19.4% DED FROM REV-CHARITY 21,295 28,006 23, % -18.5% 224, , , % -18.0% DED FROM REV-HMO/PPO 56,673 60,293 54, % -11.5% 595, , , % -10.0% DED FROM REV-OTHER 40,038 32,491 51, % 36.7% 564, , , % 39.5% DED FROM REV-BAD DEBT 19,065 12,505 17, % 29.5% 202, , , % 1.0% TOTAL DED FROM REV 462, , , % -8.2% 4,929,801 4,861,606 4,537, % -7.1% NET PATIENT REVENUE 135, , , % 14.7% 1,391,030 1,417,085 1,321, % 7.3% OTHER OPERATING REVENUE 3,696 (1,522) 3, % % 35,226 33,157 35, % -5.6% TOTAL OPERATING REV 138, , , % 10.5% 1,426,255 1,450,241 1,356, % 6.9% OPERATING EXPENSES PROD SALARIES 58,556 57,532 52, % -8.9% 590, , , % -9.9% PROD OVERTIME 1,662 1,739 1, % 2.3% 17,508 20,296 20, % -0.9% CONTRACT LABOR % 85.3% 1,619 2,290 3, % 32.1% NON-PROD SALARIES 5,891 8,214 6, % -35.5% 62,279 74,547 66, % -12.9% TOTAL SALARIES & WAGES 66,176 67,570 61, % -10.3% 672, , , % -9.7% FRINGE BENEFITS 10,251 8,565 10, % 18.7% 107, , , % -1.6% HEALTH CARE ACCESS 1,544 1,631 1, % -12.2% 16,228 16,646 14, % -12.1% SUPPLIES 25,842 25,493 23, % -10.2% 269, , , % -8.0% OTHER SERVICES 6,546 6,608 6, % -5.5% 68,970 67,155 69, % 3.3% PURCHASED SERVICES 12,662 14,496 12, % -14.1% 128, , , % -10.2% TOTAL OPER EXPENSES 123, , , % -7.8% 1,263,608 1,291,330 1,195, % -8.0% EBITDA 15,976 15,116 10, % 39.1% 162, , , % -0.9% DEPRECIATION/AMORT 9,433 9,322 7, % -27.0% 75,047 74,569 69, % -7.5% INTEREST EXPENSE 2,073 1,976 1, % -9.3% 17,681 17,656 18, % 4.4% OVERHEAD ALLOCATION (0) (0) % 450.0% 0 0 (0) % % GAIN(LOSS) FROM OPER 4,471 3,818 1, % 122.2% 69,920 66,686 72, % -8.0% Page A.4

100 LEE MEMORIAL HEALTH SYSTEM STATEMENT OF CASH FLOWS For the Period Ending July 31, 2017 (In thousands) Current Month Year to Date Sources of Cash: Gain From Operations 3,818 66,686 Non Operating Revenue (excluding Investment Income) 2,130 9,368 Depreciation & Amortization 9,322 74,569 (Gain)/Loss on Sale of Assets (6) (24) Total Sources of Cash 15, ,600 Uses of Cash: Change in Patient Accounts Receivable (6,316) (30,403) Repayments Long Term Debt Principal (1,840) (21,074) Additions to Property, Plant & Equipment, Net (9,794) (158,532) Change in All Other Assets (1,715) 7,133 Change in All Other Liabilities 12,491 (19,862) Total Uses of Cash (7,174) (222,737) Cash Provided (Used) Prior to Investment Income 8,094 (72,137) Cash Provided from Investment Income 16,380 74,462 Cash Provided (Used) 24,470 2,325 Cash Balance, beginning of period 988,431 1,010,576 Cash Balance, end of period 1,012,901 1,012,901 Total Bonds & Notes Payable 681,900 Cash to Debt Ratio 148.5% Page A.5

101 LEE MEMORIAL HEALTH SYSTEM CONSOLDIATED BALANCE SHEET For the Period Ending July 31, 2017 in Thousands (000's) ASSETS Current Prior Month Prior Year LIABILITIES AND NET ASSETS Current Prior Month Prior Year Current Assets: Current Liabilities: Cash and Cash Equivalents * 25,259 17,613 43,265 Accounts Payable 44,456 37,850 55,692 Short-term Cash Investments * 962, , ,046 Current Installments of LT Debt 38,048 38,091 36,321 Assests whose use is restricted ,034 Accrued Expenses Net Patient Accounts Receivable 218, , ,168 Employee Compensation 36,672 30,905 40,035 Inventory 31,757 31,708 30,660 Interest 4,505 3,744 8,308 Other Current Assets 33,344 33,371 35,049 Other 28,175 30,031 36,744 Estimated Third Party 51,478 53,090 59,307 Total Current Assets 1,271,791 1,241,131 1,248,222 Total Current Liabilities 203, , ,408 Noncurrent Assets: NonCurrent Liabilities: Long Term Investments Assests whose use is restricted * 25,150 24,998 24,265 Capital Assets, Net 944, , ,229 LT Debt Excluding Current Installments 643, , ,661 Other Assets, Net 40,999 39,047 37,300 Other Liabilities 98,847 95,911 82,869 Total Noncurrent Assets 1,010,365 1,007, ,794 Total Noncurrent Liabilities 742, , ,529 Deferred Outflows of Resources: Deferred Inflows of Resources: Deferred Loss on Debt Refunding 2,609 2,658 5,617 Excess Consideration Provided for Acquisition 102, , ,654 Deferred Inflows on Pension 4,428 4,537 5,468 Total Deferred Outflows of Resources 104, , ,271 Total Deferred Inflows of Resources 4,428 4,537 5,468 Net Position: Restricted for Non-Expendable 5,992 5,992 5,992 Expendable 33,753 32,738 58,232 Net Investment in Capital Assets 262, , ,247 Unrestricted 1,134,337 1,115,391 1,067,411 Total Net Position 1,436,398 1,414,070 1,285,882 Total Assets and Deferred Outflows of Resources 2,386,860 2,353,925 2,280,287 Total Liabilities and Net Position 2,386,860 2,353,925 2,280,287 * Cash & Investments Page A.6

102 LEE MEMORIAL HEALTH SYSTEM FINANCIAL RATIOS For the Period Ending July 31, Moody's Financial FYE YTD Median Goals 9/30/ /31/17 PROFITABILITY RATIOS: Operating Margin 3.9% 4.0% 5.2% 4.6% + Excess Margin 6.7% 8.2% 9.9% 9.8% + Operating Cash Flow Margin 10.8% 10.9% 11.6% 11.0% + LIQUIDITY RATIOS: Days Cash on Hand Cushion Ratio (x) Cash to Debt 158.9% 152.2% 143.1% 148.5% + CAPITALIZATION RATIOS: Debt to Capitalization 32.8% 33.7% 36.6% 33.2% (-) Annual Debt Service Coverage (x) Debt to Cash Flow (-) NOTE: + = Ratios that should be above the Moody's median (-) = Ratios that should be lower than the Moody's median Page A.7

103 LEE MEMORIAL HEALTH SYSTEM OPERATING RATIOS For the Period Ending July 31, 2017 (in thousands) Current Month Budget Actual Prior Year Act to Bud % Variance Year-to-Date Act to Prior % Variance Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance AS % NET OPERATING REVENUE Wages and Benefits 55.0% 54.6% 56.9% 0.7% 4.0% 54.7% 54.1% 53.3% 1.1% -1.5% Supplies 18.6% 18.3% 18.3% 1.7% 0.3% 18.9% 19.2% 19.0% -1.5% -1.0% All Other Operating Expenses 14.9% 16.3% 16.2% -9.2% -0.8% 15.0% 15.8% 15.9% -5.2% 0.9% Capital Costs 8.3% 8.1% 7.2% 2.1% -11.8% 6.5% 6.4% 6.5% 2.2% 1.8% EBDITA Margin 11.5% 10.8% 8.6% -5.7% 25.9% 11.4% 11.0% 11.8% -3.9% -7.3% Operating Margin 3.2% 2.7% 1.4% -14.9% 101.1% 4.9% 4.6% 5.3% -6.2% -13.9% Excess Margin 7.0% 14.1% 15.6% 101.1% -9.2% 8.5% 9.8% 10.5% 14.9% -6.3% Per CMI ADJ ADMIT/VISIT Net Operating Revenue 7,710 7,953 7, % 5.6% 7,360 7,473 7, % 3.0% Total Operating Expenses 6,824 7,091 6, % -3.0% 6,521 6,654 6, % -4.0% Wages and Benefits 4,239 4,341 4, % -1.3% 4,026 4,041 3, % -4.6% Supplies 1,433 1,454 1, % -5.2% 1,393 1,435 1, % -4.0% All Other Operating Expenses 1,151 1,296 1, % -6.4% 1,102 1,177 1, % -2.1% Capital Costs % -18.0% % -1.1% Operating Margin % 112.3% % -11.4% Excess Margin 564 1,273 1, % -7.1% % -3.5% LABOR Productive FTE's/Adj Daily Admit % -2.3% % -2.1% Average Hourly Rate % -4.2% % -4.0% OP Rev % of Total Revenue 46.0% 45.9% 45.7% -0.2% 0.3% 45.9% 46.0% 44.8% 0.2% 2.5% Page A.8

104 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED - PAYOR MIX (BASED ON GROSS REVENUE) For the Period Ending July 31, 2017 Current Month Budget Actual Prior Year Budget Year-to-Date Actual Prior Year MEDICARE 34.5% 34.4% 32.2% 34.7% 33.8% 34.4% MEDICARE HMO 13.4% 14.5% 13.9% 13.5% 15.3% 13.7% MEDICAID 3.3% 4.8% 2.5% 3.3% 3.3% 3.2% MEDICAID HMO 9.7% 9.7% 9.8% 9.3% 9.2% 9.2% HMO/PPO 18.0% 21.1% 19.4% 17.9% 18.5% 18.3% COMMERCIAL 4.0% 4.0% 3.1% 4.0% 3.8% 3.9% OTHER 17.1% 11.5% 19.1% 17.3% 16.1% 17.3% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% MEDICARE CASE MIX INDEX SYSTEM CASE MIX INDEX (In Thousands) 09/30/16 07/31/17 Variance Gross Accounts Receivable 437, ,309 54,172 Net Accounts Receivable 189, ,571 29,158 Net Days in Accounts Receivable Page A.9

105 BOARD OF DIRECTORS FY2018 BUDGET (Ben Spence, Chief Financial & Business Services Officer) (APPROVE) 1. FY2018 Operating Budget 2. FY2018 Capital Budget 3. FY2018 Room Rates Lee Memorial Health System Board of Directors

106 BOARD OF DIIRECTORS RECOMMENDED FOR BOARD ACTION (Action includes Acceptance, Approval, Adoption, etc) Keep form to one page, to: by Noon Eight (8) days PRIOR to presenting. DATE: September 28 th, 2017 LEGAL SERVICE REVIEW? YES NO X SUBJECT: FY 2018 Operating Budget REQUESTOR & TITLE: Ben Spence, Chief Financial Officer PREVIOUS BOARD ACTION ON THIS ITEM (IF ANY) (justification and/or background for recommendations internal groups which support the recommendation) The Board of Directors approved the Financial Goal Policy #20.17R, as recommended, on May 18 th, The 2018 Financial Goal targets included a 4.5% operating margin. SPECIFIC PROPOSED MOTION: To approve the FY 2018 operating budget that provides a 4.5% Gain from Operations. The approval of the FY 2018 operating budget will provide the funding for the FY 2018 Capital Budget of $80 million. FINANCIAL IMPLICATIONS Budgeted Account Non-Budgeted (Annual Project Budget and Total Project Budget) N/A STAFFING & OPERATIONAL IMPLICATIONS (including FTEs, facility needs, etc.) N/A PURPOSE/REASON FOR RECOMMENDATION SUMMARY (including alternatives considered, Pros and Cons) This recommendation will provide the FY 2018 operations budget that meets the financial needs of the organization as defined by the Lee Health System Board Financial Goal Policy. Lee Memorial Health System Board of Directors Updated 3/2/17

107 Lee Health System FY 2018 Operating and Capital Budgets Fiscal Year Ending September 30, 2018 # Rev. 10/16

108 FY 2018 Operating and Capital Budgets Topics: Budget Assumptions Payor Mix Medicare & Medicaid Rate Changes Inpatient Volume Summary Outpatient Volume Summary Cost Savings Income Statement Summary Financial Ratios Capital Budget & Cash Flow Available for Capital

109 Budget Assumptions Revenue: Net Rate Increase - (Per CMI Adjusted Admit) 2.2% Case Mix Index: Resource Intensity 0.3% Volumes: Adjusted Admissions 2.8% Salaries: Merit 3.0% Staffing Level: Salaries % of Net Operating Revenue 47.0% Supplies: Inflation 2.3% Investments: Investment Return Net of Fees 5.2% Profitability Ratios: Operating Margin 4.5% Excess Margin 7.9% Capital Expenditures: Cash Flow for Capital Budget 37.5% Capital Budget $80,000,000

110 Payor Mix and Reimbursement Changes (Based on Gross Charges) No major shifts in payor mix are expected in FY 2018 Any potential final repeal and replacement of ACA too uncertain to forecast impact on payor mix at this time. Projected 2017 Insurance 20.2% Other* 14.6% Medicare 51.7% Medicaid 13.5% *Other: LHS Employee Health Plan, State, Champus, Non-Contracted Commercial

111 Medicare IP Payment Updates Market Basket Update 2.5% Affordable Care Act Mandated Reduction -1.3% 21 st Century Cures Act Mandated Coding Adjustment 0.4% Two Midnight Rule Adjustment -0.6% Wage Index -2.2% DSH Uncompensated Care Payment Changes 1.6% MS DRG Updates 0.4% Quality Based Payment Adjustments 0.2% Net % Increase 1.0% $ Increase $2.96 Million

112 Quality Based Payment Adjustments FY 2017 FY 2018 Change Value Based Purchasing (1,540,400) (1,974,200) (433,800) Readmission Reductions (3,544,800) (3,398,400) 146,400 Hospital Acquired Conditions (2,883,800) (1,962,400) 921,400 Total Payment Reduction (7,969,000) (7,335,000) 634,000 Medicare Outpatient Payments -0.8% decrease or -$1.9 Million

113 Medicaid and Low Income Pool Low Income Pool Potential Medicaid Disproportionate Share Reduction Medicaid Legislated Hospital Rate Cuts Net Increase million million million $ 1.7 million

114 Inpatient Volume Summary FY 2016 FY 2017 FY 2018 % Admissions Actual Projected Budget Variance Adults 71,329 72,954 73, % Pediatrics 4,162 3,540 3, % NICU % Post Acute 2,582 2,574 2, % Total Adult & Peds 78,924 79,930 81, % Newborns 6,187 5,914 5, % Total Admissions 85,111 85,844 86, % Patient Days Adults 314, , , % Pediatrics 13,596 12,417 12, % NICU 16,178 17,295 17, % Post Acute 56,861 54,950 60, % Total Adult & Peds 400, , , % Newborns 14,277 11,980 13, % Total Patient Days 415, , , % Average Length of Stay Adults % Pediatrics % NICU % Post Acute % Total Adult & Peds % Newborns % Total Average Length of Stay % Short Stay Days (OBS days) 55,554 55,764 58, % Average Daily Census 1,247 1,263 1, % Includes OBS days

115 Outpatient Volume Summary FY 2016 FY 2017 FY 2018 % Actual Projected Budget Variance OP Registrations Emergency Room 214, , , % OP Surgery Cases 24,355 23,560 24, % Subtotal 239, , , % Visits / Encounters Home Health Visits 68,310 67,685 74, % Physician Encounters 1,299,470 1,402,148 1,534, % Trauma Services District 12,505 12,165 13, % Subtotal 1,380,285 1,481,998 1,622, % Total Outpatient 1,619,580 1,721,700 1,870, %

116 Cost Savings (In Millions) 2.5% Productivity Improvement $ 28.0 million ACO Shared Savings $ 3.0 million Pharmacy Rebates $ 3.0 million Supply Standardization $ 3.0 million Purchased Services $ 8.0 million Total Cost Savings $ 45.0 million

117 Income Statement Summary Variance FY 2016 FY 2017 FY 2018 Budget '18 vs Proj '17 Actual Projected Budget $ % Net Patient Revenue 1,588,220 1,674,476 1,758,862 84, % Other Operating Revenue 42,707 41,555 42, % Total Operating Revenue 1,630,927 1,716,031 1,800,970 84, % Operating Expenses Salaries & Wages 744, , ,158 45, % Fringe Benefits 120, , ,997 5, % Health Care Assessment 17,929 19,304 20,455 1, % Supplies 310, , ,140 11, % Other Services 83,875 81,764 80,929 (835) -1.0% Purchased Services 164, , ,174 14, % Total Operating Expenses 1,441,993 1,524,685 1,601,852 77, % EBITDA 188, , ,118 7, % Depreciation/ Amortization 81,890 92,684 99,818 7, % Interest Expense 22,113 22,189 19,010 (3,179) -14.3% Gain (loss) from Operations 84,931 76,473 80,290 3, % Operating Margin % 5.2% 4.5% 4.5% Total Non Operating Revenue 85,775 89,695 67,978 (21,717) -24.2% Excess of Revenue/Expenses 170, , ,268 (17,900) -10.8%

118 Financial Ratios LMHS Goals 2018 A MOODY'S MEDIANS AUDIT 2016 PROJ 2017 BUDGET 2018 Profitability Ratios: Operating Margin 4.5% 3.2% 5.2% 4.5% 4.5% + Excess Margin 6.8% 6.1% 9.9% 9.2% 7.9% + Operating Cash Flow Margin 11.2% 10.0% 11.6% 11.2% 11.1% + Liquidity Ratios: Days Cash on Hand Cushion Ratio Cash to Debt 135.5% 160.6% 143.1% 148.9% 143.7% + Capital Ratios: Debt to Capitalization (%) 30.4% 33.9% 36.6% 32.8% 29.6% (-) Annual Debt Service Coverage Debt to Cash Flow (-) Note + = Ratios that should be above the Moody's median (-) = Ratios that should be lower than the Moody's median

119 Capital Budget & Cashflow ACUTE CARE 13,068,635 SUBS & CORPORATE 772,986 POST ACUTE 506,009 OUTPATIENT 2,522,465 LPG/MSO 787,832 SURGICAL SERVICES 6,151,037 RADIOLOGY 5,954,626 CONTINGENCY 1,500,000 ROUTINE 31,263,590 FACILITIES 12,000,000 INFORMATION TECHNOLOGY 15,040,160 STRATEGIC GROWTH/PROGRAM DEVELOPMENT 21,696,250 TOTAL PROPOSED CAPITAL BUDGET ,000,000 CASHFLOW FROM OPERATIONS AVAILABLE FOR CAPITAL 213,314,311 CAPITAL BUDGET AS A % OF CASHFLOW 37.5% EXCESS (DEFICIT) 133,314,311

120 BOARD OF DIIRECTORS RECOMMENDED FOR BOARD ACTION (Action includes Acceptance, Approval, Adoption, etc) Keep form to one page, to: by Noon Eight (8) days PRIOR to presenting. DATE: September 28, 2017 LEGAL SERVICE REVIEW? YES NO SUBJECT: FY2018 Capital Budget REQUESTOR & TITLE: Ben Spence, CFO PREVIOUS BOARD ACTION ON THIS ITEM (IF ANY) (justification and/or background for recommendations internal groups which support the recommendation) On August 28 th, 2017, in accordance with the Board of Director s Policy #20.09J, a detailed list of the FY2018 capital requests was provided to the Board for a 30-day preliminary review. At the time, efforts were still being made to reduce the capital budget requests from approximately $87.3 million to $80 million. SPECIFIC PROPOSED MOTION: Requesting a motion to approve the FY2018 Capital Budget of $80 million to include Contingency in the amount of $1,500,000. The total FY2018 Capital Budget represents approximately 37.5% of the FY2018 Operating Budget cash flow available for capital. FINANCIAL IMPLICATIONS Budgeted Account Non-Budgeted (Annual Project Budget and Total Project Budget) STAFFING & OPERATIONAL IMPLICATIONS (including FTEs, facility needs, etc.) PURPOSE/REASON FOR RECOMMENDATION SUMMARY (including alternatives considered, Pros and Cons) Total capital submitted for the FY2018 capital budget is $80,000,000 to be funded by LMHS operating cash flow. Lee Memorial Health System Board of Directors Updated 3/2/17

121 LEE MEMORIAL HEALTH SYSTEM FY18 CAPITAL BUDGET REQUESTS FY18 TOTAL REQUESTS Acute 13,068,635 Subs & Corp 772,986 Post Acute 506,009 Outpatient 2,522,465 LPG/MSO 787,832 Surgical Services 6,151,037 Radiology 5,954,626 Contingency 1,500,000 ROUTINE 31,263,590 Facilities 12,000,000 Information Technology 11,040,160 GEAC Replacement 4,000,000 New Growth/Program Development 12,096,250 ACO/Medicaid Provider Infrastructure 5,000,000 LeeSar Expansion 4,600,000 TOTAL REQUESTED 80,000,000

