UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHINGTON, DC AUG

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1 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS AUG 3 1 The Honorable Carl Levin Chairman, Committee on Armed Services United States Senate Washington, DC Dear Mr. Chairman: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.) , May 25, 2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub. L , January 28, 2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent ofthe housing facilities complied with established standards. A total cost of$278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support of the Military Health System. Sincerely, Enclosure: As stated cc: The Honorable John McCain Ranking Member (lnol Clifford L. Stanley

2 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS AUG 3 1 The Honorable James H. Webb Chairman, Subcommittee on Personnel Committee on Armed Services United States Senate Washington, DC Dear Mr. Chairman: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.) , May 25,2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub. L , January 28, 2008, Sections 1616, 1648, and 1662). We regret the lateness of this annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent of the medical and 100 percent ofthe housing facilities complied with established standards. A total cost of$278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department of Defense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support ofthe Military Health System. Sincerely, Enclosure: As stated cc: The Honorable Lindsey O. Graham Ranking Member

3 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS AUG 3 1 The Honorable ke Skelton Chainnan, Committee on Armed Services U.S. House ofrepresentatives Washington, DC Dear Mr. Chainnan: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.) , May 25,2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub. L , January 28,2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent of the housing facilities complied with established standards. A total cost of $278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support of the Military Health System. Sincerely, Enclosure: As stated cc: The Honorable Howard P. "Buck" McKeon Ranking Member.,

4 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS AUG 31 The Honorable Susan Davis Chairwoman, Subcommittee on Military Personnel Committee on Armed Services U.S. House ofrepresentatives Washington, DC Dear Madam Chairwoman: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.) , May 25,2007, Section 3307}, and the National Defense Authorization Act for FY 2008 (Pub. L , January 28,2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent ofthe housing facilities complied with established standards. A total cost of$278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support ofthe Military Health System. Sincerely, Enclosure: As stated cc: The Honorable Joe Wilson Ranking Member

5 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON. DC PERSONNEL AND READNESS AUG 31 The Honorable Daniel K. nouye Chairman, Committee on Appropriations United States Senate Washington, DC Dear Mr. Chairman: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.)110-28, May 25,2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub. L , January 28, 2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent ofthe housing facilities complied with established standards. A total cost of$278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support ofthe Military Health System. Sincerely, Enclosure: As stated cc: The Honorable Thad Cochran Ranking Member

6 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS AUG 31 The Honorable Daniel K. nouye Chairman, Subcommittee on Defense Committee on Appropriations United States Senate Washington, DC Dear Mr. Chairman: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.) , May 25,2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub. L , January 28, 2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent ofthe housing facilities complied with established standards. A total cost of$278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support ofthe Military Health System. Sincerely, Enclosure: As stated cc: The Honorable Thad Cochran Ranking Member (k'ltot Clifford L. Stanley G

7 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS The Honorable David R. Obey Chairman, Committee on Appropriations U.S. House ofrepresentatives Washington, DC Dear Mr. Chairman: We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. 1.) , May 25, 2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub , January 28,2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent ofthe housing facilities complied with established standards. A total cost of$278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support ofthe Military Health System. Sincerely, Enclosure: As stated cc: The Honorable Jerry Lewis Ranking Member

8 UNDER SECRETARY OF DEFENSE 4000 DEFENSE PENTAGON WASHNGTON, DC PERSONNEL AND READNESS The Honorable Nonn Dicks Chainnan, Subcommittee on Defense Committee on Appropriations U.S. House of Representatives Washington, DC Dear Mr. Chainnan: AUG 31 2em We are pleased to forward the enclosed report required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act for Fiscal Year (FY) 2007 (Public Law (Pub. L.) , May 25, 2007, Section 3307), and the National Defense Authorization Act for FY 2008 (Pub. L , January 28, 2008, Sections 1616, 1648, and 1662). We regret the lateness ofthis annual report and are working with the Service Secretaries to ensure subsequent reports are accomplished on schedule. The third annual inspection by the Military Departments revealed 96 percent ofthe medical and 100 percent ofthe housing facilities complied with established standards. A total cost of $278,761,000 was identified to correct deficiencies in medical treatment facilities. No funds were identified for medical hold housing as noted deficiencies were promptly corrected or the affected members were relocated to housing that met Department ofdefense standards. Congressional funding has provided the catalyst to realize significant improvements in medical facilities supporting Wounded Warriors. We thank you for your continued support ofthe Military Health System. Sincerely, Enclosure: As stated cc: The Honorable C. W. Bill Young Ranking Member

9 Office of the Secretary of Defense ANNUAL REPORT TO CONGRESS Annual Report on nspections of Military Medical Treatment Facilities and Medical Hold Housing Office of the Under Secretary of Defense (Personnel and Readiness) July

10 Table ofcontents EECUTVE SUMMARY ANNUAL REPORT TO CONGRESS-OVERVEW A. ntroduction B. Senior Oversight Committee... " C. Applicable Legislation D. MTF and MHH nspection Evaluation Standards and Criteria...4 E. MTF and MHH nspection Processes and Procedures F. Cost Development and mpacts G. Organization of Aru1Ual Report...'...4 PART 1: TOLL-FREE TELEPHONE (HOT LNE) AND NTERNET WEBSTE (WEBSTE) NQURES RELATED TO MEDCAL FACLTY CONDTONS SUPPORTNG WOUNDED WARRORS A. ntroduction B. General nformation Regarding Hot Line and Website nquiries C. Specific Findings and Analysis ofhot Line and Website nquiries...7 PART : NSPECTONS OF MEDCAL TREATMENT FACLTES (MTF) A. ntroduction , "... 9 B. General Findings and Analysis ofmtf nspections C. Specific Findings and Analysis ofmtf nspections..., ! Army MTF nspections Navy MTF nspections Air Force MTF nspections nformation Applicable to All Military Department MTF nspections D. Conclusion offindings and Analysis ofmtf nspections PART : NSPECTONS OF MEDCAL HOLD HOUSNG (MHH) A. ntroduction B. General Findings and Analysis ofmhh nspections ;.. 18 C. Specific Findings and Analysis of MHH nspections Army MHH nspections " Navy MHH nspections J Air Force MHH nspections nformation Applicable to All Military Department MHH nspections

11 D. Conclusion offindings and Analysis ofmhh nspections CONCLUSON AND WAY FORWARD COORDNATON TABLES: TABLE 1: MLTARY DEPARTMENTS' HOT LNE NUMBERS AND NTERNET WEBSTE ACCESS :.. 7 TABLE 2: HOT LNE NQURES ACCORDNG TO THE OFFCE OF THE SECRETARY OF DEFENSE (OSD) WOUNDED WARROR RESOURCE CENTER (WWRC) , '".., :.. 8 TABLE 3: COMPARSON OF TOTAL MTF NSPECTED, NUMBER OF COMPLANT VERSUS NON-COMPLANT FACLTES, AND COSTS TO CORRECT NOTED DEFCENCES PER EACH MLTARY DEPARTMENT FOR FY 2009, 2008, AND TABLE 4: COMPARSON OF COMPLANT MTF WTH NON COMPLANT FACLTES N PERCENTAGES PER EACH MLTARY DEPARTMENT FOR FY 2009, 2008, AND TABLE 5: PERCENTAGE OF MTF N COMPLANCE PER TOTAL NUMBER OF FACLTES NSPECTED FOR FY TABLE 6: PERCENTAGE OF MTF N COMPLANCE PER TOTAL NUMBER OF FACLTES NSPECTED PER MLTARY DEPARTMENTS FOR FY TABLE 7 : TOTAL PERSONNEL N VAROUS MHH COMPLANT HOUSNG TYPES, PERCENTAGES PER TYPE, AND AN ANNUAL SUMMARY FOR FY 2009, 2008, AND 2007 PER EACH MLTARY DEPARTMENT "... ','.. 22 TABLE 8: PERCENTAGE COMPARSON OF VAROUS MHH TYPES FO FY TABLE 9: PERCENTAGE COMPARSON OF PERSONNEL ACROSS VAROUS MHH TYPES PER EACH MLTARY DEPARTMENT FOR FY !.

12 ATTACHMENTS '.. 26 ATTACHMENT - DOD EVALUATON STANDARDS AND CRTERA FR NSPECTON OF MTF AND MHH 27 A. Evaluation Standards and Criteria for nspection of MTF General Comments Basic Standards and Criteria Supplemental Standards and Criteria i B. Evaluation Standards and Criteria for nspection of MHH General Comments Basic Standards and Criteria Supplemental Standards and Criteria... j Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel" ATACHMENT -MLTARY DEPARTMENTS' MTF AND MHH NSPECTON REPORTS A. Detailed Military Departments' MTF nspection Reports TAB ARMY-Detailed nspection Report TAB NAVY-Detailed nspection Report TAB AR FORCE-Detailed nspection Report B. Detailed Military Departments' MHH nspection Reports "' TAB ARMY-Detailed nspection Report...\ TAB NAVY- Detailed nspection Report TAB AR FORCE-Detailed nspection Report... : mportant Note to this Document: The Navy assisted the Marine Corps with respect to Congressional reporting and inspection requirements. The medical treatment and housing facility inspections provided by the Navy and included in this reporting action also incorporated applicable Marine Corps facilities. Although these two military services were very distinct in their contributions, they were considered one and the same for purposes ofthis document. Thus, all references to "Navy" are synonymous with the "Marine Corps" and will not be men! ioned separately from the "Navy" in this document.

13 ANNUAL REPORT TO CONGRESS Annual Report on nspections of Military Medical Treatment Facilities and Medical Hold Housing Executive Summary The United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act of2007 (Public Law , May 25,2007, Section 3307) and the National Defense Authorization Act of Fiscal Year 2008 (Public Law , January 28, 2008, Sections 1616, 1648, and 1662) established the requirement to provide adequate medical treatment and housing facilities supporting wounded warriors and their families. Under these Acts, the military departments -Army, Navy, and Air Force-were to perform the following tasks: A. Develop and implement standards for medical treatment facilities and medical hold housing. B. Annually assess the condition of these facilities against established standflrds. C. Establish a Wounded Warrior Resource Center (WWRC)r, toll-free telephone call numbers, and internet websites to assist military personnel in reporting facility deficiencies, addressing medical care concerns, and receiving benefits information. D. Report all results in accordance with these Acts. The Department of Defense (DoD) historically maintained standards for the ope ration and maintenance of MTF. Similar standards for military housing were established and implemented under a memorandum signed by the Deputy Secretary of Defense on 18 September This third annual facility inspection examined the following facility types: A. MTF, B. Specialty medical care facilities, and C. Military housing for out-patients. These inspections showed a 96 percent compliance with the MTF and 100 perce t compliance with the MHH to established standards. During the period covered by this third inspection, a total of $278,761,000 in defiiciencies was identified for MTF. No deficiencies or associated costs were identified for MHH Jal

14 deficiencies noted during the inspections were promptly corrected or the affected mem J ers were relocated to housing that met DoD standards. i n addition to facility inspections, Congress directed the creation of a Wounded Warrior Resource Center (WWRC), a referral service for all military personnel and their families, to record, track, and monitor all responses received. The WWRC addressed a large number of referral calls during this reporting period, but the specific military departments did not teceive any successive calls on the same matter on Service unique hot lines. The Service members had several avenues to address their concerns. Service unique hot lines were utilized as a final option.

15 ANNUAL REPORT TO CONGRESS Overview Annual Report on nspections of Military Medical Treatment Facilities and Medical Hold Housing A. ntroduction As in prior annual inspection reports, the goals and objectives of the medical treatment facility (MTF) and medical hold housing (MHH) inspections are to: ' 1. Utilize a unified system of standards and criteria to assess the quality of TF and MHH, 2. Execute annual facility inspections across the Military Health System, 3. dentify deficiencies requiring corrective action, 4. Create and execute a plan of action to correct noted deficiencies, and 5. Establish hot line telephonelintemet access and a Wounded Warrior Resource Center (WWRC) to simplify the referral, notification, reporting, and query process for military personnel and their families. This third annual report covers inspections conducted during Fiscal Year The first annual inspection report was submitted by DoD to the Congressional Defense Committees on 2 April The second report was submitted by DoD on 2 November B. Senior Oversight Committee n May 2007, the Senior Oversight Committee (SOC) for Wounded, ll, and lnj ed (W) was established to oversee improvements to the treatment, care, and transition of hese service members (W is a term synonymous with wounded warriors and will be used interchangeably in this report). The SOC is co-chaired by the Deputy Secretary of Defer,se and Deputy Secretary of Veterans Affairs. The Deputy Under Secretary of Defense for nstallations and Environment has overall responsibility for wounded warrior facility issues and functional responsibility for MHH. The Assistant Secretary of Defense for Health Affairs has fun cltiona responsibility for MTF.

16 C. Applicable Legislation To assess how well DoD facilities supported wounded warriors and family ml bers, Congress initiated the statutory provisions listed below: 1. Public Law , May 25, United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act, Section 3307 (TAB D-1). 2. Public Law , January 28, National Defense Authorization Act (NDAA) for Fiscal Year 2008, Sections 1616, 1648, and 1662 (TAB D-2). D. MTF and MHH nspection Evaluation Standards and Criteria Under Public Law , January 28,2008, Section 1648, Congress stated l at established standards were to be uniform and consistent related to appearance, maintenance, size, operations, and comply with the Americans with Disabilities Act of To support consistency throughout inspections of all MTF and MHH facilities, existing design standards were reviewed, reaffirmed, and/or newly developed. MTF design standards already exih ed under prior code and criteria development and compliances. However, MHH design sd ndards had to be developed and were established via a memorandum issued in September 2007 by the Deputy Secretary of Defense. Attachment provides further details on specific evaluatibn standards, criteria, memorandums, and guidance utilized during the MTF and MHH facility inspections. E. MTF and MHH nspection Processes and Procedures The military departments developed inspection procedures and protocols for meclical treatment and housing facilities to account for all MTF and MHH in the system. The protocols and team compositions that conducted inspections were slightly different for each of the military departments. Facility managers, health facility personnel, medical case managers, medif al hold unit personnel, housing managers, engineers of various disciplines, tradesmen of diverse backgrounds, maintenance contractors, and other base civil engineering personnel partioipated on the inspection teams. n some cases, inspections created up-to-date web-based lists of d tailed deficiencies while in others more localized lists applicable to the direct installation were developed. n either case, the inspection information served to produce the basis for development of maintenance and operation project requirements targeted at reducing the backlog of deficiencies and improving the condition of facilities. F. Cost Development and mpacts Costs reflected in each military department's report were derived using several different means and methods. The majority of cost estimates were based on the Means Cost Estirpating Criteria. Other estimates were based on unit costs identified in existing maintenance cftracts, experiences of the cost estimator, and/or actual costs noted from similar projects. Addit onal

17 cost factors under the MTF accounted for the need to maintain on-going health care operations. Some project actions were consolidated into larger projects in order to minimize the number of potential contractors and simplify the acquisition process. Reflected costs denoted a rough order of magnitude for projects that were not well developed. Hence, noted costs could vary las much as 10% from their actual amounts. More detailed designs would be required to identify more accurate shortfalls in the maintenance and operation budgets for projects minimally deflned. G. Organization of Annual Report This report is divided into three parts: 1. Part : Toll-Free Telephone (Hot Line) and nternet Website C\Vebsite) nquiries Related to Medical Facility Conditions Supporting Wounded Warriors--Discusses results related to the established hot line telephone c umbers, WWRC, and internet website programs. 2. Part : nspections of Medical Treatment Facilities (MTF)--Covers TF and their inspection results; and, 3. Part : nspections of Medical Hold Housing (MHH)--Addresses medical housing supporting out-patient care and their inspection results.

18 PART : TOLL-FREE TELEPHONE (HOT LNE) AND NTERNET WEBSTE (WEBSTE) NQURES RELATED TO MEDCAL FACLTY CONDT ONS SUPPORTNG WOUNDED WARRORS A. ntroduction As required by the National Defense Authorization Act for Fiscal Year 2008 (P blic Law , January 28,2008, Section 1648), this part of the report provides consoljdated information on "any deficiencies in the adequacy, quality, or state of repair of medical-related support facilities raised as a result of information received during the period covered by the report through the toll-free hot line required by Section 1616." The military departments established hot line numbers as of 1 April 2008 and websites as of 1 July The putpose of the WWRC was "to provide wounded warriors, their families, and their primary caregij ers with a single point of contact for assistance with reporting deficiencies in covered military facilities, obtaining health care services, receiving benefits information, and any other difficulties encountered while supporting wounded warriors." B. General nformation Regarding Hot Line and Website nquiries "TABLE 1: Military Departments' Hot Line Numbers and nternet Website Achess" summarizes the access numbers that were established for each of the military departmeits in an effort to support this Act. For this third inspection period, hot line calls and website inquiries were recorded from 1 October 2008 through 30 September 2009 (FY 2009) for all military departments and tl{e WWRC. This reporting period was established to coincide with annual, fiscal year opetation and maintenance planning, programming, and execution efforts. This permitted each military department to allocate funds, on an annual basis, to expedite necessary corrective actiorl. The next reporting period will span from 1 October 2009 to 30 September (FY ). C. Specific Findings and Analysis of Hot Line and Website nquiries The WWRC received 1278 calls during this reporting period. One hundred percent ofthe caller issues were resolved on the first call by providing direct information, referral to a specific military department wounded warrior program, or transfer to other non-medical resourcbs. n 77% of the calls (978 calls), callers were directed to TRCARE, VA, or related military department wounded warrior programs. Of these calls, none were directly related to the "adequacy, quality, or state of repair ofmedical-related support facilities." n 23% of te calls (300 calls), callers were directed to non-medical resources (i.e. commerce, banking, corpmunity services, and school systems). Army represented the largest group of calls received o). The primary focus of the calls received by the WWRC was related to medical treatment issues. (57r "TABLE 2: Hot Line nquiries According to the Office ofthe Secretary ofdefense (OSD) Wounded Warrior Resource Center (WWRC)" provides a summary and breakdown of rfferral calls according to each military department to include number of calls, percent of calls to the total, and number referred to departmental wounded warrior care centers, V A, TRCARjE, or non-medical resources/services.

19 TABLE 1: MLTARY DEPARTMENTS' HOT LNE NUMBERS AND NTERNET WEBSTE ACCESS DEPARTMENT -REF HOT LNE NUMBERS NTERNET WEBSTE ACCESS ALTERNATE MAN NUMBER NUMBER Reference Each ndividual WTU DSN NOTES: NMG NMNCA NMW NMSC NME WWRC WTU NAVY MEDCNE NSPECTOR GENERAL (BUREAU OF MEDCNE AND SURGERY) NAVY MEDCNE NATONAL CAPTAL AREA NAVY MEDCNE WEST NAVY MEDCNE SUPPORT COMMAND NAVY MEDCNE EAST WOUNDED WARROR RESOURCE CENTER (MLTARY ONE SOURCE) WARROR N TRANSTON UNT

20 TABLE 2: HOT LNE NQURES ACCORDNG TO THE OFFCE OF THE SECRETARY OF DEFENSE (OSD) WOUNDED WARROR RESOURCE CENTER (WWRC) HOTLNE CALLS RECEVED FROM OSD WOUNDED WARROR RESOURCE CENTER (wwrc) CALLS RECEVED PER MLTARY MLTARY DEPARTMENTS DEPARTMENT NUMBER OF PERCENT OF CALLS CALLS CALLS REFERRED TO WWNATRCARE SERVCE NUMBER OF PERCENT OF CALLS CALLS REFERRED REFERRED REMARKS ARMY % % NAVY % 93 69% AR FORCE 74 6% 39 53% MARNES 112 9% 79 71% NATONAL GUARD 115 9% 0 0% RESERVE 111 9% 0 0% All Nation1 Guard Re erred to Parent Service All ReserVe Referred t Parent Se ice TRCARE NA NA 18 NA VA NA NA 255 NA 300 Referrals GRAND TOTALS % % to Other Resources 23%) General Note: 100% of caller issues reolved. Resolutions achieved through WWRC directly; referrals [to individual military departments and their wounded warrior programs, TRCARE, or VA; or, transfer to nonmedical entities. Medical treatment represented the number one issue. " PERCENT OF TOTAL CALLS PER MLTARY DEPARTMENTS Reserve, 9% National Guard, 9% Marines, 9% Air Force, 6% Army, 57% Navy, 10 %

21 PART : NSPECTONS OF MEDCAL TREATMENT FACLTES (MTF) A. ntroduction As required by the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act (Public Law , May 25, 2007, Sectidn 3307) and the National Defense Authorization Act for FY 2008 (Public Law , January 28, 2008, Section 1648), this part of the report consolidates infonnation on military depart$ent inspections of medical treatment and specialty treatment facilities caring for Service anq family members. Utilizing specific criteria and checklists, the condition of each facility was identified during the annual inspections. B. General Findings and Analysis of MTF nspections The Departments of the Anny, Navy, and Air Force inspected all hospitals and medical/dental clinics supporting wounded warriors. These inspections recorded whether each examined facility met or did not meet established standards. n addition, all military departments participated in the accreditation process of the Joint Commission on Accreditation of Ht spitals (TJC). The accreditation process was continuous, data-driven, and focused on operational systems critical to the safety and quality of patient care. The military departments' reports, under Attachment, provided the methodology of the inspections and changes from previous inspection reports. All MTF were inspected within the required time frame and followed established standards as described under Attachment 1. For FY 2009, the inspection teams detennied that the 95% overall average of MTF met standards for operations and maintenance, and the 97% overall average met standards for the Americans With Disabilities Act of 1990 (ADA) compliance; thus, the total average for both categories was 96%. This reflected a 2% overall improvement from the previous year and an 8% improvement over the first inspection year. Routine deficiencies that were corrected by a service call were not reported. No deficiencies were identified that would jeopardize the accreditation of an MTF or pose an immediate danger to the patients or practitioners at the applicable facility. Hence, in accordance with applicable standards, all MTF were in compliance and accredited for FY Where deficiencies were noted, a corrective plan of action was included. The Anny and Air Force funded their deficiencies in FY while the Navy prioritized their requirements across a 5-year pod (from FY to FY 2015). The detailed data tabulations in each military department' report noted deficiencies and projected rough order of magnitude costs for each facility inspected. Overall, the Anny identified $8.255M, the Navy $ M, and the Air Force $0.455M in required funding to fully address the MTF deficiencies observed and recorded during this third annual inspection period. C. Specific Findings and Analysis of MTF nspections 1 The military department inspection reports listed installations alphabetically. number of facilities inspected for each of these services was as follows: Navy equaled 98; Annyequaled 130; and Air Force equaled 182. Based on noted deficiencies for ADA, e Anny

22 was at 1 %, the Navy at 5%, and the Air Force at 2%. Under Operations and Maintenanfe deficiencies, the Army was at 15%, the Navy at 1%, and the Air Force at 0% (all inspected facilities were found to be compliant). On average, all military departments noted 3% ih ADA deficiencies and 5% in Operations and Maintenance deficiencies for a total overall percntage of 4% deficiencies identified during the FY 2009 inspections. Continued reductions in total deficiencies were identified during the FY 2009 facility inspections compared to previous years. This trend reflects the military departments' dedicated efforts to improve MTF supporting wounded warriors and their families. Based on the total number of facilities inspected, "TABLE 3: Comparison oftotal MTF nspected, Number ofcompliant Versus Non-Compliant Facilities, and Costs to Correc Noted Deficiencies Per Each Military Department For FY 2009, 2008, and 2007" indicates the number of compliant facilities and associated costs to correct these deficiencies within the evaljation categories of ADA, Operations, and Maintenance for not only FY 2009 but all previous inspection years for comparison. n addition, this table indicates the total costs per year per military department to correct deficiencies in MTF. "TABLE 4: Comparison ofcompliant MTF with Non-Compliant Facilities in Percentages Per Each Military Department for FY 2009, 2008, and 2007" conveys percentages of compliant facilities within the evaluation criteria categories of ADA, Operations, and Maintenance for FY 2009 as well as all previous inspection years for comparison. This table also summarizes percentages of noted deficiencies pei\1 each year of inspections. n most cases, MTF that were inspected met the standard and no actions were generated or cost estimates required. Other situations existed where MTF met standards, but recognized deficiencies existed which did not affect the operations or accreditation. n these cases, lcost estimates to correct noted deficiencies were developed and a time frame for its execution indicated. Since many deficiencies were not easily mitigated through a single project or fiscal year, corrections were planned for execution through several years-from FY thrqugh FY n these cases, constructability, new work limitations, and continuity of MTF operations required a series ofprojects over a period of time. Costs identified with the deficiencies did not reflect a project cost but rather the cost of the specific deficiency. Total project costs would generally be higher as work and scope of services were more specifically defined. Additional evaluation standards and criteria (see Attacrunent ) note facility defilencies primarily in the building envelope systems. ADA non-compliance, environmental improvements strengthening rehabilitative care, and functional shortfalls within administrative and other patient areas were additional deficiencies that occurred. 1. Army MTF nspections The U.S. Army Medical Command (MEDCOM) identified, during the FY 2009 building inspections, $0.052M for ADA deficiencies and $8.203M for operations and maintenance deficiencies; this equated to a total overall cost of $8.255M. All noted deficiencies would be corrected during the FY execution period.

23 n accordance with their inspection report provided under Attachment -A. 1., the Army noted non-compliance according to the following percentages: ' a. Building Systems and Envelope 42% b. Life Safety and Fire Protection 27% c. nterior/functional Conditions 23% d. SitelMedical Campus 04% e. Americans with Disability Act (ADA) 04% Total Percentage 100% As in previous years, the Army's non-compliance predominately centered on the Building Systems and Envelope which was also true for the Air Force and the Navy. This covered an array ofdeficiency concerns such as elevators, cooling towers, roof systems, electrical service and equipment, generator systems, and exterior doors and windows. Life Safety and Fire Protection and nterior/functional Conditions were second in demonstr'lting the most noted deficiencies. Concerns in these two areas covered sprinkler systems, egress conditions, fire alarm systems, emergency exit signs, interior doors, surface finishes, anti space reconfigurations to improve opertionl efficiencies. SitelMedical Campus and AD 4red equal focus as the last set of deficences. Related areas focused on door hardware, mteror signage, restrooms, and accessible ramps. Actions noted under ADA were directly associated, with ADA compliant corrections. Many of the broader ADA, life safety, and fire protection issues were also addressed under the other criteria. 2. Navy MTF nspections During the FY 2009 building inspections, the Navy identified $12,204M for ADA deficiencies and $257,857M for operations and maintenance deficiencies; this equated to a total overall cost of$ m. All noted deficiencies would be programmed for correction lthrough the next five years. n accordance with their inspection report provided under Attachment -A.2., the Navy noted non-compliance according to the following percentages: a. Building Systems and Envelope 34% b. Life Safety and Fire Protection 22% c. nteriorlfunctional Conditions 21% d. Site/Medical Campus 07% e. Americans with Disability Act (ADA) 16% Total Percentage 100% Like the Army and the Air Force, the Navy's most predominant non-compliance centered on Building Systems and Envelope. Deficiencies such as windows, roof systems, exteriqr fayade, and building conditions were identified. Life Safety and Fire Protection and nteriorlfunctional Conditions were second in demonstrating the most noted deficiencies.

