Comms. DeYoung, Butler, Greenfield, Hirt, McLaughlin, Pilcher and Snyder. Jim O'Callaghan, MD; Jack Handley, MD; Jim Brown, MD

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1 King County Public Hospital District No. 2 d/b/a EvergreenHealth Board of Commissioners' Meeting EvergreenHealth Medical Center, Kirkland, WA April 17, 2018 Minutes Comms. Present: Medical Staff Leadership: Others Present: Guests: Comms. DeYoung, Butler, Greenfield, Hirt, McLaughlin, Pilcher and Snyder Jim O'Callaghan, MD; Jack Handley, MD; Jim Brown, MD Bob Malte; Laurene Burton; Jim Fitzgerald; Jeff Friedman; Nancee Hofmeister; Renee Jensen; Tom Martin; Aileen Mickey, MD; Tina Mycroft; Monique Ruyle; Bob Sampson; Kay Taylor John Sambrook (Exhibit A) ,., " PUBLC MEETNG and EXECUTVE SESSON Comm. DeYoung called the April 17, 2018 Regular Public Meeting of 1 the Board of Commissioners of King County Public Hospital District No. 2 to order at 5:00 p.m. and announced that the Board would immediately adjourn into Executive Session to consider and discuss medical staff privileges, personnel, property, litigation and quality, matters. Comm. DeYoung further announced that the Executive Session would adjourn at approximately 6:30 p.m. and that the open Public Meeting would resume at approximately 6:35 p.m. 1 The Executive Session commenced at 5:01 p.m. The Executive Session was concluded at 6:28 p.m., at which time a short recess was. taken. Comm. DeYoung reconvened the Public Meeting, calling it to order at 6:33 p.m. and welcoming those present Order of Business There were no changes to the agenda. Public Comment Mr. John Sambrook, Kirkland resident, voiced his concerns regarding non-therapeutic circumcision and encouraged EvergreenHealth to review the current practice of allowing this surgery. The Board thanked Mr. Sambrook for his comments.

2 KCPHD #2 Board Meeting Minutes 4/17/2018 page 2 of PRESENTATONS Medical Staff! Dr. Jim Brown, Chair of the Practitioner Peer Support Committee j Wellness and Burnout 1 ("PPSC"), reviewed the genesis and history of the PPSC and Report, expressed his gratitude to the Board for helping to create the culture that exists today at Evergreen Health. He observed that this incredible culture is a reflection of the Board's selection of leadership and an excellent administrative team. Dr. Brown stated that provider burnout is a healthcare industry-wide problem that exists far beyond EvergreenHealth. Ors. Brown, Handley and Mickey then presented on the following topics: History of the Medical Staff Wellness Program; Evergreen Health Medical Staff Wellness Program Charter; National ssue - Provider Burnout; Burnout mpact on the Provider Experience and Engagement with the Organization and Patient; History of Physician Feedback Engagement Survey and Wellness & Burnout Survey; 2015 Survey and Strategies; 2017 Provider Wellness & Burnout Survey, including General Participation; Demographics, Provider Practices Primary v. Specialty; What We Learned from the 1 : 2017 Survey, including Overall Themes; Next Steps; Work Plan : Structure; Feedback Sessions; and Work Plan Strategy. The Board thanked the group for an excellent report and for their efforts in working hard to mitigate the challenges of professional burnout Quarterly Digital Kay Taylor and Tom Martin presented the report, which included: Health and Consumer ' Committee Update; Recent nnovations and Portfolio Updates; Nytec nnovation Advisory Update; and Key Outcomes for Next Meetings. Comm. McLaughlin, Committee Report t Committee Chair, noted there are many other initiatives and opportunities that they are reviewing and the challenge is to focus on a vital few. ACTON TEMS MNUTES Regular Board Meeting of March 20, 2018, Study Session of April 3, 2018 and Leadership Educational of April 13, 2018 Comm. Butler made a motion to approve the meeting minutes for the! Regular Board meeting of March 20, 2018, Study Session of April 3, ' 2018 and Leadership Educational of April 13, Comm. Pilcher seconded the motion. The motion carried unanimously.