122 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested ACUTE CARE 227 Lee Memorial Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Vacuum-Carpet (Upright) 6 3, Lee Memorial Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Mattress-Bed (Versacare) 30 22, Lee Memorial Hospital, Hosp Based Phy TRANSPORTATION SVS Stretcher with 5th Wheel 1 6, Lee Memorial Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Scrubber (Focus II 32 BOOST) 1 10, Lee Memorial Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Aqius Ozone Clean Core Fill Station 6 11, Lee Memorial Hospital, Hosp Based Phy CARDIOVASCULAR SERVICES Holter Monitor, Add 25 Monitors for new holter system 25 45, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Other, Sewer Drain Cleaning machine Lee Memorial Hospital, Hosp Based Phy NURSING ADMINISTRATION Pulse Oximeter-Table Top, Obstructive Sleep Apnea Risk Screening and Monitor , Lee Memorial Hospital, Hosp Based Phy EMERGENCY SERVICES Recliner-Patient 4 14, Lee Memorial Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, CCO Clean Core Chemical Free Caddy 1 4, Lee Memorial Hospital, Hosp Based Phy EMERGENCY SERVICES Other, Site-Rite hand held Preview ultrasound 1 8, Lee Memorial Hospital, Hosp Based Phy EMERGENCY SERVICES Cardiac Monitor (MX450) 1 449, Lee Memorial Hospital, Hosp Based Phy EMERGENCY SERVICES Cardiac Monitor (MP5) 2 27, Lee Memorial Hospital, Hosp Based Phy N3 PCU Vital Signs Monitor (VS4 w/ temp), Vital sign machine with temp 3 12, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Other, Chipping Hammer Routine Cap 1 1, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Other, Dehumidifiers DRI-EAZ 2 4, Lee Memorial Hospital, Hosp Based Phy ORTHOPEDICS CENTER Vital Signs Monitor (VS4 w/ temp) 3 12, Lee Memorial Hospital, Hosp Based Phy N3 PCU Other, Accucheck Inform 2 2 1, Lee Memorial Hospital, Hosp Based Phy N3 PCU Doppler-Vascular Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Other, Clarke Summit 20 Gallon wet vacuum 5 4, Lee Memorial Hospital, Hosp Based Phy INFUSION CENTER Defibrillator-Complete 1 11, Lee Memorial Hospital, Hosp Based Phy NEURO Vital Signs Monitor (VS4 w/ temp), SureSigns VS4 NBP, SPO2 with Temperature Probe 1 4, Lee Memorial Hospital, Hosp Based Phy GENERAL MED/INFECTIOUS DISEASE Vital Signs Monitor (VS4 w/ temp) 3 12, Lee Memorial Hospital, Hosp Based Phy NEURO Vital Signs Monitor (VS4 w/ temp), SureSigns VS4 NBP, SPO2 with Temperature Probe 1 4, Lee Memorial Hospital, Hosp Based Phy NEURO PCU Vital Signs Monitor (VS4 w/ temp), SureSigns VS4 NBP, SPO2 with Temperature Probe 1 4, Lee Memorial Hospital, Hosp Based Phy GENERAL MED/INFECTIOUS DISEASE Pulse Oximeter-Hand Held 3 1, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Other, Milwaukee Pro Press Tool 1 3, Lee Memorial Hospital, Hosp Based Phy TRANSPORTATION SVS Other, Stretcher Mattress 4 4, Lee Memorial Hospital, Hosp Based Phy SICU NURSING Other, Phillips module cable for Cheetah 2 7, Lee Memorial Hospital, Hosp Based Phy MICU NURSING Other, Phillips module cable for Cheetah 2 7, Lee Memorial Hospital, Hosp Based Phy SICU NURSING Doppler-Vascular, Portable hand held 2 1, Lee Memorial Hospital, Hosp Based Phy MICU NURSING Doppler-Vascular, portable hand held 2 1, Lee Memorial Hospital, Hosp Based Phy EMERGENCY SERVICES ETCO2 Module (MMS) 14 77, Lee Memorial Hospital, Hosp Based Phy PULMONARY REHAB Treadmill (Patterson), Replacment treadmills for LMH pulm rehab. 3 13, Lee Memorial Hospital, Hosp Based Phy PULMONARY REHAB Upper Body Exerciser (SciFit Pro1), Upper Body Cycle 3 13, Lee Memorial Hospital, Hosp Based Phy PULMONARY DIAGNOSTIC LAB Other, Leak tester for bronchoscope 1 9, Lee Memorial Hospital, Hosp Based Phy PULMONARY DIAGNOSTIC LAB Other, Vyntus Walk 1 4, Lee Memorial Hospital, Hosp Based Phy NEURO Pulse Oximeter-Hand Held, MASIMO RAD-5V Lee Memorial Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Ultra Violet Light Machine 2 84, Lee Memorial Hospital, Hosp Based Phy NEURO Pulse Oximeter-Hand Held, MASIMO RAD-5V Lee Memorial Hospital, Hosp Based Phy NEURO PCU Pulse Oximeter-Hand Held, MASIMO RAD-5V Lee Memorial Hospital, Hosp Based Phy NEURO PCU Cardiac Monitor (MX450), PHILIPS CARDIAC MONITOR 2 44, Lee Memorial Hospital, Hosp Based Phy RESPIRATORY CARE Bronchoscope, Bronchoscope 1 31, Lee Memorial Hospital, Hosp Based Phy RESPIRATORY CARE Laryngoscope (GlideScope), Glidescope 1 14, Lee Memorial Hospital, Hosp Based Phy RESPIRATORY CARE Other, Medical Equipment Dryer 1 31, Lee Memorial Hospital, Hosp Based Phy LAB - HISTOLOGY Cryostat, Cryostat 1 25, Lee Memorial Hospital, Hosp Based Phy NURSING REDESIGN 5N Pulse Oximeter-Hand Held Lee Memorial Hospital, Hosp Based Phy LAB - GENERAL Other, Rover Device with printer and battery charger 2 6, Lee Memorial Hospital, Hosp Based Phy LAB - GENERAL Phlebotomy Cart 2 3, Lee Memorial Hospital, Hosp Based Phy LAB - GENERAL Phlebotomy Cart 2 6, Lee Memorial Hospital, Hosp Based Phy LAB - GENERAL Other, TEG Hemostasis Analyzers 2 65, Lee Memorial Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Blood Bank Plasma Freezer 1 11, Lee Memorial Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Blood Bank Analyzer 1 127, Lee Memorial Hospital, Hosp Based Phy LAB - DONOR SVS Other, Plasma Freezer 1 9, Lee Memorial Hospital, Hosp Based Phy LAB - GENERAL Other, Refrigerator - Single door 1 7, Corporate Services LAB - GENERAL CORPORATE Other, Upgrade to istat 300 Wireless meter 4 6, Gulf Coast Hospital, Hosp Based Phy GENERAL MED Pulse Oximeter-Hand Held, Oxygen qualification for patients. 2 1, Gulf Coast Hospital, Hosp Based Phy RESPIRATORY CARE Other, Hamilton -T1 Transport Ventillators and componets 2 53, Gulf Coast Hospital, Hosp Based Phy FOOD & NUTRITION SERVICES Other, Cold and Hot Well Replacement 1 13, Gulf Coast Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Blood Bank Analyzer 1 136, Gulf Coast Hospital, Hosp Based Phy NEURO ICU Other, BIS monitoring 3 28, Gulf Coast Hospital, Hosp Based Phy LAB - GENERAL Phlebotomy Cart 4 7, Gulf Coast Hospital, Hosp Based Phy LAB - GENERAL Other, Rover device with printer and battery recharger 1 3, Gulf Coast Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Tools/Attachments for King Cobra equipment 1 1, Gulf Coast Hospital, Hosp Based Phy LAB - GENERAL Other, VerifyNow System 1 15, Gulf Coast Hospital, Hosp Based Phy LAB - GENERAL Microscope, Microscope 1 6, Gulf Coast Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Plasma Freezer 1 9, Gulf Coast Hospital, Hosp Based Phy LAB - HISTOLOGY Other, Solvent recycler 1 21, Gulf Coast Hospital, Hosp Based Phy LAB - GENERAL Other, Rover device with printer and battery recharger 1 3, Gulf Coast Hospital, Hosp Based Phy LAB - GENERAL Other, Barcode Scanner and Printer for Osmometer 1 1, Gulf Coast Hospital, Hosp Based Phy PCU Other, Linen Cart Gulf Coast Hospital, Hosp Based Phy CARDIAC MED Cardiac Monitor (MX400) 2 40, Gulf Coast Hospital, Hosp Based Phy CARDIAC MED Oto/Ophthalmoscope-Desk Gulf Coast Hospital, Hosp Based Phy LABOR & DELIVERY Other, Fetal Heart Monitors 9 187, Gulf Coast Hospital, Hosp Based Phy ORTHOPEDICS UNIT Table-Overbed, Med/Surg (HillRom) 2 1, Gulf Coast Hospital, Hosp Based Phy PCU Table-Overbed, Med/Surg (HillRom) 25 21, Gulf Coast Hospital, Hosp Based Phy WOMENS CARE CENTER Phototherapy System 2 7, Gulf Coast Hospital, Hosp Based Phy MPCU Cardiac Monitor (MX400) 2 40, Gulf Coast Hospital, Hosp Based Phy CARDIAC MED Cart-Emergency/Crash 1 2, Gulf Coast Hospital, Hosp Based Phy CPCU Cardiac Monitor (MX400) 2 40, Gulf Coast Hospital, Hosp Based Phy NEURO SCIENCE PCU Bladder Scanner 1 8, Gulf Coast Hospital, Hosp Based Phy LAB - HISTOLOGY Other, Face to face second view station for BX model microscopes 1 6, Gulf Coast Hospital, Hosp Based Phy NEURO SCIENCE PCU Oto/Ophthalmoscope-Desk Gulf Coast Hospital, Hosp Based Phy LAB - HISTOLOGY Cryostat, Cryostat 1 26, Gulf Coast Hospital, Hosp Based Phy LAB - HISTOLOGY Other, Autospy saw 1 1, Gulf Coast Hospital, Hosp Based Phy WOMENS CARE CENTER Phototherapy System, GE Blue Spot PT Lite 2 7, Gulf Coast Hospital, Hosp Based Phy PCU Cardiac Monitor (MX400) 1 22, Gulf Coast Hospital, Hosp Based Phy CARDIAC MED Cardiac Monitor (MX400) 1 22, Gulf Coast Hospital, Hosp Based Phy LABOR & DELIVERY Other, Hill Rom Prima Procedural Light 3 6, Gulf Coast Hospital, Hosp Based Phy ORTHOPEDICS UNIT Oto/Ophthalmoscope-Desk Gulf Coast Hospital, Hosp Based Phy WOMENS CARE CENTER Bladder Scanner 1 8, Gulf Coast Hospital, Hosp Based Phy ORTHOPEDICS UNIT Scale-Stand On 1 2,800

123 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1470 Gulf Coast Hospital, Hosp Based Phy NEURO SCIENCE PCU Cardiac Monitor (MX450) 1 305, Gulf Coast Hospital, Hosp Based Phy EMERGENCY SERVICES Other, Cheetah Philips Cable 1 4, Gulf Coast Hospital, Hosp Based Phy EMERGENCY SERVICES TeleBox/Lead (CCH-GCMC-HPMC), Mobile Telemetry Pack 1 225, Gulf Coast Hospital, Hosp Based Phy INTENSIVE CARE UNIT Other, continious cardiac output 3 68, Gulf Coast Hospital, Hosp Based Phy INTENSIVE CARE UNIT Other, primaflo Fluid Warmer 2 5, Gulf Coast Hospital, Hosp Based Phy EMERGENCY SERVICES Cardiac Monitor (MP5), Portable Monitor 6 64, Gulf Coast Hospital, Hosp Based Phy EMERGENCY SERVICES Oto/Ophthalmoscope-Desk 2 1, Gulf Coast Hospital, Hosp Based Phy NEURO ICU Other, phillips modules- 3 10, Gulf Coast Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, The Doodle Scrub with Skate 2 1, Gulf Coast Hospital, Hosp Based Phy INTENSIVE CARE UNIT Other, chetetah monitor module 2 7, Gulf Coast Hospital, Hosp Based Phy INTENSIVE CARE UNIT Defibrillator-Complete 1 11, Gulf Coast Hospital, Hosp Based Phy DIALYSIS Dialysis System 1 14, Gulf Coast Hospital, Hosp Based Phy MPCU Vital Signs Monitor (VS4 w/ temp), NA 2 8, Gulf Coast Hospital, Hosp Based Phy CPCU Vital Signs Monitor (VS4 w/ temp) 2 8, Gulf Coast Hospital, Hosp Based Phy INTENSIVE CARE UNIT Vein Illuminator/Viewer (Accuvein AV400) 1 4, Gulf Coast Hospital, Hosp Based Phy MED SURG Bladder Scanner 1 8, Gulf Coast Hospital, Hosp Based Phy MED SURG Doppler-Vascular Gulf Coast Hospital, Hosp Based Phy MED SURG Table-Overbed, Med/Surg (HillRom) 2 1, Gulf Coast Hospital, Hosp Based Phy DIALYSIS Other, scale with stabilization bars 1 1, Gulf Coast Hospital, Hosp Based Phy DIALYSIS Cardiac Monitor (MX400), on rolling stand 1 22, Gulf Coast Hospital, Hosp Based Phy INTENSIVE CARE UNIT Cardiac Monitor (X2), transport monitors 4 38, Gulf Coast Hospital, Hosp Based Phy CARDIOVASCULAR SERVICES Stress Test w/ Treadmill (GE) 2 76, Gulf Coast Hospital, Hosp Based Phy CPCU Vein Illuminator/Viewer (Accuvein AV400) 1 4, Gulf Coast Hospital, Hosp Based Phy NEURO SCIENCE PCU Seizure Pads (Hill-Rom P855E7) 4 3, Gulf Coast Hospital, Hosp Based Phy CARDIAC OBSERVATION Vein Illuminator/Viewer (Accuvein AV400) 1 4, Gulf Coast Hospital, Hosp Based Phy RESPIRATORY CARE Other, Ventilator-Adult (Servo-U) 8 398, Gulf Coast Hospital, Hosp Based Phy CARDIAC CATH Cath/EP X-Ray System: Single Plane (Philips FD20) 1 2,435, Gulf Coast Hospital, Hosp Based Phy VASCULAR ACCESS NURSING Other, Mobile PICC supply cart 1 1, Health Park Medical Center, Hosp Based Phy CARDIAC CATH C-Arm (GE OEC 9900) 1 218, Health Park Medical Center, Hosp Based Phy CARDIAC CATH Pacemaker, Temporary Pacemaker 1 7, Health Park Medical Center, Hosp Based Phy CARDIAC CATH Other, Rolling Full Size Lead Shields 1 5, Health Park Medical Center, Hosp Based Phy CARDIOVASCULAR SERVICES Pulse Volume Recorder (ERGO IDC) 1 40, Health Park Medical Center, Hosp Based Phy W - CARDIOLOGY PCU Pulse Oximeter-Hand Held Health Park Medical Center, Hosp Based Phy W - CARDIOLOGY PCU Cardiac Monitor (MP5) 4 44, Health Park Medical Center, Hosp Based Phy W - PCU Bladder Scanner 4 35, Health Park Medical Center, Hosp Based Phy DISCHARGE NURSES Warming Cabinet-Floor 1 9, Health Park Medical Center, Hosp Based Phy DISCHARGE NURSES Recliner-Patient 4 12, Health Park Medical Center, Hosp Based Phy W - PCU Scale-Stand On 2 5, Health Park Medical Center, Hosp Based Phy W - PCU Cardiac Monitor (MP5) 6 64, Health Park Medical Center, Hosp Based Phy W - PCU Patient Lift (SaraPlus), 1 SaraPlus 1 7, Health Park Medical Center, Hosp Based Phy CENTRAL SUPPLY Other, 3 - Medela Symphony Plus Breast Pumps 3 4, Health Park Medical Center, Hosp Based Phy CARDIAC DECISION UNIT TeleBox/Lead (CCH-GCMC-HPMC) 5 27, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES TeleBox/Lead (CCH-GCMC-HPMC) , Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Bladder Scanner 1 8, Health Park Medical Center, Hosp Based Phy CARDIAC DECISION UNIT Defibrillator-AED Complete 3 4, Health Park Medical Center, Hosp Based Phy CARDIAC DECISION UNIT Vital Signs Monitor (VS4 w/ temp) 6 25, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Recliner-Patient 14 43, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Slit Lamp 1 4, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Scale-Chair 1 2, Health Park Medical Center, Hosp Based Phy HEART CENTRAL Other, LMH needs PIIX ix plus new tele boxes 1 1,580, Health Park Medical Center, Hosp Based Phy HEART CENTRAL TeleBox/Lead (CCH-GCMC-HPMC) , Health Park Medical Center, Hosp Based Phy W - CARDIOLOGY PCU Doppler-Vascular 4 3, Health Park Medical Center, Hosp Based Phy MED/SURG 7W Vital Signs Monitor (VS4 w/ temp) 2 8, Health Park Medical Center, Hosp Based Phy RESPIRATORY CARE Blood Gas Analyzer (i-stat), Rapidpoint 500 Blood Gas Analyzers 2 21, Health Park Medical Center, Hosp Based Phy RESPIRATORY CARE Cart-Procedure, Davi Cart Bronch cart 1 3, Health Park Medical Center, Hosp Based Phy LABOR & DELIVERY Stirrups-Allen w/cart 1 7, Health Park Medical Center, Hosp Based Phy ANTEPARTUM Doppler-Vascular Health Park Medical Center, Hosp Based Phy RESPIRATORY CARE Bronchoscope 1 29, Health Park Medical Center, Hosp Based Phy RESPIRATORY CARE Bronchoscope 1 29, Health Park Medical Center, Hosp Based Phy CARDIOVASCULAR SERVICES Vital Signs Monitor (VS4 w/ temp) 2 8, Health Park Medical Center, Hosp Based Phy RESPIRATORY CARE Proc/Lightsource/Print/Monitor, Evis Exera Video System 1 42, Health Park Medical Center, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Aqueous Ozone Clean Core Fill Station 6 15, Health Park Medical Center, Hosp Based Phy ENVIRONMENTAL SERVICES Other, CCO Clean Core Chemical Free Caddy 1 4, Health Park Medical Center, Hosp Based Phy CARDIAC CATH Defibrillator-Complete, Cardiac Defibrillators needed for Cath Lab 3 32, Health Park Medical Center, Hosp Based Phy MED/SURG 7W Pulse Oximeter-Hand Held 2 1, Health Park Medical Center, Hosp Based Phy MED/SURG 8W Pulse Oximeter-Hand Held 2 1, Health Park Medical Center, Hosp Based Phy MED/SURG 7W Cardiac Monitor (MP5) 1 14, Health Park Medical Center, Hosp Based Phy MED/SURG 8W Cardiac Monitor (MP5) 1 14, Health Park Medical Center, Hosp Based Phy TH FLOOR OBSERVATION UNIT Warming Cabinet-Table Top 1 5, Health Park Medical Center, Hosp Based Phy MED/SURG 8W Bladder Scanner 1 8, Health Park Medical Center, Hosp Based Phy MED/SURG 7W Pulse Oximeter-Table Top 1 4, Health Park Medical Center, Hosp Based Phy CPCU Other, Scale 1 3, Health Park Medical Center, Hosp Based Phy SPCU-HPF Vital Signs Monitor (VS4 w/ temp) 1 4, Health Park Medical Center, Hosp Based Phy MED/SURG 7W Bladder Scanner 1 8, Health Park Medical Center, Hosp Based Phy CPCU Vital Signs Monitor (VS4 w/ temp) 4 17, Health Park Medical Center, Hosp Based Phy CARDIAC DECISION UNIT Blood Gas Analyzer System (i-stat) 2 18, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Defibrillator-Complete 3 32, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Other, Cheetah Monitor Cable- EPIC Integration 1 4, Health Park Medical Center, Hosp Based Phy FAMILY EDUCATION/SUPPORT Other, Infant Smart Scale- Olympic - Table top- Model #60 1 3, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Other, Prevue+ 1 8, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Blood Gas Analyzer (i-stat), I-Stat 1 9, Health Park Medical Center, Hosp Based Phy EMERGENCY SERVICES Blood Gas Analyzer System (i-stat) 2 22, Health Park Medical Center, Hosp Based Phy SPCU-HPF Pulse Oximeter-Hand Held 3 1, Health Park Medical Center, Hosp Based Phy TRANSPORTATION SVS Other, Hovermat 1 1, Health Park Medical Center, Hosp Based Phy OHICU Warming Cabinet-Floor, Same as warming cabinet that is currently in SICU. 1 10, Health Park Medical Center, Hosp Based Phy MED/SURG 8W Vital Signs Monitor (VS4 w/ temp) 1 4, Health Park Medical Center, Hosp Based Phy MED/SURG 8W Pulse Oximeter-Table Top 1 4, Health Park Medical Center, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Motorized Cart Mover 1 11, Health Park Medical Center, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Double Chamber Compactor , Health Park Medical Center, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Three tote Transporter 1 10, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Other, verticle band saw 1 3, Health Park Medical Center, Hosp Based Phy SPCU-HPF Vital Signs Monitor (VS4 w/ temp) 3 12, Health Park Medical Center, Hosp Based Phy SPCU-HPF Pulse Oximeter-Table Top 1 4, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Other, gantry lift with chain fall 1 2,962