24 Concerns in these two areas covered sprinkler systems, egress conditions, fire alarm sy terns, emergency exit signs, interior doors, surface finishes, heating/ventilation/air conditionig equipment, electrical systems, departmental renovations, whole building and clinic renovations, facility modernization, interior finish conditions, and space reconfigurations to improve operational efficiencies. SitelMedical Campus noted the least number of deficiencies. Concerns in this area covered sidewalks, ramps, and exterior surface finish conditions. ADA issues noted the fourth major area of concern for identified deficiencies. Related areas focused on sidewalks, floor leveling, entry access, door hardware, interior signage, restrooms, and accessible ramps. Actions noted under ADA were specific and directly associated with ADA compliant corrections. Many of the broader ADA, life safety, and fire protection issues were also addressed under other criteria. 3. Air Force MTF nspections The Air Force identified, during the FY 2009 building inspections, $0.455M for ADA deficiencies. No deficiencies were noted under operations and maintenance. Thus, the total overall cost of deficiencies equaled $0.455M. All noted deficiencies would be corrected during the FY execution period. n accordance with their inspection report provided under Attachment -A.3., the Air Force noted non-compliance according to the following percentages: a. Building Systems and Envelope 25% b. Life Safety and Fire Protection 12% c. nteriorlfunctional Conditions 25% d. SitelMedical Campus 00% e. Americans with Disability Act (ADA) 38% Total Percentage 100% Non-compliance for the Air Force focused around ADA issues. Sidewalks, floo leveling, entry access, door hardware, interior signage, restrooms, and accessible ramps were examples of these criteria. Actions noted under ADA were directly associated with ADA compliant l corrections. Building Systems and Envelope and nteriorlfunctional Conditions carried the second highest set of deficiencies. Concerns in these two areas covered interior doors'lurface i finishes, whole building and clinic renovations, facility modernizations, departmental renovations, and space reconfigurations to improve operational efficiencies, heating, v. tilation, and air conditioning equipment, windows, roof systems, electrical systems, exterior fa9des, and exterior building conditions. Life Safety and Fire Protection was the third area of concclrn for identified deficiencies. This covered deficiencies such as emergency egress, fire alarm hstems, and emergency exit signs. Site/Medical Campus noted no deficiencies. 4. nformation Applicable to All Military Department MTF nspections For all the military departments, "TABLE 5: Percentage ofmtf in Complianc Per Total Number offacilities nspected" and "TABLE 6: Percentage ofmtf in Compli nce Per

25 Total Number offacilities nspected Per Military Departments" graphically summariz s the percentages of facilities in compliance per each additional evaluation standard and critepa across each military department and per each military department. Attachment contains eacp military department's MTF inspection report along with associated details and data. D. Conclusion of Findings and Analysis of MTF nspections During the third facility inspections, all military departments noted a need to expend a total of$278,761m in operations, maintenance, and ADA costs to address the most urgtmt and immediate corrective actions related to MTF (97% of this cost related to Navy MTF). Congress's support in the past has contributed greatly toward DoD's goal to provide world-class medical treatment facilities for wounded warriors and their families. Although Congress requires inspections to be conducted on an annual basis, ong ing facility management inspections occur daily in an effort to create and sustain world-clas 1s military medical facilities. DoD will continue an aggressive inspection of the MTF on an annual basis to ensure compliance with all applicable standards.

26 TABLE 3: COMPARSON OF TOTAL MTF NSPECTED, NUMBER OF COM;PLANT VERSUS NON-COMPLANT FACLTES, AND COSTS TO CORRECT NOTED DEFCENCES PER EACH MLTARY DEPARTMENT FOR FY 2009, 2008, AND 2007 FSCAL YEARS 2009, 2008, AND 2007 PER EACH MLTARY DEPARTMENT MLTARY DEPARTMENT FSCAL YEAR COMPLANT ADA NOT COMPLANT COSTS TO CORRECT SOOO) COMPLANT OPERATON AND MANTENANCE COSTS TO CORRECT ($000) TOTAL COSTS (ADA+OM) (SOOO)

27 TABLE 4: COMPARSON OF COMPLANT MTF WTH NON-COMPLANT FACLTES N PERCENTAGES PER EACH MLTARY DEPARTMENT FOR FY 2009, 2008, AND 2007

28 TABLE 5: PERCENTAGE OF MTF N COMPLANCE PER TOTAL NUMBER OF FACLTES NSPECTED FOR FY 2009./)... z w :E... <t c.. w c > :::i w c.. w (!) z w (,) w c.. SUB-EVALUATON CRTERA CATEGORES WTH ASSOCATED CLASSFCATONS SUB-EVALUATON CRTERA CATEGORES WTH ASSOCATED CLASSFCATONS [!]OPERATONS AND MANTENANCE CLASSFCATONS 1 BULDNG SYSTEMS AND ENVELOPE 2 LFE/SAFETY AND FRE PROTECTON NTEROR/FUNCTONAL CONDTONS CANS WTH DSABLTES ACT OF 1990 (ADA) CLASSFCATON M'VC:r'"J""S WTH DSABLTY ACT (ADA)

29 TABLE 6: PERCENT AGE OF MTF N COMPLANCE PER TOTAL NUMBER OF FACLTES NSPECTED PER MLTARY DEPARTMENTS FOR FY 2009 en Z W :!; 0:: it w c < :; 0:: W 0.. W <.!) z w (,,) 0:: W 0.. SUB-EVALUATON CRTERA CATEGORES PER MLTARY DEPARTMENTS SUB-EVALUATON CRTERA CATEGORES WTH ASSOCATED CLASSFCATONS moperatons AND MANTENANCE CLASSFCATONS 1 BULDNG SYSTEMS AND ENVELOPE 2 LFE/SAFETY AND FRE PROTECTON NTEROR/FUNCTONAL CONDTONS RCANS WTH DSABLTES ACT OF 1990 (ADA) CLASSFCATON RCANS WTH DSABLTY ACT (ADA) ltary DEPARTMENTS

30 A. ntroduction PART : NSPECTONS OF MEDCAL HOLD HOUSNG (MHH) Pursuant to the United States Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act (Public Law , May 25, 2007, Section 3307) and the National Defense Authorization Act for FY 2008 (Public Law , January 28, 2008, Section 1648), this portion of the report consolidated infonnation related to military department inspections of medical hold housing for wounded warriors and their families. Following specific standards, criteria, and checklists, an indication of the condition of each facility inspected was ascertained. B. General Findings and Analysis of MHH nspections The military departments' inspection reports included data tabulations that reflected how the wounded warrior was accommodated at a point in time. The inspections did not focus on all types of housing potentially available for use as MHH. t was critical that each wounded warrior had the proper accommodations based on his or her unique medical condition and other requirements. Based on established inspection standards and criteria (see Attachment ), all military departments met the housing needs of their personnel using a variety of means, including the referral of individuals into housing on and off base that met or could easily be adapted to meet the individual medical requirements of the wounded warrior. Focused actions to comply with the standards and criteria included renovating and modernizing existing barracks, lodging, and family housing; and, contracting or leasing private sector housing or lodging in the surrounding communities. When deficiencies were observed, efforts were focused and directed to execute the corrections promptly or, immediately relocate the wounded warriors to proper accommodations. C. Specific Findings and Analysis of MHH nspections All MHH were inspected within the required time frame. The inspection teams found all wounded warriors to be adequately housed in accordance with their physical limitations and medical conditions. Thus, 100% of all medical hold personnel were housed in compliance with established standards related to "assignment," "baseline," and "special medical" (see Attachment ) with the following exception. Two sailors on medical hold at Naval Station Norfolk were housed in a building (Building A28) that did not meet baseline standards. They were subsequently relocated from this building to accommodations that met necessary standards. Routine deficiencies that were corrected by a service call were not listed or included as a facility deficiency. Full MHH compliance to all established criteria also resulted in no required funds to correct deficiencies for the FY 2009 inspection year. The number of personnel housed during this inspection period versus that of the previous inspection year decreased across all military departments. The Anny housed 6,789 wounded warriors while the Navy housed 658 within various types of accommodations. The Air Force

31 had no wounded warriors at Air Force installations but had several Airmen wounded warriors treated and housed at Navy and Army nstallations. n each of their reports (see Attachment ), the military departments discussed, in more detail, the methodology and results of the inspections performed during the third reporting period. 1. Army MHH nspections Housing played an integral role in the Army Medical Action Plan (AMAP) for wounded warriors. The goal of this plan was to provide continuous, integrated care and services from point of injury, illness, or disease to return to duty or transition from active duty. As part of this plan, the Army, in FY 2009, consolidated medical hold personnel into 33 Warrior in Transition Units (WTUs) under the command and control of each installation MTF Commander. The objective was for every wounded warrior and family member to be supported by a triad comprised of the squad leader, a primary care manager, and a nurse case manager. Unlike the Navy, the Army performed its annual MHH inspections independent of the regional nspector General (G) requirements stipulated in Public Law , January 28, 2008, Section Of particular note, the number of wounded warriors housed during the third inspection period decreased by 26% in FY 2009 compared to the previous year. Because the Anny was in full compliance with all their housing facilities, there was no cost associated or necessary to bring facilities up to standard. Of the 6,789 Soldiers assigned to WTU s at the time of inspections, the majority of these personnel occupied privately owned or rented residences or unaccompanied housing owned by DoD. The following percentages represented the number of wounded warriors accommodated in different housing types at the time of the inspections: a. DoD Owned Family Housing 00% b. DoD Owned Unaccompanied Personnel Housing 36% c. Leased, Contracted, or Privatized Family Housing or Lodging on The Community 14% d. DoDlMilitary Department Owned Lodging (including Fisher Houses) 10% e. Privately Owned or Rented Housing 40% Total Percentages 100% 2. Navy MHH nspections n contrast to the Army, the Navy headquarters (HQ) inspections were performed concurrently with the inspections of the regional medical command G. Because the timing of the G inspections coincided with that of the HQ inspections, duplicate inspections were not performed in order to minimize the disruption to housing occupants. Like significant personnel decreases noted by the Army, the number of Navy wounded warriors also decreased by an overall 16% in FY 2009 compared to the previous year.

32 Of the 658 personnel assigned to wounded warrior units, the greatest numbers were housed in unaccompanied housing owned by the Navy and of a percentage similar to the previous year. This type ofhousing provided a quick, efficient, and cost effective means to accommodate wounded warriors with special requirements. The following percentages represented the number of personnel accommodated in different housing types: a. DoD Owned Family Housing 00% b. DoD Owned Unaccompanied Personnel Housing 80% c. Leased, Contracted, or Privatized Family Housing or Lodging on The Community 06% d. DoDlMilitary Department Owned Lodging (including Fisher Houses) 06% e. Privately Owned or Rented Housing 08% Total Percentages 100% 3. Air Force MHH nspections Although the Air Force did not have any wounded warrior Airmen on Air Force installations during this reporting period, it maintained current procedures for housing and lodging that require inspections as part of the process that each installation must perform in accordance with the Air Force Housing Program. Regular inspections were performed when the occupant ofthe house relocated, and then, when the new individual took occupancy of the quarters. Lodging inspections followed stipulated standards defined in the Air Force Lodging Program. The Air Force Services Agency Golden Eagle Lodging Standard's Checklist was followed for their inspections in conjunction with established standards (see Attachment ). 4. nformation Applicable to All Military Department MHH nspections "TABLE 7: TOTAL PERSONNEL N VAROUS MHH COMPLANT HOUSNG TYPES, PERCENTAGES PER TYPE, AND ANNUAL SUMMARY FOR FY 2009, 2008, AND 2007 PER EACH MLTARY DEPARTMENT' compares the number ofpersonnel across various housing types across several inspection years per each military department. "TABLE 8: PERCENTAGE COMPARSON OF VAROUS MHH TYPES FOR FY 2009" compares the percentage of personnel living in various housing types. "TABLE 9: PERCENTAGE COMPARSON OF PERSONNEL ACROSS VAROUS MHH TYPES PER EACH MLTARY DEPARTMENT FOR FY 2009" summarizes these percentages per each military department. D. Conclusion of Findings and Analysis of MHH nspections All wounded warriors and their families were housed in appropriate facilities during this inspection period. Since most of these accommodations were provided by interim facilities, the Army, Navy, and Marine Corps are constructing over $1 billion in new complexes adjacent to MTF. These complexes provide a complete healing environment by including: 1) housing that meets the fullest extent ofada standards; 2) administrative space for command and control elements of the wounded warrior units, including case managers and their care givers who

33 perfonn daily outpatient services needed to effect healing; and, 3) support facilities such as the Anny Soldier and Family Assistance Centers and the Marine Recovery and Resource Centers. Overall, the inspections have shown that the military departments provided adequate housing to wounded warriors and their families by aggressively addressing and correcting noted facility issues.

34 TABLE 7: TOTAL PERSONNEL N VAROUS MHH COMPLANT HOUSNG TYPES, PERCENTAGES PER TYPE, AND AN ANNUAL SUMMARY FOR FY 2009, 2008, AND 2007 PER EACH MLTARY DEPARTMENT FSAL YEARS 2009, 2008, AND 2007 AND EAcH MLTARY DEPARTMENT 000 OWNED UNACCOMPAltEO PERSONNEL HOUSNG OR LODGNG ON THE COMMUNTY COMPLANT '10 OF TOTAL COMPLANT '!.OFTOTAL COMPUAHT.OF TOTAL COMPlANT %OFTOTAL COMPlAltT '!.OFTOTAL 0% % % % % 7447 SEE NOTES 1AND2 NOTES:. VALUES REPRESENT TOTAL PERSONNEL OCCUPYNG VAROUS HOUSNG TYPES PER MLTARY DEPARTMENT 2. ESTABLSHED STANDARDS DD NOT APPLY TO PRVATE HOMES OCCUPED BY THE SERVCE MEMBER 3. TOTAL NUMBER OF ARMY PERSONNEL NOTED DD NOT NCLUDE MTF NPATENT PERSONNEL OF 276. ADDNG THS POPULATON FGURE TO 6,789, RESULTS N A TOTAL NUMBER OF PERSONNEL HOUSED ACTUALLY EQUAL TO 7,065 N FY 2009

35 TABLE 8: PERCENTAGE COMPARSON OF VAROUS MHH TYPES FOR FY J W Z o ) t: W 11. L.. o t: W ;:) Z t: w 11. W (!) «z W (.) t: W 11. DSTRBUTON OF HOUSNG TYPES PER MLTARY DEPARTMENTS FOR FY 2009 HOUSNG TYPES [!]HOUSNG CLASSFCATONS 1 2 DOD OWNED FAMLY HOUSNG DOD OWNED UNACCOMPANED PERSONNEL HOUSNG LEASED, CONTRACTED, OR PRVATZED FAMLY HOUSNG OR LODGNG ON THE COMMUNTY DOD/MLTARY DEPARTMENT OWNED LODGNG (NCLUDES FSHER HOUSES) PRVATELY OWNED OR RENTED HOUSNG ARY DEPARTMENTS

36 TABLE 9: PERCENTAGE COMPARSON OF PERSONNEL ACROSS VAROUS MHH TYPES PER EACH MLTARY DEPARTMENT FOR FY J W Z Z o w c.. u.. o W :!! :;) z w c.. w (!) z w w c.. DSPERSMENT OF PERSONNEL WTHN HOUSNG TYPES PER MLTARY DEPARTMENTS FOR FY 2009 HOUSNG TYPES CDHOUSNG CLASSFCATONS ' '1 A N AF DOD OWNED FAMLY HOUSNG DOD OWNED UNACCOMPANED PERSONNEL HOUSNG LEASED, CONTRACTED, OR PRVATZED FAMLY HOUSNG OR LODGNG ON THE COMMUNTY DOD/MLTARY DEPARTMENT OWNED LODGNG (NCLUDED FSHER HOUSES) PRVATELY OWNED OR RENTED HOUSNG LiTARY DEPARTMENTS..

37 CONCLUSON AND WAY FORWARD The military departments demonstrated a commitment to provide high quality MTF and MHH in support of wounded warriors and their families. These facility improvements did not happen without a considerable investment from reprioritizing existing military department funds, and from additional funding provided by Congress. DoD is very grateful for the supplemental funding in the American Recovery and Reinvestment Act of 2009, which provided $1.73 billion for medical treatment facilities ($1.33 billion for replacement of two hospitals and alteration of a third; and, $400 million for sustainment, restoration, and modernization). Additionally, from FY 2008 to FY, Congress appropriated $1.379 billion for wounded warrior complexes for the Army ($1, 128M), Navy ($ 134M), and Marine Corps ($117M). This completes all planned complexes except for one at Fort Eustis, Virginia budgeted in FY 2011 for $18M, and one in Germany which will be requested in a future budget request. DoD will continue to oversee an aggressive inspection program of MTF and MHH to identify and correct deficiencies. This effort, together with a continued commitment to provide adequate military construction and sustainment, restoration, and maintenance funding, will ensure that wounded warriors are treated and housed in facilities that aid in their transition to the next stage in their recovery.

38 ATTACHMENTS

39 ATTACHMENT -DOD EVALUATON STANDARDS AND CRTERA FOR NSPECTON OF MTF AND MHH A. Evaluation Standards and Criteria for nspection of MTF 1. General Comments 2. Basic Standards and Criteria 3. Supplemental Standards and Criteria B. Evaluation Standards and Criteria for nspection of MHH 1. General Comments 2. Basic Standards and Criteria 3. Supplemental Standards and Criteria 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold Housing Personnel"

40 A. Evaluation Standards and Criteria for nspection of MTF 1. General Comments: MTF were described as facilities established for the purpose of furnishing medical and/or dental care to eligible individuals on an inpatient or out-patient basis. This did not include battalion aid stations, post/base in or out processing facilities, or soldier readiness processing facilities unless they were an integral part of an MTF. Under Public Law , January 28,2008, Section 1648, Congress stated that established standards were to be uniform and consistent related to appearance, maintenance, size, operations, and compliance with the Americans with Disabilities Act of Basic Standards and Criteria: DoD design standards for MTF existed under the Unified Facilities Criteria (UFC) Document , "Design: Medical Facilities Criteria." These standards were available for public use through the National nstitute of Building Science's Whole Building Design Guideline publications and website. When supplemented with the standards established by the Joint Commission for Accreditation of Hospital Organizations (TJC), full, reliable and standardized inspection criteria for the operation and maintenance of MTF were available and uniformly implemented. This Joint Commission certifies healthcare facilities for both the public and private sector. 3. Supplemental Standards and Criteria: Additional evaluation standards and criteria were created in 2007 by the SOC, Line of Action (LoA) #5 Working Group to support these annual inspections and their reporting requirements. Descriptions of these additional standards and criteria were as follows: a. Operation and Maintenance-covered the following: 1) Building Systems and Envelope: included utility infrastructure; all engineering systems and requirements (i.e. mechanical, plumbing, electrical, telephone and communications); elevators, escalators, and other horizontal/vertical electronic transportation walkways; building exterior and fayade (i.e. roof, walls, windows, porticos, coverings, and exterior doors); and, other special systems. A sampling of deficiency conditions under this sub-category included: condensate lines, communication systems, medical gas systems, cooling towers, air handling units, absorption chillers, HV AC, roofs, and windows. 2) Life Safety and Fire Protection: included all fire protection equipment and systems, means of egress, emergency lighting and generators, exit signs, and automatic transfer switches. A sampling of deficiency conditions under this sub-category included: emergency generators, enunciator panels, public address systems, and various fire alarm system parts.

41 3) nterior/functional Conditions: included all types of functional areas and overall departments; interior finishes, equipment, and fixtures; whole building additions and renovations; modifications and expansions to existing spaces; interior signage and way finding; and, doors, walls, floors, and ceilings. A sampling of deficiency conditions under this sub-category included: painting, floor finishes, interior doors, pharmacy, operating rooms, mental health clinics, warehouses, appointment centers, and other medical and dental clinic departments. 4) Site/Medical Campus: included exterior site amenities, sidewalks, roads, drainage, erosion control, storm water management, curbs and gutters, parking lots and garages, stairs and ramps, and other site conditions. This category also included all issues related to exterior settings necessary to comply with antiterrorism force protection standards. A sampling of deficiency conditions under this sub-category included: sidewalks, antiterrorism force protection measures, way finding, signage, and site lighting. b. Americans with Disabilities Act and Accessibility Guidelines of 1990-covered the following: 1) Americans with Disabilities Act of 1990 (ADA): included all related conditions not addressed in other areas that assured compliance with ADA. Not included were grand fathered ADA deficiencies. A sampling of deficiency conditions occurring herein included: specific interior and exterior ADA conditions including sidewalks, way finding, signage, restroom facilities, stairwells, and exterior building access. Standards related to the Uniform Facilities Accessibility Standards (UFAS) also applied to inspections performed. When there were conflicts between ADA and UF AS critelia. the most stringent conditions took precedence. 2) n accordance with the provisions of the Americans with Disabilities Act of 1990, existing deficiencies outside the scope of a renovation project were exempt from compliance. However, construction projects executed during the fiscal year were required to comply with the current ADA standards within the limits and bounds of the applicable construction project. Deficiencies noted in the military departments' reports under ADA were totally related to ADA. But, many other ADA related deficiencies were accounted for under other additional categories (i.e. Building Systems and Envelope, Life/Safety and Fire Protection, SitelMedical Campus, and nterior/functional Conditions). Each MTF deficiency listed by the military departments was classified according to one of the evaluation criteria noted above. A percentage was assigned to each

42 additional standard and criteria according to the total number of projects listed per military department. B. Evaluation Standards and Criteria for nspection of MHH 1. General Comments: MHH were for wounded, ill, or injured Service members in a medical hold status receiving out-patient medical treatment. Medical hold referred to the assignment ofpersonnel housed to a medical hold unit under the cognizance of a MTF whose members had conditions that precluded them from returning to full duty. MHH included the following types of housing: a. DoD Owned Family Housing-Housing owned by the military department for occupancy by eligible members with dependents. b. DoD Owned Unaccompanied Personnel Housing-Housing owned by the military department for occupancy by eligible military personnel without dependents. c. Leased, Contracted, or Privatized Family Housing or Lodging in the Community-Private sector housing privatized or leased by the military department for occupancy by families, unaccompanied personnel, or transient personnel. d. DoD/Military Department Owned Lodging (ncludes Fisher Houses) Lodging (transient housing) owned by the military department for occupancy by military personnel, families, unaccompanied personnel, or transient personnel. MHH does not include private sector housing in the community (not privatized), rented, or owned by an individual service member. 2. Basic Standards and Criteria: nspections of MHH used standards issued on 18 September 2007, under a DoD Memorandum signed by the Deputy Secretary of Defense, titled "DoD Housing nspection Standards for Medical Hold and Holdover Personnel." This standard stated that wounded warriors and their families would be assigned or referred to housing that must exceed or meet applicable standards and must be appropriate for the medical condition, expected duration of treatment, dependency status, and pay grade of the service member. These standards also stated that medical hold housing and associated amenities and specialty services shall be considered as an integral part of each wounded warrior's medical treatment plan. n addition, the chain of command was responsible, in consultation with the patient, the patient's medical support team, and case managers, to validate that each housing unit assigned or referred to a recovering service member was adequate in the following three additional evaluation criteria for the particular member occupying the unit: a. Whether the ASSGNMENT to a specific unit was adequate for the MHH in terms of configuration, size, and features.

43 b. Whether the building met BASELNE standards related to its physical condition and any support services that were needed. c. Whether the housing unit met any SPECAL MEDCAL requirements as determined by the primary care physician, patient, and chain of command. 3. Supplemental Standards and Criteria: For the MHH, each of the military departments developed their own checklists based on the 18 September 2007 DoD Memorandum to assist in their detennination of whether wounded warriors were being housed properly. Uniform data tabulations related to inspection results were developed that identified the specific facility being inspected; compliance or non-compliance to identified standards; number ofimpacted personnel; housing types; and, rough order of magnitude costs to correct indicated deficiencies. ndividual tables were provided for each facility inspected. n addition, housing inspections included interviews ofpersonnel (i.e. wounded warriors and their families), physical inspections of the facility and its supporting infrastructure, and review of available documents. The documents reviewed included work orders executed within the past 6 months; asbestos, lead paint, pest control, and mold documentation; recurring service calls; regularly scheduled maintenance records; and, common complaints about living quarters. The inspection teams were composed of medical case managers, housing and facility managers, engineers within various disciplines, engineering technicians, and tradesman of various backgrounds. 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel". The following pages provide a copy of this memorandum.

44 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 1.' ' DEPUTY SECRETARY OF DEFENSE 1010 DEFENSE PENTAGON WASHNGTON, DC SEP 8 'J07 MEMORANDUM FOR SECRETARES OF Tm MLTARY DEPARTMENTS UNDER SECRETARY OF DEFENSE FOR PERSONNEL AND READNESS UNDER SECRETARY OF DEFENSE FOR ACQUSTON, TECHNOLOGY AND LOGSTCS ASSSTANT SECRETARY OF DEFENSE FOR HEAL1H AFFARS SUBJECT: DoD Housing nspection Standards for Medical Hold and Holdover Personnel The Wounded, and njured Senior Oversight Committee (Wll-SOC), ajoint DoDDV A committee, met and approved the following policy changes on August 28, Effective immediately, the Military Services will provide housing for medical hold and holdover personnel in accordance with the attached standards. These standards address baseline accommodations and special features and services that may be required depending on a member's medical condition and treatment plan. The Secretaries of the Military Departments are directed to use these standards for conducting the inspections required by section 3307 of the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and raq Accountability Appropriations Act, 2007 (Public Law ), and to report inspection findings to the Under Secretary of Defense for Personnel and Readiness not later than October 31, Timely implementation of these standards is a top Department priority. Attachment: As stated OSD /1B/ :20:09 AM

45 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 2 (continued) HOUSNG NSPECTON STANDARDS FOR MEDCAL HOLD AND HQLDQVER PERSONNEL 1. PURPOSE These standards shall be used as a basis for evaluating the adequacy of facilities that house medical hold and holdover personnel. 2. GENERAL n general, medical hold and holdover personnel receiving outpatient medical treatment (hereafter referred to as MH personnel or MH members) shall be assigned or referred to housing that exceeds or meets the applicable quality standards and is appropriate for their medical condition, expected duration of treatment, dependency status (including authorization of a non-medical attendant), and pay grade. The particular housing and associated amenities/services provided shall be an integral part of their medical treatment plan as detennined by the primary care physician, patient, and chain of command. Note that some MH personnel with serious medical conditions are authorized non-medical attendants at the discretion of their primary care physician to ass.ist in their recovery and rehabilitation. Non-medical attendants can include the member's parent, guardian, or another adult (18 or over). 3. APPLCABLTY These standards address baseline accommodations, and any special medically needed facility features and services. Standards and guidance are also provided for associated fumishings, amenities, operations/services, and maintenance that are critical to well being and morale. These standards apply to the following types of housing when occupied by MH personnel: DoD-owned family housing (FH) DoD-owned unaccompanied personnel housing (UP H) Lodging owned by DoD, whether supported by appropriated funds or a nonappropriated funded instrumentality (NAF). Lodging types include temporary duty (TDY) lodging, permanent change of station (pes) lodging, recreational lodging, and military treatment facilities (MTF) lodging, e.g., Fisher Houses. Lease/contracted housing and lodging, to the maximum extent permitted by the associated agreement. Privatized housing and lodging, to the maximum extent permitted by the associated agreement. Note these standards do not apply to a service member's privately-owned home, or a rented home in the community (not privatized) that a service member obtains on his or her own.