3 KCPHD #2 Board Meeting Minutes 4/17/2018 page 3 of 13 Consent Agenda Comm. Hirt made a motion to approve the Consent Agenda. The Consent Agenda included: ' A) Voucher No. 552, March 2018, totaling $64,741,087 (Exhibit 8). B) Contractor Pay Requests EHMC-Cath/lR Lab Replacement & Expansion o Western Ventures Construction, nc. $ 481, Total Contractor Pay Requests: $ E) Disposal of Surplus Equipment (as identified in Exhibit C) Comm. Pilcher seconded the motion. ' The motion carried unanimously. - Annual Hospital Plan of Care and Nursing Report s Comm. Greenfield made a motion to approve the EvergreenHealthi Annual Hospital Plan of Care and Nursing Report as submitted. Comm. Butler seconded the motion. The motion carried unanimously. 1 For the Annual Nursing Report to the Board, Ms. Hofmeister presented! the following: EvergreenHealth Nursing Professional Practice Model; Sta~ing Effectiven_ess; s_taff~ng Committee; _Missed Me~ and Breaks; ; Assignment Despite ObJect1on; Organ & Tissue Donation; and 2018 Focus - Overall Nursing Quality and Strategic Plan. The Board thanked Ms. Hofmeister for her report Medical Staff: New Appointments, Reappointments and Status Changes._ '. eo H - -, o - -- ~ Comm. Greenfield made a motion to approve the New Appointments, Reappointments, Status Changes, and Privileges pertaining to the EvergreenHealth Medical Center Medical Staff and AHPs as: presented and stated in Exhibit D. 1 Comm. Butler seconded the motion. The motion carried unanimously.

4 KCPHD #2 Board Meeting Minutes 4/17/2018 page 4 of ~ ~ D SC USS 10 N TEMS 2017 Year End Levy Report -OAO 000, ~ - S. 0 Laurene Burton presented the 2017 Year End Levy Report, noting the good work of the ten programs funded by the levy. Comm. De Young, noted that a lot of hard work has been done to use the levy funds toi the public's best advantage and he thanked Ms. Burton in particular for her hard work and an excellent report. Comm. Butler expressed' appreciatio_n for the valuable levy pro_grams that benefit so many, such: as Healthhne. Comm. McLaughlin asked about the degree of knowledge of the public about these programs and their benefits, and Comm. Pilcher noted that the funds are investments back into the 1 community. Comms. DeYoung, Greenfield and Hirt were thanked for serving on the Levy Funded Services Committee. Rolling Agenda: May,; Ms. Burton pre!;ented the-roiling.. agenda for the... m.onth s of May, June: June and July and July 2018, noting the Leadership/Board Retreat would be held ; May 3-4. Ms. Burton also suggested moving the July Study Session date to July 10, given the 4th of July holiday, and the Board concurred.: - Medical Staff Report Executive Team Reports Jim O'Callaghan, President, had no additional report at this time Executive Team members reported on and gave notice of the 1 following: o Renee Jensen, CAO, EvergreenHealth Monroe ("EHM") Ms. Jensen thanked the Board for its time, attention and diligence in reviewing the EHM capital needs at the Educational on April 13. She expressed her opinion that should EHM continue its pursuit of operational excellence and stay on track, it should end the year with a positive margin, even in this difficult climate for healthcare reimbursement. Ms. Jensen thanked Dr. Handley for serving as CMO, noting that he has been a wonderful partner and an excellent mentor to the incoming CMO, Dr. Midori Larrabee. o Aileen Mickey, MD, EHMG CMO Dr. Mickey reminded everyone about the EHMG retreat i to be held on Thursday, April 18.