124 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1500 Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Copier (IR4235) 1 4, Health Park Medical Center, Hosp Based Phy SPCU-HPF Glucometer 1 1, Health Park Medical Center, Hosp Based Phy CPCU Glucometer Health Park Medical Center, Hosp Based Phy SPCU-HPF Warming Cabinet-Floor 1 9, Health Park Medical Center, Hosp Based Phy CENTRAL SUPPLY Cart-Procedure, System Standard Procedure Carts 5 7, Health Park Medical Center, Hosp Based Phy SPCU-HPF Cardiac Monitor (MP5) 7 74, Health Park Medical Center, Hosp Based Phy MICU - HP Other, Portable suction unit 1 1, Health Park Medical Center, Hosp Based Phy VASCULAR ACCESS NURSING Other, Site Rite 8 with 20mL wand - 2 units please 2 60, Health Park Medical Center, Hosp Based Phy OHICU Other, istat machines - 3 units please 1 11, Health Park Medical Center, Hosp Based Phy FOOD & NUTRITION SERVICES Other, Double Deck Gas Convection Oven 1 12, Health Park Medical Center, Hosp Based Phy SICU - HP Other, Upgrade of Monitors for new OHICU 1 10, Health Park Medical Center, Hosp Based Phy THORACIC ICU Other, Upgrade of Monitors for new TICU 1 21, Health Park Medical Center, Hosp Based Phy MICU - HP Other, 2nd Monitor for Central Station 1 6, Health Park Medical Center, Hosp Based Phy SICU - HP Other, 2nd Monitor for Central Station 1 6, Health Park Medical Center, Hosp Based Phy OHICU Other, 2nd Monitor for Central Station 1 6, Health Park Medical Center, Hosp Based Phy MICU - HP Other, Phillips Module & Cable for Cheetah Monitor , Health Park Medical Center, Hosp Based Phy MET NURSES Cardiac Monitor (MP2), Portable monitor MP2-2 units please 2 21, Health Park Medical Center, Hosp Based Phy THORACIC ICU Cardiac Monitor (MP2), Portable monitor MP2-2 units please 2 21, Health Park Medical Center, Hosp Based Phy MICU - HP Wheelchair-Staxi, Wheelchair same as transport model 1 1, Health Park Medical Center, Hosp Based Phy SICU - HP Wheelchair-Staxi, Wheelchair same as transport model 1 1, Health Park Medical Center, Hosp Based Phy SICU - HP Other, EV1000 with clearsight - 6 units 6 136, Health Park Medical Center, Hosp Based Phy MICU - HP Other, EV1000 with clearsight - 6 units 1 22, Health Park Medical Center, Hosp Based Phy LAB - GENERAL Other, Rover device with printer and battery charger 2 9, Health Park Medical Center, Hosp Based Phy OHICU Other, Intellibridge Modules and cables 10 31, Health Park Medical Center, Hosp Based Phy LAB - TRANSFUSION SVS Other, Blood Bank Analzyer 1 133, Health Park Medical Center, Hosp Based Phy LAB - GENERAL Other, Molecular Analzyer - Torch 1 162, Health Park Medical Center, Hosp Based Phy THORACIC ICU Bladder Scanner, Latest model bladder scanner 1 8, Health Park Medical Center, Hosp Based Phy LAB - GENERAL Refrigerator-Two Door (Lab), 2-door Reagent 52 cu ft 1 7, Health Park Medical Center, Hosp Based Phy LAB - GENERAL Freezer (Lab), 2 Door Reagent 1 7, Health Park Medical Center, Hosp Based Phy LAB - GENERAL Other, Vein Finder 1 4, Health Park Medical Center, Hosp Based Phy LAB - HISTOLOGY Other, Faxitron Biovision 1 79, Health Park Medical Center, Hosp Based Phy LABOR & DELIVERY Wheelchair-Ultra Light 4 10, Health Park Medical Center, Hosp Based Phy WOMENS CARE CENTER Wheelchair-Staxi 4 6, Health Park Medical Center, Hosp Based Phy W - CARDIOLOGY PCU Cardiac Monitor (MP5), 2 south Interventional Unit 1 490, Cape Coral Hospital, Hosp Based Phy LAB - DONOR SERVICES Other, Apheresis System 1 75, Cape Coral Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Plasma Freezer 1 8, Cape Coral Hospital, Hosp Based Phy LAB - MICROBIOLOGY Incubator-Microbiology, Incubator - CO2 1 16, Cape Coral Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Single door refrigerator 1 7, Cape Coral Hospital, Hosp Based Phy LAB - MICROBIOLOGY Incubator-Microbiology 1 1, Cape Coral Hospital, Hosp Based Phy LAB - MICROBIOLOGY Other, 3-door refrigerator 2 20, Cape Coral Hospital, Hosp Based Phy LAB - MICROBIOLOGY Other, Single door refrigerator 1 6, Cape Coral Hospital, Hosp Based Phy LAB - TRANSFUSION SVS Other, Blood Bank Analyzer 1 133, Cape Coral Hospital, Hosp Based Phy LAB - GENERAL Centrifuge-Table Top, Fixed Angle Centrifuge 1 3, Cape Coral Hospital, Hosp Based Phy LAB - MICROBIOLOGY Other, Biological Safety Cabinet 1 11, Cape Coral Hospital, Hosp Based Phy LAB - MICROBIOLOGY Other, Molecular Instrument - TORCH 1 163, Cape Coral Hospital, Hosp Based Phy LAB - GENERAL Freezer (Lab), Double door freezer 1 10, Cape Coral Hospital, Hosp Based Phy LAB - GENERAL Microscope, Microscope 1 7, Cape Coral Hospital, Hosp Based Phy LAB - GENERAL Other, Thermal Printer for Osmometer Cape Coral Hospital, Hosp Based Phy LAB - GENERAL Other, Rover device with printer and battery charger 2 6, Cape Coral Hospital, Hosp Based Phy LAB - HISTOLOGY Other, Face to face second view station for microscope 1 5, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Scale-Wheelchair, In-floor Flush patient scale 1 6, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Transilluminator, Bard Site Right 8000 Prevue 1 8, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Other, Cheetah module and cable 1 4, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Cardiac Monitor (X2), Central Telemetry Monitor 1 66, Cape Coral Hospital, Hosp Based Phy W PROGRESSIVE CARE Doppler-Vascular, 3W PCU does not have a doppler for use on unit Cape Coral Hospital, Hosp Based Phy RESPIRATORY CARE Other, Transport Ventilator 1 24, Cape Coral Hospital, Hosp Based Phy EMPLOYEE HEALTH SVS Other, Request for Lab Analizer for QuantiFERON Testing 1 113, Cape Coral Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Mattress-Bed (Versacare), Replacement mattresses 3 2, Cape Coral Hospital, Hosp Based Phy N CDU / CARDIAC PCU TeleBox/Lead (CCH-GCMC-HPMC), Monitoring device 2 10, Cape Coral Hospital, Hosp Based Phy LEE PAIN SERVICE Vital Signs Monitor (VS4 w/ temp) 6 25, Cape Coral Hospital, Hosp Based Phy CENTRAL SUPPLY Cart-Procedure, ENT Cart needed for floor procedure 1 13, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Vein Illuminator/Viewer (Accuvein AV400), Vein Finder 1 4, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Other, Welch Allyn Vital Signs Monitor 10 43, Cape Coral Hospital, Hosp Based Phy RESPIRATORY CARE Bronchoscope, UBUS Bronchoscope 1 53, Cape Coral Hospital, Hosp Based Phy ICU Other, AccuVein - Vein Illuminator with Rolling Stand 1 4, Cape Coral Hospital, Hosp Based Phy RESPIRATORY CARE Ventilator-BiPAP V60, Non-invasive ventilators 3 43, Cape Coral Hospital, Hosp Based Phy ICU Other, Philips cable for Cheeta integration 1 4, Cape Coral Hospital, Hosp Based Phy W ORTHO/GENERAL SURGERY Vital Signs Monitor (VS4 w/ temp) 3 12, Cape Coral Hospital, Hosp Based Phy W MED/SURG - TELE Scale-Stand On 1 2, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Other, Philips module for MP , Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES Pacemaker, Medtronic Transvenous Pacer 2 14, Cape Coral Hospital, Hosp Based Phy E MED/SURG - TELE TeleBox/Lead (CCH-GCMC-HPMC) 2 12, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES ETCO2 Module (MMS) 1 5, Cape Coral Hospital, Hosp Based Phy EMERGENCY SERVICES TeleBox/Lead (CCH-GCMC-HPMC), Portable tele boxes 5 27, Cape Coral Hospital, Hosp Based Phy SPECIAL CARE NURSERY Other, Meter Phototherapy 1 1, Cape Coral Hospital, Hosp Based Phy SPECIAL CARE NURSERY Other, Scale: Infant 1 4, Cape Coral Hospital, Hosp Based Phy N CDU / CARDIAC PCU Pulse Oximeter-Hand Held, Rad 5 w/ boot cover 4 2, Cape Coral Hospital, Hosp Based Phy N CDU / CARDIAC PCU Vital Signs Monitor (VS4 w/ temp) 4 17, Cape Coral Hospital, Hosp Based Phy W MED/SURG - TELE Vital Signs Monitor (VS4 w/ temp) 2 8, Cape Coral Hospital, Hosp Based Phy N CDU / CARDIAC PCU Cardiac Monitor (MP5) 4 44, Cape Coral Hospital, Hosp Based Phy W MED/SURG - TELE Bladder Scanner 1 8, Cape Coral Hospital, Hosp Based Phy W PROGRESSIVE CARE Cardiac Monitor (MP5), wall mounted type MP5 appropriate for a PCU 5 60, Cape Coral Hospital, Hosp Based Phy N NEUROSCIENCE / MED/SURG TELE Cardiac Monitor (MP5), Needed if 4N transitions to a PCU level unit 6 64, Cape Coral Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, CleanCore Fill Station 10 24, Cape Coral Hospital, Hosp Based Phy ENVIRONMENTAL SERVICES Other, Clark MA10 12E Floor Scrubber 2 1, Cape Coral Hospital, Hosp Based Phy CARDIAC REHAB Other, NuStep T5 Recumbent Cross Trainer HB 1 6, Cape Coral Hospital, Hosp Based Phy CARDIOVASCULAR SERVICES Other, Case Cart Stress Test System 1 32, Cape Coral Hospital, Hosp Based Phy CARDIOVASCULAR SERVICES Vital Signs Monitor (VS4 w/ temp) 1 4, Cape Coral Hospital, Hosp Based Phy HEART CENTRAL Other, Tele-monitoring for 9 OB Patients 1 325, Cape Coral Hospital, Hosp Based Phy PHARMACY Other, Refrigerator - pharmaceutical grade 1 7, Cape Coral Hospital, Hosp Based Phy WOMENS CARE CENTER Cart-Procedure, OB HEMORRHAGE CART WITH SCALE 1 4, Cape Coral Hospital, Hosp Based Phy SPECIAL CARE NURSERY Infant Warmer (GIRAFFE) 3 84, Golisano Children's Hospital of Southwest Florida ENVIRONMENTAL SERVICES Other, Double Chamber Compactor 7 82, Golisano Children's Hospital of Southwest Florida RESPIRATORY CARE Other, Transcutaneous Monitoring System 2 27,600

125 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1368 Golisano Children's Hospital of Southwest Florida TRANSPORTATION SVS Other, Stretcher Mattress 2 2, Golisano Children's Hospital of Southwest Florida PH3 NEONATAL ICU Blood Gas Analyzer System (i-stat) 5 56, Golisano Children's Hospital of Southwest Florida PH3 NEONATAL ICU Cardiac Monitor (MP2), for in house transport 3 29, Golisano Children's Hospital of Southwest Florida ENVIRONMENTAL SERVICES Other, Ultra Violet Light 2 84, Golisano Children's Hospital of Southwest Florida GCHSWF TRANSPORT / VASCULAR ACCESS Other, Re-Mount Ped/Neo Critical Care Ambulance 1 250, Lee Community HealthCare LCH OB/GYN Cardiac Monitor (MP2), TEST 1 3,333 ACUTE CARE Total 13,068,635 POST ACUTE 1533 The Rehab Hosptial REHAB NURSING Vital Signs Monitor (VS4 w/ temp) 4 17, The Rehab Hosptial REHAB NURSING Recliner-Patient 6 27, The Rehab Hosptial REHAB NURSING Other, EvacuSled 20 18, The Rehab Hosptial REHAB HOSP - PT Table-Hi/Low, Barihab SKS 1 28, The Rehab Hosptial REHAB HOSP - OT Other, SVI Sanet Vision Integrator 1 11, The Rehab Hosptial REHAB HOSP - OT Other, Tran-Sit Car Transfer Simulator 1 9, The Rehab Hosptial REHAB NURSING Other, Bariatric Patient Lift 1 7, The Rehab Hosptial REHAB NURSING Bladder Scanner 1 8, Health Park Care Center NURSING- SNF Patient Lift (MaxiMove) 1 8, Health Park Care Center NURSING- SNF Oxygen Concentrator, 10L Oxygen Concentrators 4 3, Health Park Care Center ENVIRONMENTAL SERVICES Burnisher (Walk Behind) 1 1, Health Park Care Center ADMINISTRATION SERVICES - HPCC Other, Evacu Sled LMH Skilled Nursing Unit 18 16, Health Park Care Center ENVIRONMENTAL SERVICES Other, Clean Core Caddy 1 4, Health Park Care Center ENVIRONMENTAL SERVICES Other, Clean Core Fill Station 1 2, Health Park Care Center HPCRC PHYSICAL THERAPY Parallel Bars 1 8, Health Park Care Center HPCRC PHYSICAL THERAPY Bike-Recumbent (NuStep) 1 6, Health Park Care Center HPCRC OCCUPATIONAL THERAPY Other, ACP/Hanger Omnicycle 1 7, Health Park Care Center HPCRC OCCUPATIONAL THERAPY Other, Treatment Table 1 2, Health Park Care Center NURSING- SNF Vital Signs Monitor (VS4 w/ temp) 2 8, Health Park Care Center PLANT OPERATIONS Other, Zenith APS , Health Park Care Center FOOD & NUTRITION SERVICES Dishwasher, Commercial Dishwasher - Hobart Model AM , Health Park Care Center ADMINISTRATION SERVICES - HPCC Copier (IR4225) 2 11, Home Health ACCESS MEDICAL SOUTH Vehicle-Plant Ops Truck, Isuzu NPR Gas DB , Home Health ACCESS MEDICAL SOUTH Other, Vertical Compressor Home Health PHYSICAL THERAPY Other, ACP Modality Equipment 10 28, Home Health HEALTHY START Copier (IR4245), old model, very slow, satff dissatisfaction. 1 4, Home Health ACCESS MEDICAL SOUTH Other, Stainless Steel Medical Equipment Cleaning Table 1 1, Home Health PHYSICAL THERAPY Ultrasound-Estim/Combo, ComboCare Units 5 5, Home Health PHYSICAL THERAPY Other, Coaguchek XS Meter 40 23, Skilled Nursing Unit PHYSICAL THERAPY Pulse Oximeter-Hand Held, 3 yellow boot covers with 3 units 3 1, Skilled Nursing Unit OCCUPATIONAL THERAPY Vital Signs Monitor (VS4 w/ temp) 1 4, Skilled Nursing Unit PHYSICAL THERAPY Other, ACP Modalities, Portable FX2Pro 10 8,950 POST ACUTE Total 506,009 OUTPATIENT 1128 Lee Memorial Hospital, Hosp Based Phy REHABILITATION SERVICES Training Simulator, Car Transfer Simulator 1 12, Sanctuary and OP Surgery Center SPINE CENTER Copier (IR6265) 1 12, Sanctuary and OP Surgery Center SPINE CENTER Vital Signs Monitor (VS4 w/ temp) 2 8, Sanctuary and OP Surgery Center RADIOLOGY - MRI Other, Breast MRI CAD software 1 171, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Vital Signs Monitor (VS4 w/o temp), Philips VS4 Vital signs Monitor plus roll cart 2 7, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Table-Hi/Low, Metron Elite Patterson Medical storm grey 3 8, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Other, SciFIT Pro 2 UBE/lowerbody 1 4, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Other, MicroFET 2 manual muscle tester 2 1, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Other, Shuttle MVP Elite Plus # , Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Moist Heat Therapy Pack, Hydrocollator 1 2, Sanctuary and OP Surgery Center RADIOLOGY - MRI Wheelchair-Bariatric, MRI safe wheelchair 1 2, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Other, Red Cord Trainer 1 6, Sanctuary and OP Surgery Center REHABILITATION SERVICES-SANCTUARY Other, Lojer mobile speed pulley 1 2, Sanctuary and OP Surgery Center RADIOLOGY - CT SCAN CT Scanner, 64-slice (Siemens) 1 1,225, Plantation Sleep Lab ASTHMA/COPD MANAGEMENT Other, English & Spanish education materials, 2-12 years. 1 2, Gulf Coast Hospital, Hosp Based Phy REHABILITATION SERVICES-GCMC Other, Set of Graston Tools Instrument Set 1 1, Gulf Coast Hospital, Hosp Based Phy REHABILITATION SERVICES-GCMC Other, Upright Bicycle 1 4, Gulf Coast Hospital, Hosp Based Phy REHABILITATION SERVICES-GCMC Other, Sectional Wall Storage System 1 5, Gulf Coast Hospital, Hosp Based Phy REHABILITATION SERVICES-GCMC Other, 2 Performa 3-sect X Treatment Tables w/power Flex 2 6, Gulf Coast Hospital, Hosp Based Phy REHABILITATION SERVICES-GCMC Other, Forma Splint Pan 1 1, Gulf Coast Hospital, Hosp Based Phy REHABILITATION SERVICES-GCMC Other, Performa Traction Table and Stool 1 4, Riverwalk Imaging RADIOLOGY - ULTRASOUND Stretcher-OB/Gyn, Ultrasound 1 6, Riverwalk Imaging RADIOLOGY - ADMIN RIVERWALK Copier (IR4235) 1 4, Riverwalk Sports Medicine RIVERWALK SPORTS-RIVERWALK Other, Trapeze Table - Pilates equipment 1 5, Riverwalk Sports Medicine RIVERWALK SPORTS-RIVERWALK Other, RealEyes xdvr Review DS 1 7, Riverwalk Sports Medicine RIVERWALK SPORTS-RIVERWALK Table-Hi/Low, Bariatric high/low table 2 6, Riverwalk Sports Medicine RIVERWALK SPORTS-RIVERWALK Vital Signs Monitor (VS4 w/ temp) 1 4, Women & Childrens Medical Plaza REHAB SVCS WOMEN & CHILDREN'S MED POther, 72-inch Interactive Bubble Tube 1 2, Women & Childrens Medical Plaza REHAB SVCS WOMEN & CHILDREN'S MED POther, Bioness Integrated Therapy System (BITS ) 1 23, Women & Childrens Medical Plaza REHAB SVCS WOMEN & CHILDREN'S MED POther, Evidence-Based Therapeutic Listening Women & Childrens Medical Plaza REHAB SVCS WOMEN & CHILDREN'S MED POther, Probe for Madsen Otoflex 1 1, Bass Road REHABILITATION SERVICES-BASS RD Other, Graston instruments 1 1, Bass Road REHABILITATION SERVICES-BASS RD Other, US/ESTIM combo neo units 2 12, Bass Road REHABILITATION SERVICES-BASS RD Other, Microfet2 handheld dynamometer 1 1, Bass Road WOMENS BREAST CENTER Mammography 2D to 3D Upgrade (Hologic) 1 235, Bass Road CARDIOVASCULAR SERVICES Vital Signs Monitor (VS4 w/ temp) 1 4, Bass Road LEE PAIN SERVICE Other, RF Reusable Electrode-5cm 10 10, Bass Road LEE PAIN SERVICE Other, RF Reusable Electrode-10cm 10 10, Bass Road LEE PAIN SERVICE Vital Signs Monitor (VS4 w/ temp) 3 12, Bass Road LEE PAIN SERVICE Vital Signs Monitor (VS4 w/ temp) 2 8, Bass Road LAB - OUTREACH SERVICES Vehicle-Lab (Nissan Versa), Courier 2 37, Bass Road REHABILITATION SERVICES-BASS RD Other, Adjustable treatment tables 4 3, Surfside Outpatient Center WOMENS BREAST CENTER Stereotactic Table:Prone Affirm 3D (Hologic) 1 300, Plantation Wound Care LEE WOUND CARE CLINIC Other, 3 exam chairs 3 21, Plantation Wound Care LEE WOUND CARE CLINIC Other, Replacement of 13 year old TCOM 1 49, Cape Coral Hospital, Hosp Based Phy REHABILITATION SERVICES-CCH OP Parallel Bars 1 2, Cape Coral Hospital, Hosp Based Phy REHABILITATION SERVICES-CCH OP Other, Dynamometer Cape Coral Hospital, Hosp Based Phy REHABILITATION SERVICES-CCH OP Other, RealEyes Binocular Video Goggles 1 7, Cape Coral Hospital, Hosp Based Phy REHABILITATION SERVICES-CCH OP Total Body Exerciser (SciFit Pro2) 1 4,951