46 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 3 (continued) 4. PRORTY FOR SEROUS MEDCAL CONDTONS AS A DRECT RESULT OF ARMED CONFLCT t is fitting that medical hold personnel who have "serious physical disabilities" or that are the "direct result of armed conflicf"! have priority for housing and certain services. While the minimum housing standards are the same for a/l medical hold personnel, 000 has a special obligation to provide the best for seriously Wounded Warriors. Examples where priority should be considered include: housing waiting lists, fumishings and electronic equipment, pal1<ing spaces, time to respond to maintenance requests, etc. Furthermore, the housing status of these seriously Wounded Warriors should be monitored at the Service HQ level. 5. RESPONSBLTES The chain of command shall be responsible, in consultation with the patient and the patient's medical support team and case managers, to validate that everymh member is adequately housed in accordance with these standards. Before a MHmember is assigned/referred to housing (e.g., before transitioning from inpatient to outpatient status), the case manager shall provide consultation to the chain of command to ensure that the intended patient housing meets any special medical needs. f an assigned/referred housing unit for a member does not meet all the applicable standards in this document, the installation or garrison commander shall document the reasons why the standards were not met (authority can be delegated), and the respective Military Service headquarters must be notified no later than one week after the MH member takes occupancy. 1 For purposes of this provision, "serious physical disability" means: (a) any physiological disorder or condition or anatomical loss affecting one or more body systems which has lasted, or with reasonable certainty is expected to last, for a minlmum period of 12 contiguous months, and which precludes the person with the disorder, condition or anatomical loss from unaided performance of at least one of the following major life activities: breathing, cognition, hearing, seeing, and age appropriate ability essential to bathing, dressing, eating, grooming, speaking, stair use, toilet use, transferring, and walking; or (b) serious psychological disabilities, such as post-traumatic stress disorder. (Ths definition s based primarily on 32 C.F.R , the regulations for the CHAMPUSTRCARE program.) 2 For purposes of this provision, "direct result of armed conflict" means there was a definite causal relationship between the armed conflict and the resulting unfitting disability. The fact that a member may have ncurred a disability during a period of war or in an area of armed conflict, or while participating in combat operations is not sufficient to support this finding. Armed confiict includes a war, expedition, occupation of an area or territory, battle, skirmish, raid, invasion, rebellion, insurrection, guerrilla action, riot, or any other action in which Service members are engaged with a hostile or belligerent nation, faction, force, or terrorists. Armed confliei may also include such situations' as incidents involving a member while interned as 8 prisoner of war or while detained against his or her will in custody of a hostile or beiligerent force or while escaping or attempting to escape from such confinement, prisoner of war. or det!lined status. (This definition s based on , Physical Disability Evaluation, paragraphs E3.PS and E3.PS.1.2.), 2

47 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 4 (continued) 6. ASSGNMENT As a general rule, unless dictated otherwise by special medical requirements, MH personnel shall be assigned/referred to housing that exceeds or meets the applicable quality standards and that: (a) is appropriate for their expected duration of their treatment, (b) supports a non-medical attendant, f authorized, (c) supports accompaniment by their dependents when desired and not incompatible with their treatment, and (d) is appropriate for their pay grade (e.g., configuration and size). Note that from a housing assignmenvreferral perspective, an authorized non-medical attendant shall be treated like a dependant, e.g., if no other acceptable accommodations are available, a single MH member with an authorized non-medical attendant shall be eligible for temporary assignment to family housing. For example, MH personnel (whether single or married) with an authorized non-medical attendant and facing a long rehabilitation period should not be housed in a one-room lodging unit, but instead be provided with a lodging unit with a minimum of two bedrooms with a kitchen and living room (e.g., pes lodging), or family housing (DoD-owned or privatized). When eligible for DoD-owned housing, MH personnel shall be included as part of "Priority 1", as defined by DoDD M, DoD Housing Management Manual. This referral priority should also apply to privatized or long-term leased (e.g., section 801) housing or lodging provided the referral is consistent with the privatized project's operating agreement f appropriate housing is not available on the installation on which the member is receiving care, or at nearby military installations, and the service member does not reside in a privately-owned or rented home, MH personnel should be housed off the installation in private sector accommodations that are appropriate for their expected duration of treatment, dependency status (at their treatment location), and pay grade - unless dictated otherwise by special medical requirements. 7. BASELNE STANDARDS Condition All MH personnel housing must be in good overall condition with no major problems with any of the building systems, Le., all are working property and not at risk of imminent failure or malfunction. Building systems include but are not limited to roof, exterior walls, foundation, doors and windows, interior finishes, plumbing, lighting, electrical, life and fire safety. and heating-ventilating-and air-conditioning (HVAC). t is important that MH personnel be able to adequately control the temperature in their housing units. There shall be no mold, exposed lead-based paint, unsealed asbestos, inadequate air circulation, or any other environmentavsafetylhealth hazard. Kitchens Kitchens are an important quality of life feature for MH personnel who face long rehabilitation periods, especially those with authorized non-medical attendants. Accordingly, kitchens shall be provided that exceed or meet existing applicable standards for the type of accommodations provided (unaccompanied housing, lodging, or family housing). 3

48 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 5 (continued) Laundry Facilities Laundry facilities shall be provided as defined by the type of housing (unaccompanied personnel housing, lodging, or family housing), or as applic8.ble based on medical condition. f an assignedlreferredhousfng unit only has laundry equipment hook-ups, a residential-quality clothes washer and a dryer should be provided as loaned fumishings. Fumishinas Provide loaned furnishings as appropriate. Electronic Equipment Generally, a television with cable/satellite service, internet service, and a telephone with local service shall be provided in each MH members housing unit. f a MH member is unable to bring their personal electronic equipment to their assigned/referred housing, and they face a long rehabilitation period, efforts should be made to provide additional electronic devices such as a VCR/DVD player, stereo, computer with printer, and video game player. f the internet service is hard-wired, consideration should also be given to providing WF and a laptop computer. Housekeeping and Pest Management MH personnel housing shall be kept free of pests and litter, and trash containers shall be emptied on an appropriate cycle. Landscaping. Grounds Maintenance, and Parking Parking areas, turf, and grounds shall be well-maintained, attractive and litter-free. The number of parking spaces shall be adequate to support expected occupancy. Snow and ice shall be removed promptly from walkways and parking areas to ensure safety and prevent injuries. Physical Security MH member accommodations shall be provided with appropriate physical security measures, including required lighting levels inside and outside (parking and walkways). Building Maintenance and Housekeeping Requests An effective preventative maintenance program shall be in place for MH personnel housing. Also, installations shall have a mechanism where MH personnel can request building maintenance and housekeeping services. 8. SPECAL MEDCAL REQUREMENTS Many MH members will have certain medical conditions that resul1 in various functional limitations. For these members, it is essential that special accommodations and services be provided as an integral part of their medical treatment plan as determined by the primary care physician, patient, and chain of command. Some of these limitations will be permanent, but many others wilt change during recovery and rehabilitation, which may eliminate the need for certain special accommodations or services. 4

49 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 6 (continued) Accessibility For members who have accessibility requirements, accommodations must, at a minimum, comply with the most current standards issued by the Department of Defense under the Architectural Barriers Act ot 1968, as amended. Note that accessibility also' applies to the route and distance (e.g., walkways, ramps, parking) that a MH member must travel from their housing accommodations to reach their medical treatment center, dining facility, or other support services. For all other MH member accommodations, consideration should be given to incorporating "universal design" principles (e.g., lever type door handles in lieu of knobs). Cognition When required, MH member accommodations shall address the range of cognitive limitations that result from conditions such as Traumatic Brain njury (TB), Post Traumatic Stress Disorder (PTSD), and stroke. For example, sometimes complex geometric patterns on rugs, linens, or flooring can cause disorientation in these patients. Flooring and carpet with a subtle texture or pattern often helps with depth perception. Visual and Auditory Necessary features for visually and auditorily impaired MH personnel shall be provided in accordance with the 000 standards. Bums MH personnel recovering from serious bums or nerve/neurological injuries are very sensitive to hot water, so consideration shall be given to installing special devices to regulate the water temperature. Other Physical Limitations Standard accessibility guidelines generally are adequate for ambulatory impaired MH personnel except in special cases such as when they are in a wheelchair with one or both legs in an extended position. n this case, normal wheelchair clearances and tuming circles may be inadequate. Even with the loss of both legs, MH personnel can be fully ambulatory with their prostheses, but still need accessible accommodations when they are in a wheelchair (such as when they have to use the bathroom at night). For physically mpaired MH personnel, bathrooms are the major source of concern. Suggestions for improvement include doors that open to the outside, additional clearance for wheelchairs, and longer hoses on shower nozzles. For MH personnel with loss of or injury to arms and hands, accommodations shall be provided with either a bidet bowl or an electrically powered 'add-on bidet' that replaces a normal toilet seat to rinse the peritoneal area. Housekeeping f a MH member without a non-medical attendant would have difficulty with basic housekeeping, it may be necessary to assign them to housing where these services are included with the accommodations, such as lodging, or to provide the required services for their housing unit such as by contract. Provide disposal of bio-hazard waste as required. 5

50 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 7 (continued) Laundry Services and Equipment Special laundry service may also have to be provided for MH personnel who have a medical condition that requires their inens, towels, and clothing to be disinfected. n accessible units with a laundry, the clothes washer and dryer should be accessible from a wheelchair. Kitchens and Food service For certain medical conditions, a kitchen or kitchenette may be prescribed, either in the unit or located within the same building. On the other hand, there could be special dietary requirements that would be most effectively handled by a hospital or installation dining facility. Note that ranges and cook tops in accessible units shall have control knobs on the front for easy wheelchair access. Furnishings Accessible rooms need to have accessible furnishings, such as computer desks and higher beds. Parking MH personnel with mobility impairments shall have first priority in assignment and use of all parking spaces under the control of the facility, beginning with those spaces closest to the entrances and exits used by MH personnel. The next level of priority shalt be extended to individuals who transport MH personnel with these types of disabilities. f ossible, spaces shall be provided for pickup and drop-off in addition to daily and overnight use. The number of spaces shall be adequate to support the expected occupancy, including the required number of accessible spaces. Additional spaces shall be provided on an expedited basis to meet unforeseen needs. Proximity to Outpatient Treatment Center and Other Services MH personnel may require housing in close proximity to a medical treatment facility for reasons related to their disabilities or medical conditions. For example, there may be a substantial risk of unanticipated urgent medical situations that require prompt attention by caregivers, or the frequency and duration of routine medical treatment may dictate the need for housing nearby. Transportation must be provided for MH personnel who do not have their own means of transport (e.g., transportation by a non-medical attendant with a POV) and who are not housed adjacent to their outpatient medical treatment facilites (whether on or off the installation). This transportation must be adequate to ensure timely access to treatment, dining facilities, and other important support facilities such as exchanges and commissaries. 9. NSPECTONS The Military Services shall conduct periodic inspections of MH personnel housing in accordance with these standards, at least on an annual basis. nspections of privatized housing and lodging containing MH personnel shall be accomplished only with prior coordination with the project partner or owner. n the event a deficiency is identified, the commander of such facility shall submit to the Secretary of the Military Department a detailed plan to correct the deficiency; and the commander shall reinspect such facility not less often than once every 180 days until the deficiency is corrected. 6

51 4. Deputy Secretary of Defense Memorandum Dated 18 September 2007: "DoD Housing nspection Standards for Medical Hold and Holdover Personnel", Page 8 (continued) 10. FEEDBACK AND UPDATES The Military Services shall implement periodic and comprehensive follow up programs using surveys, one-an-one interviews. focus groups, and town-hall meetings to learn how to improve MH personnel housing and related amenities/services. Such feed back should be solicited from the MH members, their families and friends, care-givers, chain of command, and housing owners/operators. Summaries of the feedback with resulting changes should be provided on a periodic basis to OSD, in conjunction with any other reporting requirements. 11. MPLEMENTATON The Military Departments have the authority to issue supplemental instructions to provide for unique requirements within their respective organizations provided they conform to the basic policy guidance in this document. 7

52 ATTACHMENT - MLTARY DEPARTMENTS' MTF AND MHH NSPECTON REPORTS A. Detailed Military Departments' MTF nspection Reports 1. TAB ARMY-Detailed nspection Report 2. TAB NAVY-Detailed nspection Report 3. TAB AR FORCE-Detailed nspection Report B. Detailed Military Departments' Mhh 1. TAB ARMY-Detailed nspection Report 2. TAB NAVY-Detailed nspection Report 3. TAB AR FORCE-Detailed nspection Report

53 A. Detailed Military Departments' MTF nspection Reports --1. TAB ARMY Executive Summary U.S. Anny Report on nspections of Military Medical Treatment Facilities, Military Quarters Housing Medical Hold Personnel, and Military Quarters Housing Medical Holdonr Personnel Num bero fmtf. Component Military Medical Treatment Facilities CMTFs) smected: 130 Americans with Facility Operations & Disabilities Act (ADA) Maintenance* Met J Not Met Met Not Met Standard Standard Standard Standard Army 129 J J 15 ncludes deficencies found in the fouowmg categones: Building System/Envelope, LifelFire Safety, nterior Conditions, and Site Conditions Cost to brina inspected facilities to standard ($ Thousand: $5,303K Component Americallll with Facility Operations & Disabilities Act (ADA) Maintenance Army $S2K $S,252K Per the Deputy Secretary of Defense Memo dated 18 September 2007, The US Army Medical Command (MEDCOM) medical activities were tasked to inspect MTFs and, in coordination with nstallation Management Conunand (1M COM), inspect quarters housing medical hold and holdover personnel using standards and checklists developed by the Senior Oversight Committee, Line of Action (LOA) 5 Working Group. Thirty MEDCOM activities inspected a total of 130 MTFs facilities at 30 sites. The results of the inspections are captured in this report. nspection Reports: Detail information found in Excel Worksheet file name AMAP 2009 MTF nspection Detail.xlsx. 1. Service Definitions/Terms of Reference: npatient - An individual, other than a transient patient, who is admitted (placed under treatment or observation) to a bed in a Medical Treatment Facility that has authorized or designated beds for inpatient medical or dental care. A person is considered an inpatient status if formally admitted as an inpatient with the expectation that he or she will remain at least overnight and occupy a bed even though it later develops that the patient can be discharged or transferred to another hospital or does not actually use a hospital bed overnight. This does not include a patient administratively admitted to the hospital for the purposes of a same day surgery procedure. Outpatient - An individual receiving healthcare services for an actual or potential disease, injury, or life style-related problem that does not require admission to a medical treatment facility for inpatient care. - 1

54 A. Detailed Military Departments' MTF nspection Reports --1. TAB ARMY (continued) Medical Hold - enlisted personnel housed in a Medical Hold Company (MHC) under the cognizance ofthe MTF whose current condition precludes them from returning to full duty. Medical Holdover - Retention of persolulel on active duty to receive medical treatment for serviceconnected injuries, illnesses and/or disease until determined Fit for Duty by the Benefit ssuing Authority (SA) Senior Medical Officer (SMO) andjor Medical Status Review Officer (MSRO), or until fmal disposition is determined by the PEB. Medical Evaluation Board (MEB) - A body of physicians attached to one of the medical treatment facilities (MTF's) whose commander or commanding officer (CO) has been expressly designated to hold "convening authority" (CA) for MEB's to identify members whose physical and/or mental qualiiication to continue on full duty is in doubt or whose physical andjor mental limitations preclude their return to full duty within a reasonable period of time. They are convened to evaluate and report through on the diagnosis; prognosis for return to full duty; plan for further treatment, rehabilitation, or convalescence; estimate ofthe length of further disability; and medical recommendation for disposition of such members. Department ofthe Anny Disability Evaluation System (DES) - A case usually enters the Department ofthe Army DES when a Medical Evaluation Board (MEB) is dictated for the purpose of evaluating the diagnosis and treatment of a member who is unable to return to military duty because the member's condition most likely is permanent, and/or any further period of temporary limited duty etld) is unlikely to return the member to full duty. A condition is considered permanent when the nature and degree of the condition render the member unable to continue service within a reasonable period of time. Physical Evaluation Board (PEB) - The PEB provides a review (a documentary review, a due process hearing upon demand, and appeal by petition) for a Service member whose physical conditions have been referred to it by a medical evaluation board (MEB) of an MTF that believes that the member's physical condition raises questions about his ability to perform the duties of his or her office, grade, rank or rating. The nspection Reports will be included alphabetically by installation (if an installation has a MTF and medical hold andjor holdover housing, they will be addressed by separate reports) Service Unique MTF Standards: nclude any service unique items identiiied during the inspection above the basic standard defmed by OS D. Costs to implement these items must be identified separately within the fmdings table. Part 1: Military Medical Treatment Facilities A recent contract was awarded to conduct a new cycle of engineered assessments during FY2009 which will be evaluated and take affect for the FY2009 AMAP inspection. - 2

55 A. Detailed Military Departments' MTF nspection Reports --1. TAB ARMY (continued) The purpose of the inspection was to provide an up-to-date web-based list of detailed deficiencies. This list formed the basis for development of project requirements targeted at reducing the backlog of deficiencies and improving the condition of facilities. Progress was measured by a target of \0% reduction in critical system (HV AC, emergency electrical support systems, etc.) deficiencies. Projects submitted in the MEDCOM Major Repair and Renewal (MRR) program are evaluated to determine their impact on reduction in critical infrastructure deficiencies. The MRR program's prescribed methodology gave priority to infrastructure deficiencies and regulatory violations. Progress on infrastructure improvement is reported in Balanced Score Card (BSC) metrics on a quarterly basis. Outstanding infrastructure deficiencies thal are not addressed in the current year program are addressed in the outyears. CulTent nspection PJ'otocol/PJ'ocess - USAMEDCOM developed an inspection procedure and protocol for medical treatment facilities (MTF) to account for all required MTFs (hospital, medical, and dental buildings on installations supporting warriors in transition) and to align with the past inspection process. The past inspection process, utilizing DMLSS (Requirements Management Module) data, standardized deficiencies by infrastructure component designation, category, and priority. The deficiency population was refmed to encompass Priority 1 and Priority 2 deficiencies pertinent to designated infrastructure components included in DoD Q-Rating criteria and to phys ical accessibility of warriors in transition. Priority 1 deficiencies were defmed as those deficiencies requiring immediate initiation of a plan of action. Priority 2 deficiencies were defmed as those deficiencies requiring initiation of an action plan in the next year. Priority and priority 2 deficiencies were further quantified in terms of the ratio of deficiency cost to the respective component replacement value. A threshold Q-Rating of less than 80 was established to designate an advanced state of deterioration that requires immediate action. This means that deficiency cost is over 20 percent of the replacement value. t should be noted thal a ratio of 0.80 or greater does not suggest a plan of action and timetable is not required. A ratio of 0.80 or greater does however suggest tilat the priority of the deficiencies can be weighed in light of projected service life, financial constraints, and project integration capability and can be addressed within normal funding levels. The plan of action and timetable for correction of deficiencies is managed through the MRR program for large requirements above $500k., and on a regional and local basis for requirements less than $SOOk. Prior to the FY2009 MTF AMAP facility assessment and after close out of the FY2009 investments, the DMLSS deficiency data was updated by MTF facility managers. The data update process included closing corrected deficiencies, evaluati.ng the priority of remaining deficiencies and adding any new deficiencies identified through routine maintenance inspections. The FY2009 MTF medical and dental facilities were assessed with the refreshed data. Deficiencies that were reported in the FY2008 assessment and deferred for correction in FY2009 are maintained for inclusion on this report. The inspection protocol required that deficiencies meeting Priority criteria be assembled and validated by the MTF facility managers with the assistance of OACSFAC, HQMEDCOM. To facilitate this effort, OACSFAC centrally developed a series of reports designed to provide preliminary information to the building level on ) tl1e deficiency description, 2) estimated cosl to correct deficiency (costs to execute a project), and 3) tile expected correction completion or action date. - 3

56 A. Detailed Military Departments' MTF nspection Reports --1. TAB ARMY (continued) Also, the ratio of deficiency cost to replacement value, called the System Condition ndex (SC), was calculated to establish the Q-Rating. Priority 1 deficiencies that contributed to a Q-Rating of less than 80% were compiled for inclusion in the report. f the Q-Rating is greater than.80, it is considered to be "Met" for the standard in that building and the deficiencies will not be included in the report. The preliminary deficiency listing and findings were then transmitted to each respective MTF for validation and update. Validated information was processed by OASCFAC into the required OSD format, included as an Excel worksheet with this report. The cost was derived using Means Estimating Criteria with provision for markup in medical treatment facilities due to work-around in on-going healthcare operations. t is reasonable to assume that some actions may be consolidated into larger projects to minimize the number of contractors and simplify the acquisition process. Resultant project costs for this type of integrated activity can be larger than those expressed in the findings. Project costs are also contingent on local labor and material rates, and logistical requirements that are beyond the scope of this report. The schedule for remediation of action items requires that a plan of implementation be developed in FYO and executed as expeditiously as funds availability and acquisition capacity will allow. Not all deficiencies are reasonably mitigated with a single project. Current major repair projects will mitigate some but not all deficiencies. mplementation will be tracked on a minimum six month basis and reported on an annual basis. Facilities being replaced by BRAC actions were included in the MTF facility assessment but are not included in the detailed report results. Future Plans: MEDCOM's plan to meet the future needs of Wounded Warriors is based on utilization and expansion of the processes and protocol established in this document. The plan integrates O&M infrastructure requirements into a capital investment strategy whose goal is to provide a reliable and accessible infrastructure when and where required. The plan is based on proven life cycle management principles that can be incorporated into the common goal of providing a world-class healthcare network to our Wounded Warnors. Execution of the plan will require a joint integrated effort managed in concert with the Army Medical Action Plan (AMAP) that links USAMEDCOM, OSD-HA (TMA), Department of the Army (DA), Veterans Administration, and private-sector assets into a facility platform capable of meeting the mission to support the future needs of Wounded Warriors. - 4

57 COMPOtENT: ARMY 12J1B120[ll A MEDCAL TREATMENT FACLTES (MTF) 10 STATE FACUTY BLDG# BLDG NAME BLDG FUNCTlON PDA OPERATON AND MAJ NTENANCE TOTAL COST TO CORRECT DEFCENCY (000) MET NOT COST TO MET NOT CATEGORY COST TO! MET CORRECT MET OFREPAJRS CCRRECT DEFCENCY (1 THRU 4) DEFCENCY _.. - ($000) ($000) rt> - -.-t 1 r,ta FORT BELVOR VA DEWT AAMYCOMM UNTY HOSPTAL B $0000 c:.: 2 r,ta FORT BELVOR VA MENTALHEALTlH E $0000 rt> Q.. 3 A FORT BELVOR VA OHB9 DENTAL CUNC 0 2 $ $ A FORT BELVOR VA AViATlON HEALTH CUNC E $ GA FORT BE NNN G TMC#1 E 1 $60607 $ t 6 GA FORT BE NNN G BERNHEM DC 0 $0.000., 7 GA FORT B ENNN G TMC#5 E $ $ $ :'-ot!! 8 GA FORT BE NNN G SALOMOO DC D 1,3 $ $94 119,.-.. n rt> 9 GA FORT BE NNN G WNDE RHEALTlH CUNC E $0 000 o "0 10 GA FORT BENNNG TMC#7 E $0.000 = > 11 GA FORT BENNNG MAATN AAMY COMMUNTY HOSPTAL B $0.000 g.:4. 12 GA FORT BENNN G LCNE DENTAL CUNC $ $ = > 8 rt> 13T FORT BUSS T CONSOUDATED TROOP MElCAL ClJNC E $0.000 rt> Q.. = '-' 14 T FORT BUSS T DENTAL CUNC 0 $ T FORT BUSS T Wl WAM BEAUMOO TARMY MED CAL CENTER A $ < 16 NC FORT BRAGG 418 DAVS DENTAL CLNC D $ NC FORT BRAGG WOMACKARMY MElCAL CEN TER A 1,3 $ $ NC FOR TBRAGG CLA HEALTH CUNC E $0000 = 19 '" NC FORT BRAGG C722 ROSCOE G.ROBNSOO CU NC E $0.000 "0 rt> 20 NC FORT BRAGG C6238 LAFLAMME 0 C 0 $0.000 n.-t NC FORT BRAGG D36 ROHDE DENTAL CUNC 0 $ , 22 NC FORT BRAGG H3718 DENTAL CUNC #5 0 $0000 == 23 NC FOR TBRAGG M4861 JOELHEALTH &DENTAL CLNC E $0.000 i rt> 24 KY FORT CAMPBELL KY EPPERLY DENTAL CUNC 0 $0.000 J "0 25 KY FORT CAMPBEUL KY LAPONTE HEALTlH CLNC E $ ,.-t 26 KY FORT CAMPBELL KY DE T.Al CU N 4 0 $0.000 '" 27 KY FORT CAMPBELL KY AVlATlON HEALTH CUNC E $ KY FORT CAMPBEUL TN BlANCHFELD AAMY COMMUNTY HOSPTAL B $ KY FORT CAMPBEUL TN TAYLOR DENTAL CLNC 0 $ CO FORT CAASOO 01[111 DRNMOODO FAMLY MED CNECL NC E $0.000 : 31 CO FORTCAASOO LAASOO DENTAL CUNC 0 $0.000! REF. NOTES

58 A COMPO f>.e NT: ARMY MEDCAL TREATMENT FACLTES (MTFJ 10 STATE FACL TY BUDG # BLDG NAME BLDG FLNCnON ftjja OPERATON AND MANTENANCE MET NOT COS TTO ME T NOT CAnEGORY COST TO MET CORRECT MET OF REPARS COORE CT DEF C ENCY (1 THRU 4) DEF C EN CY ($000) (WOO) 1,2,3,4 $ TOTAL COSTTO CORRECT DEF CENCY (000) 32 CO FORTCAASOO ohl55 SMTH DENTAL CLNC 0 $ co FOR TCAASOO DENTAL CLNC #1 D $ CO FORT CAASOO ROO N SON FAMLY MEDCNECUNC E $ CO FORTCAASOO 07O EVANS AAMY COMM UNTY HOSPTAL B 1 $ $ NY FORTDRU M PEBLO E $ NY FORT DRUM RVA RDGEDENTAlCUNC D $0.000 FORT DRUM 10 CTM CMooULAA E FORT DRU M 1O6 COONER TROCF MEDCALCLNC E FORT DRU M GU THRE AMBULATORY HEALTH CAAE CUNC E $ NY 39 NY 40 NY 41 VA 42 VA 43 VA 44 VA 45 VA FOR T EUSnS FORT EU SnS FORT EUSnS SOClL WOOK SERVCESilMD BUUD NG ORTHCFEDl CCUN C WOMEN'S HEA LTH CLN C E E E FOR TEUSnS MCDON AlD AAMY HEALTH CENTE R B FORT EUSnS ngnor DENTAL CUNC 0 1 $ $ GA FOR TGORDOO MR A $0.000 p. $0.000 $0000 $0000 $35509 $0.000 $0.000 $0.000 REF. NOTES S" c.: s:- p..., 1'<,-:-' n o..., "0 = > g. ;4. = > 3 - = 47 GA FOR TGORDOO OO:JJO EAMC A $ GA FOR TGORDOO 003D l HOSPTALCUNC E $ < 49 GA FOR TGORDOO nngay DENTAL CL NC 0 $ , 50 GA FOR TGORDOO TM C4 CL NC E $ GA FOR TGORDl 25 1 SNYDER DENTAL CLNC 0 $0.000 = 52 GA FORTGORDOO COON ELLEY HEALTH CLNC E $0.000 "0 '" 53 T FORT HOOD BENNE TT HEALTH CL NC E $ n 54 T FOR THOOD MOORE HEALTH CUNC E $ T FOR T HOO D TROCF MEDCAL CUNC 12 E $0.000 o 56 T 57 T 58 T FORT HOOD FDR TH ood FORT HOOD FAiRBAA KDC PERKN SDENTAL OU NC COO SOUDATED TROOPMECl CAL OU N C 0 D E 1 2 $ $ $0.000 $0.000 $ T FORT HOOD CAALR. OARNAUL ARMY MEDCAL CENT ER A 60 T FOR THOOD N CAALR. OARNA UL ARMY MED CAL CENTER - PHASE 1 A 161 T FOR T HOOD B LLY JOH NSO N DENTAl CUNC 0 $ T FORT HOOD 391l3 DEN TAL CLNC THRE E 0 $ T FORT HOOD 563 rnocf MEDCAL CL NC 14 (ANNE) E $ T FORT HOOD TROCF MEDCAL CLN C 10 E $ Q. AZ FORT HUACHUCA 5001 RW BUSS ARMY HEALTH CENTE R E $0.000 '-" '" = :;;c "0 o $0.000 a.