5 KCPHD #2 Board Meeting Minutes 4/17/2018 page 5 of 13 o o -"" Kay Taylor, Senior VP, Marketing, Communication and Patient Experience Ms. Taylor reported that, in partnership with the City of Kirkland, a traffic study is underway to look at the best short and long-term solutions to traffic in the Totem Lake area - results should be out within six months. Tina Mycroft, Senior VP and Chief Financial Officer March results were positive for EvergreenHealth and EHM, due to high volumes in both surgery and the Family Maternity Center. The EHM financial officer is well underway. o Nancee Hofmeister, Senior VP & Chief Nursing Officer Barb Jensen, Manager, Trauma Services, has been asked by the City of Kirkland to provide "Stop the Bleed" classes to 300 city employees. Ms. Hofmeister invited the Board to attend the Nursing Excellence awards at noon on May 11 in the Red Auditorium. A new online program named Clockwise, which allows scheduled Emergency Department appointments, is being tested in the Redmond ED. o o Bob Sampson, Senior VP, Human Resources Negotiations with UOE for a new collective bargaining: agreement will now start early in May. SEU negotiations are underway at EHM. Monique Ruyle, Vice-President, Home Health & Hospice Ms. Ruyle thanked the Board for approving the appointment of Dr. Neil Venard for tele-psych services: He will be consulting for the ED and Home Health as well: as providing tele-psych services for in-home Mental Health. o Jeff Friedman, Senior VP, Hospital & Medical Group '. Operations Mr. Friedman reported that the transition with LabCorp is in the ninth week and work on issues is continuing.: Many issues have been resolved. We are examining service and performance reports which outline issues and steps taken to resolve them. LabCorp has been a willing ~_n_tj.f~~pon._~i~~ p_ar!r::i.~r.

6 -- KCPHD #2 Board Meeting Minutes 4/17/2018 page 6 of Executive Team Reports, cont ~......,._ Laurene Burton, Exec. Director, Governance & Comm. Affairs Ms. Burton reminded the Board that the Board meeting; on May 1 will commence at 4 p.m. She invited the Board to attend the Annual Volunteer Recognition event on the morning of April 25, Ms. Burton distributed copies of Kirkland Living Magazine that included two articles referencing Evergreen Health. o Jim Fitzgerald, Vice-President, Chief Legal Officer and General Counsel Mr. Fitzgerald attended a legal presentation on peer review and quality and brought back some ideas on how to link administration and the Medical Staff on this! important topic. CEO Update. -...,._ Bob Malte, CEO, reported on and gave notice of the following: Mr. Malte announced the LeapFrog "A" score and celebrated the hard work that had gone into achieving that score. Commissioner Reports Comm. Snyder commented that it was great to attend the annual : Easter Egg dash, as well as the Annual Medical Staff Meeting, Dinner : and Recognition. The positive comments of attendees and 1 opportunities for communication emphasize for him the importance of : commissioner attendance at such events. Comm. Hirt thanked Ms. Taylor for working on the traffic study, noting that hopefully Totem Lake traffic will not be as bad as that which traffic she recently experienced while driving in California. - Adjourn The April 17, 2018 Meeting of the Board of Commissioners for King County Public Hospital District No. 2 was adjourned at 8:38 p.m. SUBMTTED: AF. DeYoung,C

7 KCPHD #2 Board Meeting Minutes 4/17/2018 page 7 of 13 ATTEST: Minerva Butler, Secretary/Commissioner Charles A. Pilcher, MD, Commissioner -==- Approved as to content and form:

8 KCPHD #2 Board Meeting Minutes 4/17/2018 page 8 of 13 Exhibit A - Guests Name i John Sambrook Residence, Kirkland

9 KCPHD #2 Board Meeting Minutes 4/17/2018 page 9 of 13 Exhibit B - Monthly Voucher Summary KNG COUNTY PUBLC HOSPTAL DSTRCT NO. 2 d/b/a EVERGREENHEAL TH VOUCHER SUMMARY #552 March 2018 PATENT & NSURANCE REFUNDS ACCOUNTS PAYABLE -Warrants/Refunds ACCOUNTS PAYABLE -Wire Transfers RSK MANAGEMENT CLAMS - Wire Transfers WORKERS COMPENSATON CLAMS FRST CHOCE PPO CLAMS * PAYROLL -Warrants** PAYROLL - Direct Deposit** PAYROLL TAXES ** B &OTAXES CURRENT MONTH $637,721 $17,557,889 $4,098,227 $19,357 $136,614 $2,215,222 $225,066 $28,180,532 $11,144,822 $525,636 $64,741,087 6-MONTH ROLLNG AVERAGE $515,399 $19,614,006 $4,794,886 $36,909 $143,670 $1,693,810 $217,819 $20,311,449 $8,346,321 $604,196 $56,278,465