126 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 886 Cape Coral Hospital, Hosp Based Phy REHABILITATION SERVICES-CCH OP Table-Hi/Low, Performa X-frame with Power Flex 1 2, Cape Coral Hospital, Hosp Based Phy REHABILITATION SERVICES Training Simulator, Car Transfer Simulator 1 13, Med Plaza I LMH CARDIOLOGY - MED PLAZA 1 Pulse Oximeter-Hand Held Med Plaza I LMH CARDIOLOGY - MED PLAZA 1 Copier (IR4235) 1 4, Med Plaza I LMH CARDIOLOGY - MED PLAZA 1 Wheelchair-Ultra Light, standard wheelchair w/ footrests 1 1, Lee Center for OP Rehab REHABILITATION SERVICES - CITY CENTER P Other, Seating and positioning chair 1 4, Lee Center for OP Rehab REHABILITATION SERVICES - CITY CENTER P Other, 6' x 10' floor mat Lee Center for OP Rehab REHABILITATION SERVICES-CITY CENTER ADOther, Performa 350 series table, taupe 1 2, Lee Center for OP Rehab REHABILITATION SERVICES-CITY CENTER ADOther, Deluxe skeleton 1 1, Lee Center for OP Rehab REHABILITATION SERVICES-CITY CENTER ADOther, Hydraulic Butcher Block table 1 1, Lee Center for OP Rehab REHABILITATION SERVICES-CITY CENTER ADOther, Tuffy Bariatric wheelchair Lee Center for OP Rehab REHABILITATION SERVICES-CITY CENTER ADOther, 6'x 8' high-lo table 1 4, College Parkway MRI COLLEGE PARKWAY - MRI Wheelchair-Bariatric, MRI safe Wheel Chair 1 2, Bass Rd LMH CARDIOLOGY - BASS RD Dose Calibrator, Nuclear Isotope dose calibrator neded 1 10, Bass Rd LMH CARDIOLOGY - BASS RD Pulse Volume Recorder (ERGO IDC), Ankle Brachial Index Vascular Scanner 1 40, Metro Pkwy LMH CARDIOLOGY - METRO PKWY Vital Signs Monitor (VS4 w/ temp), Telemetry monitor 1 4, Metro Pkwy LMH CARDIOLOGY - METRO PKWY Pulse Volume Recorder (ERGO IDC), Replacement of Vasoguard 1 40, The Children's Rehabilitation Center THE CHILDREN'S REHABILITATION CENTER OOther, Evidence-Based Therapeutic Listening The Children's Rehabilitation Center THE CHILDREN'S REHABILITATION CENTER OOther, Cardio Kids Elementary Indoor Cycle 1 1, The Children's Rehabilitation Center THE CHILDREN'S REHABILITATION CENTER OOther, Keiser M3i Indoor Cycle 1 2, The Children's Rehabilitation Center THE CHILDREN'S REHABILITATION CENTER OOther, Fiber Optic Spray Harness The Children's Rehabilitation Center THE CHILDREN'S REHABILITATION CENTER OOther, Interactive Fiber Optic Light Source 1 2, The Children's Rehabilitation Center THE CHILDREN'S REHABILITATION CENTER OOther, Rifton Tricycle 1 2, Pediatric Orthopedic Rehab REHAB SVCS PEDIATRIC ORTHOPEDIC Table-Performa, Performa 350 Series Table 1 3, Pediatric Orthopedic Rehab REHAB SVCS PEDIATRIC ORTHOPEDIC Other, PTS BFR Tourniquet Instrument and Cuff Set 1 5, Lee Rehab & Wellness Center WELLNESS CENTER - FT MYERS Other, Leg press 1 6, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Climber 1 7, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Assault Airbike Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Glut Hamstring Developer Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Upright Bike 2 9, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Leg Press 1 6, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Synchro 2 13, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Recline Bike 1 4, Bonita Bay Therapy Outpatient Center REHAB SVCS BONITA BAY THERAPY OUTPATOther, Graston Technique Instrument Set 1 1, Bonita Bay Therapy Outpatient Center REHAB SVCS BONITA BAY THERAPY OUTPATVital Signs Monitor (VS4 w/ temp) 1 4, YMCA Therapy Outpatient Center REHABILITATION SERVICES - YMCA Other, Rifton Medium Activity Chair 1 3, YMCA Therapy Outpatient Center REHABILITATION SERVICES - YMCA Other, Pure Tone And Tympanometry Screener 1 3, Golisano Children's Hospital of Southwest Florida REHABILITATION SERVICES Other, Video Imaging Chair - Powered 1 7, Golisano Children's Hospital of Southwest Florida REHABILITATION SERVICES Other, VitalStim Plus Electrotherapy System 1 2, Ortho Center of Florida Creekside REHABILITATION SERVICES-CREEKSIDE Other, Vectra Neo e-stim, US, Laser combo unit 1 8, Ortho Center of Florida Creekside REHABILITATION SERVICES-CREEKSIDE Other, Dolphin Neurostim OUTPATIENT Total 2,522,465 LPG/MSO 1033 LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Fundus Camera Canon CR-2 AF 1 48, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SURGERY SPECIALTIES Slit Lamp 2 28, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, 20 D, 28 D and 78 D lenses 3 2, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Autorefractor 1 10, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Autolensometer 1 3, LPG Specialists - Physicians, Admininstration LPG CARDIOLOGY - CAPE CORAL Other, Glucometer 1 1, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Headlight with battery pack for procedures 1 1, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Slit Lamp 1 4, LPG Specialists - Physicians, Admininstration LPG PULMONOLOGY - HP - GCH (Based) Defibrillator-AED Complete, AED 1 3, LPG Specialists - Physicians, Admininstration LPG ENDOCRINOLOGY Other, Continuous Glucose Monitor 2 1, LPG Specialists - Physicians, Admininstration LPG PULMONOLOGY - HP - GCH (Based) Other, Niox Vero machine 1 2, LPG Specialists - Physicians, Admininstration LPG ADULT INFECTIOUS DISEASE Stretcher with 5th Wheel 1 6, LPG Specialists - Physicians, Admininstration LPG ADULT INFECTIOUS DISEASE Vital Signs Monitor (VS4 w/ temp) 1 4, LPG Specialists - Physicians, Admininstration LPG SURGERY - RIVERWALK Vital Signs Monitor (VS4 w/ temp) 2 8, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Vital Signs Monitor (VS4 w/ temp), increased volumes 2 8, LPG Specialists - Physicians, Admininstration GCHSW PEDIATRIC CARDIOLOGY Copier (IR4235) 1 4, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, infant scale 1 3, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Copier (IR4235) 1 4, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC NEUROLOGY Other, Green Series 777 Integrated Wall System 7 6, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC NEUROLOGY Vital Signs Monitor (VS4 w/ temp), Replacement of OMRON HEM-907XL 1 4, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC NEUROLOGY Other, Equipment to assess ADHD 12 12, LPG Specialists - Physicians, Admininstration LPG PULMONOLOGY - LMH - CCH (Based) Oto/Ophthalmoscope-Desk 5 4, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Tonometer 1 3, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SPECIALISTS Other, Developmental Testing Kit for NICU graduates 1 1, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Bovie Cautery Device 1 2, LPG Specialists - Physicians, Admininstration GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Earwell Moldable device to correct ear deformity 1 2, LPG Specialists - Physicians, Admininstration LPG NEUROLOGY EMG (Sierra Summit) 1 23, LPG Specialists - Physicians, Admininstration LPG CARDIOLOGY - SANCTUARY (GC) Table-Treatment (Exam), Add exam beds 3 6, LPG Specialists - Physicians, Admininstration LPG NEUROLOGY EEG (ARC) 1 25, LPG Primary LPG OBSTETRICS AND GYNECOLOGY Other, reuseable plastic tray for Hysterscope LPG Primary LPG OBSTETRICS AND GYNECOLOGY Other, Exam bed 1 2, LPG Primary LPG FAMILY-INTERNAL MEDICINE - SOUTH Other, Ritter 253 LED Light/mobile stand 1 1, LPG Primary LPG OCCUPATIONAL HEALTH Other, CLINITEK URINALYSIS LPG Primary LPG FAMILY-INTERNAL MEDICINE - SOUTH Other, Welch Allyn GS600 Minor Procedure Light w/stand 2 1, LPG Primary LPG OB BASS ROAD Other, Colposcope with video 2 22, LPG Primary LPG OB BASS ROAD Other, Ultrasound machine 1 148, LPG Primary LPG CONVENIENT CARE - PINE ISLAND RD Other, EXAM TABLE 1 2, LPG Primary LPG FAMILY-INTERNAL MEDICINE - SOUTH Other, Hyfrecator 1 1, LPG Primary LPG FAMILY-INTERNAL MEDICINE - COLLEG Vital Signs Monitor (VS4 w/ temp), Philips Automated BP Cuff/SureSigns V53 1 4, LPG Primary LPG FAMILY-INTERNAL MEDICINE - COLLEG EKG (Philips TC50) 1 12, LPG Primary LPG FAMILY-INTERNAL MEDICINE - SOUTH Spirometer 1 4, LPG Primary LPG FAMILY MEDICINE - CLAYTON CT EKG (Philips TC50) 3 36, LPG Primary LPG FAMILY-INTERNAL MEDICINE - SOUTH Doppler-Vascular, EDAN SD6 Ultrasonic Tabletop Doppler 1 1, LPG Primary LPG ALLERGY Domestic Refrigerator 1 1, LPG Primary LPG PEDIATRICS - LEHIGH Other, SPOT Vision tester 1 6, LPG Primary LPG FP/IM BONITA BAY Pulse Oximeter-Hand Held LPG Primary LPG CONVENIENT CARE - PINE ISLAND RD Other, Exam table 1 2, LPG Primary LPG FAMILY-INTERNAL MEDICINE - COLLEG Pulse Oximeter-Hand Held, Rad-5v Pulse oximeter with protective boot 5 2, LPG Primary LPG FAMILY-INTERNAL MEDICINE - SANCTUEKG (Philips TC50) 2 24,000

127 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1437 LPG Primary LPG FAMILY-INTERNAL MEDICINE - SOUTH Table-Treatment (Exam), Ritter 204 Manual Exam Table 10 18, LPG Primary LPG PEDIATRICS - PAGE FIELD Pulse Oximeter-Hand Held, Hand Held LPG Primary LPG PEDIATRICS - LEHIGH Pulse Oximeter-Hand Held, hand held 3 1, LPG Primary LPG GME PROGRAM Bilimeter 1 6, LPG Primary LPG PEDIATRICS - BONITA Audiometer 1 3, LPG Primary LPG PEDIATRICS - BONITA EKG (Philips TC50) 1 12, LPG Primary LPG OBGYN - PI ROAD Other, Colposcope 1 8, LPG Primary LPG PEDIATRICS - PAGE FIELD EKG (Philips TC50) 1 12, LPG Primary LPG PEDIATRICS - CAPE EKG (Philips TC50) 1 12, LPG Primary LPG FAMILY-INTERNAL MED - PI ROAD Pulse Oximeter-Hand Held LPG Primary LPG OBGYN - PI ROAD Doppler-Fetal Heart, Fetal Heart Monitor for New provider LPG Primary LPG PEDIATRICS - LEHIGH EKG (Philips TC50) 1 12, LPG Primary LPG FAMILY-INTERNAL MED - PI ROAD Oto/Ophthalmoscope-Desk, expansion of primary care office 10 9, LPG Primary LPG OBGYN - PI ROAD Doppler-Fetal Heart LPG Primary LPG PEDIATRICS - PAGE FIELD Audiometer, replacement audiometer 1 3, LPG Primary LPG PEDIATRICS - CAPE Audiometer 1 3, LPG Primary LPG GME PROGRAM Vital Signs Monitor (VS4 w/ temp) 1 4, LPG Primary LPG OB BASS ROAD Other, Ultrasound machine 1 148, LPG Primary LPG ALLERGY Spirometer 1 4, LPG Primary LPG PEDIATRICS - PAGE FIELD Other, Tempstable refrigeration 1 4, Lee Community HealthCare LEE COMMUNITY HEALTHCARE - DUNBAR Defibrillator-AED Complete 1 3, Lee Community HealthCare LEE COMMUNITY HEALTHCARE-CAPE CORADefibrillator-AED Complete 1 3,700 LPG/MSO Total 787,832 SUBS & CORP 1826 Corporate Services PATIENT BUSINESS OFFICE Other, Check folder/sealer 1 8, Corporate Services SUPPLY CHAIN MANAGEMENT Other, Ambulatory Pain Pump System Replacement ,391 SUBS & CORP Total 772,986 RADIOLOGY 856 Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - SPEC PROCEDURES Doppler-Vascular Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - SPEC PROCEDURES Cart-Medication (6 drawer), Lab Draw Supply Cart 1 2, Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - SPEC PROCEDURES Warming Cabinet-Table Top, Blanket Warmer 1 6, Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS Detector-Large (Canon) 1 75, Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS RF Room (Siemens Agile Max), LMH Room , Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - ULTRASOUND Ultrasound-Gen Rad/Vascular (GE Logiq E9), Multi-Campus Siemens 3 450, Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS C-Arm Tech Vision Monitor (only)/ge OEC9900), Multi-Campus 13 45, Lee Memorial Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS Other, Hardware/Software- Dose Registry 1 8, Gulf Coast Hospital, Hosp Based Phy RADIOLOGY - NUCLEAR MEDICINE Siemens Nuclear Med (Dual-head) 1 1,025, Gulf Coast Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS CR to DR Upgrade, 2 CR Rad Room Upgrades 2 250, Gulf Coast Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS Other, Cradle Charger for Portable Batteries (2) 2 3, Gulf Coast Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS Other, C-Arm Laser Aimer 1 3, Gulf Coast Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS C-Arm (GE OEC 9900) w/printer (B&W), Flat panel 1 210, Gulf Coast Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS Other, Mobile Grid Holder on Wheels 1 5, Health Park Medical Center, Hosp Based Phy RADIOLOGY - DIAGNOSTICS RF Room (Siemens Agile Max) 1 1,146, Health Park Medical Center, Hosp Based Phy RADIOLOGY - NUCLEAR MEDICINE Siemens Nuclear Med (Dual-head) 1 999, Health Park Medical Center, Hosp Based Phy RADIOLOGY - MRI MRI Door Magnetic Screener, Walk by 1 16, Health Park Medical Center, Hosp Based Phy RADIOLOGY - CT SCAN Cardiac Monitor (MX450), With Pulse Oximetry (2) 2 44, Cape Coral Hospital, Hosp Based Phy RADIOLOGY - DIAGNOSTICS Other, Mobile Grid Holder on Wheels 1 5, Cape Coral Hospital, Hosp Based Phy RADIOLOGY - MRI MRI (Philips 1.5T), CCH Additional Funds 1 808,170 RADIOLOGY Total 5,954,626 SURGICAL SERVICES 844 Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 482, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, ORTHO POWER TRAY INSERTS 1 92, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 68, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - KERRISON INSTRUMENT UPGRADE 1 48, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - NEW SURGEON CONTINGENCY 1 100, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, CRANI EXTRAS 1 2, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, GOLD TIP CERVICAL KERRISONS 2 1, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, EXTRA LONG DRILL ATTACHMENT 1 1, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, CASPAR HEADREST 1 6, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, DR. SPRINGER KNEE EXTRAS 1 2, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, STULBERG POSITIONER 2 8, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, SYNTHES SMALL FRAG 1 68, Lee Memorial Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Scale-Bariatric Stand-on 1 3, Lee Memorial Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, ULTRASONIC DOPPLER FLOW DETECTORS Lee Memorial Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, BIPAP MACHINE 1 15, Lee Memorial Hospital, Hosp Based Phy ENDOSCOPY Colonoscope-Pedi 1 42, Lee Memorial Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, BARIATRIC BESIDE COMMODE Lee Memorial Hospital, Hosp Based Phy ENDOSCOPY Other, 26" FULL HD LCD MONITOR 1 6, Lee Memorial Hospital, Hosp Based Phy ENDOSCOPY Other, SCOPE BUDDY 1 2, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Table-OR, , Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Injector-Table (Med Rad) 1 38, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Sonosite EDGE (General Imaging), II Review DS 1 75, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, OMNI RETRACTOR - GENERAL 1 24, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, PNEUMATIC DERMATOME - ENT 1 10, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, HEADLIGHT WITH EXTRA BATTERY - ENT 1 3, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, XENON LIGHTSOURCE 1 4, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, BK LAP PROBE 1 23, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM ESU-Force Triad 1 19, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, BULLDOG CLAMP TRAY 2 3, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, PURSE STRING Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, BLOOMSTON INSTRUMENT TRAY 1 2, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, ICG COMPONENTS 1 28, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Tray-GYN Laparoscopy 1 7, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, LAVH RETRACTOR TRAY - GYN ONC 1 2, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, LAVH TRAY - GYN ONC 1 7, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Table-OR, , Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Other, METRX TRAYS 1 5, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Tray-ACF 1 8, Corporate Services STERILE PROCESSING Other, 3M ATTEST READER 6 5, Corporate Services STERILE PROCESSING Other, CASE CARTS 10 31, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, ACUFEX TRAYS 1 16, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, REMB TRAY 2 72,366

128 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 890 Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, EXTREMITY TRAY 1 3, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Arthroscope, WITH CAMERA, LENS, CORD 2 33, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, FUNDUS GRASPER 2 1, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, VEIN FINDER 1 4, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 30, Sanctuary and OP Surgery Center SURGERY CENTER SANCTUARY Other, SYSTEM-WIDE REMB UPGRADES 1 86, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 307, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 114, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - KERRISON INSTRUMENT UPGRADE 1 49, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - ORTHO POWER TRAY INSERTS 1 58, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Table-OR, , Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM ESU-Standard 8 83, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM ESU-Force Triad 2 42, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, HANA TABLE 1 105, Gulf Coast Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, MINI DOPPLERS 2 1, Gulf Coast Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, Need MMS modules- not etco2 modules 15 82, Gulf Coast Hospital, Hosp Based Phy ANESTHESIA Other, Sonosite POC US 1 31, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Waste Mgmnt Sys. (Neptune) 2 40, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, M7 SHAVER HAND PIECE 1 61, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, TRAY FUSION NAVIGATION SET S7 MEDTRONIC - ENT 1 11, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, SHUNT PASSER Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, HIP PADS FOR JACKSON TABLE 1 4, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, CERVICAL MGMT BASE 1 6, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, OBSERVER / ASSIST ARM FOR SCOPE (16_772GC) 1 13, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, INFRARED FOR MICROSCOPE (16_772GC) 1 148, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM CORE Sumex System, SUMEX DRILL 4 99, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, WILSON GEL SETS 1 1, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Tourniquet w/ Rolling Cart 1 12, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, MARTIN ARM 2 6, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, TRAY FACIAL FRACTURE 1 4, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, FACIAL OSTEOTOMY TRAY 1 9, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, AQUILEX 1 19, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, TRAY HYSTEROSCOPE MYOSURE 1 7, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, ULTRASONIC ASPIRATOR - MALIS 1 26, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, NEURO POSITIONING EQUIPMENT 1 46, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Tray-Craniotomy Instr. 1 7, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, DORO STEALTH ATTACHMENT 1 12, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, METRX TUBE SET 1 5, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, FORAMINOTOMY RONGUERS 1 2, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, MINI DOPPLERS WITH NON-DISP PROBE 2 1, Gulf Coast Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, NERVE STIMULATORS 3 2, Gulf Coast Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Cardiac Monitor (MP2) 1 9, Gulf Coast Hospital, Hosp Based Phy ENDOSCOPY Colonoscope-Pedi 1 42, Gulf Coast Hospital, Hosp Based Phy ENDOSCOPY Gastroscope 1 38, Gulf Coast Hospital, Hosp Based Phy ENDOSCOPY Cart-Motorized Endo Call 1 15, Gulf Coast Hospital, Hosp Based Phy ENDOSCOPY Other, BOUGIE 2 8, Gulf Coast Hospital, Hosp Based Phy ENDOSCOPY Other, SPACE SAVER SCOPE RACK Gulf Coast Hospital, Hosp Based Phy ENDOSCOPY Other, VEINFINDER 1 4, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, LEAD MAN 2 1, Gulf Coast Hospital, Hosp Based Phy OPERATING ROOM Other, ARM TABLE 1 2, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TAVR TRAY 1 14, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY ACL CRUCIATE TOOLBOX INST 1 12, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY GRAFT STATION MASTER SET 1 5, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Tray-ACMI Basic Cysto, AND TUR TRAYS 1 114, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, SHUTT UNIVERSAL STRESS POST Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY CHONDRO PICKS 1 2, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY MENISCECTOMY 1 10, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY ARTHROSCOPY INSTRUMENTS 1 20, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY ARTHROSCOPY CAMERA/LENS/CORD 1 17, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY TRANSFIX ACL RECONSTRUCTION 1 11, Health Park Medical Center, Hosp Based Phy OPERATING ROOM ESU-Standard 2 19, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Table-OR, STERIS , Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, ROBOT INSTRUMENTS 1 2, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, DENTAL HAND PIECES AND ATTACHMENTS 1 7, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, LIGHT CORD 1 1, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, SUCTION COAGULATOR Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, BATTERY OPERATED LIGHT SOURCE Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, TRAY RETRACTOR LAP NATHANSON HP 1 6, Health Park Medical Center, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, MINI DOPPLERS 4 3, Health Park Medical Center, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, VEINFINDER WITH FLEXIBLE ARM 1 4, Health Park Medical Center, Hosp Based Phy ANESTHESIA Ultrasound - ECHO (Philips EPIQ7 3D) 5 925, Health Park Medical Center, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Other, ETCO2 module 6 33, Health Park Medical Center, Hosp Based Phy ANESTHESIA ETCO2 Module (MMS) 1 5, Health Park Medical Center, Hosp Based Phy ANESTHESIA Other, BIS MONITOR 1 10, Health Park Medical Center, Hosp Based Phy ANESTHESIA Other, HEAD BUTLER WITH BED CLAMPS Health Park Medical Center, Hosp Based Phy OPERATING ROOM Heart Lung Bypass Unit 4 680, Health Park Medical Center, Hosp Based Phy ANESTHESIA Cardiac Monitor (MP5) 2 24, Health Park Medical Center, Hosp Based Phy ENDOSCOPY Other, ENDO FLUSH PUMP 1 1, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, SYNTHES BROKEN SCREW REMOVAL SET 1 19, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, MOBILE STORAGE CARTS 1 3, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 76, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, SYSTEM - ORTHO POWER TRAY INSERTS 1 13, Health Park Medical Center, Hosp Based Phy OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 68, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 14, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 53, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, ORTHO POWER TRAY INSERTS 1 27, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, SYSTEM - KERRISON INSTRUMENT UPGRADE 1 29, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, JUMBO MAYO STAND 2 1, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Laparoscope 10mm, 30 DEGREE 2 6, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Microscope-Neuro 1 300, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, WILSON FRAME PAD SET 1 1, Cape Coral Hospital, Hosp Based Phy ENDOSCOPY Scope Washer D w/leak Test 1 54, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Tray-Urology Camera 3 54, Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, RIGID CYSTOSCOPE, LONG 2 13,106