59 FAC UTY BUDG# BLDG NAME REF. NOT ES a: C... 5:......, > Oi' > 1 -<3 -- o... r'l = = en g. a: =..., - en = "'C r'l... o = "'C o ::len

60 COMPONENT: ARM Y A MED CAL TREATMEt-T FACLTES (M TF) 10 STATE FAC UlY. 100 KS FORT RLEY-MEDDAC 101 KS FOR T RlLEY-MEDDAC 102 1)( FORT SAM HOUS TON 103 1)( FORT SAM HOUS TON 104 1)( FORT SAM HOUS TON 105 1)( FOR T SAM HOUSTON 106 OK FOR T S LL 107 OK FOR T SLL 108 OK FOR T S LL 109 OK FORT SLL 110 GA FORT STEWART 11 1 GA FOR T STE WART 112 GA FORT SnEWART 11 3 GA FORT SnEWART 114 FT. RCHARDSON 115 FT. RCHARDSON 116 FT W-'JNGHT 117 F T.W-'JNGHT 118 H SCHOFlELD BARRACKS 119 H SC HOFl EUD BARRACKS 120 H SC HOFlEUD BARRACKS 121 H SCH OFlELD BARRACKS 122 H TAMC H 123 H TAMC H 124 H TAM C H 125 H TAMC H 126 H TAMC H 127 DC WALTER REED AMC 128 DC WALTER RE ED AMC 129 NY WEST PONT NY nr NY WEST PONT NY "'. BLDG # TOTALS 1 PERCENTAGESS kqjlli CATEGORY OF REPARS' BUUDNG SYST EMS AN D ENVELOPES UFE SAFlElY AN D Fl RE PROTECTOO NTERMEUN CT OOAL STElMEDCALCAM PU ADA BLDG NAME DENTAL CUNC # COOSOUDATED m oop ME!lCAL ajnc BUDGE DENTAL CUNC m oo' MEDCAL CUNC RHODES DENTAL CU NC MEDCAL CE NTER CONAN DENTAL CUNC RACH - HOSP TAL ALUEN DENTAL CU NC moo' MEDCAL CUNC # WlNN ARMY COMM UNTY HOSPTAL TROO' FAMLY CARE MEDCAL CUNC DENTAL CU NC # OENTAL CUNC # m oo' MEDCAL CUNC TROO' DEN TALCUNC KAMSH HEALTH CUNC AND DENTAC BASSETT ARMY COMMUNTY HOSPTAL DENTAL CUN C m OP CAL U GH Tl NG TMC AVATON MEDCNE OOGaO OBiGYN, PEDATR CS aj NCS 00Ga2 FAM LY PRAC T CEilMMUNZATOO WlN GS A 8 &C WNG O WNGS F G & H DENTAL CU N C SCHOFEUD BARRACKS HEALTH AND DENTAL CLNC HEATON PAVlUON M R MAG. RES. MG CADET HEALTH CUNC KEUUE RARMY COMMUN TY HOSP TAL BLDG FU NC T ON D E 0 E 0 A D 8 0 E 8 E 0 D E 0 E B D E E E A A A 0 0 A E E B />DA MET NOT COST TO MET MET CORRECT DEFlCENCY ($000) x x $ OPERATON AND MA NTENANCE NOT CATEGORY COS T TO MET OF REP-'JRS CORRECT (1 THRU 4) DEFCH 'CY (jooo) 1, 2,3 $ , R 18 $ TO TAL COST TO CORRECT DE FlCE NCY (000) L $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0 000 $0.000 $0 000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $ $0000 $0.000 $ ' SS1 RS 1 $ REF. NOTES, > :.: rd S=... 6:......, > 'o:l >rd -<9 -.rd n o... = = "'... S s= =..., g, - "t: o = rd "t: o '"' = '" ṇ rd '" REF NqreS' ADD AN Y SU PPORTN G NO TES, EPLANAT ONS, OR OTHER N FORMATON AS APPR OPRATE A B C o BUi LDN G funct ON' M EDCAL TREATMENT- REG ONAL MEDCAL CEN TER MEDCAL TREATMEN T -HOSP TAL (NCLUDES CCt.4MUNTY HOSPTALS ) MEDCAL RESEARCH DENTALCUNC MEDCAL CUNC OT HER (SPECFY)

61 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY Executive Summary u.s. Navy Report on nspections of Military Medical Treatment Facilities Military Medical Treatment Facilities (MTFs) Number 0 fmtf s mspec. t e d: 198 Americans with Facility Operations & Disabilities Act (ADt\! Maintenance* Component Met Not Met Met Not Met Standard Standard Standard Standard Navy '" ncludes deficiences found n the followmg categores: Buldmg System/Envelope, LifefFire Safety, nterior Conditions, and Site Conditions Cost to brin!!: inspected facilities to standard ($ Thousands):$ Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance ($K) ($K) Navy $12,204 $257,857 Cost to brin inspected facilities to standard by planned execution fiscal year (FY). Component Americans with Facility Operations & Total ($K) Disabilities Act (ADA) Maintenance ($K) ($K) FY 10 $6,837 $195,188 $202,025 FYl $30 $30,183 $30213 FY 12 $235 $10117 $ FY13 $1607 $9569 $ FY 14 $500 $5,285 $5,785 FY 15 $2994 $7514 $ Per the FY 2008 National Defense Authorization Act (NOAA) (Section 1648), Bureau of Medicine and Surgery (BUM ED) activities and Commander Naval nstallation Command (CNC) were tasked to inspect military MTFs, specialty medical care facilities and military quarters or leased housing for patients. The MTFs and specialty medical care facilities inspections were conducted by BUMED using standards and checklists developed by the Senior Oversight Committee, Line of Action (LOA) 5 Working Group in All MTF and specialty medical care facilities deficiencies noted during the inspections were new or existing requirements previously identified by facilities management personnel and do not affect the medical activities' ability to adequately provide patient care. BUMED identified over $270M in building deficiencies that have been programmed for correction through FY Section 1662 of the FY 2008 NOAA required the inspector general of each regional medical co=and to inspect quarters of recovering service members. Because the inspector general inspections were performed within 90 days of the Section 1648 tasking, no additional quarter inspections were conducted by BUMED activities. See the Appendix for the Navy Medicine nspector General's Report on quarters ofrecovering service members. - Page 1 of 5

62 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) nspection Report Report Organization: Military Medical Treatment Facilities Summary of Past nspections Current nspection ProtocollProcess Regional Findings Appendix 1: Bureau of Medicine and Surgery MTF nspection Summary Appendix 2: Department of the Navy's nspection Report on Medical Hold and Holdover Facility Findings Appendix 3: MTF nspection Checklist Military Medical Treatment Facilities Summary of Past nspections: The material condition of BUMED' s facilities is currently monitored and reported using a centrally managed continuous inspection process as described in NA VFAC MO-322, nspection of Shore Facilities. Sustainment Restoration and Modernization (SRM) requirements identified during the inspection process are documented in single web accessible database using the COTS product VF A. facility. Centrally funded inspections by professional engineering teams have been historically completed for all class type 2 real property assets once every three years using a single inspection service provider and a common set of evaluation criteria that are consistent with all applicable codes and standards. Asset condition is evaluated using the industry standard metric Facility Condition ndex (FC!) which is calculated as total unfunded SRM requirement divided by asset Plant Replacement Value (PRV). The calculated FC is consistent with the Quality factor Q as defined by OSD and is the reporting metric common to all service branches. n addition, all of BVMED's hospitals participate in the accreditation process for the Joint Commission. The accreditation process is continuous, data-driven and focuses on operational systems critical to the safety and quality of patient care. Hospitals must maintain a Statement of Condition (SOC) addressing life safety code deficiencies. The SOC requires development of a plan of action and milestones to correct the noted deficiencies. At the activity level, facility management pers0lll1el conduct zone inspections as required with non facilities management personnel assigned to the activity (typically E-7 and above corpsman), participate in fire inspections, and review deficiencies identified by maintenance personnel (government or contractor) while performing preventative maintenance inspections (PMls). Centrally funded inspections, Joint Commission, and activity level inspections are meant to continuously identify requirements. Activities have the authority at the local level to execute projects below the $200K threshold, and submit projects to BUMED for funding for any Special Project over this amount. n FY 2009, BUMED funded $167M in Special Projects correcting identified deficiencies. BUMED's FY 2009 funding included the original programmed funds, reprogrammed funds, American Recovery and Reinvestment Act (ARRA) funds, and Joint Explanatory Statement House Resolution 2638 (Warriors in Transition) funds. BUMED has budgeted $129M in Special Projects for the correction of noted deficiencies in FY 20 O. - Page 2 of5

63 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) Current nspection Protocol/Process: The MTF checklist for this inspection was developed in 2007 by an LOA 5 sub working group staffed with representatives from Tricare Management Activity, Air Force, Army, and Navy. The checklist contains questions separated into five categories that included: Building Systems/Envelope, LifelFire Safety, nterior Conditions, Site/Medical Campus, and ADA requirements. The MTF Checklist is included in Appendix 3. Each activity was requested to establish teams from their respective facility management departments. Teams typically included facility managers, engineers of various disciplines, engineering technicians and tradesmen ofvarious backgrounds. The teams were advised to perform a visual inspection of each MTF after reviewing requirements generated as a result ofrecent Joint Co=ission inspections, in VF A, recurring service calls identified in various computer aided facilities management tools and regularly scheduled preventative maintenance inspections. n FY 2009, BUMED utilized a computer software program called VF A.Auditor. This program facilitates the orderly sorting/collating/reporting of data by activity and by region of survey results. Activity responses were varied. Most activities indicated that their MTF met the standard and as a result no actions or estimates were required. Other activities indicated that their MTF met the standard, but recognized that deficiencies exist in the MTF and provided estimates or developed projects accordingly. n all cases when an MTF did not meet the standard, the activity provided an estimate to correct the deficiency or indicated that corrections were underway. The results are reported in two categories, ADA and Facility Operations and Maintenance. The results ofthose inspections are as follows: Findings (See Appendix 1 for detailed fmdings): Navy Medicine Support Command CNMSC) NumberofMTF' s mspected : 1 Americans with Facility Operations & Disabilities Act (ADA) Maintenance* Component Met Not Met Met Not Met Standard Standard Standard Standard NMSC * ncludes deficiencies found m the followmg categones: BUJldmg System/Envelope, Life/Fire Safety, nterior Conditions, and Site Conditions Cost to bring inspected facilities to standard ($ Thousands):$35K Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance ($K) ($K) 1\TMSC $0 $35 Cost to b' nne; mspected ft' ac lties to standard by planned executon iscal year (FY). Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance ($K) ($K) FY 10 $0 $35 - Page 3 of 5

64 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) Navy Medicine National Capital Area (NCA) Nurn berofmtf' s illspecte d: 29 Americans with Facility Operations & Disabilities Act (ADA) Maintenance* Component Met Not Met Met Not Met Standard Standard Standard Standard NCA >< ncludes deficiencies found in the following categories: Building System/Envelope, Life/Fire Safety, nterior Conditions, and Site Conditions Cost to bring inspected facilities to standard ($ Thousands):$ Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance ($K) ($K) NCA $646 $42,872K Cost to brin inspected facilities to standard by planned execution fiscal year (FY). Component Americans with Facility Operations & Total ($K) Disabilities Act (ADA) Maintenance ($K) ($K) FY0 $271 $36027 $36298 FYll $0 $1,482 $1.482 FY 12 $0 $0 $0 FY 13 $205 $138 $343 FY14 $0 $35 $35 FY 15 $170 $5 191 $5361 Navy Medicine East (NME) Nurnber 0 fmtfs illspec t e d: 83 Americans "ith Facility Operations & Disabilities Act (ADA) Maintenance* Component Met Not Met Met Not Met Standard Standard Standard Standard NME ncludes deficences found ill the followmg categores: BuJldmg System/Envelope, Life/Fire Safety, nterior Conditions, and Site Conditions Cost to bring inspected facilities to standard ($ Thousands):Sl Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance ($K) ($K) NME $3,931 $104,553 - Page 4 of 5

65 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) Cost to brin inspected facilities to standard by planned execution fiscal year (FY). Component Americans with Facility Operations & Total ($K) Disabilities Act (ADA) Maintenance ($K) ($K) FYlO $433 $79587 $80019 FY $30 $7699 $7729 FY2 $35 $7167 $7202 FY 13 $854 $8156 $9 Oil FY14 $0 $88 $88 FY 15 $2,579 $1,856 $4,435 Nayy Medicine West (NMW) Nurnb er 0fMTF' 1 S mspec t e d : 85 Americans with Facility Operations & Disabilities Act (ADA) Maintenance* Component Met Not Met Met Not Met Standard Standard Standard Standard NMW ncludes deficiencies found ill the followmg categories: Buildmg System/Envelope, LifelFire Safety, nterior Conditions, and Site Conditions Cost to brine inspected facilities to standard ($ Thousands):$118,023 Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance ($K) ($K) NMW $7627 $ Cost to brinl inspected facilities to standard by planned execution fiscal year (FY). Component Americans with Facility Operations & Total ($K) Disabilities Act (ADA) Maintenance ($K) ($K) FYlO $6134 $79539 $85673 FYll $.500 $21002 $ FY2 $200 $2951 $3 151 FY13 $547 $1,275 $1,822 FY14 $500 $5 162 $5662 FY 15 $245 $468 $713 - Page 5 of 5

66 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary BUMED Summary Number of MTF's nspected: 198 Americans with Disabilities Act Facility Operations and Maintenance Met standard 189 Met standard 197 Not Met standard 9 Not Met standard 1 Cost to bring inspected facilities to Standard: $270,060,498 Facility Operations and Maintenance $257,856,735 Americans with Disabilities Act $12,203,763 Cost to bring inspected facilities to standard by planned fiscal year Americans with Disabilities Act Facility Operations and Maintenance Total FY $6,837,344 $195,187,765 $202,025,109 FY2011 $30,485 $30,182,784 $30,213,269 FY2012 $235,000 $10,117,418 $10,352,418 FY2013 $1,606,699 $9,569,060 $11,175,759 FY2014 $500,000 $5,285,220 $5,785,220 FY2015 $2,994,235 $7,514,488 $10,508,723 Total: $12,203,763 $257,856,735 $270,060,498

67 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: National Capitol Area Number of MTF's nspected: 29 Americans with Disabilities Act Facility Operations and Maintenance Met Standard 28 Met Standard 29 Not Met Standard 1 Not Met Standard o Cost to bring inspected facilities to Standard: $43,518,248 Facility Operations and Maintenance $42,871,957 Americans with Disabilities Act $646,291 Cost to bring inspected facilities to standard by planned fiscal year Americans with Disabilities Act Facility Operations and Maintenance Total FY $270,862 $36,027,038 $36,297,900 FY2011 $0 $1,481,547 $1,481,547 FY2012 $0 $0 $0 FY2013 $205,129 $137,795 $342,924 FY2014 $0 $35,032 $35,032 FY2015 $170,300 $5,190,545 $5,360,845 Total: $646,291 $42,871,957 $43,518,248 Activity Totals NHC Annapolis (N00162) NHC Patuxent River (N6609S) NHC Quantico (N00231) NN MC Bethesda (N00168) 10MTF's 5 MTF's 5 MTF's 9 MTF's U.S. Navy Report on nspections of Militacy Medeal Treatment Facilities, Appendx 1 Page 1 of4

68 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Number of MTF's nspected 83 Americans with Disabilities Act Facility Operations and Maintenance Met standard 82 Met standard 83 Not Met standard 1 Not Met standard o Cost to bring inspected facilities to Standard: $108,483,599 Facility Operations and Maintenance $104,552,943 Americans with Disabilities Act $3,930,656 Cost to bring inspected facilities to standard by planned fiscal year Americans with Disabilities Act Facility Operations and Maintenance Total FY $432,685 $79,586,721 $80,019,406 FY2011 $30,000 $7,698,741 $7,728,741 FY2012 $35,000 $7,166,759 $7,201,759 FY2013 $854,185 $8,156,500 $9,010,685 FY2014 $0 $88,188 $88,188 FY2015 $2,578,786 $1,856,034 $4,434,820 Total: $3,930,656 $104,552,943 $108,483,599 Activity Totals NH Beaufort (N61337) NH Camp Lejeune (N68093) NH Guantanamo Bay (N61564) NH Jacksonville (N00232) NH Naples (N66096) NH Pensacola (N00203) NH Rota (N661 01) NH Sigonella (N39163) NHC Charleston (N68084) NHC Cherry Point (N66094) NHC Corpus Christi (N00285) NHC Great Lakes (N00211) NHCNE (N32185) NMC Portsmouth (N00183) 4MTF's 12MTF's 4MTF's 8 MTF's 2MTF's 13MTF's 1 MTF's 5MTF's 5MTF's 2 MTF's 4MTF's 6MTF's 6 MTF's 11 MTF's U.s. Navy Report on nspections of Military Medeal Treatment Facilities, Appenc:b. 1 Page2of4

69 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Naval Medicine Support Command Number of MTF's nspected: Americans with Disabilities Act Facility Operations and Maintenance Met Standard Met Standard Not Met Standard 0 Not Met Standard o Cost to bring inspected facilities to Standard: Facility Operations and Maintenance Americans with Disabilities Act $35,200 $35,200 $0 Cost to bring inspected facilities to standard by planned fiscal year FY FY2011 FY201 2 FY2013 FY2014 FY2015 Total: Ame ricans with Disabilities Act $0 $0 $0 $0 $0 $0 $0 Facility Operations and Maintenance $35,200 $0 $0 $0 $0 $0 $35,200 Total $35,200 $0 $0 $0 $0 $0 $35,200 Activity Totals NOM Pensacola 1 MTF's u.s. Navy Report an nspections of Military Medeal Treatment Facilities, Append' 1 Page 30f4

70 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Number of MTF's nspected 85 Americans with Disabilities Act Facility Operations and Maintenance Met standard 78 Met standard 84 Not Met standard 7 Not Met standard Cost to bring inspected facilities to Standard: $118,023,451 Facility Operations and Maintenance $110,396,635 Americans with Disabilities Act $7,626,816 Cost to bring inspected facilities to standard by planned fiscal year Americans with Disabilities Act Facility Operations and Maintenance Total FY $6,133,797 $79,538,806 $85,672,603 FY2011 $485 $21,002,496 $21,002,981 FY2012 $200,000 $2,950,659 $3,150,659 FY2013 $547,385 $1,274,765 $1,822,150 FY2014 $500,000 $5,162,000 $5,662,000 FY2015 $245,149 $467,909 $713,058 Total : $7,626,816 $110,396,835 $118,023,451 Activity Totals NH Bremerton (N68095) NH Camp Pendleton (N68094) NH Guam (N68096) NH Lemoore (N66095) NH Oak Harbor (N66097) NH Okinawa (N68470) NH Twentynine Palms (N35949) NH Yokosuka (N68292) NHC Hawaii (N68098) NMC San Diego (N00259) 7 MTF's 22MTF's 3 MTF's 4MTF's 1 MTF's 10MTF's 4MTF's 13 MTF's 4MTF's 17MTF's U,S. Ns:vy Repcn an nspections of Military Medical Treatment Facilities, Appenci)( 1 Page 4 of 4

71 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: National Capitol Area Activity Detail Activity: NHC Annapolis (N00162) 1016 BOO Bancroft Hall Wing 6 (Medical) Annapolis, MD ADA : MetlNA FMO: MetlNA Acoon to Meet Standard Cost to meet standard FY 1016 BOO Bancroft Hall Wing 6 (Dental) Annapolis, MD ADA MetfNA FMQ:MetfNA Total: Action to Maat Standard Cost to maet standard FY 1018 BOO Bancroft Hall Wing 8 (Optometry/Pn Annapolis, MD ADA MetfNA FM.Q: MetfNA Total: Action to Meet Standard Cost to meet standard FY 23A Occ Heatth Clinic- Mechanicsburg Mechanicsburg, PA ADA MetlNA FMO MetfNA Total: Action to Meet Standard Cost to meat standard FY 250 Main Hospital Annapolis, MD ADA MetlNA FMOMetfNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REQ-3880 Exterior Walls : Dirty and Unsightly $279,935 REQ-388 t Exterior Walls: Mortar Joints Deteriorated $537,187 REQ-321S Lighting and Branch Wiring: Aged Circuitry $173,098 20tO REQ-3655 Lighting and Branch Wiring: Various ssues $14,048 REQ Recertify Rra-Rated Door $2, Americans with Disabilities Act Action to Meet Standard Cost to maet standard FY REQ Plumbing Fixtures : Toilet Rooms Antiquated $128, 244 Total: Total: $1,006, Hospital NE Ward Annapolis, MD ADA MetlNA FM.QMetlNA Total: $128,244 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ lighting and Branch Wiring: Maintenance ssues $2,710 20tO REQ Roofing: Open coping joints $t,1 t7 J REQ-3976 Missing Closer $292 REQ-t4001 Roofing: Coping damaged $28,083 20tO REQ Stairs : Handrails not Code Compliant $39, REQ Stairs : Non-compliant Thresholds $ REQ Non-compliant nterior Door Hardware $11, REQ Stairs: Non-compliant Handrail $1, Total: $84,059 u.s. Navy Report on nspections of M"ary Medical Treatment Facilities, Appendix t Page 1 of 57

72 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NHC Annapolis (N00162) National Capitol Area 274 Outpatient Clinic Annapolis, MD ADA: MeliNA FMQ MeliNA Action to Meet Standard Cost to maet standard FY 275 Medical Clinic Annex Annapolis, MD ADA: MetiNA FMQ MeliNA Americans with Disabilities Act Action to Meet Standard Cost to maet standard FY REO-3576 Plumbing Fixtures: Antiquated/Not ADA Compliant $124,12 1 Total: Total: $124,121 Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REO-3654 Exterior Windows: Antiquated and Deteriorated $1,087,784 REO-5347 Lighting and Branch Wiring: Additional Circ Needed $19,792 REO-l045 Lighting and Branch Wiring : Aged Circuitry $97,853 REO Sprinklers: Lacking Automatic Sprinkler $19, Total: $1,225, Primary Care Clinic - Lakehurst Lakehurst, NJ ADA : MetiNA FMOMetiNA Action to Meet Standard Cost to maet standard FY C3 Primary Care Clinic - Earle Cos Neck, NJ ADA: MetiNA FMOMellNA Total: Action to Meet Standard Cost to maet standard FY Total: Activity: NHC Patuxent River (N66098) 1370 Naval Health Clinic Patuxent River, MD ADA MeliNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REO Exterior Windows Beyond Service Ufe $629,762 REO Lighting and Branch Wiring : Non GFC (NEC) $14,297 REO Missing Exit signs $611 REO Electrical System Condition $35,000 REO Emerg Ught and Power: Exit Sign nsufficient $6,456 Total: $686, Primary Care Clinic - ndian Head ndian Head, MD ADA: MetiNA FMQ: MetiNA Americans with Disabilities Act Acti on to Meet Standard Cost to maet standard FY RE nterior Doors: Openings Too Narrow $31,246 REO-397S Furnishings : Non-ADAAG Compliant Service Count $1,364 T01al: $32,610 Fadllty Operations & Maintenance Action to Meet Standard Cost to maet standard FY RE Ceiling Finishes Replace Spline $589 U.S. Navy Report on nspections of Mary Medical Treatment Facilities, Apperdix 1 Page 2 of 57