10 KCPHD #2 Board Meeting Minutes 4/17/2018 page 10 of 13 Exhibit C - Surplus Equipment 1 _ ~ESCR:TON~ LOCATON l MODEL# Comments t --1 j Printers 15 3 Silver HP 4100 Recycle! Exam Table 1 Surplus Mid Mark Scrap

11 KCPHD #2 Board Meeting Minutes 4/17/2018 page 11 of 13 Exhibit D - Medical Staff/AHP Appointments/Reappointments/Scope of Practice EvergreenHealth Medical Center March 20, 2018 NTAL APPONTMENTS: The following individuals are approved for appointment to the Provisional Medical Staff or as Allied Health Professionals with the privileges as delineated in their credentials files: NAME SPECALTY DEPT STATUS APPNT PEROD i Jackson, Teresa, MD Addiction Medicine Primary Care Active 04/17/18-03/31/2020 Kavasseri, Kripa, MD Urology Surgery Active 04/17/18-03/31/2020 Lazareva, Maria, MD Adult Hospitalist Hospital Medicine Active 04/17/18-03/31/2020 Parveen, Jinat, MD Family Medicine Primary Care Active 04/17 /18-03/31/2020 Selvaraj, Subathra, MD Family Medicine Primary Care Active 04/17 /18-03/31/2020 Venard, Neil, MD Psychiatry Medicine Telemedicine 04/17 /18-03/31/2020 DELEGATED CREDENTALNG: The following individuals are added to delegated credentialing only. They are not new applicants nor are they up for reappointment. NAME SPECALTY DEPT STATUS None REAPPONTMENTS: The following indiyiduals are approved for reappointment to the Medical Staff or as Allied Health Professionals with the privileges as delineated in their credentials files: NAME SPECALTY DEPT STATUS REAPPNT PEROD Crozier, Graham B., ARNP Heme/One Medicine AHP 04/17/18-03/31/2020! Davalian, Faranek, MD Neonatology W&C Active 04/17/18-03/31/2020 Dowidar, Bassim M., MD Emergency Medicine Hospital Medicine Active! 04/17/18-03/31/2020 i Drescher, Charles, MD Gyn Oncology W&C Active 04/17/18-03/31/2020 i Johnson, Shayna, CRNA Anesthesiology Surgery AHP / 04/17/18-03/31/2020 Kaine, Lars P., MD Family Medicine PC Active 04/17/18-03/31/2020 Kyaw, Win, MD Nephrology Medicine Active 04/17/18-03/31/2020 Mazzoncini Jr. Joseph P., MD Emergency Medicine Hospital Medicine Active 04/17/18-03/31/2020 McFall, Teri, MD Anesthesiology Surgery Active 04/17 /18-03/31/2020 Molloy, Loulie B., MD Mammography Hospital Medicine Active 04/17/18-03/31/2020 Mustafa, Syed MD Psychiatry Medicine Courtesy 10/17/ /30/2019 Naumann, Erich, DMD Oral/Maxillofacial Surgery Active 04/17/18-03/31/2020 Surgery Nguyen-Vermillion, Annie, Neonatology W&C Active 04/17/18-03/31/2020 MD