129 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 802 Cape Coral Hospital, Hosp Based Phy OPERATING ROOM Other, RIGID CYSTOSCOPE, SHORT 1 6, Cape Coral Hospital, Hosp Based Phy ENDOSCOPY Colonoscope-Pedi 1 42, Cape Coral Hospital, Hosp Based Phy PERI-ANESTHESIA CARE UNIT Sonosite X-Porte (Needle Guidance) 1 63,081 SURGICAL SERVICES Total 6,151,037 FACILITIES 1857 Lee Memorial Hospital, Hosp Based Phy FOOD & NUTRITION SERVICES Other, Walkin Cooler and Freezer Replacement 1 395, Lee Memorial Hospital, Hosp Based Phy REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 563 (Design) - LMH 1 25, Lee Memorial Hospital, Hosp Based Phy REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 564 (Design) - LMH 1 25, Lee Memorial Hospital, Hosp Based Phy REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 565 (Design) - LMH 1 25, Lee Memorial Hospital, Hosp Based Phy ER HOLDING UNIT Air Handler Unit, Plant Ops - AHU 339 (Design) - LMH 1 25, Lee Memorial Hospital, Hosp Based Phy REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 665 (Design) - LMH 1 25, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, Plant Operations - AHU LMH 1 220, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, gas farm controllers and manifold upgrade 1 25, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, UTILITY PIPING REPLACEMENT 1 125, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, COOLING TOWER SUPPORTS AND CATWALK REPLACEMENTS 1 250, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, REPLACEMENT OF MRI CHILLER UNIT 1 10, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, COOLING TOWER CONDENSER PIPING REPLACEMENT 1 450, Lee Memorial Hospital, Hosp Based Phy OPERATING ROOM Infrastructure, Surgery Services - OR Electrical Upgrades - LMH 1 250, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, Plant Operations - RTU ED X-ray - LMH 1 65, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, Plant Ops - IT Data Ctr Liebert Replacement - LMH 1 240, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, Plant Operations - 5 North Roof Replacement - LMH 1 325, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, Plant Ops - Clinial Lab Roof Replacement - LMH 1 102, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, Plant Operations - RTU LMH 1 197, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, Plant Operations - AHU LMH 1 350, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, Plant Operations - AHU 989 Replacement - LMH 1 65, Lee Memorial Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, Plant Ops - Kalwall Panels Main Entrance - LMH 1 150, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Infrastructure, Plant Ops - Modernize Service Elevator #8 - LMH 1 350, Corporate Services PROPERTY MANAGEMENT Infrastructure, LPG/Outpatient Renovation/Coordination 1 462, Corporate Services PROPERTY MANAGEMENT Code Compliance/Life Safety, Property Management Life Safety 1 40, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Other, Facilities Office Renov Add'l Funds 1 50, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Other, System Project Coordination 1 300, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO ADA, Code requried updating to ADA requirements 1 200, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Infrastructure, Nurse Call - Upgrade Wescom to CAS - LMH 1 175, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Code Compliance/Life Safety, Replace Exhaust Fans 12, 9, 11, 20 - HPMC 1 40, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Infrastructure, HPCC - Phase 4 Continuation 1 200, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 14 (Design) - HPMC 1 25, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 39 (Design) - CCH 1 25, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 25 (Design) - CCH 1 25, Corporate Services FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 26 (Design) - CCH 1 25, Corporate Services FACILITY PLNG & CONSTRUCTION Code Compliance/Life Safety, Major Facilities Capital Budget Code Compliance 1 400, Corporate Services FACILITIES ASSET MANAGEMENT Furniture, To fund capital furniture in FY , Corporate Services FACILITIES ASSET MANAGEMENT Signage, TO FUND SIGNAGE IN FY , Corporate Services FACILITIES WAREHOUSE Other, STORAGE RACKS FOR WAREHOUSE 1 10, Corporate Services FACILITIES WAREHOUSE Other, SPECIALTY EQUIPMENT FOR WAREHOUSE 1 15, Corporate Services FACILITY PLNG & CONSTRUCTION Sitework 1 500, Corporate Services FACILITY PLNG & CONSTRUCTION Infrastructure, Major Facilities Capital Infrastructure 1 900, Corporate Services FACILITY PLNG & CONSTRUCTION Building Controls/Energy Management, Major Facilities Capital Energy Management 1 350, Cancer Center PHARMACY - CANCER Expand Space, Sterile Product Mixing Area 1 653, Gulf Coast Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, COOLING TOWER PIPING 1 100, Gulf Coast Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, REDESIGN OF SOUTH TOWER EXHAUST 1 200, Gulf Coast Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, ICE MACHINE REPLACEMENT 1 35, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, REPLACE HOT WATER HEATERS MAIN HOSPITAL KITCHEN 1 40, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, BOILER ROOM SUPPLY FAN REPLACEMENT 1 20, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Fan Coil Unit, FCU 5 - HPMC - (IT) 1 75, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Building Controls/Energy Management, Plant Ops - MOB HVAC Controls, VAVs, PIBs - GCMC 1 250, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, ENTRANCE A OUTSIDE DOORS AND CONTROLS 1 20, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, PATIENT BATHROOM FACUET REPLACEMENT 1 15, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, PIPING REPLACEMENT 1 30, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, AHU 8 Replacement - HPMC 1 447, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, REPLACEMENT OF HOT WATER HEATERS AND 1 35, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, CONTINUING REPLACEMENT OF ICE MACHINES 1 60, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, Exhaust Fan Replacement 1 4, Health Park Medical Center, Hosp Based Phy PLANT OPERATIONS Infrastructure, REPLACEMENT OF OR DOORS 1 60, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Fan Coil Unit, PATIENT ROOM FCU REPLACEMENT 1 50, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, REPLACEMENT OF COILS IN AHUS 1 38, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, REPLACEMENT OF DUCTWORK 1 25, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, VARIABLE SPEED DRIVES FOR PUMPS IN PLANT 1 12, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, BED STORAGE LIFT 1 75, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, AHU 19 Replacement - CCH 1 339, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, AHU 18 Replacement - CCH 1 325, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, AHU 38 Replacement - CCH 1 60, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, FIRE DAMPER REPLACEMENT 1 30, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, REPLACE EXTERIOR DOORS 1 30, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, REPLACEMENT OF SUPPLY FANS 1 & , Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, AHU #16 Replacement - CCH 1 21, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Air Handler Unit, AHU 40 Blower Assembly Replacement - CCH 1 36, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, REPLACEMENT OF PUMP ON DOMESTIC WATER PUMP 1 2, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Building Controls/Energy Management, UPGRADE ELE CONTROL VALVES FOR COOLING TOWER 1 38, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Infrastructure, CHILLED WATER PUMP 1 30, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Sitework, UPGRADE PARKING LOT LIGHTING 1 75, Cape Coral Hospital, Hosp Based Phy PLANT OPERATIONS Code Compliance/Life Safety, SURGERY SERVICES DOORS AND FRAME REPLACEMENT 1 100, LMH Child Development Centers LMH DAY CARE CTR Fan Coil Unit, DAY CARE AC UNIT MINI SPLIT 1 15, HP Child Development Centers HP DAY CARE CTR Infrastructure, REPLACE WINDOWS 1 5, CCH Child Development Center CCH DAY CARE CTR Other, ROOM DIVIDERS FOR LARGE ROOM 1 50, CCH Child Development Center CCH DAY CARE CTR Other, Replace 4-14 A/C unit 4 42, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Pool vacuum 1 2, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Pool heater 1 7, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Other, Pool chemical controllers 1 13, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Air Handler Unit, AHU #44 EVAP COIL REPLACEMENT W/UV LIGHT 1 24, Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Air Handler Unit, REPLACEMENT OF CONDENSING UNIT , Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Air Handler Unit, REPLACEMENT OF CONDENSING UNIT , Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Air Handler Unit, REPLACEMENT OD CONDENSING UNIT , Wellness Center of Cape Coral WELLNESS CENTER OF CAPE CORAL Sitework, REPLACEMENT OF POOL PUMP 1 19,143

130 FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 2023 LPG Primary LPG FAMILY MEDICINE - CLAYTON CT Air Handler Unit, FPCC - Air Handlers 1 20, LPG Primary LPG INTERNAL MEDICINE - LABELLE Air Handler Unit, LaBelle - Package Units 1 20, LPG Primary LPG FAMILY-INTERNAL MEDICINE - BASS RDAir Handler Unit, LPG Bass - 5 Split Systems 1 27, Lee Community HealthCare LEE COMMUNITY HEALTHCARE - N FT MYERAir Handler Unit, LCH NFM - Package Units 1 14, Health Park Care Center ADMINISTRATION SERVICES - HPCC Infrastructure, REPLACEMENT OF PATIENT ROOM PTAC UNITS 1 8,000 INFORMATION SYSTEMS FACILITIES Total 12,000, Corporate Services I/S INFORMATION TECHNOLOGY SVCS GEAC Replacement, Conversion for all General Financial Applications 1 4,000, Corporate Services I/S DATA NETWORK SERVICES Office Automation Refresh 1 1,104, Corporate Services I/S INFORMATION TECHNOLOGY SVCS EPIC, Inpatient and Ambulatory Licenses 1 1,180, Corporate Services I/S DATA NETWORK SERVICES IS Infrastructure 1 4,795, Corporate Services I/S DATA NETWORK SERVICES EPIC, Infrastructure Upgrades 1 1,880, Corporate Services I/S INFORMATION TECHNOLOGY SVCS Other, Best Care Collaborative IT Needs 1 102, Corporate Services I/S INFORMATION TECHNOLOGY SVCS Diagnostic/Imaging, Workstation Replacements (Radiology/Cardiology) 1 675, Corporate Services I/S INFORMATION TECHNOLOGY SVCS Strategic Innovation/Optimization 1 1,020, Corporate Services I/S INFORMATION TECHNOLOGY SVCS Software Upgrades 1 282,000 STRATEGIC GROWTH/NEW DEVELOPMENT INFORMATION SYSTEMS Total 15,040, Corporate Services OVERHEAD CENTER Strategic Growth/New Development Projects 12,096,250 Next Gen ACO/ Medicaid Provider Service Network Infrastructure 5,000,000 LeeSar Expansion 4,600,000 STRATEGIC GROWTH/NEW DEVELOPMENT Total 21,696,250

131 BOARD OF DIIRECTORS RECOMMENDED FOR BOARD ACTION (Action includes Acceptance, Approval, Adoption, etc) Keep form to one page, to: by Noon Eight (8) days PRIOR to presenting. DATE: September 28 th, 2017 LEGAL SERVICE REVIEW? YES NO_X_ SUBJECT: FY 2018 Room Rates REQUESTOR & TITLE: Ben Spence, Chief Financial Officer PREVIOUS BOARD ACTION ON THIS ITEM (IF ANY) (justification and/or background for recommendations internal groups which support the recommendation) On September 22 nd, 2016, the Board approved the FY 2017 room rates. This approval is requested annually for each budget cycle. SPECIFIC PROPOSED MOTION: To approve the FY 2018 Acute Care Hospital room rates which provide for a 5% increase over current rates. FINANCIAL IMPLICATIONS Budgeted Account Non-Budgeted (Annual Project Budget and Total Project Budget) STAFFING & OPERATIONAL IMPLICATIONS (including FTEs, facility needs, etc.) PURPOSE/REASON FOR RECOMMENDATION SUMMARY (including alternatives considered, Pros and Cons) Attached you will find the FY 2018 Room Rate Schedule. Lee Memorial Health System Board of Directors Updated 3/2/17

132 LEE HEALTH SYSTEM OPERATING BUDGET 2018 ACUTE CARE HOSPITALS ROOM RATE COMPARISON Current Proposed LHS LEVEL OF CARE LHS LHS Increase ROUTINE PRIVATE $ 1,327 $ 1,399 5% ROUTINE SEMI PRIVATE $ 1,327 $ 1,399 5% PROGRESSIVE CARE - SURG $ 2,195 $ 2,314 5% PROGRESSIVE CARE - MED $ 2,195 $ 2,314 5% PROGRESSIVE CARE - NEURO $ 2,195 $ 2,314 5% INTENSIVE CARE - MEDICAL $ 3,342 $ 3,522 5% INTENSIVE CARE - SURGICAL $ 3,342 $ 3,522 5% INTENSIVE CARE - OPEN HEART $ 3,342 $ 3,522 5% OB PRIVATE $ 2,704 $ 2,839 5% OBSTETRICS SEMI $ 1,352 $ 1,425 5% NURSERY $ 1,125 $ 1,186 5% NICU $ 3,150 $ 3,320 5% PEDIATRICS ROUTINE $ 1,642 $ 1,731 5% PEDIATRICS PROGRESSIVE $ 2,195 $ 2,314 5% PEDIATRICS INTENSIVE $ 3,341 $ 3,521 5%

133 BOARD OF DIRECTORS FINANCIAL AND STATISTICAL REPORTS AS OF AUGUST 31 ST, 2017 (Ben Spence, Chief Financial & Business Services Officer) (ACCEPT) Lee Memorial Health System Board of Directors

134 LEE MEMORIAL HEALTH SYSTEM LEE COUNTY, FLORIDA CONSOLIDATED FINANCIAL STATEMENTS AND STATISTICAL REPORTS AUGUST 31, 2017

135 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS & STATISTICAL REPORTS TABLE OF CONTENTS SECTION A PAGE CONSOLIDATED SCHEDULES HIGHLIGHTS A.1 EXECUTIVE SUMMARY A.2 CONSOLIDATED STATISTICAL REPORT A.3 CONSOLIDATED INCOME STATEMENT A.4 STATEM ENT OF CASH FLOWS A.5 CONSOLIDATED BALANCE SHEET A.6 CONSOLIDATED FINANCIAL RATIOS A.7 CONSOLIDATED OPERATING RATIOS A.8 CONSOLIDATED PAYOR MIX A.9

136 Lee Memorial Health System Operating Highlights For the month ended August 31, 2017 Adjusted admits for the month ended August 31, 2017 are 12,301 which is 655 or 5.6% higher than budget. Actual inpatient admits for the month are 6,582 which are 354 admits or 5.7% greater than budget. Inpatient days are 33,000 or 3.0% higher than budget which resulted in a 5.01 day length of stay. Emergency room visits are 1.1% higher than budget at 17,220 and outpatient surgeries of 1,989 are greater than budget by 5.8%. Net patient revenue for August reflects a $6.1 million or 4.5% favorable variance to budget. The majority of this variance is due to a volume variance of $7.7 million offset by a negative rate variance $1.5 million. Net Patient Revenue per CMI adjusted admit for the month ended August 31, 2017 is $7,313 vs. budget of $7,494. Total operating expenses before depreciation and interest expense are 6.8% greater than budget. Salaries & Wages are greater than budget at $69.2 million, and above budget on a case mix adjusted admission basis by $88 as well. The majority of this variance ($3.7 million) was due to staff not flexing to the volumes as well as payments made per physician agreements. The average hourly pay rate is $34.01 which is $0.37 lower than budget. Productivity as measured by FTEs/AOB is unfavorable to budget by 2.6% (5.78 actual vs budget). Productive FTE s per adjusted daily admission were 0.8% lower than budget at vs. a budget of Supply expense is higher than budget by $1.5 million or 5.8%, while on a case mix adjusted admission basis the supply variance is favorable at $1,380 actual vs. $1,397 budget. Total operating costs per case mix adjusted admit are less than budget at $6,803 actual vs. $6,820. For August 2017, the gain from operations is $3.0 million or 2.0% versus a budget of $4.3 million or 3.1%. Excess revenue over expenses is a gain of $7.7 million versus a budget of $10.0 million. For the month, Cash & Investments decreased by $2.0 million to $1,010.9 million. Total sources of cash from operations are $12.1 million and from investments are $4.0 million offset by uses of cash totaling $18.1 million. The majority of the uses of cash were due to cash outflows of $17.9 million for purchases of property, plant & equipment. Days in Accounts Receivable decreased from 47.2 days in July to 46.5 days resulting in a $4.9 million increase in cash. Total Notes & Bonds payable on August 31, 2017 is $680.3 million resulting in the Cash to Debt ratio of 148.6%. Page A.1

137 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED EXECUTIVE SUMMARY For the Period Ending August 31, 2017 CURRENT MONTH Budget Actual Prior Year Budget Actual Prior Year Inpatient Volumes: Admits - Adults & Peds 6,228 6,582 6, % 6.2% 73,636 73,850 72, % 1.4% Patient Days - Adults & Peds 32,024 33,000 31, % 6.4% 376, , , % 1.1% Short Stay Days 4,667 4,338 4, % -6.1% 51,568 52,051 51, % 1.9% Total Patient Days plus Short Stay Days 36,691 37,338 35, % 4.7% 427, , , % 1.2% Average Length of Stay % -0.2% % 0.3% Inpatient Surgeries 1,711 1,751 1, % 1.6% 20,020 20,218 19, % 3.4% Outpatient Volumes: Emergency Room Visits 17,027 17,220 17, % -0.5% 202, , , % 2.2% Outpatient Surgeries 1,880 1,989 2, % -3.8% 22,234 21,597 22, % -3.3% Hospital Based Physician Visits 39,926 31,535 32, % -2.4% 436, , , % -5.0% Physician Visits 85,821 79,853 75, % 5.9% 889, , , % 15.4% Home Health Visits 7,269 5,112 6, % -17.7% 78,546 61,516 63, % -2.4% Adjusted Admits 11,646 12,301 11, % 4.7% 136, , , % 3.3% (overall in/outpat volume indicator) Total Case Mix Index % 1.4% % 0.7% Operating Ratios: Net Revenue/Adj Adm CMI 7,494 7,313 7, % 2.8% 7,206 7,304 7, % 3.3% Operating Exp/Adj Adm CMI 6,820 6,803 6, % -2.2% 6,547 6,668 6, % -3.9% Supply Exp/Adj Adm CMI 1,397 1,380 1, % 6.6% 1,393 1,431 1, % -3.0% Wages/Ben - % of Net Oper Rev 55.7% 55.5% 53.7% 0.4% -3.3% 54.8% 54.2% 53.3% 1.1% -1.7% Supplies as a % of Net Oper Rev 18.2% 18.5% 20.2% -1.6% 8.7% 18.9% 19.1% 19.1% -1.5% -0.1% Charity/Bad Debt - % of Gross Rev 6.8% 7.4% 7.5% -9.4% 0.7% 6.8% 6.7% 6.6% 0.6% -1.5% FTEs/AOB % -1.5% % -2.4% Productive Hours/Adjusted Admit % -1.3% % -2.0% Average Hourly Rate % -5.4% % -4.3% Financial Ratios: Operating Margin (%) 3.1% 2.0% 2.2% -33.9% -8.9% 4.7% 4.4% 5.1% -7.9% -13.8% Excess Margin (%) 6.9% 5.1% 3.7% -25.8% 37.0% 8.4% 9.4% 9.9% 12.0% -5.0% Liquidity Ratios: Days Cash on Hand Cash to Debt (%) 157.2% 148.6% 145.3% Days in Acct Receivable Income Statement Summary (in Thousands) Total Net Operating Revenue 139, , , % 8.5% 1,566,087 1,595,905 1,490, % 7.1% Total Operating Expenses 135, , , % -8.7% 1,491,851 1,526,248 1,415, % -7.9% Consolidated Gain(Loss) from Oper 4,315 2,971 3, % -1.1% 74,235 69,657 75, % -7.7% Investment Earnings/Non Op Income 5,667 4,681 2, % 127.1% 62,323 88,511 79, % 11.0% Consolidated Excess Rev over Exp 9,982 7,652 5, % 51.0% 136, , , % 1.9% Balance Sheet Highlights (In Thousands): Cash & Investments 1,040,707 1,010,909 1,025,735 Bonds & Notes Payable 662, , ,120 Act to Bud % Variance Act to Prior % Variance YEAR-to-DATE Act to Bud % Variance Act to Prior % Variance CMI = Case Mix Index Page A.2

138 LEE HEALTH CONSOLIDATED STATISTICAL SUMMARY For the Period Ending August 31, 2017 Budget Actual Current Month Year-to-Date Prior Year % Variance % Variance Budget Actual Prior Year Act to Bud Act to PY Act to Bud Act to PY Admissions ADULTS 5,554 5,983 5, % 6.6% 66,153 67,512 65, % 2.7% PEDIATRICS % 12.0% 4,100 3,283 3, % -15.0% NICU % -9.9% % -5.8% POST ACUTE % -4.6% 2,597 2,319 2, % -3.7% Total Adult & Peds 6,228 6,582 6, % 6.2% 73,636 73,850 72, % 1.4% NEWBORNS % -0.2% 5,602 5,620 5, % -0.1% Total Admissions 6,749 7,167 6, % 5.6% 79,238 79,470 78, % 1.3% Patient Days ADULTS 24,062 25,077 23, % 5.6% 290, , , % 1.7% PEDIATRICS 1,126 1, % 24.4% 13,422 11,488 12, % -9.0% NICU 1,656 1,758 1, % 12.7% 15,581 15,660 14, % 6.3% POST ACUTE 5,181 5,084 4, % 5.0% 56,295 51,544 52, % -1.4% Total Adult & Peds 32,024 33,000 31, % 6.4% 376, , , % 1.1% NEWBORNS 1,150 1,341 1, % -3.0% 12,602 12,704 12, % -1.8% Total Patient Days 33,174 34,341 32, % 6.0% 388, , , % 1.0% Average Length of Stay ADULTS % 0.9% % 0.9% PEDIATRICS % -11.0% % -7.0% NICU % -25.0% % -12.8% POST ACUTE % -10.0% % -2.4% Total Adult & Peds % -0.2% % 0.3% NEWBORNS % 2.8% % 1.7% Total Length of Stay % -0.3% % 0.3% OP Registrations EMERGENCY ROOM 17,027 17,220 17, % -0.5% 202, , , % 2.2% OP SURGERY CASES 1,880 1,989 2, % -3.8% 22,234 21,597 22, % -3.3% Subtotal 18,907 19,209 19, % -0.8% 224, , , % 1.6% Visits HOME HEALTH VISITS 7,269 5,112 6, % -17.7% 78,546 61,516 63, % -2.4% HOSP BASED PHY VISITS 39,926 31,535 32, % -2.4% 436, , , % -5.0% PHYSICIAN VISITS 85,821 79,853 75, % 5.9% 889, , , % 15.4% TRAUMA SERVICES DISTRICT 1,015 1,030 1, % -9.1% 12,148 10,964 11, % -5.0% Subtotal 134, , , % 2.1% 1,416,151 1,336,392 1,239, % 7.8% TOTAL OP 152, , , % 1.7% 1,641,022 1,559,651 1,459, % 6.9% Page A.3