73 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NHC Patuxent River (N66098) National Capitol Area 1600 Primary Care Clinic - ndian Head ndian Head, MD ADA : MeliNA FMQ: MetlNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY RE Exterior Walls : nvestiga te Damage $5,804 REO-3963 Parking Lots : Replace Wearing Course $72,911 REO-3927 lighting and Branch Wiring: Has T-12 Fluorescent $27,093 Total: $106, Primary Care Clinic - Dahlgren Dahlgren, VA ADA MetiNA FM.Q MeliNA Americans with Disabilities Act Action to Meat Standard Cost to moot standard FY REO-3316 Furnishings: Non-ADAAG Compliant Kitchenette $1,277 REO-3414 Plumbing Fixtures: Non-A A Restrooms/Showers $32,162 REO-3403 Furnishings : Non-ADAAG Compliant Service Count $2,141 Total: $35,580 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard REO-3397 Fire Prot Spec: Fire Extinguishers Lacking $3,236 RE Comm and Sec: ntercom Systems Aged $17,734 REO-3466 nterior Doors: Not FSA at Exit Access Corridors $1,54 1 Total: $22,511 FY 3282 Primary Care Clinic - Andrews AFB Andrews AFB, MD Action to Meet Standard ADA : MeliNA FMQ:MetlNA Cost to meet standard FY Total: 341 Clinic Laundry - Dahlgren Dahlgren, VA Facility Operations & Maintenance Action to Meet Standard RE Roofing : Aged Built-Up ADA MeliNA FMQMellNA Cost to meet standard FY $10,435 Total : $10,435 Activity: NHC Quantico (N00231) 175 Primary Care Clinic - Navy Yard Washington, DC Facility Operations & Maintenance Action to Meet Standard REO HVAC Pipes Secured $8,000 REO Fire Door Condition $1,000 RE Roof Condition $ Branch Medical Clinic (TBS) Quantico, VA Americans with Disabilities Act Action to Meet Standard REQ-3548 Plumbin g Fixtures: Drinking Fountains Aged!Non-A $11,098 T REO-3499 Fittings: Room Signage Non- Compliant $11, REQ-3627 Plumbing Fixtures : Res trooms Non-Compliant $1 37, REO-2602 Furni shings : Service Counters Non-Compliant $20, u.s. Navy Report on nspections of Mlitary Medical Treatment Facilities, Apperdix 1 Page 3 of 57 ADA : MelNA Cost to meet standard Total: $9,500 ADA : Not Met Cost to moot standard Total : $180,217 FMQ: MelNA FY FMQ: MetlNA FY

74 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NHC Quantico (N00231) National Capitol Area Branch Medical Clinic (TBS) Quantico, VA ADA : Not Met FMQ: MeUNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-2616 Pedestrian Paving: Change in Elevation Nan-Compli $3, Total: $3, Naval Health Clinic Quantico, VA ADA : MeUNA FMQ MeUNA Americans with Disabilities Act Action to Meet Standard Cost to maet standard FY REO-3601 Plumbing Fixtures: Non-Compliant Accessories $19, Total: $19,134 Facility Operations & Maintenanc e Action to Meet Standard Cost to meet standard FY REQ Roof Condition $50, Total: $50, Branch Medical Clinic (OCS) Quantico, VA ADA MeUNA FMO: MeUNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-3539 Plumbing Rxtures: Drinking Fountains AgadiNan-A $7,399 Total: $7,399 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Fire Alarm Condition $25, Total: $25, Pers Support Bldg/UEPH W/ Mess Sugar Grove, WV ADA : MeUNA FMO MeUNA Action to Meet Standard Cost to meet standard FY Total: Activity: NNMC Bethesda (N00168) Dental Clinic Bethesda, MD ADA : MeUNA FMO: MeUNA Action to Meet Standard Cost to meet standard FY 10 Hosprtal (Nursing Tower 01 Repl Hasp) Bethesda, MD ADA MeUNA FMO:MeUNA Total : Action to Meet Standard Cost to meet standard FY 137 MedicaVDental Clinic - Willow Grove Horsham, PA ADA : Met/NA FMO: MeUNA Total : Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-3330 Furnishings : Non-ADAAG Compliant Service Count $2, REO-344 Ptumbing Fixtures : Non ADA Employae Restroams $53, REO-2838 Communications and Sec: Rre Alarm Non-ADAAG $9, REO-3301 Furnishings : Non-ADAAG Compliant Kitchenettes $3, u.s. Navy Report on nspections of Mary Medical Treatment Facilitieo, Appeooix 1 Page 4 of 57

75 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: National Capitol Area Activity: NNMC Bethesda (N0016B) 137 MedicaVDental Clinic - Willow Grove Horsham, PA ADA MetJNA FMQ MetJNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-640 nteri or Doors : Lack ADA-Compliant Hardware $24, Total: $94, 178 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ nterior Wall Leaks $7,000 REO Emergency Power Condition $10,000 Total: $17,000 2 Personnel Support and Services Bethesda, MD ADA: MetJNA FMOMeVNA Action to Meet Standard Cost to meet standard FY Total: 22 Occ Heatth Clinic - Carderock Bethesda, MD ADA MetlNA FMO:MetlNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Exterior Door Condition $3,500 REO-3964 Roofing: Deteriorated and Multiple Leaks $37,276 REQ nterior Wall Leaks $2,500 Total: $43,276 5 Administrative Building 5 Bethesda, MD ADA MetlNA FMOMetJNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Exterior Watls: Grille Paint Deteriorated $5,304 REQ Rain Water Drainage: Aged Pping $40,497 REQ Emerg Ught and Power Sys : Emergency Boxes Not $9,330 REQ No Central Air Conditioning in Portion of Building (R $473,882 REQ Other Elee Systems : As-Built Drawings Lacking $18,565 " 2015 REQ Lighting and Brancih Wiring : Roof ssues $5, Total: $552,998 7 MedicaVHospital Bethesda, MD ADA : MetlNA FMQ: MetJNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-966 Furnishings : Cashier Counte r Non-ADMG Complia $6,235 REO-986 Furnishings : Non-ADAAG Compliant Kitchenettes $17,392 REO Comm and Sec: Public Pay Phone Not ADA $1,181 Total: $24,808 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-990 Ceiling Rnlshes : ACT Aged $127,299 REO-997 nterior Doors: Refinish $2,989 " REQ-1200 Wall Finishes: Aged Paint at nterior Walls $68,097 REO Comm and Sec: ntercom System Aged $61,221 " REO-1049 Exterior Doors: Paint Deteriorated $2,525 REO-1OS0 Exterior Wafls : Aged Rnish and Deteriorated $95,727 REO-l0Sl Exterior Wafls: Deteriorated Louver Paint $8,308 U.S. Navy Report on nspections of Mary Medical Treatment Facilities. Apperdix 1 Page 5 of 57

76 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NNMC Bethesda (N00168) National Capitol Area 7 MedicaVHospital Bethesda, MD ADA MetiNA FMQMetiNA Facility Operations & Main ten ance Action to Meet Standard Cost to meet standard FY REO-1597 Control and nstrumentation : End of ufe (ST025-09) $949,904 REO Modemlze Exerutive Health Spaces $2.688,210 REO-4508 Emerg ught and Pwr Sys : nsufficient Exit Signs $5,832 REO-996 nterior Doors: Refinish Frames $4 3,192 REO Light and Branch Wiring: Open Penetration $5,614 REO-4498 Comm and Sec: Nurses Call System Aged $275,807 REO-4473 Comm and Sec: Rre Alarm System Obsolete $135, REO-979 Floor Finishes : Aged Carpet $146,459 REO-749 Exterior Walls: Precast Panel ntegrity $48, REO Terminal Equipment Control and nstrumentation: E $169,657 REO-891 Roofing: Cover Aged and Worn (ST035-09) $597,698 REQ-563 Roof Construction : Canopy Fascia and Soffit $4, 147 REQ-564 Stairs : Non-Comp/iant Egress $89,817 REQ-1273 Furnishings : Casewor1< Aged $47,444 REQ-4490 Emerg ught and Pwr Sys: Boxes Not dentified $9,678 REQ REQ Elec Serv and Distr: Panels Obsolete $14,764 nduction Units : nefficient and End of We (R-96) $3,665,102 REQ-1377 Light and Branch Wiring : Occupancy Sensors nstall $25, REQ-1409 Electrical Service and Distribution: Roof Outlets $ 2, REQ Comm and Sec: Telephone Wiring System Obsolet $82, REQ-4535 Communications and Security: Master Clock otlsole $30, REQ-4491 Comm and Sec: Telecom/Data Cable mproper Sup $26, TOlal: $9,431,570 8 Hospilal Bethesda, MD ADA MetiNA FMQ MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-2233 Ceiling Rnishes : ACT Aged $298,783 REQ-2172 nlerior Doors : Refinish Frames $43,880 REQ Terminal Equipment ConlTol an d nstrumentation: E $203, 477 REQ-83 Air Handler Units: End of Useful Life (STOtO-On $2,827,365 20tO REQ-770 Distribution System s: Air Handlers End of life $392,631 REQ-4516 Elec Serv and Distr: Clearance ssues $12, 468 REQ-2014 nterior Doors : Refinish $3, 874 REQ-2231 Control and nstrumentation : End of Life (ST ) $709,837 REO-1753 Exterior Walls : Precast Panel ntegrity $48, REO-2409 Floor Finishes : Aged Carpet $159, 564 REO-2281 Exterior Walls : Aged Finish and Deteriorated $119, 139 REO-2316 Exteri or Walls: Deteriorated Louver Paint $8,308 REO-1534 Stairs : Non-Comp/iant Egress $89, 817 REQ-1613 Elec Serv and Distr: Access to Panel $4,521 REO-2280 Exterior Doors: Paint Deteriorated $2,525 REQ Roofing : Cover Aged and Worn (ST036-09) $499, 773 REQ-1527 Comm and Sec: Rre Alarm System Obsolete $388, 052 REQ-4493 Lighting and Branch Wiring: Additional Circ Needed $20,818 REQ-1905 Wall Finishes: Aged Paint at nterior Walls $83,096 REQ-4564 Lighting and Branch Wiring: Outiets No t GFC $3, 232 REQ Light and Branch Wiring : Open Penetration $7, U.S. Navy Report on nspections of Mlnaty Moeical Treatment Facilities, App encix 1 Page 6 of 57

77 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) MTF Report Summary Region: National Capitol Area Activity: NNMC Bethesda (N00168) 8 Hosprtal Bethesda, MD ADA : MetiNA FMOMetiNA Facility Operations & Maintenance Acti on to Meet Standard Cost to meat standard FY REQ-4492 REQ-1304 REQ-1625 REO-4563 REO-1497 REO REO-4515 REO REO REO REO REO REO REO REO-445B REO-5324B Lighting and Branch Wiring: Abandoned Wiring $28, Light and Branch Wiring : Occupancy Sensors nstall $29, Other Elec Systems: Master Clock Obsolete $52, Comm and Sec: Missing Cable Hangers $30, Light and Branch Wiring: Roof Outlets $4, Comm and Sec: Telephone Wiring System Obsolet $82, Comm and Sec: Public Address System ssues $28, Total: $6,184,269 9 Hosprtal (Service Block of Repl Hospital) Beth esda, MD ADA MetiNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY Reception Desks: Replace Sprinkler Heads (R3-00) $5,008 Mechanical Wort< (R t-03) $42,401 Plumbing Work (R4-03) $409,6BO Reception Desks : Replace Ught Fixtures/Electrical $14B,l54 Steam lines: Beyond Useful Ufe (R2-0 1) $3, B7,637 Heating Hot Water System: Deteriorating (R3-0 1) $1,391, Plumbing Work (Rl-03) $349,056 Mechanical Wort< (R3-03) $1,451,100 Fire Alarm System : Obsolete (RM009-09) $2,277,462 REO-3735 Exterior: Failing Panels and Weather Stains (RB -OS $23B,555 REO Mechanical Wort< (R4-03) $512, REO-550l0 Terminal Equipment Control and nstrumentation : E $,BB,510 REO-2S84 nterior Doors: Refinish Frames $99,367 REO-3833 Architectural Work (RB-OS) $93,713 REO-2525 nterior Doors: Refinish at Operating Suites $B,975 REO-53 Switchboard Synchronization Switchgear: Beyond U $821,433 REO-3l02 Roof Openings : Aged Skylights $82,174 REO-3S64 Plumbing Work (R3-01) $154,B02 REQ-3455 Emerg Ught and Pwr Sys: Exit Signs nsufficient $13,825 REO-2927 Mechanical Work (R8-OS) $1,105,743 REQ Electrical Distribution System: Obsolete and Beyond $2,510,000 REO-4459 Plumbing Work (R3-03) $1,280,250 20tO REQ Common Area Ceilings: Replace Sprinkler Heads (S $35, REQ Humidification System: sol ated Loop Needed (RMO $1,004, REO Common Area Cellings: Replace light Fixtures (ST $392, REO-3586 Light and Branch Wiring : Occupancy Sensors nstall $8B, REQ-3519 Electrical Service and Distribution : Exterior and Roo $2, REO Electrical Wort< (R 1-03) $54, REO Electrical Work (R4-03) $382, REO Fire Protection (R4-03) $375, REO Fire Protection (R3-03) $1,280, REO-4404 Structural Work (R4-03) $409, REO Structural Work (R 1-03) $89, REQ Fire Protection (R 1-03) $71, REO Comm and Sec: Telecom Cable mproper Support $433, REO Electrical Work (R3-03) $1,280, U.S. Navy Report on nspections of Mlitary Medical Treatment Facifities, Apperdix 1 Page 7 of 57

78 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NNMC B9th9sda (N00168) National Capitol Area 9 Hospital (Service Block of Repl Hospital) Bethesda, MD ADA : MetlNA FMOMetlNA Facili1 Operations & Maintenance Action to Maat Standard Cost to moot standard FY REQ $382,380 Tolal: $23,413, U.S. Navy Report on nspections of MlitaJY Medical Treatment Facilities, Appendix 1 PageS of 57

79 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Naval Medicine Support Command Activity Detail Activity: NOM Pensacola 3933 Robert E. Mitchell Center Pensacola, FL ADA MetiNA FMO: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ HVAC Acceptable $8,000 REQ nterior Floor Condition $8,000 REQ Exterior Wall Moisture $2,500 REQ Roof Condition $1,800 REQ HVAC Condition $5,000 REQ Roof Drainage $900 REQ nterior Wall Condition $9,000 Total: $35,200 U.S. Navy Report on nspections of Mlrtary Medical Treatment Facilities, Appendix 1 Page 9 of 57

80 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity Detail Activity: NH Beaufort (N61337) Hosprtal Beaufort, SC ADA MeVNA FMO MeVNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ 2044 Furnishings : Non ADMG Compliant Sign ln Counte $16,590 REQ-2058 Plumbing Fixtures: Drinking Fountains, Non ADMG $53,571 RE Plumbing Fixtures : Lavatories, Non ADMG $3,197 RE0-958 REQ 1437 REQ 2319 REQ REQ 1988 REO 1788 REO HVAC : Steam and Hot W ater System Pipes Aged Other Elec Systems: Lighb1ing Protection lnadequat $842,883 $1,213,267 $19,741 $48,472 $4, i L Pl umbing Fixtures: Wall Spigots Unprotected $2,074 Electrical Modiijcations (NF006 09) $247,037 Plumbing Fixtures: Medical Fixtlles Aged Sanitary Waste: Piping End of Ufe nstall suspended Ceiling $46, $818,806 $36,091 $12,443 REO 1952 Plumbing Fixtures : Aged $73,244 RE Q 2084 Exhaust and Vent Syst: Dirty Ductwork $9, 177 REQ 2239 Wall Finishes: Aged Paint at nterior Walls $55,563 REQ 2248 Distribution Systems: Damaged Steam Pipe nsul $12,508 REQ-2277 Roofing: Ponding at Drains $489,764 REQ 2389 RE Elec Serv and Dist: Aged Safety Switches $20,164 Control and nstrumentation: Hybrid Devices $252,662 REO-1956 Distribution Systems: Corroded AHU $20,477 REQ 933 Distribution Systems: Pumps Aged $50,023 REO nstall VCT $8,820 REO nstall HVAC Ductwork $7,035 REO 2047 Total: $13,358 Fadlity Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO 1170 REO 1376 REO 1380 REO 1890 Distribution System: Chilled Water Pipes Aged Light and Branch Wiring: nterior Ughting Aged Tarm and Pack Units: Aged Radiators Plumbing Fixtures: Mop Sinks Damaged RE Material Delivery (NF006 09) $7,570 Elec Serv and Dist: Corroded Safety Switches $41,889 REQ 69Bl Distribution Systems: Missing Fire/Smoke Dampers $31,398 REQ 1875 Distribution Systems: Ductwork End of Ute $995,408 REQ 1572 Ught and Branch Wiring : Exterior Ughting Aged $2,917 REQ Elec Serv and Dist: Misc. Repairs Required $2,009 REQ HVAC Modiijcations (NF006 09) $408,125 REQ 2209 Heat Generating Systems : Steam PRY Aged/Leakin $60,491 REQ Elevator Condition $0 REQ Elevator nspeclion $0 REQ nlerior Signage Condilion $20,000 REO 2213 Distribution Syslems: Damaged Pipe nsulalion $13,432 REO-494 Floor Finishes : Aged Carpel $196,655 REQ 2141 Sanitary Wasle : Floor Drains Blocked $1,150 REQ l0376 Other Plumbing: ncorrecl Air nlakes for Medical G $8, REQ 721 Disl System : Undelermined Air Distribution $86, REQ 814 HVAC: Non Complied to Seismic $56, AEQ 1752 Comm and Sec: mproper Wiring $24, u.s. Navy Report on nspections of Mlitary Mooical Treatment Fa cilitiels, Apperdix 1 Page 10 of 57

81 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Beaufort (N61337) Hospital Beaufort, SC ADA: MeliNA FMQMellNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ 5926 Rl 03 Replace HVAC Components and Controls $5.492,330 REQ 1431 Light and Branch Wiring: Lacking Rooftop Outlets $4,667 Total: $11,726, Dispensary and Dental Clinic MCAS Beaufort, SC ADkMellNA FMQMellNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ 2330 Furnishings : Pharm. Counter Non ADAAG Compli $2,847 REQ 5562 Plumbing Fixtures; Non ADAAG Comp/iant Drinking $10,032 REQ 781 nterior Doors : Lack ADA Compliant Hardware $29,904 Total: $42,783 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ 2139 Sanitary Waste: Aged Solids Trap $362 REO Exterior Windows: Aged and Non Energy Efficient $142,873 REO 1981 nterior Doors: Replace Doors and Frames $147,941 REO Exterior Door Condition $100, REO Smoke Barrier Condition $60, REO nterior Signage Condition $20, REO Fire Door Condition $10, REO 2109 Plumbing Fixtures: Wall Spigots Unprotected $3, REO 2022 Other Plumbing: CA Pipes Missing Hangers $ REQ 2252 Cooling Generation Systems: Pumps Without Backu $27, REO-1742 Light and Branch Wiring : Lacking Occupancy Sensa $10, Total: $522, Medical Clinic - Parris sland Parris sland, SC ADA: MeliNA FMQ MeliNA Facility Operations & Maintenance Action to Meet Standard Cost 10 meet standard FY RE Elevalor nspection $0 REO nstallation of Electronic Door Security $251,000 Total: $251, Denal Clinic Parris sland Parris sland, SC ADA: MeliNA FMQ: MelNA Americans wilh Disabilities Act Action 10 Meet Standard Cost to meet standard FY REO-5346 Communication and Security: Fire Alarm System Ag $45, REO-1915 Plumbing Fixtures: Non-ADAAG RestroomsiShower $96, REQ-602 nterior Doors: Non-ADAAG Compliant Hardware $29, REQ Furnishings : Pharmacy Counter - Non-ADAAG Com $2, REQ-1609 Furnishings : Not-ADAAG Compliant - Reception De $7, REQ-1734 Furnishings : Kitchen and Lounge Non-ADAAG Acce $10, REQ-1474 Plumbing Fixtures: Aged, Non-ADAAG Drinking Fou $24, Total: $216,454 Facility Operations & Maintenance Action to Meel Siandard Cost to meel standard FY REO-730 Wall Finishes: Damaged GWB $14,049 REQ-054 Domestic Waler: End of Ufe $50,934 REQ- 563S Roof Drainage $250,000 u.s. Navy Report on nspections of Mtttary Medical Treatmenl Facilities, Apperdix Page 11 of 57

82 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Beaufort (N61337) 674 Dental Clinic - Parris sland Parris sland, S C ADA: MetlNA FMQMe tlna Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO-1464 Floor Finishes: Aged VCT $10,273 REO Communication and Security: PA System Aged $47,117 REO-2396 Plumbing Fixtures: Mop Sinks Damaged $5,748 REO Elevator nspection $0 20t O REO Roof Condition $250, REO Exterior Window Condition $100, REO nterior Signage Condition $20, REO Total restoration of the building finishes $1,204,800 J 2012 REO-955 Other Plumbing: Vacuum Vents Stain the Wall $2, REO-2397 Plumbing Fixtures: Wall Spigots Unprotected $3, Total: $1,958,722 Activity: NH Camp Lejeune (N68093) 15 Malns lde Dental Medical Clinic Camp Lejeune, NC ADA: MetlNA FMO' MetlNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO Fl oor Finishes: Carpet Deteriorated $25,487 REO-S4646 Replace Windows $1,650,968 TOlal: $1,676, Substance Abuse Rehab Program Camp Lejeune, NC ADA: MetlNA FMOMetlNA Action to Meet Standard Cost to meet standard FY 460 Hadnot Point Dental Clinic Camp Lejeune, NC ADA MetlNA FMO : MetlNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY Total: REQ Medical Gas: Tanks Not Stored Property $3,554 REQ Distribution Systems: Aged Radiators $5, REQ Plumbing Fixtures : Water Coolers Aged/Non-Compli $4,778 REQ Plumbing Fixtures : Service Sink Aged $2,575 REO Gas Distribution: Aged Piping $3,378 REO Replace AHU on Roof and Rs-insulate Piping $133,221 REO Electrical Service and Distribution : Branch Panels a $95, REQ Electrical Service and Distribution : Switchgear Aged $22, REO Communication and Sec: Fire Alarm Aged $43, REQ Floor Finishes: Aged VCT $38, REQ-5757 Domestic Water Distribution: Aged Water Heater $19, REO Electrical Service and Distribution: Electrical Service $15, RE Q Plumbing Rxlures: Aged RR Rxtures $36, Total: $424, Occupational and Preventative Med icine Camp Lejeune, NC ADA: MetlNA FMO: MeUNA Action to Meet Standard Cost to meat standard FY u.s. Navy Report on nspections 01 Mary Medical Treatment Facilities, Apperdix 1 Page

83 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Camp Lejeune (N6B093) 65 Occupational and Preventative Medicine Camp Lejeune, NC ADA MeVNA FMQ: MeVNA Action to Meet Standard Cost to moot standard FY AS100 Medical Dental Clinic - New River MCAS New River, NC ADA Met/NA FMOMeVNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY Total: REQ Ught and Branch Wiring: Open Penetration $2,577 REQ Packaged Units: Aged Unit $22, REQ-8435 Communication and Sec: Fire Alarm Aged $88, REQ Exit Signs: Aged $14, REQ Lighting and Branch Wiring: nefficient Fixtures $80, REQ Lighting and Branch Wiring: Lack 01 GFC Receptac $4, REQ-8434 Electrical Service and Distribution : Access to Panel $2, Total : $215,959 BB118 Courthouse Bay Medical Dental Clinic Camp Lejeune, NC ADA: MeVNA FMO : MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO Replace VCT in Den tal Department $36, Total: $36,276 FC308 French Creek Medical/Dental Clinic Camp Lejeune, NC ADA : MetiNA FMO: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-7226 Plumbing Fixtures : Kitchenette Aged/Not ADA Com $1,969 REQ Floor Finishes : Deterlorated Carpet $4,491 REQ Room 018 $3,512 REQ Medical Gas: Tanks Not Stored Properly $3,554 REQ-6235 Plumbing Fixtures: Sink nsulation Missing $756 REQ-7218 Plumbing Fixtures: Drinking Fountains AgediNon-A $12,672 20t 1 REQ HVAC Controls: Aged $41, REQ-6202 Lighting and Branch Wiring: Aged and nefficient $59, REQ-8423 Communication and Sec: Fire Alarm Aged $80, REQ-32 Floor Finishes : Vinyl Sheet Goods $53, REQ-7228 Distribution Systems: GB/RR Exhaust Fans Aged $9, Total: $270,148 G770 Geiger Medical/Dental Clinic Camp Geiger, NC ADA: MetiNA FMOMetiNA Action to Meet Standard Cost to moot standard FY H Sports Medicine and Dental Clinic ADA MetiNA FMOMeVNA Total: Americans with Disabilities Act Action to Meet Standard Cost to meat standard FY REO-S618 1 ADA Requirements $5,000 REO-S6180 Handicap Restrooms $3 0,000 Total: $35,000 U.S. Navy Report on nspections 0' M"ary Modlcal Treatment Facilities, Appendix 1 Page 13 0' 57

84 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Camp Lejeune (N68093) H Sports Medicine and Dental Clinic ADA Me1fNA FMQMe1fNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-S8177 Em ergency Power Condition $2, REO-S6178 Fire Alarm Condition $15, REO-S6176 Lighting Fixture Condition $15, REO nterior Wall Condition $2, Total : $34,500 M128 Camp Johnson MedicalfDental Clinic Camp Johnson, NC ADA: Me1fNA FMOMe1fNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-2380 Plumbing Fixtures : Sink nsulation Missing $458 RE Plumbing Fixtures : Non ADA Restroom Fixtures $15,461 Total : $15,919 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Floor Finishes : Aged Carpet $7,089 REO Exterior Windows: Single Glazed Units $30,015 Total: $37,104 NH100 Hosprtal Jacksonville, NC ADA : Me1fNA FMQ: Me1fNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-7764 Ext Stairs: Cracked Concrete $ 137 REO-28 Distribution Sys tems: Duct nsulation Repairs - 05 S $10,248 REO-6S97 Electrical Service and Distribution: Rusty Roof Cond $4,992 J REO-7243 Floor Finishes : Ceramic Tile Aged and Damaged $74, REO-9456 Domestic Water Supply: Booster Pumps Aged $85, REO Floor Finishes : Replace VCT $1,006, REO Distribution Systems: HV Units Aged $138,660 J 2012 REO-22 Dis tribution Systems: Heat Exchangers Aged $108, REO Electrical Service and Distribution: MCC Units Aged $483, REO-29 Medical Gas: Aged Valves and Panels $313,275 J 2012 REO-7714 nterior Doors: Hardware AgediOperationallssues $814, REO Domestic Water: HW Recirculation Pumps Aged $22, REO Emergency Ught and Power System: Aged Dist Sys $914, REO Ceiling Finishes: ACT Aged and Damaged $838,0 10 J 2013 Total : $4,593,532 TC805 Camp Geiger Smart Clinic Jacksonville, NC ADA MetiNA FMOMe1fNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Emergency Ught and Power Systems: EM Ughts n $5,711 REO REO-4543 Emergency Light and Power: Exit Signs nsufficient Package Units: Aged Split System O Units $1,981 $22,105 Total: $29,797 Activity: NH Guantanamo Bay (N61564) 2040 Oee Health and ndustrial Hygiene Guantanamo Bay, CU ADANol Mel FMQ: MetiNA U.S. Navy Report on nspections of Mlttary Medic., Treatment Facilities. Appendix 1 Page 14 of 57

