BEST PLACE TO WORK BEST PLACE TO PRACTICE BEST PLACE TO RECEIVE CARE. Building integrated health systems to elevate the health of our communities

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1 MARCH 2017

2 BEST PLACE TO WORK BEST PLACE TO PRACTICE BEST PLACE TO RECEIVE CARE Building integrated health systems to elevate the health of our communities

3 About HCCA We meet the future of healthcare delivery today by partnering with health systems, hospitals, and health care districts to create successful integrated health delivery systems that achieve global community health through prevention, intervention and innovative economically sustainable strategies. Our Mission To create integrated healthcare delivery systems To improve the health of communities To provide Cost Effective Service Excellence

4 WHAT WE FOUND Loss of $1,000,000 per month Less than one month s Days Cash on Hand OIG Corporate Integrity Agreement (CIA) in place Going Concern qualification (audit) 65 year old building 6 bed Emergency Department serving a district population of 100,000 Employee morale at an all-time low $20,000,000 in construction related liabilities No clear plan forward Tulare County Healthcare Access to care has been hindered for Tulare County residents for generations 55% of Tulare County Residents are on Medi-Cal 49 th out of 58 counties for the present state of clinical care 56 th out of 58 counties for quality of life Region is SEVERELY underbedded 2,350:1 ratio of population to primary care physicians

5 JANUARY 2014 Unfinished project YEARS behind schedule.

6 UNDER HCCA In January 2014, the Tulare Local Healthcare District Board entered into a unique public/private partnership with HCCA, a physician-led organization, whose expertise and laser focus realized a $28,000,000 increase in net position in just the last two years alone. By the third month, hospital became profitable and has now been profitable for 35 consecutive months Federal CIA successfully completed and lifted Going Concern qualification removed from audit All pending construction-related claims cleared New tower exterior completed New tower construction ready to move forward

7 LEADERSHIP

8 STABILITY GROWTH FUTURE Hospital s net operating margin over the last three fiscal years Hospital s operating margin over the past 12 years

9 FINANCIAL IMPROVEMENT Multiple Confirmations: 2 audits Multiple credit upgrades AUDIT #1 AUDIT #2

10 RATINGS UPGRADE AUGUST 2015 AUGUST 2014

11 DRAMATIC TURNAROUND

12 LET S GET REAL ABOUT OUR

13 PUBLIC HOSPITAL HCCA ACCOMPLISHMENTS BEST BABY DELIVERY CARE WHOLE PERSON PREGNANCY CARE TULARE S PREMIERE WOMEN S HEALTH CARE FACILITY COUNTY S FIRST PERMANENT SCHOOL-BASED CLINIC STROKE SPECIALTY CARE EXPANDED MEDICAL OUTREACH PERSONALIZED COMMUNITY NUTRITION OUTREACH INNOVATIVE DIABETIC CARE THE AREA S ONLY INFARED SAUNAS IN OUR ADVANCED FITNESS FACILITY DRAMATIC FINANCIAL TURNAROUND CREDIT RATINGS UPGRADES DNV ACCREDITED IMAGING ACR (AMERICAN COLLEGE OF RADIOLOGY) ACCREDITATION ALL THIS IN JUST THREE SHORT YEARS!

14 HCCA/TRMC RECEIVES AWARDS FOR EXCELLENCE IN QUALITY OF CARE Tulare Regional Medical Center has received the 2016 award for achieving the Healthy People 2020 goal for low-risk, first-birth Cesarean sections (C-sections). By reaching this goal in 2015, our team is delivering safer and more affordable care for Californians. The Collaborative Alliance for Nursing Outcomes has recognized HCCA/Tulare Regional Medical Center for 2016 Performance Excellence in Prevention of Hospital Acquired Infections MRSA Total Facility. HCCA/Tulare Regional Medical Center Scores 92% In CDC Maternity Benchmark Report HCCA/Tulare Regional Medical Center was one of just 176 California hospitals that contributed to patient safety in preventing over 1,618 harms. This one-year project saved nearly $9.2 million in healthcare costs. Tulare Regional Medical Center surpassed California and national standards in the Center for Disease Control and Prevention s 2015 survey of Maternity Practices in Infant Nutrition and Care by scoring a 92 out of a possible 100.

15 Long Term Strategy Trauma Level II Robust medical office/clinic network throughout Central California Effective population health targeted to the needs of our communities Clinical/Quality Excellence at the highest deciles Strong physician staff sized to meet the needs of the Integrated Delivery System of the future

16 A Healthier Tulare with HCCA

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