139 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATING STATEMENT OF OPERATIONS For the Period Ending August 31, 2017 (in thousands) Current Month Year-to-Date Act to Bud % Act to Prior Budget Actual Prior Year Variance % Variance Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance INPATIENT REVENUE 319, , , % 9.2% 3,739,154 3,719,103 3,531, % 5.3% OUTPATIENT REVENUE 277, , , % 6.0% 3,178,787 3,170,478 2,895, % 9.5% TOTAL PATIENT REVENUE 597, , , % 7.7% 6,917,941 6,889,581 6,426, % 7.2% DED FROM REV-MEDICARE 251, , , % -13.8% 2,878,480 2,925,871 2,511, % -16.5% DED FROM REV-MEDICAID 72,928 78,967 61, % -28.0% 787, , , % -20.2% DED FROM REV-CHARITY 21,198 26,743 23, % -13.0% 245, , , % -17.5% DED FROM REV-HMO/PPO 55,530 63,178 59, % -5.6% 650, , , % -9.6% DED FROM REV-OTHER 40,644 42,998 63, % 32.7% 605, , , % 38.9% DED FROM REV-BAD DEBT 19,359 18,638 18, % 0.7% 222, , , % 0.9% TOTAL DED FROM REV 460, , , % -7.2% 5,390,640 5,330,078 4,974, % -7.1% NET PATIENT REVENUE 136, , , % 9.1% 1,527,301 1,559,504 1,451, % 7.4% OTHER OPERATING REVENUE 3,559 3,244 3, % -12.5% 38,785 36,401 38, % -6.3% TOTAL OPERATING REV 139, , , % 8.5% 1,566,087 1,595,905 1,490, % 7.1% OPERATING EXPENSES PROD SALARIES 58,429 59,701 53, % -10.7% 649, , , % -10.0% PROD OVERTIME 1,650 1,685 1, % 2.3% 19,158 21,980 21, % -0.7% CONTRACT LABOR % 78.0% 1,686 2,393 3, % 37.7% NON-PROD SALARIES 6,097 7,742 5, % -39.5% 68,376 82,288 71, % -14.9% TOTAL SALARIES & WAGES 66,243 69,230 61, % -12.3% 738, , , % -9.9% FRINGE BENEFITS 11,651 11,554 10, % -11.0% 119, , , % -2.5% HEALTH CARE ACCESS 1,530 1,531 1, % 2.0% 17,758 18,177 16, % -10.8% SUPPLIES 25,398 26,880 27, % 0.9% 295, , , % -7.2% OTHER SERVICES 6,486 7,147 6, % -13.6% 75,457 74,301 75, % 1.9% PURCHASED SERVICES 12,706 16,136 15, % -6.8% 141, , , % -9.8% TOTAL OPER EXPENSES 124, , , % -8.4% 1,387,621 1,423,808 1,318, % -8.0% EBITDA 15,818 13,185 12, % 9.0% 178, , , % -0.2% DEPRECIATION/AMORT 9,433 8,425 7, % -15.2% 84,479 82,994 76, % -8.2% INTEREST EXPENSE 2,070 1,790 1, % -0.8% 19,751 19,446 20, % 3.9% OVERHEAD ALLOCATION (0) 0 (0) 137.1% 200.0% (0) 0 (0) % % GAIN(LOSS) FROM OPER 4,315 2,971 3, % -1.1% 74,235 69,657 75, % -7.7% Page A.4

140 LEE MEMORIAL HEALTH SYSTEM STATEMENT OF CASH FLOWS For the Period Ending August 31, 2017 (In thousands) Current Month Year to Date Sources of Cash: Gain From Operations 2,971 69,657 Non Operating Revenue (excluding Investment Income) ,083 Depreciation & Amortization 8,425 82,994 (Gain)/Loss on Sale of Assets (16) (40) Total Sources of Cash 12, ,694 Uses of Cash: Change in Patient Accounts Receivable 4,902 (25,501) Repayments Long Term Debt Principal (1,586) (22,659) Additions to Property, Plant & Equipment, Net (17,907) (176,439) Change in All Other Assets 644 7,777 Change in All Other Liabilities (4,105) (23,967) Total Uses of Cash (18,052) (240,789) Cash Provided (Used) Prior to Investment Income (5,958) (78,095) Cash Provided from Investment Income 3,967 78,428 Cash Provided (Used) (1,991) 333 Cash Balance, beginning of period 1,012,901 1,010,576 Cash Balance, end of period 1,010,909 1,010,909 Total Bonds & Notes Payable 680,265 Cash to Debt Ratio 148.6% Page A.5

141 LEE MEMORIAL HEALTH SYSTEM CONSOLDIATED BALANCE SHEET For the Period Ending August 31, 2017 in Thousands (000's) ASSETS Current Prior Month Prior Year LIABILITIES AND NET ASSETS Current Prior Month Prior Year Current Assets: Current Liabilities: Cash and Cash Equivalents * 19,345 25,259 43,265 Accounts Payable 40,475 44,456 55,692 Short-term Cash Investments * 966, , ,046 Current Installments of LT Debt 38,037 38,048 36,321 Assests whose use is restricted ,034 Accrued Expenses Net Patient Accounts Receivable 213, , ,168 Employee Compensation 43,626 36,672 40,035 Inventory 31,782 31,757 30,660 Interest 5,741 4,505 8,308 Other Current Assets 33,228 33,343 35,049 Other 28,159 28,175 36,744 Estimated Third Party 41,364 51,478 59,307 Total Current Assets 1,264,768 1,271,790 1,248,222 Total Current Liabilities 197, , ,408 Noncurrent Assets: NonCurrent Liabilities: Long Term Investments Assests whose use is restricted * 25,189 25,150 24,265 Capital Assets, Net 953, , ,229 LT Debt Excluding Current Installments 642, , ,661 Other Assets, Net 40,704 41,000 37,300 Other Liabilities 100,772 98,847 82,869 Total Noncurrent Assets 1,019,607 1,010, ,794 Total Noncurrent Liabilities 743, , ,529 Deferred Outflows of Resources: Deferred Inflows of Resources: Deferred Loss on Debt Refunding 2,560 2,609 5,617 Excess Consideration Provided for Acquisition 101, , ,654 Deferred Inflows on Pension 4,320 4,428 5,468 Total Deferred Outflows of Resources 104, , ,271 Total Deferred Inflows of Resources 4,320 4,428 5,468 Net Position: Restricted for Non-Expendable 5,992 5,992 5,992 Expendable 34,336 33,753 58,232 Net Investment in Capital Assets 273, , ,247 Unrestricted 1,130,273 1,134,337 1,067,411 Total Net Position 1,444,049 1,436,398 1,285,882 Total Assets and Deferred Outflows of Resources 2,388,771 2,386,860 2,280,287 Total Liabilities and Net Position 2,388,771 2,386,860 2,280,287 * Cash & Investments Page A.6

142 LEE MEMORIAL HEALTH SYSTEM FINANCIAL RATIOS For the Year-to-Date Ending August 31, Moody's Financial FYE YTD Median Goals 9/30/ /31/17 PROFITABILITY RATIOS: Operating Margin 3.2% 4.0% 5.2% 4.4% + Excess Margin 6.1% 8.2% 9.9% 9.4% + Operating Cash Flow Margin 10.0% 10.9% 11.6% 10.8% + LIQUIDITY RATIOS: Days Cash on Hand Cushion Ratio (x) Cash to Debt 160.6% 152.2% 143.1% 148.6% + CAPITALIZATION RATIOS: Debt to Capitalization 33.9% 33.7% 36.6% 33.0% (-) Annual Debt Service Coverage (x) Debt to Cash Flow (-) NOTE: + = Ratios that should be above the Moody's median (-) = Ratios that should be lower than the Moody's median Page A.7

143 LEE MEMORIAL HEALTH SYSTEM OPERATING RATIOS For the Period Ending August 31, 2017 (in thousands) Current Month Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance Year-to-Date Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance AS % NET OPERATING REVENUE Wages and Benefits 55.7% 55.5% 53.7% 0.4% -3.3% 54.8% 54.2% 53.3% 1.1% -1.7% Supplies 18.2% 18.5% 20.2% -1.6% 8.7% 18.9% 19.1% 19.1% -1.5% -0.1% All Other Operating Expenses 14.8% 17.0% 17.1% -14.9% 0.4% 15.0% 15.9% 16.0% -6.1% 0.8% Capital Costs 8.2% 7.0% 6.8% 14.8% -3.6% 6.7% 6.4% 6.5% 3.6% 1.3% EBDITA Margin 11.3% 9.1% 9.0% -20.0% 0.5% 11.4% 10.8% 11.6% -5.4% -6.8% Operating Margin 3.1% 2.0% 2.2% -33.9% -8.9% 4.7% 4.4% 5.1% -7.9% -13.8% Excess Margin 6.9% 5.1% 3.7% -25.8% 37.0% 8.4% 9.4% 9.9% 12.0% -5.0% Per CMI ADJ ADMIT/VISIT Net Operating Revenue 7,690 7,480 7, % 2.2% 7,389 7,474 7, % 2.9% Total Operating Expenses 6,820 6,803 6, % -2.2% 6,547 6,668 6, % -3.9% Wages and Benefits 4,284 4,148 3, % -5.6% 4,048 4,051 3, % -4.7% Supplies 1,397 1,380 1, % 6.6% 1,393 1,431 1, % -3.0% All Other Operating Expenses 1,140 1,274 1, % -1.8% 1,105 1,186 1, % -2.1% Capital Costs % -5.9% % -1.6% Operating Margin % -6.9% % -11.3% Excess Margin % 42.3% % -2.1% LABOR Productive FTE's/Adj Daily Admit % -1.3% % -2.0% Average Hourly Rate % -5.1% % -4.1% OP Rev % of Total Revenue 46.5% 46.5% 47.2% -0.1% -1.6% 45.9% 46.0% 45.1% 0.1% 2.1% Page A.8

144 LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED - PAYOR MIX (BASED ON GROSS REVENUE) For the Period Ending August 31, 2017 Current Month Budget Actual Prior Year Budget Year-to-Date Actual Prior Year MEDICARE 34.1% 33.0% 31.0% 34.6% 33.8% 34.1% MEDICARE HMO 13.2% 15.1% 13.8% 13.5% 15.2% 13.7% MEDICAID 3.3% 5.6% 2.7% 3.3% 3.6% 3.1% MEDICAID HMO 9.6% 10.1% 9.8% 9.3% 9.2% 9.3% HMO/PPO 17.7% 21.0% 20.0% 17.8% 18.8% 18.4% COMMERCIAL 4.0% 4.3% 3.5% 4.0% 3.8% 3.9% OTHER 18.1% 10.9% 19.2% 17.5% 15.6% 17.5% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% MEDICARE CASE MIX INDEX SYSTEM CASE MIX INDEX (In Thousands) 09/30/16 08/31/17 Variance Gross Accounts Receivable 437, ,477 37,340 Net Accounts Receivable 189, ,669 24,256 Net Days in Accounts Receivable Page A.9

145 Board of Directors Financial Update FY 2017 period ending 08/31/17 Presented on 9/28/17 Financial Services # Rev. 10/16

146 System Adjusted Admits FY 17 Period Ending 8/31/2017 Adjusted admission increased 5% from prior year and 5.6% from budget

147 Hospital Census For the eleven months ending August 31, 2017 Inpatient Admissions Budget Actual Prior $ Variance Actual to Budget % Variance Actual to Budget $ Variance Actual to Prior % Variance Actual to Prior 73,636 73,850 72, % 1, % Average Length of Stay Budget Actual Prior $ Variance Actual to Budget % Variance Actual to Budget $ Variance Actual to Prior % Variance Actual to Prior (0.04) -0.8% (0.02) -0.4%

148 Hospital Census For the eleven months ending August 31, 2017 Case Mix Index Budget Actual Prior $ Variance Actual to Budget % Variance Actual to Budget $ Variance Actual to Prior % Variance Actual to Prior % 0 0.6% >1.0 = more resource intensive than average <1.0 = less resources intensive than average Average Daily Census (ADC) Budget Actual Prior Change from Prior Year % Change from Prior Year % Variance from Budget Inpatients 1,123 1,118 1, % -0.4% Observation % 0.6% ADC 1,277 1,273 1, % -0.3%

149 Outpatient For the eleven months ending August 31, 2017 Outpatient % of Gross Revenues % % Variance Variance Budget Actual Prior Actual to Budget Actual to Prior 45.9% 46.0% 45.1% 0.1% 0.8% Primary Care Physician Visits $ % Variance Variance $ Variance Actual to Actual to Actual to Budget Actual Prior Budget Budget Prior % Variance Actual to Prior 261, , ,443 (7,394) 2.8% 12, %

150 Payor Mix (Based on Gross Revenue) Year to date through 8/31/ % 22.6% 12.8% 49.0% Medicare Medicaid Commercial/HMO/PPO Other Year to date through 8/31/ % 22.3% 12.4% 47.8% Medicare Medicaid Commercial/HMO/PPO Other

151 Net Revenue & Operating Expense Analysis FY 2017 Ending 8/31/2017

152 Net Patient Revenue For the eleven months ending August 31, 2017 Budget Actual Variance to Budget Net Patient Revenue $1,527,301,252 $1,559,503, % $ Variance to Budget $32,202,267 Net Patient Revenue per CMI Adjusted Admission $7,206 $7, % Case Mix Index (CMI) % Adjusted Admissions 136, , % Due to Volume Variance $6,381,915 Due to Rate Variance $25,820,352 Total Variance to Budget $32,202,267

153 Charity Write-offs & Bad Debt Expense For the eleven months ending August 31, 2017 Budget Actual Variance Charity Write-offs 245,894, ,368,482 18,473,599 Bad Debt Expense 222,247, ,996,262 (23,251,438) Total Charity Write-offs & Bad Debt Expense 468,142, ,364,744 (4,777,839) Gross Patient Revenues 6,917,941,387 6,889,581,130 (28,360,257) Net Patient Revenue 1,527,301,252 1,559,503,519 32,202,267 Charity as a % of Gross Revenue 3.6% 3.8% Bad Debt as a % of Expected Net Revenue 14.6% 12.8%

154 Salaries For the eleven months ending August 31, 2017 Salaries & Wages Budget Actual $ Variance % Variance Salaries & Wages $ 738,389,122 $ 748,601,331 $ 10,212, % Labor Productivity Budget Actual $ Variance % Variance Productive Hours per Adjusted Patient Day % Adjusted Patient Day 695, ,520 (2,406) -0.3% Average Hourly Rate %

155 Supplies & Purchased Services For the eleven months ending August 31, 2017 Supplies Budget Actual $ Variance % Variance Other Supplies $ 295,352,849 $ 305,451,961 $ 10,099, % Variance Heart Valves $ 3,490,125 Drug Expense $ 1,856,975 Reagents $ 2,105,855 Other Supplies $ 2,646,157 Purchased Services Budget Actual $ Variance % Variance Purchased Services 141,081, ,794,223 19,712, % Variance IT Maintenance Contracts $ 3,616,599 BioMed Contracts $ 2,187,431 Hospitalists Contracts $ 6,722,606 Other Physician Contracts $ 1,962,984 Consulting $ 4,406,072

156 Percent of Total Operating Revenue For the eleven months ending August 31, 2017 FYTD 2017 FYTD % 6.4% 16.0% 6.5% 4.4% 5.1% 19.1% 19.1% 54.2% 53.3% Salaries/Benefits Supplies Salaries/Benefits Supplies Other services Depreciation/Interest Other services Depreciation/Interest Gain from operations Gain from operations

157 Financial Statements For the eleven months ending August 31, 2017 Current Month (In Thousands) % Variance Budget Actual Prior Year STATEMENT OF OPERATIONS: Act to Bud Act to PY Revenues: Net Patient Revenue 136, , , % 9.1% Other Operating Revenue 3,559 3,244 3, % -12.5% Total Net Operating Revenue 139, , , % 8.5% Expenses: Operating Expenses 124, , , % 8.4% Capital Expenses 11,503 10,215 9, % 12.4% Total Expenses 135, , , % 8.7% Operating Gain 4,315 2,971 3, % -1.1% Operating Margin % 3.1% 2.0% 2.2% -33.9% -8.9% Fiscal Year To Date (In Thousands) % Variance Budget Actual Prior Year STATEMENT OF OPERATIONS: Act to Bud Act to PY Revenues: Net Patient Revenue 1,527,301 1,559,504 1,451, % 7.4% Other Operating Revenue 38,785 36,401 38, % -6.3% Total Net Operating Revenue 1,566,086 1,595,905 1,490, % 7.1% Expenses: Operating Expenses 1,387,621 1,423,808 1,318, % -8.0% Capital Expenses 104, ,440 96, % -5.7% Total Expenses 1,491,851 1,526,248 1,415, % -7.9% Operating Gain 74,235 69,657 75, % -7.7% Operating Margin % 4.7% 4.4% 5.1% -7.9% -13.8%

158 Gain (Loss) From Operations ( in 000 s ) 18,000 16,500 BUDGET 2017 ACTUAL 2017 ACTUAL ,000 13,500 12,000 10,500 9,000 7,500 6,000 4,500 3,000 1,500 0 OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP

159 ADJOURNMENT DATE OF THE NEXT REGULARLY SCHEDULED FINANCE MEETING THURSDAY, November 9, :00 P.M. Gulf Coast Medical Center- Boardroom Medical Office Building Doctors Way Ft. Myers, FL 33912

160 LIAISON TO CHAIRMAN: Lee Health (Health System) FULL BOARD OF DIRECTORS MEETING Thursday, September 28, 2017 BOARD CHAIRMAN: Sanford Cohen, M.D.

161 BOARD OF DIRECTORS FULL BOARD MEETING MINUTES OF 8/24/17 (APPROVE)

162 FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 LOCATION: Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom, Doctors Way, Fort Myers, FL MEMBERS PRESENT: Sanford N. Cohen, M.D., Board Chairman; Donna Clarke, Board Vice Chairman; David Collins, Board Treasurer; Therese Everly, Board Secretary; Steven Brown, M.D., Board Member; Chris Hansen, Board Member; Jessica Carter Peer, Board Member; Stephanie Meyer, BSN, RN, Board Member; Nancy McGovern, RN, MSM, Board Member; Diane Champion, Board Member MEMBERS ABSENT: NOTE: Documents referred to in these minutes are on file by reference to this meeting date in the Office of the Board of Directors and on the Board of Directors website at for public inspection. SUBJECT DISCUSSION ACTION FOLLOW-UP MEETING CALLED TO ORDER FULL BOARD OF DIRECTORS MEETING was CALLED TO ORDER at 1:00 p.m. by Sanford Cohen, M.D., Board Chairman. INVOCATION AND PLEDGE OF ALLEGIANCE Rev. Mike Warthen, MDiv, BCC, gave the Invocation, followed by the Pledge of Allegiance. PUBLIC INPUT None at this time. ANNUAL UNITED WAY CAMPAIGN FOR LEE HEALTH Scott Nygaard presented an update on the Annual United Way Campaign for Lee Health with the addition of a brief video. Cliff Smith, President of United Way gave a brief overview of the United Way and thanked Lee Health for their involvement. Jessica Carter Peer arrived at 1:20 p.m. PRESIDENT S REPORT Larry Antonucci, M.D., President & CEO presented the President s Report including items on Patient Safety, CMS Bundle Program, Telemetry & Physician Statistics. He also included two brief videos on Patient Safety and LINK. RECESS MEETING MEETING RECESSED at 1:41 p.m. to Convene Lee County Trauma Services District Meeting. RECONVENE MEETING RECONVENED FULL BOARD MEETING at 2:04 p.m. by Sanford N. Cohen, M.D., Board Chairman. CONSENT AGENDA Dr. Cohen asked for approval of the Consent Agenda. Therese Everly stated she would like the Board Members to vote on the Workshop topics before the next break in December. A motion was made by Donna Clarke to approve the Consent Agenda consisting of: 1. Planning and Full Board Meeting Minutes of 8/10/ Board Calendar The motion was seconded by David Collins and carried with no opposition. Board Workshop Topics/TBD Lee Memorial Health System Board of Directors