85 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Guantanamo Bay (N61564) Navy Medicine East 2040 Oee H eah and ndustrial Hygiene Guantanamo Bay, CU ADA : Not Met FMQMetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ REQ REQ Disabled Access ADA Requirements Handicap Restrooms $20,000 $30,000 $50,000 Total: $100,000 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ HVAC Acceptable $70,000 REQ nterior Wall Leaks $5,000 REQ nterior Wall Coverings $5,000 REQ Lighting Fixture Condition $50,000 REQ nterior Wall Condition $55,000 REQ Electrical System Condition $75,000 REO nterior Door Condition $ 1,000 REO DuctWork Condition $10,000 REQ Foundation Condition $60,000 REO Exterior Wall Moisture $50,000 REO Handrail Condition $5,000 REO Pipes Secured $1,000 REQ Plumbing Fixture Conditi on $20,000 REO HVAC Condition $10,000 REO Domestic Water Condition $52, REO Stair Condition $15, REO Exterior Window Conditi on $55, REQ Exterior Door Condition $5,000 J 2011 REQ Roof Condition $15, REQ Exterior Wall Condition $50, Total: $629, Gym Guantanamo Bay, CU ADA : MetiNA FMO MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO 5609B ADA Requirements $10,000 REQ Disabled Parking $10,000 Total: $20,000 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ l0241 Exterior Windows : Aged Single Pane $4,846 REO Exterior Window Condition $30,000 REQ Exterior Wall Condition $20,000 REO l0265 Ceiling Finishes: Damaged Ceiling Finish $1,416 REQ nterior Door Condition $5,000 REO nterior Wall Condition $50,000 REQ nterior R oor Condition $20,000 REQ l01s8 Roofing: Damaged Panel Finish $2,991 REQ Sidewalk Condition $40,000 REQ l0262 Lighting and Branoh Wiring: Energy Replacement $7, TOlat : $181,790 U.S. Navy Report on nspections 01 Mary Medical Treatment Facilities, Apperdix 1 Page

86 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Guantanamo Bay (N61564) Hl Hosprtal Guantanamo Bay, CU ADA: MeVNA FMQ MeVNA Americans with Disabilities Acl Action 10 Meel Siandard COSllo moo slandard FY RE Plumbing Filuras: Restrooms Not ADA Compllanl $27, Total: $27,607 Facility Operalions & Mainlenance Action 10 Meel Siandard Cosl 10 meel slandard FY REO-9454 Exl Stairs and FE : Non-Compliant/Missing Handrails $13,758 REO Sanitary Waste - End of Ufe $315,780 REO Emergency Power Condition $20,000 REO Wall Finishes: Aged Painl allnt"';or Walls $153,447 RE Exterior Doors: Aged/Damaged Doors $8,973 RE Exterior Doors: Poor Rnish and Hardware $6,011 REO Plumbing Restoration for SP $2,432, t06 REO Hot Water Storage Tank - Aged $31,879 REO-S3457 Electrical Restoration for SP $519,239 REO-S3456 HVAC Restoration for SP $9 13, 198 RE Domestic Water Distribution : Replace Piping $1,921,208 RE Distribution Systems: ncomplete Coverage $423,945 REO Elevator Condition $20,000 REO Fire Protection Reswration for SP $663,666 Total : $7,443,210 HS P hys ieal Therapy Guantanamo Bay, CUB ADA MeVNA FMO : Met/NA Americans with Disabilities Act Action to Meet Standard Cost to moot standard FY REO-l0222 Exterior Doors: Hardware Non-ADA Compliant $1,731 REO ADA Requirements $20,000 Total: $21,731 Facility Operalions & Maintenance Action 10 Meet Standard Cost to moot standard FY REO Ex terior Walls : Aged Finish $2, REO Cooling Unil: Aged $28,994 REO Exterior Doors: Exhibiling Signs of Wear $1,030 REO Access Road Condition $20, REO Exterior Wall Conditi on $50, REO Pipes Secured $5, REO-S6083 nterior Door Condition $20, REO-S6085 Sidewalk Condition $20, t REO Roof Condition $50, REO-560a2 nterior Wall Leaks $20, REO-l0152 Exterior Windows: Single Pane Units $ 18, Totat: $236,029 Activity: NH Jacksonville (N00232) 1028 Branch Heatth Clinic - Kings Bay Kings Bay, GA ADA: MeVNA FMO:MeVNA Action to Meel Standard Cost to meel standard FY Total : U.S. Navy Repat on nspection6 of Mlitary Medical Treatmmt Facilities, Apperdix 1 Pag.Sof57

87 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Jacksonville (N00232) 2080 Naval Hospal Jacksonville, FL ADA MetiNA FMQMellNA Action to Meet Standard Cost to meet standard FY Total: 2104 Medical/Dental Clinic - Maypon Maypon, FL ADA: MetiNA FMQ: MellNA Action to Meet Standard Cost to meet standard FY Total : 30 Dispensary/D ental Clinic - Athens Athens, GA ADA MeliNA FMO' MeliNA Action to Meet Standard Cost to meet standard FY Total: 550 Dispensary/Dental Clinic - Atlanta Marlena, GA ADA MeliNA FMO MeliNA Action to Maet Standard Cost to meet standard FY Total: 7000 MedicaUDental Clinic - Albany Albany, GA ADA: MetiNA FMO MeliNA Action to Meet Standard Cost to meet standard FY Total : 964 MedicaVDental Clinic - NAS Jacksonville Jacksonville, FL ADA: MetiNA FMQ' MellNA Action to Meat Standard Cost to meet standard FY Total: L48 MedicaUDental Clinic - Key West Key West, FL ADA : MetiNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-4982 Floor Finishes: Replace VCT flooring $62,3B3 REQ Repair / Seal Exterior Walls $389,Q t REQ Repair Roof / Repair Flashing & Seal $55, REQ nterior Floor Condition $1,200, REQ-49n Exterior Walls: Parging Separating $ Total: $1,707,551 Activity: NH Naples (N66096) 2082 Naval Hosprtal - Gricignano lno d'aversa (C El, T ADA MetiNA FMOMellNA Action to Maet Standard Cost to meet standard FY U,S, Navy Report on nspectiofl6 01 Mary Medical Treatment Facilities. Apperdix 1 Page

88 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Naples (N66096) 2082 Naval Hospal - Grlcignano no d'aversa (CE), T ADA: MetiNA FMQ MetiNA Action to Meet Standard Cost to meet standard FY Total: 457 Medical Dental Clinic - Capodichino Naples, T ADA MetiNA FMO MetiNA Action to Meet Standard Cost to meet standard FY Total: Activity: NH Pensacola (N00203) 148 Panama City Heah Clinic Panama City, FL ADA: MetiNA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-S6174 Roof Condition $25,000 REQ-s617S Exterior Window Condition $5,000 Total: $30, Naval Hospal Pensacola Pensacola, FL ADA: Met/NA FMQMetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-6409 Plumbing Fixtures: Non ADAAG Compliant $4,934 REO-6249 nterior Construction: Not ADAAG Stage Access $11,996 REQ-s421 Fittings: Signage Non-ADA Compliant $17,655 Total: $34,585 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-S709 Equipmtent: Roof Ladders Not Fully Adhered $4,006 REO-6779 nterior Construction: FRP Non-Camp Partns-Smok $8,679 REO-6406 Plumbing Fixtures: Deteriorated Sinks $7,530 REO-S413 Exterior Stairs and Fire Escapes: Aged and Damag $10,482 REO-S609 Floor Finishes: Aged Carpet $237,699 REO-5610 Floor Finishes: Replace Damaged and Aged VCT $560, REO-5647 Elevators and Ufts: Aged (Passenger Electric) $2,461,661 REO-5680 Exterior Doors: Aged and rusted $10,907 REQ-9877 Domestic Water Dist: End of Ufe $390,363 REQ-5733 nterior Construction: Dead End Corridors $37,477 REO-5744 nt Canst: FRP Smoke Doors Missing Astragals $4,021 REO-2308 Distribution System: Aged AHU Central wnav $92,698 REO-9881 Sanitary Waste: Piping End of Ufe $304,845 RE Q-6428 Exterior Wall: Deteriorated/Damaged EFS Siding $13, REO Elevators and urts: DB for RM $246,085 REO-lll09 Altemate Power Source to Main Une $172,959 REO-6371 Light and Branch Wiring: Aged Roof Ughting $3,870 REO-5766 Floor Finishes: Ht Change Quarry Tile Service Line $8,519 REO-5751 Floor Finishes: Aged/Deteriorated Quarry Tile $60,695 REO-6477 nterior Construction: FRP Open Penetrations $138, REO-6486 Stairs: Non-Compliant Handrails at Stairs $7, REO nterior Finishes: Theatre Renovations $ REO-S712 nterior Construction: Rooms Lack Fire Rating $21, u.s. Navy Report on nspections of Mlitary MEdical Treatment Facilities, Apperdix 1 Paga180157

89 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East AC1ivity: NH Pensacola (N00203) 2268 Naval Hosprtal Pensacola Pensacola, FL ADA MeUNA FMQ MeUNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY j REO 6323 j lnterior Construction: FRP Corridor Not Smoke Resi j $15, Total: $4,819, Naval Branch Health Clinic Crane Crane, n ADA: MetiNA FMQMeUNA Action to Meat Standard Cost to meet standard FY Total: 295 Gulfport Branch Health Clinic Guffport, MS ADA MeUNA FMO MeUNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY j REQ $10,000 Total: $10, Whiting Field Branch Health Clinic Milton, FL ADA MeUNA FMO : MeUNA Action to Meet Standard Cost to meet standard FY 3600 NASP Branch Health Clinic Pensacola, F L ADA : MeUNA FMO MeUNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY Total: REQ 63 Emergengy Ughting and Power Systems: Exlt Signs $30,545 1 REO 9198 Emerg Ught and Power Sys : Emergency Lights Age $25,058 REQ 5181 Roofing: Leaks Unknown Source $5,509 REQ 5288 Roofing: Repair Flashing/Power Wash Bldg $6,378 Total: $67, Meridian Branch Health Clinic Meridian, MS ADA : MeUNA FMOMeUNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REQ 5310 Dist Systems : Aged Exhaust Fans $66,646 REQ 5696 Dis tribution Systems: Aged Air Handlers $315,439 REQ 6276 Ext Stairs and FE: Damaged Stair Finish $9,329 REQ 6600 Dlst Systems : Aged Reheat Coils $50,671 L REO 5600 Dist Systems: Aged Hot Water Piping $283,t84 REQ 6380 Sprinklers : Lacking n Building $130, Total: $876, NAnc Branch Health Clinic Pensacola, FL ADA MeUNA FMQMeUNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY j REQ j Roof Condition $35,000 Total: $35, Belle Chase Branch Health Clin ic New Orleans, LA ADA MeUNA FMQ MeUNA U.S. Navy Roport on nspections of M"ary Medical Traatment Facilities. Appendix 1 Page 190f57 Action to Meet Standard Cost to maet standard FY

90 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Pensacola (N00203) Navy Medicine East 41 Belle Chase Branch Health Clinic New Orleans, LA ADA MetlNA FMQ: MetiNA Action to Meet Standard Cost to meet standard FY 535 Corry Station Branch Health Clinic Pensacola, F L ADA : MetiNA FMQ: MetiNA Total: Action to Meet Standard Cost to meet standard FY TOlal: 601 NOLA Warehouse Health Clinic New Orleans, LA ADA : MetiNA FMO : MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-653 Plumbing Fixtures : Non-ADAAG Restrooms $5,219 RE0-404 Ramps: Handicap Accessible Ramp Lacking $40,632 Total : $45,851 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-1S17 Roofing: Deteriorated Walkway Canopy $57,138 REO-784 Floor Finishes : Damaged VCT $2,512 REO-729 Floor Finishes : Aged Carpet $5,483 Total: $65, Millington Branch Health Clinic Millington, TN ADA MetiNA FMOMetiNA Facility Openetions & Maintenance Action to Meet Standard Cost to meet standard FY REO REO Emergency Power Condition Fire Door Condition $5,000 $10,000 20tO REO Cooling Tower Condition $7,000 1 REO Exteri or Window Condition $35,000 REO-5616S Stair Condition $25,000 L REO nterior Wall Condition $5,000 REO nterior Floor Condition $5, REO Sidewalk Condition $20, REO-S6167 Communication System Condition $30, Total : $142,000 H100 NOLA Herbert Tower New Orleans, LA ADA MetiNA FMO: MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-1198 : Plumbing Fixtures : Non-ADAAG Restrooms $42, Total : $42,904 Facility Operations & Maintenance Action to Meat Standard Cost to meet standard FY REO-2144 Roofi ng: Rashing and Coping Leaks $18,568 REO Roof Condition $20,000 Total: $38,568 Activity: NH Rota (N66101) U,S. Navy Report on nspections of M"ary Medical Treatment Facilities,Apperdix t Page 200f 57

91 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NH Rota (N66101) 1802 Hospal Rota, SP ADA: Met/NA FMQ MetiNA Americans with Disabilities Acl Action 10 Meel Standard CoSo meel standard FY REO Disabled Access $5,000 Total: $5,000 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-561S4 Medical Gas And Vacuum Condition $5,000 REO Plumbing Fixture Conditi on $17,000 REO Stair Condition $12,000 REO Roof Condition $40, REO-5S155 HVAC Acceptable $700, REO WR OSO 18S6 Bldg 1802 Elevator Automatic Door C $5, Total: $779,451 Activity: NH Sigonella (N39163) 19 Branch Medical Clinic - Souda Bay Chaina, GR ADA : MetiNA FMO MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-6840 Exteri or Doors: Main Entrance Lacks Auto Opener $14, Total: $14,946 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-9505 Term and Pack Unit: Rool Unit Ouestion Operation $98,324 REO-848B Exterior Doors: Corrosion/Damaged Hardwares $3,902 Total: $102,226 19A Denial Clinic - Souda Bay Facili1 Operations & Maintenance REO-96SS REO-94SS REO-1SS18 Chaina, GR Action to Meet Standard ADA : MetiNA FMQ MetiNA Cost to meet standard FY Emergency Ught and Power System: Upgrade Exits $1,671 Fire Prot Spec ' Extinguishers Lacking $1,879 Roofing: nvestigate Leaks $1,887 Total: $5, NSA Medical Dental Clinic - Bahrain Manama, BA Americans with Disabilities Act REO-9251 Action to Meel Standard Plumbing Fixtures: Non-ADA Restrooms Facility Operations & Maintenance Aclion to Meet Standard REO-5S09 7 Elevator nspection REO REO-5610S nterior Door Condition $1,517 Total: $1,517 Cost to meet standard $0 Sprinkler Claar Plane $194,000 $194,000 J REO-56to5 Smoke Barrier Condition $194,000 REO Fire Door Condition $194,000 REO Egress Clear $194,000 REO-67St Exterior Wails : Damaged Stucco Rnish $1,693 REO Fire Proofing Condition REO Facility Sprinklered U.S. Navy Report on nspections of Mlitary Medical Treatment Facilities, Apperdix 1 Page 21 of 57 ADA MetiNA Cost to meet standard FMQ: MetiNA FY FY $194,000 $194,000

92 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) MTF Report Summary Region: Activity: NH Sigonella (N39163) Navy Medicine East 265 NSA Medical Dental Clinic - Bahrain Manama, BA ADA: MetlNA FMQMetiNA Fac; li1 Operations & Maintenance Acti on to Meet Standard Cost to meet standard FY REQ-8924 Exterior Doors: nadequate Auto Openers $11,860 REQ-6863 Wall Finishes: Dam aged/aged Paint and Gypsum $22,914 REQ-S6101 Hazard Areas Sprinkiered $194,000 REQ-701S Floor Finishes : Aged Carpet $51, REQ-7121 Exterior Doors: Damaged Finish $2,007 REQ-S6099 Fire Alarm Condition $0 Total: $1,641, Naval Hospal - Sigonella Sigonella, T ADA MetfNA FMO : MetiNA Facility Operations & Mainlenance Action 10 Meel Standard Cosllo meel slandard FY REQ-6130 Floor Finishes: Aged VCT $479,817 REQ-S6323 Domestic Water Condition $431,000 Total: $910, Flight Line Medical Clinic - Sigonella Sigonella, T ADA: MetlNA FMOMetiNA Facili1 Operations & Mainlenance Action 10 Meel Standard Cost to meet standard FY REQ-S6291 Exterior Wall Condition $1,284,000 REQ-S4594 Controls and nstrumentation: rreparable DOC Sysl $222,571 Total : $1,506,571 Activity: NHC Charleston (N6B084) 2417 Dental Clinic Goose Creek, SC ADA : MetfNA FMQ: MetiNA Americans wilh Disabilities Acl Aclion 10 Meet Standard Cost 10 meel slandard FY REQ Plumbing Fixtures: Non ADAAG Compiiant Restroo $29,829 REQ-1S281 Communication and Security System : nsufficient N $4,363 Total: $34,192 Facility Operations & Mainlenance Acti on 10 Meet Standard Cost to meet slandard FY REQ Plumbing Fixtures : Em ergency Eyewash Not nstall $1,732 J REQ Other Plumbing Systems : Mercury Recovery Not ns $11,944 REQ Sanitary Waste: Damaged Roor Drain $4, REQ Exterior W alls: Masonry and EFS Stained $8,707 REQ Floor Finishes: Sheet Vinyl Roaring Damaged and $42,311 REQ-S6157 Roof Condition $25,000 REQ Floor Finishes: Aged VCT $62, REQ Other Plumbing Systems : Corroded Water Softener $7,485 REQ Fire Protection Specialities: mproper Fire Elinguis $3,709 J REQ Exterior Walls: Deteriorated Caulking $41,036 REQ-1S212 Lighting and Branch Wiring: Occupancy Sensors ns $15, REQ lighling and Branch Wiring: Remove Occupancy Se $ REQ-1S28S Light and Branch Wiring : Non-G FC - Outlet $1, TOlal: $227, Branch Medical Clinic Goose Creek, SC ADA: MetiNA FMQMetiNA u.s. Navy Report on nspections 01 Mlttary Medical Treatment Facilities, Apperdix, Page

93 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NHC Charleston (N6B084) Navy Medicine East 731 Branch Medical Clinic Goose Creek, SC ADA: MetNA FMOMetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ-7372 Plumbing Fixtures: Non-ADAAG Comp/iant Public R $33, TOlal: $33,387 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-5697 Floo r Finishes: Damaged Concrete $4,281 REQ Emerg Ught and Power Sys : Exit Signs Aged/lnsu ffi $16,657 REQ-6852 Elec Serv and Distr : Panelboard Aged $172,438 REQ Distribution System s: Air Handler at End of Service $191,589 J REQ Other Plumbing Systems: Abandoned in Place $4,993 REQ Sanitary Waste: Unreliable Drainage $31,830 REQ Floor Finishes : Aged Epoxy Roar $8,217 REQ Controls and nstrumentation: Outmoded Pneumatic $100,098 REQ-5745 Floor Finishes: Wom and Aged VCT $15,825 REQ-7358 Roofing: Aged Built-Up Damaged Rashing $78,326 REQ-7283 Ceiling Finishes: GWB Plaster Ceiling Lacking $3,496 REQ Domestic Water Distribution : Wom Hot Water Heate $20, REQ Other Plumbing Systems : Weathered Natural Gas P $8,944 REQ-6043 Floor Finisl1es : Replace VAT $42,927 REQ Light and Branch Wiring: Lamps Energy nefficient $22, REQ Lighting and Branch Wiring : Occupancy Sensors ns $36, Total: $759, Audiology and Ophthalmology Goose Creek, SC ADA : MetiNA FMO: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-4065 Exhaust and Vent Syst: Clean and Balance $2,797 20tO Total: $2, Wellness Clinic Goose Creek, SC ADA: MetiNA FMO: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet slandard FY REQ Emergency Ughtlng and Power Systems: Exit Signs $5,954 REQ Domestic Water Distribution: Weathered Hose Bibb $3,921 REQ Domestic Water Distribution: Corroded Water Heate $3,922 Total: $13,797 NH1 Naval Health Clin ic Charleston Charleston, SC ADA: MetiNA FMO MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ-7476 REQ Plumbing Fixtures: Drinking Founlains Aged Plumbing Fixtures: Non-ADAAG Restrooms $44,414 $82,472 REQ-5634 Communication and Security: Assistive Listening Sy $41,050 Total: $167,936 Facility Operations & Maintenance Action 10 Meet Standard Cost to meet standard FY REQ-5590 Control and nstrumentation: End of Ufe $227,021 REQ-5562 Exhaust and Vent Syst : Operating Rooms Air Qualit $45, 255 REQ-5568 Sanitary Waste : Floor Drain Ejectors Aged $17,130 J REQ-5628 Distribution Sys: Damaged Piping nsulation $8,197 u.s. Navy Report on nspections of Mlrtary Medical Tre<>tment Facilities, Appen:Jix 1 Page 23 of 57

94 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NHC Charleston (N68084) Navy Medicine East NH1 Naval Health Clinic Charleston Charleston, SC ADA : MetiNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-5714 Electrical Service and Distribution: Electrical Service $1,173,258 REO-5743 Floor Finishes : Damaged Concrete $13,699 REO-7438 Distribution Sys: Damaged Piping nsulation $18,291 L REO-5617 Distribution Systems: Rusted Supply Fan Housings $9,055 REO-5561 Elevators and Utts : Elevator Controls Aged $1,331,995 REO-S756 Wall Finishes: Aged Vinyl Wallcoverings $108,848 J REO Electrical Service and Distribution : Aged Motor Cant $322,295 REO-5615 Rain Water Drainage: Rool Drains-Blocked Screens $487 REO Heat Generating Systems: Worn Boiler Plant $301,129 REO 5738 nterior Doors: Aged/Operational ssues $111,643 REO-6965 Ceiling Rnishes: ACT Aged / Damaged $ REO-5762 nterior Construction: Noise from Door Openings $7,126 REO-6554 Ceiling Rnishes : Plaster/GWB Deffecting $4,630 J REO-6538 ntertor Construction: FRP Non-Compiiant at Stairs $12,647 REO-6269 Floor Finishes: Stained /Aged Carpet $88,015 REO-5761 Roar Finishes: Worn and Aged VCT $44,232 REO 6196 Sanitary Waste: Piping Aged $75,871 REO-6558 nterior Construction: FRP at Smoke Barrier $98,920 REO Emergency Power and Lighting: Exit Signs Aged/ n $83,214 REO-2711 Electricaf Service and Distribution : Electr ical Distrib $2,487,041 REO-5648 Other Plumbing: Medical Air Piping Aged $430,959 REO-5613 Cool Gen System : Computer Room Units Aged $99,554 REO Emergency Power and Lighting: Upgrade Emergenc $1,373,987 REO-5151 Wall Finishes: Aged Painl at nterior Wafl s $132,827 REO-5247 Wall Rnishes : Deteriorated Ceramic Wafl Tile $26,349 REO-5552 Communication and Security: Fire Alar m System Ag $822,873 REO 5741 Floor Finishes: Aged/Deteriorated Ceramic Tile $60,921 REO Communication and Security: Public Address Syste $2 1, REO-5616 Cool Gen System : AC nadequate at Room F049 $13, REO-5626 Communication and Security: Clock System Aged $50, REO-5676 Communication and Security: Telecom Closets Prov $706, REO-5603 Lighting and Branch Wiring: Lamps Energy nefficie $576, TOlal : $ Activity: NHC Cherry Point (N66094) 3907 Occ Health Clinic Cherry Point, NC ADA: MetiNA FMO MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Fittings: Signage Not Braille $4,473 REO Plumbing Rxtures: Restrooms Non ADA Compliant $29,3 16 Total : $ Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Lighl and Branch Wiring: nterior & Exterior Ughting $55,938 REQ t203t Plumbing Fixtures: Aged Water Fountain $7,927 20tO REQ Comm and Sec: Rre Alarm System Obsolete $26,266 REQ Elec Serv and Distr: Panelboard Aged $86,063 u.s. Navy Report on nspections of Mlttary Medical Treatment Facilities, Appendix 1 Pe 24 of 57

95 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NHC Cherry Point (N66094) Navy Medicine East 3907 Occ Heah Clinic Cherry Point, NC ADA: MetiNA FMQ: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-8369 Comm and Sec: Public Address System Aged $45,839 REO-56S0 nterior Wall Condition $1 REO Domestic Water Distribution : End 01 Life $47,860 REO nterior Door Condition $1 REO nterior Wall Leaks $1 1 REO Light and Branch Wiring: Branch Wiring Aged $21,069 REO nterlor R oor Condition $1 REO Elerior Wall : Agd Finishes $8, Total : $279, Naval Health Clinic Cherry Point, NC ADA MetJNA FMQ: MetJNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Window Wall Flashing (2nd&3rd) Elevator Lobbies $13,500 REO AHU(s) Coil Replacement (13) $140,400 REO-532S9 Main Roof Coating! Seal Rashing $220,880 TOlal: $374,780 Activity: NHC Corpus Christi (N00285) 109 Branch Heah Cline - ngleside ngleside, T ADA: MetJNA FMOMetJNA AmBficans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-S6146 Disabled Access $10, TOlal: $10, Branch Health Clinic - FOr1 Wor1h For1 Wor1h, T ADA: MetJNA FMQMetJNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-1990 Domestic Water Distribution : Pipe Deterioration $3.187 REO-S 6107 Roof Condition $5,000 REO nterior Wall Leaks $1.000 REO-558 Exterior Walls: Linear Cracking $6,483 L REO-S6W8 Exterior Door Condition $3,000 REO Domestic Water Condition $2,500 j Total: $21, Branch Heah Clinic - Kingsville Kingsville, T ADA: MetJNA FMOMetJNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-S6112 Exterior Wall Condition $ REO nterior Wall Condition $10,000 REO Smoke Barrier Condition $7,528 REO-5342 Communications and Sec: Rre Alarm Non-ADA Co $ REO Exlerior Wall Moisture $25,000 REO Exterior Window Condition $5.000 REO nterior Floor Condition $12, REO Handrail Condition $4,500 REO-561S Foundation Condition $50,000 U.S. Navy Report on nspections 01 Mlrtary Medical Treatment Facilities, Appendix 1 Paga L 1