12 KCPHD #2 Board Meeting Minutes 4/17/2018 page 12 of 13 Opsahl, Michael, MD nfertility W&C Active 04/17/18-03/31/2020 Pearson, Kathryn A., MD nternal Medicine PC Active 04/17/18-03/31/2020 Pepper, Daniel, MD Vascular Surgery Surgery Active 04/17/18-03/31/2020 Petricca, Sarah E., MD Adult Hospitalist Hospital Medicine Active 04/17/18-03/31/2020 Pham, Angie K., MD Anatomic/Clinical Hospital Medicine Active 04/17/18-03/31/2020 Pathology Portelance, Douglas A., MD nternal Medicine PC Active 04/17/18-03/31/2020 Reinfried, Patrick S., MD Emergency Medicine Hospital Medicine Active 04/17/18-03/31/2020 Rutherford, Susan, MD OB/GYN W&C Active 04/17/18-03/31/2020 Sherman, Kristen, B., PHD Mental Health Medicine AHP 04/17/18-03/31/2020. Showman, Emily, MD Pediatrics PC Active 04/17/18-03/31/2020 Sjoberg, Sandra, MD Pediatrics PC Active 04/17/18-03/31/2020 Sliman, Gregory, MD Pediatrics PC Active 04/17/18-03/31/2020 Tu,Amy,MD OB/GYN W&C Active 04/17/18-03/31/2020 Unger, Randall L., MD Emergency Medicine Hospital Medicine Active 04/17/18-03/31/2020 Weinberg, Mitchell, MD Pediatrics PC Active 04/17/18-03/31/2020 Wilkinson, Katie E., MD Anatomic/Clinical Hospital Medicine Active 04/17/18-03/31/2020 Pathology Wilson, Thomas A., MD Family Medicine PC Active 04/17/18-03/31/2020, Yau, Edwin J., MD Mammography Hospital Medicine Active 04/17/18-03/31/2020 Yeary, Suzanne E., DO Family Medicine PC Active 04/17/18-03/31/2020 Young, Audrey J., MD Adult Hospitalist Hospital Medicine Active 04/17/18-03/31/2020 Deot Swenson, James, MD Orthopedics Surgery Active 03/20/18-02/28/2020 Thakkar, Anshita, DPM Podiatry Surgery Courtesy 03/20/18-02/28/2020 Trask, William, DO Anesthesiology Surgery Active 03/20/18-02/28/2020 ' Walker, Martin, MD MFM W&C Active J 03/20/18-02/28/2020 Watanabe, Suzan, ARNP Gynecology W&C AHP 03/20/18-02/28/2020 Wechkin, Hope A., MD Palliative Care PC Active 03/20/18-02/28/2020 i Weeks, Diana, MD Anesthesiology Surgery Active 03/20/18-02/28/2020 Young, Julie A., ARNP Cardiology Medicine AHP 03/20/18-02/28/2020 REQUESTS FOR CHANGE OF STATUS: The following practitioners are approved for a change in status as noted in their credentials files: NAME SPECALTY DEPT STATUS Armstrong, Annalisa, MD General Surgery Surgery Active

13 KCPHD #2 Board Meeting Minutes 4/17/2018 page 13 of 13 RESGNATONS: The following resignations from the Medical Staff or as AHPs are accepted and approved: NAME SPECALTY DEPT STATUS Kicska, Gregory A., MD Diagnostic Radiology Hospital Medicine TeleMed Knox, Kristen, MD Family Medicine PC Active Lai, Yen-Tsun, MD Geriatrics Medicine Active Lee, Franklin C., MD. Urology Surgery Active Liu, Peony, MD! Pediatric Hospitalist PC Active Norehad, Ernest, MD Urology Surgery Active Parsons, Phillip J., MD Emergency Medicine Hospital Medicine Active 1 Pierre-Jerome, Frantz, MD Diagnostic Radiology Hospital Medicine Active Romano, Jack, PA/SA Orthopedics Surgery AHP 1 Smith, Connie, MD Geriatrics Medicine Active Shah, Jighna R., PharmD Pharmacy PC AHP Webster, Wade W., MD Emergency Medicine Hospital Medicine Active DELEGATED CREDENTALNG RESGNATONS: The following delegated credentialing resignations from the Medical Staff or as AHPs are accepted and approved: NAME SPECALTY DEPT STATUS None