163 LEE HEALTH FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 Page 2 of 4 SUBJECT DISCUSSION ACTION FOLLOW-UP CORPORATE COMPLIANCE REPORT Shelley Koltnow presented the Corporate Compliance Report. A motion was made by Donna Clarke to accept the Compliance Report for the period April 2017 June The motion was seconded by Nancy McGovern and carried with no opposition. LPG AND GOLISANO CHIEF ADMINISTRATIVE REPORTS ACUTE CARE REPORTS LEAN EFFECTIVENESS DASHBOARD Kristine Fay, CAO presented highlights of the Lee Physician Group (LPG) Chief Administrative Officer Report. Armando Llechu, CAO presented highlights of the Golisano Children s Hospital Chief Administrative Officer Report. Therese Everly requested an update on Pediatric Behavioral/Mental Health initiatives. Scott Kashman presented a summary of the Acute Care Reports. Jennifer Higgins presented highlights from the Lee Memorial Hospital Report. Wendy Piascik presented highlights from the Cape Coral Report. Holly Muller presented highlights from the Gulf Coast Medical Center Report. Cindy Brown presented highlights from the HealthPark Medical Center Report. Therese Everly requested further explanation of the new CMS mortality metrics reported in Acute Care Report Summary. Stephen Brown requested further information on the roles/responsibilities of the dyads. Also, requested Mental Health data to be reported and stressed the need and importance of mental health services. Nancy Gurnee presented the Lean Effectiveness Dashboard updates and asked Board Members to begin filling out the evaluation form. A motion was made by Nancy McGovern to approve the LPG Chief Administrative Report. The motion was seconded by Therese Everly and carried with no opposition. A motion was made by Nancy McGovern to approve the Golisano Children s Hospital Chief Administrative Report. The motion was seconded by Donna Clarke and carried with no opposition. A motion was made by Nancy McGovern to approve the Acute Care Reports. The motion was seconded by Jessica Carter Peer and carried with no opposition. Pediatric Behavioral/ Mental Health/ Armando llechu/ TBD Mortality Rate/ Marilyn Kole/ 9/7/17 Dyads/ Scott Nygaard/ 9/7/17 Behavioral Health/ Acute Care Reports/ TBD PRESIDENT/CEO (LARRY ANTONUCCI) EVALUATION Jon Cecil presented the President/CEO (Larry Antonucci) Evaluation consisting of: 1. Board Policy 40.02H-President/CEO Compensation and Performance Review A motion was made by Donna Clarke to accept Board Policy 40.02H- President/CEO Compensation and Performance Review as published in this packet. The motion was seconded by Nancy McGovern and carried with Therese Everly opposed President & CEO Evaluation Form Lee Memorial Health System Board of Directors Therese Everly made the motion to amend metric # 8 Aligned Multispecialty Group Goals to decrease the weight of the Increase the

164 LEE HEALTH FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 Page 3 of 4 SUBJECT DISCUSSION ACTION FOLLOW-UP Donna Clarke would like the metrics in the Evaluation to match the Strategic Plan. Jessica Carter Peer departed at 4:07 p.m. LPG Primary Care Base component from 5% to 2.5% and to add a Population Health component for Increase lives under management in the alternative payment models that will have a weight of 2.5%. The motion was seconded by Chris Hansen and carried with no opposition. Board Chairman called for RECESS at 3:31 p.m., meeting was RECONNVENED at 3:39 p.m. MEDICAL STAFF RECOMMENDATIONS AS OF AUGUST 22, 2017 Dr. Cohen asked for approval of the Medical Staff Recommendations as of August 22, Stephanie Meyer recused herself from voting. A motion was made by Nancy McGovern to approve the Medical Staff Recommendations as of August 22, 2017 for the following: 1. Lee Memorial Hospital 2. Cape Coral Hospital 3. Gulf Coast Medical Center 4. HealthPark Medical Center 5. Golisano Children s Hospital of Southwest Florida The motion was seconded by Chris Hansen and carried with no opposition. OLD BUSINESS 1. Policy 10.09E-Agenda Item Background Material A motion was made by Nancy McGovern to approve Policy 10.09E- Agenda Item Background Material. The motion was seconded by Chris Hansen and carried with no opposition. NEW BUSINESS None at this time. BOARD MEETING CRITIQUE Nancy Gurnee presented the results of the Lean Effectiveness Dashboard Evaluation form which are available in the Board Office. Stephen Brown stated the importance of Mental Health and the need for a leadership role in the Health System. Chris Hansen departed at 4:43 p.m. BOARD OF DIRECTORS REPORTS Board Members agreed it was a great and informational meeting. Therese Everly enjoyed participating in the Doc Coggins Prize Patrols and Leadership Update. She also attended the Opioid Town Hall Meeting. David Collins attended the Rumrunners Annual Charity Event for the Golisano Children s Hospital. Donna Clarke enjoyed attending Florida s Behavioral Health Conference and will be bringing important information from the Conference to the Board before the next Board Meeting. Diane Champion thanked the Board Staff for all their work and stated the volunteers really enjoy the parking garage. She also informed the Board of the volunteer s current projects. Stephen Brown enjoyed attending the Doc Coggins Prize Patrols and thanked the Lee Memorial Health System Board of Directors

165 LEE HEALTH FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 Page 4 of 4 SUBJECT DISCUSSION ACTION FOLLOW-UP Board Staff for all of their work. Nancy McGovern departed at 5:08 p.m. NEXT REGULAR MEETING The next LEE HEALTH QUALITY, SAFETY & EDUCATION & FULL BOARD OF DIRECTORS MEETING will be held on September 7, 2017, at 1:00 p.m. in the Gulf Coast Medical Center, Medical Office Building, Boardroom Doctors Way, Fort Myers, FL ADJOURNMENT The LEE HEALTH SYSTEM FULL BOARD OF DIRECTORS MEETINGS ADJOURNED at 5:11 p.m. by Sanford Cohen, M.D., Board Chairman. Minutes were recorded by Jennifer Zager, Assistant to the Board of Directors Therese Everly Date approved Board Secretary Lee Memorial Health System Board of Directors

166 BOARD OF DIRECTORS MEDICAL STAFF RECOMMENDATIONS (APPROVE) 1. Lee Memorial Hospital 2. Cape Coral Hospital 3. Gulf Coast Medical Center 4. HealthPark Medical Center 5. Golisano Children s Hospital of SWFL Lee Memorial Health System Board of Directors

167 LEE HEALTH Lee County, Florida M E M O R A N D U M #1 To: From: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Date: September 20, 2017 Subject: Lee Memorial Hospital Medical Staff Recommendations The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Roger Eduardo, M.D. General Surgery d. Zachary Garner, D.O. Gastroenterology e. Kevin Hall, D.D.S. Oral & Maxillofacial Surgery f. Aaron Josephson, D.O. Internal Medicine g. Andrew Levitt, D.P.M. Podiatry h. Andres Melendez-Dedos, M.D. Pain Management i. Bradley Wilson, D.O. Family Medicine j. Nicole Wilson, D.O. Family Medicine 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Anne Guyot, M.D. Teleneurology c. Cathleen Ivy, M.D. Teleradiology 3. M.S. and A.H.P. Reappointments to (list attached) 4. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Lee Memorial Health System Board of Directors

168 Memorandum to Board of Directors - LMH September 20, 2017 Page 2 of 3 Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate 5. Privilege Request: a. Rodrigo Ruiz-Gamboa, M.D. Class II Moderate Sedation b. Ronnie Word, M.D. Class II Moderate Sedation 6. Leave of Absence: a. Christopher Myer, M.D. Orthopedic Surgery, reinstatement b. William Rincon, D.O. OB/Gyn, extension through c. Silvia Velasquez, M.D. Infectious Disease, reinstatement Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary b. Larry Antonucci, M.D. Medical Administration, Honorary c. Pierre Bourgon, M.D. Ophthalmology, Honorary d. Richard H. Davis, M.D. Cardiology, Honorary e. James H. Fuller, M.D. Otolaryngology, Honorary f. Mark Greenberg, M.D. - Medical Administration, Honorary Resignation: a. Nancy Schleider M.D. Dermatology, effective First Year Completions Active Status: a. Adelbert Cabrera, M.D. Pathology b. Harvey Esrov, M.D. Diagnostic Radiology c. Michael McCann, D.O. General Surgery d. Rodrigo Ruiz Gamboa, M.D. Vascular Surgery e. Christopher Tann, M.D. Emergency Medicine 10. First Year Completions Associate Status: a. Richard Calhoun, D.P.M. Podiatry b. Karen DeSouza Ferreira Hunt, M.D. Family Medicine c. Adolfo Delgado, M.D. Internal Medicine d. Carmella Fernandez, M.D. Orthopedic Surgery e. Gema Hernandez Santiago, M.D. Family Medicine f. Daniela Kloos, M.D. Internal Medicine g. Jeannette Lopiano, M.D. OB/Gyn h. Timur Mamedov, M.D. Internal Medicine i. Doris Purvis, M.D. Internal Medicine j. Patrin Suppatkul, M.D. Internal Medicine Lee Memorial Health System Board of Directors

169 Memorandum to Board of Directors - LMH September 20, 2017 Page 3 of Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Rupert Valbuena, CRNA Medical Anesthesia d. Kisten Walker, CRNA Medical Anesthesia 12. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

170 LMH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Associate Aloise, Joseph, D.O. General Medicine Associate (R & F) Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Amezaga Urruela, Matxalen, M.D. Rheumatology Associate (R & F) Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Antonucci, Lawrence R., M.D. Medical Administration Honorary Arnold, Paul J., D.O. General Medicine Associate (R & F) Atkinson, Todd S., M.D. Orthopedic Surgery Active Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Badia, Anais A., D.O. Dermatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Boudreaux, Ann F., M.D. General Medicine Associate (R & F) Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Bulczak, Dariusz P., M.D. Diagnostic Radiology Privilege Only Bustillo, Juan C., M.D. Rheumatology Associate (R & F) Butcher, David R., M.D. Nephrology Honorary Bynum, James A., M.D. Orthopedic Surgery Active Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Castellanos, Ronald D., M.D. Urologic Surgery Honorary Centafont, Nicholas F., D.O. General Medicine Honorary Cheng, Janet F., M.D. Dermatology Associate (R & F) Churchill, John A., M.D. Pediatric Orthopedics Associate Cobb, Michael L., M.D. Diagnostic Radiology Privilege Only Collins, Sandra B., M.D. Orthopedic Surgery Active Colon-Soto, Marilu, M.D. Rheumatology Associate (R & F) Conrey, John E., M.D. Nephrology Active Cossu, John L., D.O. General Medicine Associate (R & F) Creech, Fred T., M.D. Dermatology Honorary Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Associate Daller, Meir, M.D. Urologic Surgery Associate Daoud, Mazen, M.D. Dermatology Associate (R & F) David, Nicasio M., M.D. General Medicine Honorary DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Associate Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Associate Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Durando, Dunnett C., D.O. Dermatology Associate (R & F)

171 LMH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Edleman, Thomas M., D.O. General Medicine Honorary Eichten, David E., D.O. Orthopedic Surgery Active Eisenfeld, Larry S., M.D. Orthopedic Surgery Honorary Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Farmer, Mark E., M.D. Orthopedic Surgery Active Farri, Elias P., D.O. General Medicine Honorary Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only Fernandez, Carmella, M.D. Orthopedic Surgery Associate Fett Desmond, Debra D., M.D. Dermatology Associate (R & F) Fifer, John S., M.D. Orthopedic Surgery Active Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Fiore, Joseph P., M.D. Dermatology Honorary Flores, Antonio J., M.D. Orthopedic Surgery Active Follweiler, Robert A., D.O. Orthopedic Surgery Active Friedman, Mark N., D.O. Neurology Privilege Only Frink, Dennis D., D.O. General Medicine Honorary Fuchs, Paul D., D.O. Orthopedic Surgery Associate Fuller, Donn O., M.D. Orthopedic Surgery Associate Gardner, Ronald D., M.D. Orthopedic Surgery Active Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Goldstein, Alan S., M.D. General Medicine Associate (R & F) Gomeringer, David J., D.O. General Medicine Associate (R & F) Gomez, Eduardo, M.D. Orthopedic Surgery Active Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Greenberg, Mark A., M.D. Medical Administration Honorary Grosflam, Jodi M., M.D. Rheumatology Honorary Gross, Evan D., M.D. Nephrology Active Guzman, Camilo E., M.D. Orthopedic Surgery Active Haiken, Michael, M.D. Dermatology Associate (R & F) Harmon, Daniel J., D.O. Orthopedic Surgery Active Harris, Brian A., M.D. Dermatology Associate (R & F) Harris, Keith A., M.D. Dermatology Associate (R & F) Haseeb, Ateeq A., M.D. Neurology Privilege Only Heligman, David M., M.D. Orthopedic Surgery Associate Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Howard, Joseph G., M.D. General Medicine Associate (R & F) Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Active Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Active Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Associate Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krivenko, Charles A., M.D. Medical Administration Honorary Krynetskiy, Evgeny E., M.D. Orthopedic Surgery Active

172 LMH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type LaPorta, Thomas F., M.D. Orthopedic Surgery Active Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Active Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Machiz, Stephen, M.D. Urologic Surgery Honorary Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Associate Markovich, George D., M.D. Orthopedic Surgery Associate Martinez, Robert, M.D. Orthopedic Surgery Active Mauney, Lou D., D.O. General Medicine Associate (R & F) Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only Mehalik, John N., M.D. Orthopedic Surgery Active Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Mintz, Mark A., M.D. Urologic Surgery Honorary Monserrate, Pedro E., M.D. Orthopedic Surgery Associate Montecalvo, Raymond M., M.D. Diagnostic Radiology Privilege Only Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Myer, Christopher R., M.D. Orthopedic Surgery Active Nemitz, Jason T., M.D. Orthopedic Surgery Active Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Osborne, Thomas F., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Paletsky, Steven, M.D. Urologic Surgery Associate Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petrini, Mario A., M.D. General Medicine Honorary Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilcher, Mary F., M.D. Dermatology Associate (R & F) Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Reynolds III, Fletcher A., M.D. Orthopedic Surgery Active Richards, Paul J., M.D. Orthopedic Surgery Active Rickards, James S., M.D. Diagnostic Radiology Privilege Only Rinehart, Richard A., D.O. General Medicine Honorary Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Rossin, Richard D., M.D. Diagnostic Radiology Privilege Only Saether, Linda M., M.D. General Medicine Honorary Sagini, Dennis O., M.D. Orthopedic Surgery Active Saludo, Rodolfo M., M.D. General Medicine Honorary Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Schwartz, Jeremy A., M.D. Orthopedic Surgery Active Shannon, F. Brett, D.O. Pediatric Orthopedics Associate Shen, Jason Y., M.D. Neurology Privilege Only Shneker, Bassel F., M.D. Neurology Privilege Only Singer, Thomas J., D.O. Dermatology Associate (R & F)

173 LMH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Springer, Charles P., M.D. Orthopedic Surgery Active Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Active Taylor, James H., D.O. General Medicine Associate (R & F) Testa, Joseph A., M.D. General Medicine Honorary Van Sickler, Joel T., M.D. Nephrology Active Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only Williams, Jeffrey L., M.D. General Medicine Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Bounds Jr., Donald, P.A. Physician Assistant AHP Bounds, Denise, P.A. Physician Assistant AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Brist, Kristen L., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Campbell-Wigington, Kelly E., ARNP Adv. Reg. Nurse Practitioner AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Chapman, Julie Anne M., ARNP Adv. Reg. Nurse Practitioner AHP Dean, Debra L., P.A. Physician Assistant AHP Disesa, Dianna C., ARNP Adv. Reg. Nurse Practitioner AHP Dolorfino, Jhawn A., P.A. Physician Assistant AHP Donovan, Brittanee L., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Facklam, Arnold W., ARNP Adv. Reg. Nurse Practitioner AHP Featherstone, Wendy L., P.A. Physician Assistant AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Gorfinkel, Roger L., P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Hunsucker, Patricia L., C.N.M. Cert. Nurse Midwife AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Mahoney, Denyse M., P.A. Physician Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP McGeorge, Nancy P., P.A. Physician Assistant AHP Miller, Ashley M., ARNP Adv. Reg. Nurse Practitioner AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP

174 LMH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Quigley, Lorie A., ARNP Adv. Reg. Nurse Practitioner AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Salaz, Pamela, ARNP Adv. Reg. Nurse Practitioner AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Matthew C., P.A. Physician Assistant AHP Walk, Valerie A., P.A. Physician Assistant AHP Waszkowski, Denise, C.N.M. Cert. Nurse Midwife AHP Wilkinson, Chris A., P.A. Physician Assistant AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP Wright, Arlene T., ARNP Adv. Reg. Nurse Practitioner AHP

175 LEE HEALTH Lee County, Florida M E M O R A N D U M #2 To: From: Subject: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Cape Coral Hospital Medical Staff Recommendations Date: September 20, 2017 The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Zachary Garner, D.O. Gastroenterology d. Aaron Josephson, D.O. Internal Medicine e. Andrew Levitt, D.P.M. Podiatry f. Sanjeev Manier, M.D. Neurology 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Anne Guyot, M.D. Teleneurology c. Cathleen Ivy, M.D. Teleradiology 3. M.S. and A.H.P. Reappointments to (list attached) 4. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate Lee Memorial Health System Board of Directors

176 Memorandum to Board of Directors - CCH September 20, 2017 Page 2 of 3 5. Privilege Request: a. Rodrigo Ruiz-Gamboa, M.D. Class II Moderate Sedation b. Ronnie Word, M.D. Class II Moderate Sedation 6. Leave of Absence: a. Silvia Velasquez, M.D. Infectious Disease, reinstatement Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary b. Larry Antonucci, M.D. Medical Administration, Honorary c. Pierre Bourgon, M.D. Ophthalmology, Honorary d. James H. Fuller, M.D. Otolaryngology, Honorary e. Mark Greenberg, M.D. - Medical Administration, Honorary Resignation: a. Christopher Myer, M.D. Orthopedic Surgery, effective First Year Completions Active Status: a. Scott Dunavant, M.D. Emergency Medicine b. Harvey Esrov, M.D. Diagnostic Radiology c. Timur Mamedov, M.D. Internal Medicine d. Michael McCann, D.O. General Surgery e. Rodrigo Ruiz Gamboa, M.D. Vascular Surgery f. Patrin Suppatkul, M.D. Internal Medicine 10. First Year Completions Associate Status: a. Adelbert Cabrera, M.D. Pathology b. Richard Calhoun, D.P.M. Podiatry c. Adolfo Delgado, M.D. Internal Medicine d. Gema Hernandez Santiago, M.D. Family Medicine e. Daniela Kloos, M.D. Internal Medicine f. Shahzaib Mirza, M.D. - Pediatrics g. Doris Purvis, M.D. Internal Medicine 11. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Rupert Valbuena, CRNA Medical Anesthesia d. Kisten Walker, CRNA Medical Anesthesia Lee Memorial Health System Board of Directors

177 Memorandum to Board of Directors - CCH September 20, 2017 Page 3 of Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

178 CCH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Associate Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Antonucci, Lawrence R., M.D. Medical Administration Honorary Arnold, Paul J., D.O. General Medicine Associate (R & F) Atkinson, Todd S., M.D. Orthopedic Surgery Associate Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Baldinger, David R., M.D. Rheumatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Bulczak, Dariusz P., M.D. Diagnostic Radiology Privilege Only Butcher, David R., M.D. Nephrology Honorary Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Cambio, Andrea L., M.D. Dermatology Associate (R & F) Castellanos, Ronald D., M.D. Urologic Surgery Honorary Clark, Jack W., D.O. Rheumatology Associate (R & F) Cobb, Michael L., M.D. Diagnostic Radiology Privilege Only Conrey, John E., M.D. Nephrology Active Creech, Fred T., M.D. Dermatology Honorary Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Associate DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Active Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Friedman, Mark N., D.O. Neurology Privilege Only Fuller, Donn O., M.D. Orthopedic Surgery Active Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Greenberg, Mark A., M.D. Medical Administration Honorary Gross, Evan D., M.D. Nephrology Active Gulati, Ankush, M.D. Nephrology Associate

179 CCH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Guzman, Camilo E., M.D. Orthopedic Surgery Associate Haseeb, Ateeq A., M.D. Neurology Privilege Only Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Associate Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Associate Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Associate Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krivenko, Charles A., M.D. Medical Administration Honorary LaPorta, Thomas F., M.D. Orthopedic Surgery Active Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Associate Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Associate Martinez, Robert, M.D. Orthopedic Surgery Active Mauney, Lou D., D.O. General Medicine Associate (R & F) Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Mintz, Mark A., M.D. Urologic Surgery Honorary Monserrate, Pedro E., M.D. Orthopedic Surgery Active Montecalvo, Raymond M., M.D. Diagnostic Radiology Privilege Only Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Nemitz, Jason T., M.D. Orthopedic Surgery Associate Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Osborne, Thomas F., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Rickards, James S., M.D. Diagnostic Radiology Privilege Only Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Rossin, Richard D., M.D. Diagnostic Radiology Privilege Only Saether, Linda M., M.D. General Medicine Honorary Sagini, Dennis O., M.D. Orthopedic Surgery Associate Saunders, Darrick T., D.O. Orthopedic Surgery Active Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Shen, Jason Y., M.D. Neurology Privilege Only

180 CCH REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Shenoy, Ganesh G., M.D. Nephrology Active Shneker, Bassel F., M.D. Neurology Privilege Only Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Active Testa, Joseph A., M.D. General Medicine Honorary Van Sickler, Joel T., M.D. Nephrology Active Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only White, John A., M.D. Orthopedic Surgery Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Dean, Debra L., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Facklam, Arnold W., ARNP Adv. Reg. Nurse Practitioner AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Karlsson, Marten E., P.A. Physician Assistant AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Valerie A., P.A. Physician Assistant AHP Wilkinson, Chris A., P.A. Physician Assistant AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP

181 LEE HEALTH Lee County, Florida M E M O R A N D U M #3 To: From: Subject: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Gulf Coast Medical Center Medical Staff Recommendations Date: September 20, 2017 The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Luis Brandi, M.D. Pathology b. Roger Eduardo, M.D. General Surgery c. Zachary Garner, D.O. Gastroenterology d. Kevin Hall, D.D.S. Oral & Maxillofacial Surgery e. Aaron Josephson, D.O. Internal Medicine f. Andrew Levitt, D.P.M. Podiatry g. Sanjeev Manier, M.D. - Neurology h. Danielle Matta, D.O. Diagnostic Radiology i. Hazem Matta, D.O. Diagnostic Radiology j. Andres Melendez-Dedos, M.D. Pain Management 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Cathleen Ivy, M.D. Teleradiology 3. Intrasystem Appointment: a. Debra Fett Desmond, M.D. Dermatology b. Mary Pilcher, M.D. Dermatology 4. M.S. and A.H.P. Reappointments to (list attached) 5. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Lee Memorial Health System Board of Directors