96 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) MTF Report Summary Region: Activity: NHC Corpus Christi (N00285) Navy Medicine East 3775 Branch Heah Clinic - Kingsville H- OO Facility Operations & Maint8l1ance Action to Meet Standard Kingsville, T ADA MetiNA FMQMetiNA Cost to mast standard REO Wall and Smoke Barrier P81etrations $7,528 REO Sprinklers : ncomplete Coverage $218,213 REO Basement Condition $50,000 REO Exterior Door Condition $20,000 REO Grounds Condition $300, PRMARY CARE CLNC Americans with Disabilities Act Action to Meet Standard Corpus Christi, T Totat : $766,206 ADA: MetiNA Cost to mast standard REO Plumbing Fixtures: Drinking Foun tain Antiquated $61,487 REO-8497 Comm and Sec: Rre Alanm System $56, REO-5136 Plumbing Fixtures: Patient Toilets Not Accessible $426, REO-5179 nterior Doors: Hardware Not ADA-Compliant $1,140, REO-4685 Comm and Sec: No Assistive Listening System $10, REO-5318 Plumbing Fixtures: Stafl Toilets Not Accessible $582, REO-4105 Electric Service and Distribution: Aged Equipment $80t,277 REO Smoke Barrier Condition $30,000 REO Roof Drain Piping Demolition $43,709 REO-2356 Plumbing Fixtures: Aged Shower Valves $44,519 REO Emerg Ught and Power Sys : Aged Emergency Ught $17,773 REO-1252 Plumbing Rxtures: Leaking Sink Faucets $30,996 REO-4685 Lighting and Branch Wiring: Aged Circuitry $645,788 REO-5209 nterior Doors: Mech, Room, Deteriorated $10,994 REO Distribution Systems: Hot Water Heating Pumps Ag $15,133 REQ-4890 Lighting and Branch Wiring: Various Code ssues $6,135 REQ-4966 Sprinklers : Fire Dept. Conn. Cabinets Rusted $14,228 REQ Elevators and Ufts: Aged (Passenger Electric) $1, 170,882 REQ Replace Chill Water Supply and Return Piping $713,119 J REQ-5335 Ext Stairs and FE: Guards Non-Compliant $13,630 REO Replace Roof Drains $93,610 REO-5327 Floor Finishes : Resili ent Tile Deteriorated $774, REO Other Elec Systems : Lacking As- Built Drawings $34,793 REO-5148 Comm and Sec: Aged and Abandoned Cabling $157, REQ Asbestos Abatement for interior walls $41, REO-5149 Ceiling Rnishes: Antiquated and Damaged $1, 849, REO-4836 Lighting and Branch Wiring: Aged Exterior Fi1ures $26, REQ-1251 Plumbing Fixtures: Aged Water Closats and Urinals $96, REO-5346 Other Plumbing: Surgical Air Compressor Abandone $ REO-4782 Lighting and Branch Wiring: nefficient Fixtures $18, REO-4783 Comm and Sec: Aged Clock System $18 6, REO-4905 Light and Branch Wiring : Occupancy Sensors nstall $63, REQ-2210 Other Plumbing : Medical Gas Consoles Abandoned $30, REO Eisc Sarv and Dist: Actual Load Not Known $14, J J FY FMO: MetiNA Total: $2,278,187 Facility Operations & Mainlenance Action to Meet Standard Cost to meet standard FY U,S, Navy Repoo on nspections 01 Mlhary Medical Treatment Facilities, Appendix 1 Page 26 of 57 TOlat: $6,944,868 FY

97 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NHC Corpus Christi (N00285) Activity: NHC Great Lakes (N00211) 1007 RTC Medical Clinic Great Lakes, L ADA MetiNA FMO: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REO-5SS91 Repair roof by replacement $491,60S REO-55S92 Environmental testing of elsting roofing materials $15,000 Total: $506, Recruil Dental Clinic Great Lakes, L ADA : MetiNA FMO: MetiNA Action to Meet Standard Cost to maet standard FY Total: 152 Dental Prosthetic Lab Great Lakes, L ADA: MetiNA FMQMetiNA Ac tion to Meet Standard Cost to maet standard FY Total: 1523 Medical/Dental Processing Facility Great Lakes, L ADA MetiNA FM.Q MetiNA Action to Meet Standard Cost to meet standard FY Total: 200H Naval Health Clinic Great Lakes, L ADA: MetiNA FMOMetiNA Action to Maet Standard Cost to meet standard FY Total: 237 Dispensary and Dental Clinic Great Lakes, L ADA: MetiNA FMO : MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Sprinklers : ncomplete Coverage $348,505 REO-33S5 Fire Protection Specialities: mproper Fire Extinguis $30,840 Total: $379,345 Activity: NHCNE (N32185) 1173 Dental Clinic - Newport Newport, R ADA MetiNA FM.Q: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-S6009 Emergency Power Condition $4,000 REO-5600S Communication System Condition $27,525 20tO REO-S3S42 Water nfiltration $1,204,800 REO-S600e CSR Humidity $75,000 20t t REO-Se007 HVAC Pipes Secured $20,000 J 20 t 1 Total: $1,331,325 U.S. Navy Report on nspections of Mlttary Medical Treatment Facilities, Apperdix 1 Paga 27 of 57

98 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NHCNE (N321B5) 23 NHCNE Newport Newport, R ADA: MetiNA FMOMetiNA Facility Operations & Maintenance Action to Msat Standard Cost to meat standard FY REQ-315 Distribution Systems: Restroom Ventilation Systems $110,072 REQ-3405 Ceiling Rnlshes: Stained ACT Ceiling $15,620 REQ-3441 Floor Finishes : Stained Carpet $21,899 REQ Repair Sidewalks $30,938 REQ-3442 Fl oor Finishes: Wom VCT $13,383 REQ-3923 Partitions: Wall Plaster Failure $39,952 REQ-4596 Gutters and Downspouts: Missing $8,200 REQ-4704 Roofing : nadequate Roof Drainage $25,410 REQ nterior Signage Condition $16,000 REQ Exterior Door Condition $50, RE0-5600S Parking Lot Condition $225, REQ Foundation Condition $100, Total: $656, NACC Groton Groton, CT ADA: MetiNA FMO MetiNA Facility Operation s & Maintenance Action to Meet Standard Cost to meet standard FY REQ Sidewalk Condition $35,000 REQ Distribution Systems: Dual Temp Piping Aged $619,340 20tO REQ Floor Finishes: Aged Vinyl Sheat Goods $69,71 8 REQ Elevator Replacement (3) $580,583 REQ Floor Finishes : Aged and Damaged Ceramic Floor T $133,473 REQ Hazardous Components Abatement: VCT Aged and $1,365,088 REQ-17SS4 Cooling Tower: nternal Pipe Corrosion $117,309 REQ Domestic Water Distribution: Piping and nsulation $99,378 REQ Communication System Condition $10, Total : $3,009, Dental Clinic- Groton Groton, CT ADA : MetiNA FMO: MetiNA Action to Meet Standard Cost to meat standard FY J J Total: 645 MedlcaVDental Clinic - Brunswick Brunswick, ME ADA: MetiNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REQ-4541 Floor Finishes : Aged VCT $12,336 REO-4589 Ceiling Rnishes : ACT Panels Damaged $30,092 REO-1419 Domestic Water Supply Equpl: Aged Backflow Prev $2,439 REO nterior Wall Condition $150, REO-560tO Domestic Water Condition $100, REO Remove and Replace HVAC $500, REO nterior Wall Coverings $5, REO Plumbing Fixture Condition $1, Total: $801,067 H1 NACC Portsmoulh Kittery, ME ADA : MetiNA FMOMetiNA u.s.navy Report on nspections 01 Mlnary Medical Treatment Facilities, Apperdix 1 Page

99 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine East Activity: NHCNE (N32185) H1 NACC Portsmouth Kittery, ME ADA: MetiNA FMO MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-4650 Domestic Water Disl: Replace Galvanized Piping $189,936 REO-431 Lighting and Branch Wiring: Rusted Conduits - Roof $8,958 REO-4649 Sanitary Waste: Piping End of Ule $215,771 REO-437S Lighting and Branch Wiring: Aged Circuitry $269,112 REO-6S1 Lighting and Branch Wiring: Aged Fixtures $10,483 REO-4604 Cooling Generating System : Aged AC Systeml Radi $1,128,431 REO-S60S7 Exterior Wall Moisture $150,000 REO-S451 3 Exterior Fire Doors $44, REO-S60S8 Foundation Condition $80, Total: $2,096,691 Activity: NMC Portsmouth (N00183) 1806 MedicaVDental Clinic - Yorktown Yorktown, VA ADA: MetiNA FMO. MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Furnishings : Counter Non-ADAAG Compliant $11,469 20tO Total: $11,469 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-2868 Exterior Doors: Deteriorating $5,561 REO Distribution Systems: Ductwork Beyond Rated Llle $222, 173 L REO-6520 Wall Finishes: Damaged GWB $10,613 REO Electrical Service and Distribution: Aged Switchgear $74,259 L REO Stairs: Handrails and Guardrails Non-Compliant or $20,536 REO-8522 Exterior Walls : Damaged Masonry Walls $10,628 REO Electrical Service and Distribution : Aged Distribution $1 12,969 REO Electrical Service and Distribution: Aged Feeder $58,330 REO-7758 Plumbing Fixtures: Lack of Operable Janitor Sink $5,913 Total: $520,982 2 Charette Health Care Center Portsmouth, VA ADA MetiNA FMOMetiNA Americans with Disabilities Act Action to Meat Standard Cost to meet standard FY REO-2771 Communications and Sec: Rra Alarm Devices nsufl $134,955 REO-2633 Fittings: Signage Not Braille $28,085 Total: $163,020 Facility Operations & Maintenance Action to Meel Standard Cost to meet standard FY REO-2620 Stairs : Non-Compliant Egress $10,302 REO Distribution Sys tem s: Air Handling Unit Corroding $1,300 REO Distribution Systems: Damaged nsulation $11,246 Total: $22, MedicaVDental Clinic - NNSY Portsmouth, VA ADA : MetiNA FMOMetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-3034 Elevator and Ufts: Lacking $473,655 REO-3220 Stairs : Non-Compliant Handrails at Stairs $3,775 u.s. Navy Report on nspections 01 Mlnary Medical Treatment Facilities, Appendix 1 Page

100 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC Portsmouth (N00183) Navy Medicine East 277 MedicaVDental Clinic - NNSY Portsmouth, VA ADA: MeVNA FMQ:MeVNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY TOlal: $477,430 Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO-3295 Stairs : Non-Compliant Egress $17, Total: $17, MedicaVDental Clinic - Oceana Virginia Beach, VA ADA MeVNA FMOMeVNA Facilif Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO-3609 Electric Service and Dis!: Panels Lack Sufficient Cle $200,000 REO-S61S0 nterior Floor Condition $400,000 REO-3525 Lighting and Branch Wiring: Non GFC (NEC) $8,802 REO-3782 Emergency Light and Power : Exit Sign nsufficient $1,137 REO Replace outdated attic panels leading HVAC $70,000 REO-3792 Communications and Sec: Sound System Aged $190, 808 REO-3799 Electric Service and Distril:ction: Aged/Obsolete $450,000 REO Wall Finishes: AgedDeteriorated Paint $163,425 REO-3113 Distribution Systems: Clean and Balance Ducmork $93,283 Total: $1,577,455 3 Medical Support Facility Portsmouth, VA ADA : MeVNA FMO. MeVNA Facility Operations & Maintenance Action to Meet Standard Co st to meat standard FY REO-2487 Lighting and Branch Wiring: Aged Exterior Fixtures $3,598 J REO Exterior Wall Repairs $17,634,541 REO-1S791 REPLACE ROOFNG $1,832,481 REO-7793 Fire Protection: Sprinkler Discharge Obstructed $2, REO Exterior Walls : Rusted & Faded Paint Metal Panels $170,692 REO-2967 Other Electric Systems : Lightning Protection Lackin $10,309 J REO Medical Gas: Replace 7 Medical Gas Alarm Panels $65,000 REO Exterior Windows : Antiquated $458,944 REQ-3001 nterior Doors: Not Compliant at Mechanical Plenum $8,849 REQ Electrical Repairs $28, REQ Mad Gas : Replace Mad Air & Vac Pump Skids $135, Total: $20,350, Branch Healthcare Clinic - Linle Creek Little Creek, VA ADA: MeVNA FMOMetfNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REQ-3522 Emergency Light and Power Systems: Obsolete/Ag $55,461 REQ-8409 Distribution Systems: Return Air Fans Aged $53, 389 J REQ AHU Replacement $3,012,000 REQ-2SS1 Distribution Systems: Exhaust Fans End of Life $160,006 REQ-2905 Emergency Light and Power: nsufficient Sto $5,461 REQ Exterior Window Conditi on $20,000 REO Distribution Systsms : Air Handlers at End 01 Service $276,691 REO Controls and nstrumentation : Outdated HVAC Cant $210,317 Total: $3,793,325 J J u.s. Navy Report on nspections 01 Mary Medical Treatment Facilities, Apperdix 1 Paga

101 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC Portsmouth (N001B3) Navy Medicine East 390 MedicaVDental Clinic - Northwest Chesapeake, VA ADA: MeVNA FMQMeVNA Action to Maat Standard Cost to maat standard FY 504 MedicaVDental Clinic - Dam Neck Virginia Beach, VA ADA: MeVNA FMQMeVNA Total: Action to Meet Standard Cost to maat standard FY CD2 Medical Clinic - Norfolk Nortolk, VA ADA: MeVNA FMO : MeVNA Total: Action to Meet Standard Cost to meet standard FY CD3 Denal Clinic - Nortolk Nortolk, VA ADA: MeVNA FMO : MeVNA Total: Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Furnishings : Counter Non-ADAAG Compliant $9,045 REO-2049 Extenor Stairs: Non-ADAAG Compliant Handrails $14,544 Total: $23,589 Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO Distribution Systems: Air Handlers at End of Sarvice $4,560,686 REO Controls and nstrumentation: Outmoded Pneumatic $231, REO Domestic Water Distribution: Missing Pipe nsulatio $2,209 REO Fire Protection: Sprinklers Aged and Wom Compon $621,134 REO-3048 Em ergency Ught and Power: Exit Signs nsufficient $8,339 REO-7868 Ceiling Finishes : ACT Aged and Discolored $423,412 REO Exterior Windows : Antiquated $335,154 Total: $6,182,762 CD4 Dental Support Center - Norfolk Norfolk, VA ADA: MetfNA FMQMeVNA Action to Meet Standard Cost to meet standard FY 1 Total: U.S. Navy Report on nspections of Mlrtary Medical Treatment Facilitios, Apperdix 1 Page 31 of 57

102 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity Detail Activity: NH Bremerton (N68095) Naval Hospital Bremerton Bremerton, WA ADA: MetfNA FMO:MetfNA Action to Meet Standard Cost to meet standard FY 17 Family Practice Clinic Bremerton, WA ADA MetfNA FMQ:MetfNA Total: Action to Meet Standard Cost to meet standard FY Medical Dental Clinic Everett, WA ADA MetiNA FMQ MetfNA Total: Action to Meet Standard Cost to meet standard FY 2050 Dispensary/Dental Clinic Bangor, WA ADA : MetfNA FMOMetfNA TOlal: Action to Meet Standard Cost to meet standard FY 2850 NHB Heatth and Education Center Bangor, WA ADA MetlNA FMO:MetfNA TOlal: Action to Meet Standard Cost to meel standard FY TOlal : 506 Dental Clinic Bremerton, WA ADA MetfNA FMOMetfNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-1SS83 $56,478 TOlal : $56, Medical Clinic Bremerton, WA ADA MetfNA FMOMetfNA Action to Meet Standard Cost to meet standard FY Total : Activity: NH Camp Pendleton (N68094) 1175 Health Clinic Yuma Yuma, AZ ADA : MetiNA FMO: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Cooling Tower Condition $250 REO-5620S Roof Condition $200 REO-6664 Other Electric Systems: Generator lacking $57,347 u.s. Navy Report on nspections of Mary Medical Treatment Facilities, Appendix Page 32 of 57

103 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Camp Pendleton (N68094) Navy Medicine West 1175 Health Clinic Yuma Yuma, AZ ADA : MetlNA FMQMetlNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY TOlal: $57, Dental Clinic t3128 Camp Pendleton, CA ADA : MetiNA FMOMetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Handicap Restrooms $ TOlal : $400 Facility Operations & Maintenance Action to Meet Standard Co st to meet standard FY REO Electric Service and Distribution: 12 KV Switchgear $135,512 REQ-36 nterior Construction: FRP Open Penetrations $2,346 REO Emergency Eyewash: Damaged $5,617 TOlal: $143, Medical Clinic Camp Pendleton, CA ADA MetlNA FMO: MetiNA Action to Meet Standard Cost to meet standard FY 1402 Naval Medical Clinic Port Hueneme Port Hueneme, CA ADA: Met/NA FMO MetiNA Total: Action to Meet Standard Cost to meet standard FY 159t Branch Dental Clinic 29 Palms 29 Palms, CA ADA: MetlNA FMQ MetiNA Total: Action to Meet Standard Cost to meet standard FY 17 Medical Clinic Barstow, CA ADA: MetlNA FMOMetlNA Total: Action to Meet Standard Cost to meet standard FY Health Clinic Camp Pendleton, CA ADA: MetlNA FMO:MetiNA Tolal: Americans with Disabilities Act Adon to Meet Standard COS to meet standard FY REQ Disabled Access $ Total: $85 Facility Operations & Mainlenance Action to Meet Standard Cost to meet standard FY REO Communication and Security: Security System Age $9,765 REO-9136 Lighting and Branch Wiring: Exterior Ughting Aged $4,487 REO Case-work : Aged and deteriorated. $17,833 J REO Lighting and Branch Wiring: Receptades Not To Co $6,090 REO-9144 Emergency Ughting and Power Sys : Lights Lacking $2,133 U.S. Navy Report on nspections of Mlitary Medical Treatment Facili ties, Appendix 1 Page 33 of 57

104 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Camp Pendleton (N68094) Navy Medicine West Health Clinic Camp Pendleton, CA ADA MetiNA FMQ MetNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Facility Sprinklered $ TOa: $40, Medical Clin ic Administrative Offices 22 Seal Beach, CA ADA : MetiNA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Communications and Security: Rre Alarm System A $22,367 REQ nterior Doors: Aged/Not Fire Resistance Rated $31,255 1 REQ Sprinklers: Lacking $114,031 REQ Plumbing Fixture Condition $ REQ HVAC Condition $ TOa: $168, Health Clinic Camp Pendleton, CA Action to Meet Standard ADA : MetiNA FMO: MetiNA Cost to meet standard FY Medical Clinic Camp Pendleton, CA Facili1 Operations & Maintenance Action to Meet Standard TOa : ADA: MetiNA Cost to meat standard FMQMetiNA REQ Roofing System $32,265 REQ Roofing: Metal Roofing Corroded $3,343 REQ Lighting and Branch Wiring : Lack Occupancy Sanso $4,618 REQ Roof Condition $50 201t REQ-S61 96 Roof Condition $50 201t REQ-S5333 Plumbing $1, TOa: $41,436 FY Dental Clinic Camp Pendleton, CA Action to Meat Standard ADA : MetiNA FMO: MetiNA Cost to meet standard FY Total : Health CliniC Camp Pendleton, CA Action to Meet Standard ADA MetiNA FMO: MetiNA Cost to meet standard FY Total: Health Clinic Camp Pendleton, CA Action 10 Meet Standard ADA: MetiNA FMO Me1fNA Cost to meet standard FY Health Clinic Camp Pendleton, CA Total: ADA: Me1fNA FMOMetNA U.S. Navy Report on nspections of Mfitary MedCal Treabnent Facilities, Apperdix 1 pogo

105 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Camp Pendleton (N68094) Navy Medicine West Health Clinic Camp Pendleton, C A ADA : MeUNA FMQMeUNA Action to Meet Standard Cost to maat slandard FY Total : 5 Dispensary Point Mugu, CA ADA : MetlNA FMQ MeUNA Action to Meet Standard Cosl to maal slandard FY Dental Clinic Camp Pendleton, CA ADA : MeUNA FMO MeUNA Total : Action 10 Meet Standard Cost to meet standard FY Total: Medical Clinic Camp Pendleton, CA ADA: MetlNA FMO: MetlNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-9t81 Plumbing Fixtures: Non-ADA Complianl Drinking Fa $3, Total: $3,618 Facility Operations & Malnlenance Action to Meet Standard Cost to meet standard FY REO Lighting and Brancih Wiring : Non Hospital Grade Re $4,306 REO-9606 Electric Service and Distribution: Switcihboard Aged $43,952 REQ Lighting and Brancih Wiring : Aged Circuilry $38,153 REO Electric Service and Distribution: Main Service Feed $54,877 REO-9180 Parking LoS : Asplhalt Worn $6,807 REO-9584 Lighting and Branch Wiring : Exterior Ughting Aged $4,300 REO-9177 Substructure: Concrete Surfaces Cracked $2,68 1 REO-9585 Lighting and Brancih Wiring: Lack Occupancy Sensa $9,217 REO-7297 Exterior Windows: Window Looks Uke Exit $2,668 REO-9342 Exlerior Windows: Aged and Deteriorated $145,386 REO-9134 Electric Service and Distribution: Motor Control Cenl $30,281 REO-9486 Electric Service and Distribution: Panel boards Age $82,048 REQ-9319 Emergency Lighting and Power Sys : Ughts Lacking $12,758 REQ Exterior Window Condition $ REQ Parking Lot Condition $ Total: $437, Health Clinic Camp Pendleton, CA ADA MeUNA FMQ: MeUNA Facilirj Operations & Malnlenance Action 10 Meet Standard Cosl to maal standard FY REQ Electrical Service and Distribulion: Power Panels Cir $609 REO-9S91 Communications and Security: Fire Alarms nsuffld $3,803 Total: $4,412 58SN Medical Clinic 58SN PORT HUENEME, CA ADA: MeUNA FMQ:MeUNA Action 10 Meet Standard Cosl 10 maal standard FY L J J 1 U.S. Navy Report on nspections of Mary Medical Treatment Facilities, Appendix 1 Page

106 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NH Camp Pendleton (N68094) 58SN Medical Clinic 58SN PORT HUENEME, C A ADA MetlNA FMDMetlNA Aclion 10 Meel Siandard Cosllo meel slandard FY Health Clinic Camp Pendleton, CA ADA: MetlNA FM.Q: MetlNA TOlal: Action 10 Meel Standard Cosl 10 meel slandard FY Total: 914 Dental Clinic 914 PORT HUENEME, CA ADA : MetlNA FMO: MetlNA Fadlily Operations & Mainlenance Aclion to Meet Standard Cosl to meet slandard FY REQ Facilily Sprinklered $300,000 20t 1 Total: $300,000 H t 00 Hospital Camp Pendleton, CA ADA MetlNA FMOMetlNA Action to Meet Standard Cost to meet standard FY Total : Activity: NH Guam (N68096) Dental Clinic and Family Services Santa Rita, M ADA MetNA FMO: MetlNA Fadlily Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ 8454 Electrical Service and Distribution: Aged Panelboard $37,771 REQ 7621 Comm and Sec: Remove Dangling Rope $332 REQ Exterior Doors: Corrosion/Damaged Hardw ares $7,174 REQ Sanitary Waste : End of Life 1955 Piping $29,341 REQ Ceiling Rnishes : ACT Aged and Dirty $47,140 J REQ Domestic Water Distribution: nstall Water Treatmen $21,283 REQ 5884 Exterior Windows : Loosing Weather Tight $7,519 REO 640t Distribution Systems: Aged GB Exhaust Fans $5,255 REO 7566 Electrical Service and Distribution : Update Directory $3,321 J REO 7415 Comm and Sec: Connecl AHU to FAS $4,239 1 REQ Distribution Systems: Aged RR Exhaust Fans $4,623 REO 5885 Roofing : Recoat With Elastomeric Acrylic $3,560 Total: $171,558 Hospital Agana Heights, M ADA : MetlNA FMDMetlNA Americans with Disabilities Act Action to Meel Standard COS to meel standard FY REO 6483 nterior Doors: Non Complaint Door Widths $22,406 REO 7645 Plumbing Fixtures: Aged/Non ADAAG Compliant $1,555,046 REQ 9546 Furnishings : Non ADAAG Compiiant Kitchenette $30, REO 9382 Furnishings : nlorrnabon Counter Non ADA Complia $16, TOlal: $1,624,524 U.S. Navy Report on nspections of Mary Medical Treatment Facilities, Appencix 1 Page 36 of 57

107 A. Detailed Military Departments' MTF nspection Reports --2. T AB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NH Guam (N68096) Agana Heights, M ADA MetfNA FMQMetfNA Facility Operations & Main tenance Action to Meet Standard Cost to meet standard FY REO-9355 Ceiling Finishes: ACT Aged and Damaged $895,800 REO-S618S Roof Condition $15,000 REO Repaint Exterior Bldg 1 $361,080 REO Sprinklers : Corroded Piping $10,002 REO Wall Finishes: Aged and Damaged Ceramic Tiles $304,541 REO-3182 REO REO REO-7723 Distribution Systems: Air Handlers End of Ufe $3,126,733 Plumbing Fixtures: Eye W ash Stations Non-Complia $13,758 Replace C-Converter $165,660 Sanitary Waste: Piping End of Ufe $1,626,136 REO Plumbing Fixtures: Aged Utility Sinks $76,537 REO-9510 Floor Finishes: Aged and Worn VCT $1,911,453 REO-9531 Stairs : Handrails and Guardrails Non-Compliant or $113,898 REO-9533 Wall Finishes: Aged Paint at nterior Walls $554,115 REQ-7722 Domestic Water Dis!: End of Ufe $1,308,014 REO Floor Finishes : Loading Dock Dirty and Deterioration J J J J $12,541 REO-3112 Control and nstrumentation : End of Ufe $406,578 REQ Partitions: FRP Open Penetrations $11,959 REQ Roofing : Replace Metal Roof $11,661 REO Plumbing Fixtures: Aged Laboratory Sinks $50,627 REQ nterior Doors: Fire Doors or Frames Missing Lables $10,679 REQ Exterior Windows: Bird Guano Soiling $38,714 REQ-1649S Gutters and Downspouts: Damaged Downspouts $2,464 REO Floor Finishes : Regrout Ouarry Tiles $84,902 REQ Replace Galley Equipments $175,183 REQ Floor Finishes : Aged and Damaged Carpet $287,309 REQ Floor Finishes : Aged and Damaged Ceramic Tiles $277,061 REQ Kltchen Equipment: Non Code Compliant Kitchen Si $11,940 REO Plumbing Fixtures: Aged Medical/Exam Room Sinks $121,213 REO Distribution Systems: Air Handlers End of Ufe W R9 $189,603 REO Wall Finishes: Aged and Damaged Ceramic Tiles R $816, REO Rain Water Drainage: Aged Piping $171,999 Total: $12,963,287 6 Medical Clinic Santa Rita, M ADA : Not Met FMQ. MetfNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-9406 Plumbing Fixtures: Aged/Non ADA Restrooms $185,428 REO-S6186 Disabied Access $30,000 Total: $215,428 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Dam Water Dist: WH Lacks Safety Pan $1,427 REO-6353 Plumbing Fixtures: Service Sink Aged $3,357 REO Exterior Doors: Non-Complaint Door Widths $17,051 REO-8592 Stairs : NO1-Compliant Handrails at Stairs $2,527 REQ Lighting and Branch Wiring: Replace T-12 Lamps $80,380 Total: O4,742 U.S. Navy Report on nspections of M"ary Medical Treatmenl Facilities, Apperdix 1 Page 37 of 57