182 Memorandum to Board of Directors - GCMC September 20, 2017 Page 2 of 2 Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate 6. Leave of Absence: a. Christopher Myer, M.D. Orthopedic Surgery, reinstatement b. Silvia Velasquez, M.D. Infectious Disease, reinstatement Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary b. Pierre Bourgon, M.D. Ophthalmology, Honorary c. Richard H. Davis, M.D. Cardiology, Honorary d. James H. Fuller, M.D. Otolaryngology, Honorary First Year Completions Active Status: a. Adelbert Cabrera, M.D. Pathology b. David Goldstein, M.D. Internal Medicine 9. First Year Completions Associate Status: a. Richard Calhoun, D.P.M. Podiatry b. Karen DeSouza Ferreira Hunt, M.D. Family Medicine c. Carmella Fernandez, M.D. Orthopedic Surgery d. Daniela Kloos, M.D. Internal Medicine e. Timur Mamedov, M.D. Internal Medicine f. Shahzaib Mirza, M.D. Pediatrics g. Guatham Mogilshetty, M.D. - Nephrology h. Chauchau Pham, M.D. - Otolaryngology i. Doris Purvis, M.D. Internal Medicine 10. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Robert McComas, CRNA Anesthesia & Pain Consultants d. Aleisha Rees, PA Surgical Specialists of SW FL 11. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

183 GCMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Active Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Atkinson, Todd S., M.D. Orthopedic Surgery Associate Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Badia, Anais A., D.O. Dermatology Associate (R & F) Baldinger, David R., M.D. Rheumatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Benitez, Omar, M.D. Urologic Surgery Active Blitz, Barry F., M.D. Urologic Surgery Active Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Butcher, David R., M.D. Nephrology Honorary Bynum, James A., M.D. Orthopedic Surgery Active Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Castellanos, Ronald D., M.D. Urologic Surgery Honorary Centafont, Nicholas F., D.O. General Medicine Honorary Churchill, John A., M.D. Pediatric Orthopedics Associate Clark, Jack W., D.O. Rheumatology Associate (R & F) Collins, Sandra B., M.D. Orthopedic Surgery Associate Conrey, John E., M.D. Nephrology Active Cossu, John L., D.O. General Medicine Associate (R & F) Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Active David, Nicasio M., M.D. General Medicine Honorary DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Associate Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Active Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Durando, Dunnett C., D.O. Dermatology Associate (R & F) Eichten, David E., D.O. Orthopedic Surgery Active Eisenfeld, Larry S., M.D. Orthopedic Surgery Honorary Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Farmer, Mark E., M.D. Orthopedic Surgery Associate Farri, Elias P., D.O. General Medicine Honorary Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only

184 GCMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Fernandez, Carmella, M.D. Orthopedic Surgery Associate Fernandez-Salvador, Veronique N., M.D. Urologic Surgery Active Fernando, K. Ranjit, M.D. Rheumatology Honorary Fett Desmond, Debra D., M.D. Dermatology Associate (R & F) Fifer, John S., M.D. Orthopedic Surgery Associate Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Flores, Antonio J., M.D. Orthopedic Surgery Associate Follweiler, Robert A., D.O. Orthopedic Surgery Active Friedman, Mark N., D.O. Neurology Privilege Only Fuchs, Paul D., D.O. Orthopedic Surgery Active Fuller, Donn O., M.D. Orthopedic Surgery Associate Gardner, Ronald D., M.D. Orthopedic Surgery Associate Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Gomeringer, David J., D.O. General Medicine Associate (R & F) Gomez, Eduardo, M.D. Orthopedic Surgery Associate Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Gross, Evan D., M.D. Nephrology Active Gulati, Ankush, M.D. Nephrology Active Guzman, Camilo E., M.D. Orthopedic Surgery Associate Haiken, Michael, M.D. Dermatology Associate (R & F) Harmon, Daniel J., D.O. Orthopedic Surgery Active Harris, David S., M.D. Urologic Surgery Active Harrison, Steven A., M.D. Urologic Surgery Active Haseeb, Ateeq A., M.D. Neurology Privilege Only Heligman, David M., M.D. Orthopedic Surgery Active Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Howard, Joseph G., M.D. General Medicine Associate (R & F) Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Active Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Active Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Active Kendall, Maria E., M.D. Dermatology Associate (R & F) Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krynetskiy, Evgeny E., M.D. Orthopedic Surgery Active Langford, Carolyn F., D.O. Urologic Surgery Active LaPorta, Thomas F., M.D. Orthopedic Surgery Active Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Associate Lee, Michael D., M.D. Dermatology Associate (R & F) Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Active Markovich, George D., M.D. Orthopedic Surgery Active Martinez, Robert, M.D. Orthopedic Surgery Associate Mauney, Lou D., D.O. General Medicine Associate (R & F)

185 GCMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only Mehalik, John N., M.D. Orthopedic Surgery Active Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Menendez, Roxanna M., D.O. Dermatology Associate (R & F) Mintz, Mark A., M.D. Urologic Surgery Honorary Mogilishetty, Gautham, M.D. Nephrology Associate Monserrate, Pedro E., M.D. Orthopedic Surgery Active Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Myer, Christopher R., M.D. Orthopedic Surgery Active Nemitz, Jason T., M.D. Orthopedic Surgery Associate Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Paletsky, Steven, M.D. Urologic Surgery Active Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilcher, Mary, M.D. Dermatology Associate (R & F) Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Reynolds III, Fletcher A., M.D. Orthopedic Surgery Associate Richards, Paul J., M.D. Orthopedic Surgery Associate Rickards, James S., M.D. Diagnostic Radiology Privilege Only Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Sagini, Dennis O., M.D. Orthopedic Surgery Associate Saludo, Rodolfo M., M.D. General Medicine Honorary Saunders, Darrick T., D.O. Orthopedic Surgery Associate Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Schwartz, Brian N., M.D. Urologic Surgery Active Schwartz, Jeremy A., M.D. Orthopedic Surgery Associate Shannon, F. Brett, D.O. Pediatric Orthopedics Active Shen, Jason Y., M.D. Neurology Privilege Only Shenoy, Ganesh G., M.D. Nephrology Active Shneker, Bassel F., M.D. Neurology Privilege Only Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Springer, Charles P., M.D. Orthopedic Surgery Associate Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Active Van Sickler, Joel T., M.D. Nephrology Active VanBeever, Bert F., M.D. Urologic Surgery Honorary

186 GCMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only Williams, Jeffrey L., M.D. General Medicine Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only Zucker, Ira A., M.D. Urologic Surgery Active ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Brist, Kristen L., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Chapman, Julie Anne M., ARNP Adv. Reg. Nurse Practitioner AHP Dean, Debra L., P.A. Physician Assistant AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Gorfinkel, Roger L., P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Klement, Bradley W., P.A. Physician Assistant AHP Lattray, Amber N., P.A. Physician Assistant AHP Lavenia, Ryann L., CRNA Cert. Reg. Nurse Anesthetist AHP Ledward, Pamela M., P.A. Physician Assistant AHP Mahoney, Denyse M., P.A. Physician Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP Meyer, Diana L., CRNA Cert. Reg. Nurse Anesthetist AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Pirrone, Rosalie, CRNA Cert. Reg. Nurse Anesthetist AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rodriguez, Monica L., C.N.M. Cert. Nurse Midwife AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Shepheard, Bonnie L., C.N.M. Cert. Nurse Midwife AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Matthew C., P.A. Physician Assistant AHP Walk, Valerie A., P.A. Physician Assistant AHP Wilkinson, Chris A., P.A. Physician Assistant AHP

187 LEE HEALTH Lee County, Florida M E M O R A N D U M #4 To: From: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Date: September 20, 2017 Subject: HealthPark Medical Center Medical Staff Recommendations The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Michael Carr, M.D. Pediatric Urology d. Roger Eduardo, M.D. General Surgery e. Zachary Garner, D.O. Gastroenterology f. Aaron Josephson, D.O. Internal Medicine g. Andrew Levitt, D.P.M. Podiatry h. Mary Mani, M.D. OB/Gyn 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Fouad Butto, M.D. Pediatric Cardiology c. Anne Guyot, M.D. Teleneurology d. Cathleen Ivy, M.D. Teleradiology 3. M.S. and A.H.P. Reappointments to (list attached) 4. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate Lee Memorial Health System Board of Directors

188 Memorandum to Board of Directors - HPMC September 20, 2017 Page 2 of 3 5. Privilege Request: a. Rodrigo Ruiz-Gamboa, M.D. Class II Moderate Sedation b. Ronnie Word, M.D. Class II Moderate Sedation 6. Leave of Absence: a. George Kopidakis, M.D. General Surgery, b. Christopher Myer, M.D. Orthopedic Surgery, reinstatement c. William Rincon, D.O. OB/Gyn, extension through d. Silvia Velasquez, M.D. Infectious Disease, reinstatement Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary b. Larry Antonucci, M.D. Medical Administration, Honorary c. Pierre Bourgon, M.D. Ophthalmology, Honorary d. Richard H. Davis, M.D. Cardiology, Honorary e. James H. Fuller, M.D. Otolaryngology, Honorary f. Mark Greenberg, M.D. - Medical Administration, Honorary First Year Completions Active Status: a. Harvey Esrov, M.D. Diagnostic Radiology b. Daniela Kloos, M.D. Internal Medicine c. Jeannette Lopiano, M.D. OB/Gyn d. Michael McCann, D.O. General Surgery e. Chauchau Pham, M.D. - Otolaryngology f. Doris Purvis, M.D. Internal Medicine g. Rodrigo Ruiz Gamboa, M.D. Vascular Surgery h. Patrin Suppatkul, M.D. Internal Medicine i. Christopher Tann, M.D. Emergency Medicine 9. First Year Completions Associate Status: a. Adelbert Cabrera, M.D. Pathology b. Richard Calhoun, D.P.M. Podiatry c. Karen DeSouza Ferreira Hunt, M.D. Family Medicine d. Adolfo Delgado, M.D. Internal Medicine e. Gema Hernandez Santiago, M.D. Family Medicine f. Timur Mamedov, M.D. Internal Medicine g. Shahzaib Mirza, M.D. Pediatrics 10. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Rupert Valbuena, CRNA Medical Anesthesia d. Kisten Walker, CRNA Medical Anesthesia 11. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Lee Memorial Health System Board of Directors

189 Memorandum to Board of Directors - HPMC September 20, 2017 Page 3 of Allied Health Practitioner Privilege Request: a. Carla Whitt, ARNP Order Controlled Substances Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

190 HPMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Associate Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Antonucci, Lawrence R., M.D. Medical Administration Honorary Arnold, Paul J., D.O. General Medicine Associate (R & F) Arrillaga, Frances M., M.D. Pediatric Cardiology Privilege Only Asante-Korang, Alfred, M.D. Pediatric Cardiology Privilege Only Atkinson, Todd S., M.D. Orthopedic Surgery Associate Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Badia, Anais A., D.O. Dermatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Boudreaux, Ann F., M.D. General Medicine Associate (R & F) Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Bulczak, Dariusz P., M.D. Diagnostic Radiology Privilege Only Bustillo, Juan C., M.D. Rheumatology Associate (R & F) Butcher, David R., M.D. Nephrology Honorary Bynum, James A., M.D. Orthopedic Surgery Associate Caesar, Scott R., M.D. Urologic Surgery Active Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Castellanos, Ronald D., M.D. Urologic Surgery Honorary Centafont, Nicholas F., D.O. General Medicine Honorary Cheng, Janet F., M.D. Dermatology Associate (R & F) Churchill, John A., M.D. Pediatric Orthopedics Active Cobb, Michael L., M.D. Diagnostic Radiology Privilege Only Collins, Sandra B., M.D. Orthopedic Surgery Associate Conrey, John E., M.D. Nephrology Active Cossu, John L., D.O. General Medicine Associate (R & F) Creech, Fred T., M.D. Dermatology Honorary Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Associate Daller, Meir, M.D. Urologic Surgery Associate Daoud, Mazen, M.D. Dermatology Associate (R & F) David, Nicasio M., M.D. General Medicine Honorary DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Active Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Associate Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Durando, Dunnett C., D.O. Dermatology Associate (R & F)

191 HPMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Edleman, Thomas M., D.O. General Medicine Honorary Eichten, David E., D.O. Orthopedic Surgery Associate Eisenfeld, Larry S., M.D. Orthopedic Surgery Honorary Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Farmer, Mark E., M.D. Orthopedic Surgery Associate Farri, Elias P., D.O. General Medicine Honorary Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only Fett Desmond, Debra D., M.D. Dermatology Associate (R & F) Fifer, John S., M.D. Orthopedic Surgery Associate Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Fiore, Joseph P., M.D. Dermatology Honorary Flores, Antonio J., M.D. Orthopedic Surgery Associate Follweiler, Robert A., D.O. Orthopedic Surgery Associate Friedman, Mark N., D.O. Neurology Privilege Only Frink, Dennis D., D.O. General Medicine Honorary Fuchs, Paul D., D.O. Orthopedic Surgery Associate Fuller, Donn O., M.D. Orthopedic Surgery Associate Gardner, Ronald D., M.D. Orthopedic Surgery Associate Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Goldstein, Alan S., M.D. General Medicine Associate (R & F) Gomeringer, David J., D.O. General Medicine Associate (R & F) Gomez, Eduardo, M.D. Orthopedic Surgery Associate Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Greenberg, Mark A., M.D. Medical Administration Honorary Grosflam, Jodi M., M.D. Rheumatology Honorary Gross, Evan D., M.D. Nephrology Active Gulati, Ankush, M.D. Nephrology Active Guzman, Camilo E., M.D. Orthopedic Surgery Associate Haiken, Michael, M.D. Dermatology Associate (R & F) Hardin, Joel T., M.D. Pediatric Cardiology Privilege Only Harmon, Daniel J., D.O. Orthopedic Surgery Associate Harris, Brian A., M.D. Dermatology Associate (R & F) Harris, Keith A., M.D. Dermatology Associate (R & F) Haseeb, Ateeq A., M.D. Neurology Privilege Only Heligman, David M., M.D. Orthopedic Surgery Associate Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Howard, Joseph G., M.D. General Medicine Associate (R & F) Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Huhta, James C., M.D. Pediatric Cardiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Associate Jaffe, Andrew T., M.D. Dermatology Associate (R & F) Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only John, Jonathan B., M.D. Pediatric Cardiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Associate Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Associate Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only

192 HPMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krivenko, Charles A., M.D. Medical Administration Honorary Krynetskiy, Evgeny E., M.D. Orthopedic Surgery Associate Kurtz, Stephanie A., M.D. Pediatric Cardiology Privilege Only LaPorta, Thomas F., M.D. Orthopedic Surgery Associate Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Associate Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Machiz, Stephen, M.D. Urologic Surgery Honorary Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Associate Markovich, George D., M.D. Orthopedic Surgery Associate Martinez, Richard M., M.D. Pediatric Cardiology Privilege Only Martinez, Robert, M.D. Orthopedic Surgery Associate Mauney, Lou D., D.O. General Medicine Associate (R & F) Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McCormack, Jorge, M.D. Pediatric Cardiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only McKenna, Daniel E., M.D. Pediatric Cardiology Privilege Only Mehalik, John N., M.D. Orthopedic Surgery Associate Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Mintz, Mark A., M.D. Urologic Surgery Honorary Miranda-Sousa, Alejandro J., M.D. Urologic Surgery Active Monserrate, Pedro E., M.D. Orthopedic Surgery Associate Montecalvo, Raymond M., M.D. Diagnostic Radiology Privilege Only Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Myer, Christopher R., M.D. Orthopedic Surgery Associate Nemitz, Jason T., M.D. Orthopedic Surgery Associate Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Osborne, Thomas F., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Paletsky, Steven, M.D. Urologic Surgery Associate Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petrini, Mario A., M.D. General Medicine Honorary Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilcher, Mary F., M.D. Dermatology Associate (R & F) Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Reynolds III, Fletcher A., M.D. Orthopedic Surgery Associate Richards, Paul J., M.D. Orthopedic Surgery Associate Rickards, James S., M.D. Diagnostic Radiology Privilege Only Rinehart, Richard A., D.O. General Medicine Honorary Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Rossin, Richard D., M.D. Diagnostic Radiology Privilege Only Saether, Linda M., M.D. General Medicine Honorary

193 HPMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Sagini, Dennis O., M.D. Orthopedic Surgery Associate Saludo, Rodolfo M., M.D. General Medicine Honorary Schleider, Nancy R., M.D. Dermatology Associate (R & F) Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Schwartz, Jeremy A., M.D. Orthopedic Surgery Associate Shannon, F. Brett, D.O. Pediatric Orthopedics Active Shen, Jason Y., M.D. Neurology Privilege Only Shenoy, Ganesh G., M.D. Nephrology Active Shneker, Bassel F., M.D. Neurology Privilege Only Singer, Thomas J., D.O. Dermatology Associate (R & F) Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Springer, Charles P., M.D. Orthopedic Surgery Associate Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Stapleton, Gary E., M.D. Pediatric Cardiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Associate Taylor, James H., D.O. General Medicine Associate (R & F) Testa, Joseph A., M.D. General Medicine Honorary Van Sickler, Joel T., M.D. Nephrology Active Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only Williams, Jeffrey L., M.D. General Medicine Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Bounds Jr., Donald, P.A. Physician Assistant AHP Bounds, Denise, P.A. Physician Assistant AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Brist, Kristen L., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Campbell-Wigington, Kelly E., ARNP Adv. Reg. Nurse Practitioner AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Chapman, Julie Anne M., ARNP Adv. Reg. Nurse Practitioner AHP Christian, Amber L., P.A. Physician Assistant AHP Dean, Debra L., P.A. Physician Assistant AHP Dolorfino, Jhawn A., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Featherstone, Wendy L., P.A. Physician Assistant AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Gorfinkel, Roger L., P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP

194 HPMC REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Hicks, Amy J., ARNP Adv. Reg. Nurse Practitioner AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Hunsucker, Patricia L., C.N.M. Cert. Nurse Midwife AHP Klement, Bradley W., P.A. Physician Assistant AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Mahoney, Denyse M., P.A. Physician Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Quigley, Lorie A., ARNP Adv. Reg. Nurse Practitioner AHP Reich, John R., P.A. Physician Assistant AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rodriguez, Monica L., C.N.M. Cert. Nurse Midwife AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Salaz, Pamela, ARNP Adv. Reg. Nurse Practitioner AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Shepheard, Bonnie L., C.N.M. Cert. Nurse Midwife AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Matthew C., P.A. Physician Assistant AHP Walk, Valerie A., P.A. Physician Assistant AHP Waszkowski, Denise, C.N.M. Cert. Nurse Midwife AHP Wilkinson, Chris A., P.A. Physician Assistant AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP Wright, Arlene T., ARNP Adv. Reg. Nurse Practitioner AHP

195 LEE HEALTH Lee County, Florida M E M O R A N D U M #5 To: From: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Date: September 20, 2017 Subject: Golisano Children s Hospital of Southwest Florida Medical Staff Recommendations The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Michael Carr, M.D. Pediatric Urology d. Kevin Hall, D.D.S. Oral & Maxillofacial Surgery 2. Telemedicine Appointment Privileges Only: a. Fouad Butto, M.D. Pediatric Cardiology 3. M.S. and A.H.P. Reappointments to (list attached) 4. Leave of Absence: a. William Rincon, D.O. OB/Gyn, extension through First Year Completions Active Status: a. Harvey Esrov, M.D. Diagnostic Radiology 6. First Year Completions Associate Status: a. Adelbert Cabrera, M.D. Pathology b. Shahzaib Mirza, M.D. Pediatrics c. Chauchau Pham, M.D. - Otolaryngology 7. Allied Health Practitioners: a. Rupert Valbuena, CRNA Medical Anesthesia b. Kisten Walker, CRNA Medical Anesthesia Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

196 GCHSWF REAPPOINTMENTS FOR SEPTEMBER /01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Churchill, John A., M.D. Pediatric Orthopedics Active Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Active Shannon, F. Brett, D.O. Pediatric Orthopedics Active Badia, Anais A., D.O. Dermatology Associate (R & F) Arrillaga, Frances M., M.D. Pediatric Cardiology Privilege Only Asante-Korang, Alfred, M.D. Pediatric Cardiology Privilege Only Bhatia, Sanjiv, M.D. Pediatric Neurosurgery Privilege Only Decker, Jamie A., M.D. Pediatric Cardiology Privilege Only Duchowny, Michael S., M.D. Pediatric Neurology Privilege Only Hardin, Joel T., M.D. Pediatric Cardiology Privilege Only Huhta, James C., M.D. Pediatric Cardiology Privilege Only Hyslop, Ann E., M.D. Pediatric Neurology Privilege Only Jayakar, Parul B., M.D. Pediatric Genetics Privilege Only John, Jonathan B., M.D. Pediatric Cardiology Privilege Only Kurtz, Stephanie A., M.D. Pediatric Cardiology Privilege Only Lawrence, David K., M.D. Pediatric Cardiology Privilege Only Martinez, Richard M., M.D. Pediatric Cardiology Privilege Only Martir-Negron, Arelis E., M.D. Pediatric Genetics Privilege Only McCormack, Jorge, M.D. Pediatric Cardiology Privilege Only McKenna, Daniel E., M.D. Pediatric Cardiology Privilege Only Miller, Ian O., M.D. Pediatric Neurology Privilege Only Niazi, Toba N., M.D. Pediatric Neurosurgery Privilege Only Ragheb, John, M.D. Pediatric Neurosurgery Privilege Only Rajadhyaksha, Aparna C., M.D. Pediatric Genetics Privilege Only Resnick, Trevor J., M.D. Pediatric Neurology Privilege Only Stapleton, Gary E., M.D. Pediatric Cardiology Privilege Only ALLIED HEALTH Christian, Amber L., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Komarynski, Mary A., ARNP Adv. Reg. Nurse Practitioner AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Reich, John R., P.A. Physician Assistant AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP

197 OLD BUSINESS Lee Memorial Health System Board of Directors