108 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NH lemoore (N6609 5) 11 Medical Health Clinic Lemoore, CA ADA : MetlNA FMQ: MelNA Action to Meet Standard Cost to meat standard FY 299 Medical Health Clinic Fallon, NV ADA MetlNA FMQ: MelNA Total: Action to Meet Standard Cost to meat standard FY 926 Dental Clinic Lemoore, CA ADA : MetlNA FMO : MeliNA Total : Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO Emergency Ughting and Power Systems: Exit Signs $7,986 1 REO-8561 Domestic Water Dis!: Ag ed $48,614 REO-7280 Lighting and Branch Wiring: nefficient Fix tures $74,446 j REO HVAC Acceptabie $30,000 REO-9424 Distribution Syslems: AH U Aged $131,149 RE O Distribution Systems: Aged HVAC Piping $55,145 REO-7519 Ceiling Rnishes: Replace Damaged ACT $40,094 Total : $387, Naval Hospital Lemoore Lemoore, CA ADA MeliNA FMO: MetlNA Facility Operations & Mainlenance Action 10 Meet Standard Cost to meal standard FY REO Elevator Condition $50,000 REO Emergency Ughting an d Power System: nsu fficient $4,556 REO Egress Clear $1,000 Total: $55,556 Activity: NH Oak Harbor (N66097) 993 Hospital/Dental Clinic Oak Harbor, WA ADA MeliNA FMO MeliNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO Other Plumbing Systems : Aged Medical Gas Consol $130,523 J REQ Other Plumbing Systems : Weathered Natural Gas P $21,468 REQ Communication and Security: mprove Security Syst $42,511 _L REO Sprinkiers : Aged and Not Code Compliant $113,629 REQ Test Photo $ REQ Exterior Window Condition $400, REQ Grounds Condition $50, REO Parking Lot Condition $245, REQ lighting and Branch Wiring : Occupancy Sensors Ne $84, Total: $1,087,368 Activity: NH Okinawa (N68470) 1460 Kinser Medical Clinic Dispensary (GOJ) Okinawa, JA ADA : MeliNA FMQ MeliNA U.S. Navy Report on nspections of Mlttary Medical Treatment Faciliti es, Apperdix, Page 38 of 57

109 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NH Okinawa (N68470) 1460 Kinser Medical Clinic Dispensary (GOJ) Okinawa, JA ADA: MelNA FMQMellNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-t0756 Distribution Systems: Aged Air Handlers $57,183 REO-7454 Ceiling Rnishes: ACT Stained $82,033 REO-7538 Light and Branch Wiring : Roof Equip GFC Lacking $16,808 REO Wall Finishes: Painted Surfaces Worn $73,302 REO Domestic Water Condition $700, REO-7579 Emergency Ught and Power: Replace ET Signs $12,408 J 2013 REO-6964 Lighting and Branch Wiring : Has T 12 Fluorescent $5 7, REO-7726 Li ght and Br Wire : Exterior Ughting nsufficient $7, Tolal: $1,006, Kinser Dental Clinic (GOJ) Okinawa, JA ADA: MetiNA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-6636 Exterior Windows: Storefront Sealant Weathered $2,971 REO-6656 Exterior Windows: nside Tinted Film Weathered $16,963 Total: $19, Hansen Medical Clinic Okinawa, JA ADA: MetiNA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Ceiling Rnlshes: Aged ACT $17,000 REO nterior Floor Condition $3,500 REO HVAC Condition $65,000 Tolal : $65, Hansen Dental Clinic Okinawa, JA ADA: Met/NA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Exteri or Window Condition $2,000 REQ nterior Wall Leaks $20,000 Total: $22, Schwab MedicaVDental Building Okinawa, JA ADA MetiNA FMQMellNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ nterior Wall Leaks $5, REQ DuclWork Condition $1, REQ Exterior Door Condilion $1, REO Roof Condition $35, REO Exterior Window Condi tion $\,500 J 2011 Total: $44, Courtney Medical Den1al Clinic Okinawa, JA ADA: MetiNA FMOMellNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-7766 Electrical Service: Additional Receptacles Required $28,119 REO-7658 Lighting and Branch Wiring: Various ssues $3,741 1 REO Ceiling Finishes: Aged ACT $100,762 REO Egress Clear $0 u.s. Navy Report on nspections 01 M litary Mooical Treatment Facilities, Apperdix 1 Page 39 of 57

110 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Okinawa (N68470) Navy Medicine West 4231 Courtney Medical Dental Clin ic Okinawa, JA ADA: MetiNA FMQMetfNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ DuctWork Condition $20,000 REQ Roof Condition $50,000 REQ-562t2 nterior Door Condition $5,000 Total: $207, Foster Dental Clinic/Dispensary Okinawa, JA ADA: MetiNA FMQ: MetiNA Action to Meet Standard Cost to meet standard FY 6000 Lester Hosprtal Okinawa, JA ADA : Not Met FM.Q MetiNA Total: Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ-50SS nterior Doors : Aged and Non ADA Compliant Hard $466,110 Total: $466,110 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-8530 nterior Construciton: FRR Doors Not Compliant $17,998 REQ-8034 nterior Doors : Unrated Door Assemblies $9,414 REQ-7437 nterior Doors: Aged at Eit Stairwell $55,183 REQ-6461 nterior Doors: Non-Compliant Eit Access $45,292 REQ Lighting and Branch Wiring: Missing Roof GFC Rae $11,995 REQ-9799 Plumbing Fixtures Rtures Aged and Worn $88,897 j REQ-6806 Sanitary Waste : Leaking Sanitary Cleanouts $8,841 REO-5150 Exterior Windows : Antiquated and Deteriorated $3,393,316 REQ-8007 lighting and Branch Wiring: Non Hospital Grade Re $4,428 Total: $3,635, Futenma Dental Clinic (GOJ) Okinawa, JA ADA: MetiNA FMOMetfNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard REO-t6451 Ceiling Rnishes: Aged ACT $35,148 REQ Wall Finishes: Painted Surfaces W orn $36,250 REO-7668 Exterior Doors: Entry Doors Aged $7,221 Total: $78,619 FY 676 Futenma Medical Clinic (GOJ) Okinawa, JA ADA: MetiNA FMO: MetiNA Facility Operations & Maintenance REQ REQ REQ REQ Action to Meet Standard nterior Wal l Coverings nterior Wall Condition Roof Condition Cost to meet standard FY $2, $6, $30, nterior Wall Leaks $4, Total: $42,000 Activity: NH Twentynine Palms (N35949) u.s. Navy Report on nspec!ions of Mlrtary Medical Treatment Facilitl"'"' Apperdix Page 40 of 57

111 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Twentynine Palms (N35949) Navy Medicine West 1145 Robert E. Bush Naval Hospital 29 Palms, CA ADA: MetiNA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REQ-S622S $1,800,000 Total: $1,800, Branch Heah Clinic China Lake China Lake, CA ADA: MetiNA FMQ: MetiNA Action 10 Meet Standard Cost to maet standard FY 1552 Adu Medical Care Clinic 29 Palms, CA ADA MetiNA FMOMetlNA Total : Action 10 Meet Standard Cost to meet slandard FY P-3005 Branch Heah CliniC Bridgeport Bridgeport, CA ADA MetlNA FMOMetlNA Total: Action to Meet Standard Cost to meel standard FY Total: Activity: NH Yokosuka (N68292) 111 MedicaVDental Clinic wakuni, JA ADA: MetlNA FMO: MetlNA Americans with Disabilities Act Action to Meet Standard Cost to maet standard FY REQ-1B452 Communication and Security: Fire Alarm System Ag $291,889 Total: $291,889 Facility Operations & Maintenance Action 10 Meet Standard Cost to meel standard FY REO-l 0554 Parking Lot: Asphalt Worn $4,708 REO-4203 Domestic Water Supply Equip: No Backflow Prot. $5,159 REO-l0S51 Floor Finishes: VCT Aged $248,049 REO-l0S6S Roofing: Drainage Poor $12,370 REO-S929 Cooling Generation Systems: Pipes Corroded $15,744 REO-4060 Distr Systems: Circulating Water Pumps Corroded $61,519 REO-l0SS0 Floor Finishes: Sheet Goods Wom $6,223 REO-l0617 Exterior Walls: Damaged Wall Finish $16,800 REO-62S2 Communication and Security: Public Address Syste $1 19,952 REO -1 B446 Emergency Ughting and Power System : Aged Exit $8,599 REO-BOlO Distribution Systems: Air now imbalance $76,728 REO-1D428 Wall Finishes: Paint Wom $114,627 REO Communications and Security - Antiquated Nurse C $119,929 REO-6547 HVAC Controls : DDS Not Functioning Properly $4,190 REO-5933 lighting and Branch Wiring: Lack 01 GFC Receptac $3,694 REO-1B477 Lighting and Branch Wiring: Antiquated Fluorescent $254,328 REQ-1OS00 Floor Finishes: Carpet Worn $24,458 REQ-5930 Sprinklers : No Jockey Pump $9,213 REQ-1B447 Emergency Ughting and Power System : Aged Emer $108,252 u.s. Navy Report on nspections of Mlilary Medical Trealment Facilities, Apperdix 1 Page L

112 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NH Yokosuka (N6S292) 111 MedicaVDenlal Clinic wakuni, JA ADA MeliNA FMQ: MelNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REQ-6549 Roof Drains: Clogged $404 Total: $1,214, Hospital Yokosuka, JA ADA: MeliNA FM.Q:MelNA Americans with Disabilities Act REQ-9209 Communications and Security: Rre Alarm System 0 $1,194,208 REQ-8060 Elevators And Us: Elevator Controls Not ADA $86,619 Total: $1,280,827 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Hospital Vacuum Pump: Aged $67, UEPH REQ REQ REQ REQ-6595 Domestic Hot Water Storage Tank: Aged $3,990 Water Coolers: Aged $83, lighting and Brandh Wiring : Rusted Junction Boxes $3,366 Communication and Security: Master Clock System $138,496 REQ Lavatory Exhaust: Aged $111,880 REQ-6591 Communication and Security : Public Address Syste $313, 738 REQ Communications and Security: Antiquated Nurse Ca $284,505 REQ Medical Gas Distribution : Aged $240,932 REQ Equipment: Loading Dock Bumpers Aged $5,963 REQ-6581 lighting and Brandh Wiring: Aged Ught Fixtures $704,556 Total: $1,956,889 Americans with Disabilities Act Action to Meet Standard Cost to maet standard FY Action to Meet Standard Yokosuka, JA ADA MetiNA Cost to maet standard FMOMellNA REQ-9936 nterior Construction: Lacks ADA Sleeping Quarters $43, REQ-8410 Plumbing Fixtures: Non-ADAAG Restrooms $2, REQ-9203 Plumbing Fi xtures: Non Code Compliant $48, REQ-9934 Ext Stairs and FE : Entrance Non-ADA Compliant $11, Total: $104,816 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ lighting and Brandh Wiring: No GFC Restrooms $2,7('19 REQ-9919 Roofing : Damaged Areas $3,497 REQ-92t t lighting and Brandh Wiring: Occupancy Sensors Ne $18, REQ Ext Stairs and FE : Railings Not to Code $7, REQ-9273 Exhaust and Vent Syst: No Building Makeup Air $50, REQ-9925 Exlerior Stairs: Elevation Change not Compliant $18, Total: $101,848 FY 151 Medical Facility Diego Garcia, BlOT ADA MeliNA FMOMellNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REQ Domestic Water Distribution: Hot Water Circulating $1,281 Total : $1, Sasebo Medical Clinic Sasebo, JA ADA MeliNA FMQ: MelNA U.S. Navy Report on nspections of Mlitary Mooical Treatment Facilities, Appendix 1 Page 42 of 57

113 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NH Yokosuka (N68292) 1529 Sasebo Medical Clinic Sasebo, JA ADA: MelNA FMO: MetlNA Americans with Disabilities Act Action to Meat Standard Cost to maet standard FY REQ-1 S769 Communication and Security: Fire Alarm Obsolete $163,137 Total: $163,137 Fadlity Operations & Maintenance Action \0 Maet Standard Cost to maet standard FY REQ-1S78S lighting and Branch Wiring : Antiquated Fluorescent $65,229 REQ-l0538 Parl<ing Lot: Asphalt Worn $1,798 REQ-6096 Cool Gen System : Cooling Tower Basin Corroded $6,755 REQ-6109 Lighting and Branch Wiring: Lack of GFC Recaptac $5,SOl REQ-6228 Exhaust and Vent Syst: Exhaust Fan nadacuate $1,591 REQ-92S0 Exhaust and Vent Syst: Exhaust Adjacent to ntake $2,745 RE:Q-l0414 Wall Finishes: Paint Wom $1,662 REQ Communication and Security: Public Address Syste $29,673 REQ-6220 Cooling Generating Systems : Aged Split System $13, REQ-6552 Heat Pump: Aged $56,747 20tO RE:Q-l0411 Furnishings: Damaged Counters $4,086 REQ Domestic Water Heater Tank: Aged $7,4S7 REQ-6223 Exhaust and Vent Syst: Exhaust Fan nadacuate $12,196 RE:Q-6437 Emergency Lighting and Power System: Aged Exit $5,300 Total: $214, Denal Clinic Diego Garcia, BlOT ADA: MetfNA FMOMetfNA Fadlity Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Curtain Wall System : Rainwater nfiltration $512 RE:Q lighting and Branch Wiring: Exterior HD Lighting R $4,091 REO Roofing: Rippling and Lifting in Modified Bitumen Ro $548 Total: $ Dispensary/Dental Clinic Yokohama, JA ADA MetfNA FMO:MetfNA Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY RE:O-l0614 Controls and nst: Poor Tem perature Controls $30,831 REO-l 0493 Ceiling Rnishes: ACT Damaged $5,980 J REO-6522 General Building Exhaust: Aged $16,151 REO Air Handler: Aged $49,483 REQ-l0339 Pedestrian Paving: Deteriorated $2,734 REQ-1580B Communication and Security: Public Address Syste $29,412 REQ-l0S81 Cooling Gen Systems: Cooling Tower Corroded $3,115 REQ-t6101 Return Air System : Aged $12,998 REQ Electrical Service and Dist : Panel Boards Aged $80,949 REQ-6539 Steam Heated Hot Water Storage Tank : Aged $8, REQ-l0351 Furnishings : Deteriorated Cabinets $12,970 REQ Roof Construction: Damag ed Concrete $10,953 REQ Emergency Lighting and Power System : Ag ed Exit $3, REQ-4545 Sprinklers : Lacking $58, Total : $ J 21 Atsugi Medical Clinic Atsugi, JA ADA : MetlNA FMQ MetfNA u.s. Navy Report on nspections of M"ary Mook:al Treatment F.ciflties, Apperdix 1 Page

114 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Yokosuka (N68292) Navy Medicine West 21 Atsugi Medical Clinic Atsugl, JA ADA: MetfNA FMQ: MetlNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Plumbing Fixtures: Aged and Wom $ t43,682 REO-l 0543 Com munications and Security: Rre Alarm Obsolete $195,249 Total : $338,931 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Water Distribution System : Aged $247,034 REO Boiler Room Piping and Spec: Wom Steam PRV Sy $10,526 REO-l0413 Floor Finishes : VCT Aged $117,337 REO-6465 Electrical Service and Dis!: Distribution Panel Aged $42,666 REO-l 0334 Wall Finishes: Paint Wom $4,3 88 REO-1513B Plumbing Fixtures: Antiquated Janitorial Sinks $21,867 REO Boller Room Pipi ng and Spec: Leaking Condensate $35,783 REO Domestic Wawr Distribution System : Aged $337,060 REO-6511 Lighting and Branch Wiring: Antiquated Fluorescent $104,748 REO-l 0525 Electrical Service and Dis!: Exposed Knife Switch $1,584 REO-6507 Emergency Lighting and Power System: Aged Exi t $11,544 REO Distribution Systems: Air Handler at End of Service $319,937 REO-6506 Lighting and Branch Wiring : Lack of GFC Receptac $2,914 REO-6517 Communication and Security: Public Addre ss Syste $56,332 REO-6459 Eyewash Stations: Aged $2,475 REO-1516B Domestic Water Distribution: Weathered Hose Biblo $10,259 REO-l 0438 Floor Finishes : Carpet Aged and Worn $41,006 REO Rain Water Drainage: Obstructed Drain Covers $9,871 REO-l0533 Parking Lot: Asphalt Worn $9,947 REQ-l0534 Pedestrian Paving: Damaged $3,706 REQ-l0416 Ceiling Rnishes: Ceiling Tiles Aged $13,510 REQ-l036B Roofing : Aged Shingles $9,75B REQ Distribution Systems : Unreliable Condenser Water $60,46B REO-l0357 Exterior Walls : Damaged Wall Finish $B,201 REO-1514B Fire Protection Specialties : Weathered Flammable $1,591 Total: $1,484,312 L 263 Fuji Medical/Dental Clinic Camp Fuji, JA ADA: MetlNA FMQ: MetlNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Drinking Fountains: Do Not Meet ADAAG Standards $4,679 REQ Furnishings : NorrADAAG Counter Height $4,981 Total: $9,660 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-3814 Other Plumbing Systems : Aged Medical Gas Syste $36,216 REQ Plumbing Fixtures: Aged Em ergency Eyewash/Sho $11, 780 REQ-3301 Chiller: Aged $71,233 REO-3574 Communication and Security: Public Address Syste $32,200 REO Fire Extinguishers :Do Not M... t ADAAG Standards $4,190 REO Exam & Treatment Room Plumbing Fixtures: Aged $14,137 REQ Autoclave Exhaus!: nadequate $3,289 REQ Roo r Finishes: VCT Aged $40,057 U.S. Navy Roport on nspections of Mlttary Medical Treatment Facilities, Apperdix 1 Pago 44 of 57

115 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Yokosuka (NS8292) Navy Medicine West 263 Fuji Medical/Dental Clinic Camp Fuji, JA ADA : MetiNA FMQMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Plumbing Fixlures: Aged Laboratory and Surgical Si $45,974 REQ Lighting and Branch Wiring: No GFC Receptacles i $3,398 REQ Sanitary Waste : Roor Drain n Surgical Suite $1,730 L REQ Distribution Systems: Unreliable Circulation Pumps $18,198 20tO REQ-7459 Shell And Tube Heat Exchanger: Aged $33,614 REQ Distribution Systems: nadequate Distribution $288,440 REQ Exterior Doors: Severely Undercut $4,466 REQ Eyewash Stations : Aged and Missing at Mechanical $8,009 REQ-641B Fume Hood Aged $2,838 REQ-3575 Communication and Security: Fire Alarm Obsolete $33,417 REQ Plumbing Fixtures: Aged Development Sink $17,201 REQ Lighting and Branch Wiring: T-12 Ruorescent Fixtur $20,339 REQ-6491 Custodial Sink: Aged $3,023 REQ-6480 Return Air Ductwork: Aged $21,849 L REQ Exterior Windows: Aged $24,464 20tO REQ Floor Finishes: Aged and Stained Carpet Tiles $19,200 REQ Restroom Ventilation: Aged and nadequate $13,809 Total: $771, Branch Medical Clinic Chinhae, ROK ADA MetiNA FMQMetiNA Action to Meet Standard Cost to moot standard FY Total: 5139 MedicaVDental Clinic Sasebo, JA ADA : MetiNA FMQ: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard REQ-6593 Communication and Security: Public Address Syste $25,994 REQ-6234 Lighting and Branch Wiring: Has T-12 Fluorescent F $14,133 REQ Emergency Lighting and Power System: Aged Exit $4,199 1 REO-6548 Floor Finishes : Aged Carpet $19,479 REO-6233 Cooling Generating Sys: Corroded pipes $2,821 REO-l0532 Wall Finishes: Paint Wom $3,144 Total: $69,770 FY 984 Atsugi Medical Clinic Admin Atsugi, JA ADA MetiNA FMO: MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY RE0-59 Communication and Security: Fire Alarm System Ag $53,834 Total: $53,834 Facility Operations & Maintenance Action to Meet Standard Cost to moot standard FY REO-61 Lighting and Branch Wiring: Broken Flex Conduit $2,415 REO-9389 Exterior Doors: Aged and Worn $51, REQ-9172 Wall Finishes: Paint Wom $23,254 REQ-S078 CeiUng Rnlshes : Aged and Wom $21,259 REQ-6040 Term and Pack Units: Radi ators- Aged $14,968 REQ-60 Ughtlng and Branch Wiring: Antiquated nterior and $31,929 U.S. Navy Report on nspections of Miltary Medical Treatment Faciliti.., Apperdix 1 Page 45 of 57

116 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NH Yokosuka (N6B292) Navy Medicine West 984 Atsugi Medical Clinic Admin Atsugi, JA ADA : MetfNA FMO:MetfNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY Total: $145,689 E22 ARSlPrev Med Yokosuka, JA ADA: MetfNA FMO:MetfNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO Lavatory Plumbing Fixtures : Aged $105, Total: $105,231 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO Domeslic Water Distribution: Weathered Hose Bible $10,259 REO Domestic Water Distribution : Aged and Wom $109,835 J REO Electrical Service and Dlst: Panel Boards Aged $179,260 REO-9993 Exterior Walls : Clapboards Deleriorated $15,077 REO nterior Doors: Aged and Wom $14,276 REO-9985 Roor Finishes : Vinyl Flooring Aged $37,193 REO Roofin g: Wesl Wing Roof Delerioraled $75,596 REO Exterior Doors: Aged Metal Door $3,571 REO-9S03 Comm and Sec: Corroded Telephone Junction $2,526 REO-150S6 Plumbing Fixtures: Worn Janitorial Sinks $27, REO Domestic Water Distribution : nefficient Hot Water G $38, Total: $513,202 Activity: NHC Hawaii (N6809B) 1407 Makalapa Navy Heallh Clinic Pearl Harbor, H ADANa! Mel FMOMetfNA Americans with Disabilities Act Action 10 Meet Standard Cost to meet standard FY REQ-5302 Comm and Sec: FA Devices nsufficient $2, REO-6240 Plumbing Fixtures: Non ADAAG Compliant $11, REO-1351 Plumbing Flxlures: Drinking Fountains $31,551 J 2013 REQ Disabled Parking $500,000 J 2014 Total: $546,155 Fadlity Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-6333 Floor Finishes: Aged Carpet $96,074 REQ-5019 Exterior Doors: Paint Deteriorated $2,991 REQ-S097 Wall Finishes : Aged Paint At nterior Walls $34 8,632 REQ-6694 nterior Doors: Refinish Frames $18,991 REO-5168 Electrical Rooms: mproper Storage $2,691 REQ-5293 Ceiling Finishes: Acoustic Aged $401,102 REQ Electrical Service and Distribution : Aged $71, REQ-6421 Sanitary Waste: Piping End of Life $0 REQ-6422 Domestic Water Dist: End of Life $250,021 REO-6682 Floor Finishes : Aged VCT $257,143 REO-6430 Domeslic Water Supply Equpt: Heater End of Life $24,053 REQ-6452 Other Plumbing: Medical Air System $41,664 REQ Distribution Systems: Engineer System for 8aseme $12,464 REO-5331 Comm and Sec: Telecom Wiring Support (NEC) $7, U.S. Navy Report on nspections of M"ary Medical Treatment Facilities,App erdlx 1 Page 46 of 57

117 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NHC Hawaii (N68098) 1407 Makalapa Navy Heallh Clinic Pearl Harbor, H ADA : Nol Mel FMQ: MellNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-6458 Sprinklers: Lacking $337, REQ-4715 Light and Branch Wiring : Occupancy Sensors ns tall $27, REQ-5182 Emergency Systems: Upgrade Exits to LED $5, REQ-4459 Light and Branch Wiring : T-12 Fluorescent $226,282 J 2013 REQ Basement Condition $750, REQ nterior Door Condition $250,000 J 2014 REQ Exterior Window Condition $500, REQ Foundetion Condition $1,000, REQ Rre Door Condilion $750, REQ Parking Lot Condition $1,000, REQ Elerior Door Condilion $87, Total: $6,468, Shipyard Medical Clinic (1750) Pearl Harbor, H ADA: Nol Mel FMO: MellNA Americans with Disabilities Acl Action to Meet Standard Cost 10 meet standard FY REQ Di sabled Parlling $360,000 REQ-6264 Plumbing Fixtures: Sinks Non ADAAG Compliant $655 REQ-6262 Plumbing Fixtures: Drinking Fountains $15, REQ-6248 Plumbing Fi xtures: Non ADAAG Compiiant $8, Total : $385,458 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-6289 Furnishings : Casework Aged $9,015 REQ-6299 Ceiling Finishes: Acoustic Aged $229,090 REQ-6347 Domestic Water Supply Equipment: Heater End 01 L $16,419 REQ-l064 Roofing: Standing Seam s Dirt Stained $14,443 REQ Parlling Lot Condition $360,000 1 REQ Wall Finishes: Aged Paint At nterior Walls $264,547 REQ-6291 Floor Finishes: Aged Carpet $58,11 3 REQ-6494 nterlor Doors: Refinish Frames $18,104 REQ-6346 Distribution Systems: Air Handlers End 01 Lile $436, REQ-6271 Floor Finishes : Aged VCT $232,275 REQ-5083 Comm and Sec: Fire Alarm Obsolete $201,363 1 REQ Electrical Rooms: m oper Storage $2, REQ-<l263 Exhaust and Vent Syst: nsulficient Exhausl $0 REQ Access Road Conditi on $0 REQ Access Control System $449, REQ-5183 Comm and Sec: Telecom Wiring Support (NEC) $25, REQ-4741 Light and Branch Wiring : Occupancy Sensors nstall $22, REQ-5337 Emergency Systems: Upgrade Exits to LED $15, REQ-4457 Light and Branch Wiring : T -12 Fluorescent $ 184, REQ Fire Door Condition $25, Total : $2,564, Navy He ah Clinic Wahiawa, H ADA : MeliNA FMQ: MeVNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY 1 u.s. Navy Report on nspections of Mlnary Moclcal Tr eatment Facitities, Apperdix 1 Page 47 of 57

118 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: 22 NHC Hawaii (N6809B) Navy Heah Clinic Wahiawa, H ADA: MetiNA FMQMetiNA Americans with Disabilities Act Action to Meet Standard Cost to moot standard FY REO-6400 Plumbing Fixtures: Aged and Worn $98,808 REO-6506 Pedestrian Paving: Non-Code Compiiant Steps $8,959 REQ-6302 Plumbing Fixtures: Non ADA Drinking Fountains $10,455 Total: $118,222 Facility Operations & Maintenance Action to Meet Standard Cost to moot standard FY REQ nterior Construction: Non-Code Compliant Corridor $26,325 REQ-3332 Distribution Systems: nadequate Supply Air $23,516 REQ-5328 Light and Branch Wiring : Exterior Ught Aged $3,417 REQ-4527 Sprinklers : ncomplete Coverage $ REQ Domestic Water Supply Equipment: Pressure Relief $2,411 J REQ-3148 Exhaust and Vent Systems: Worn Exhaust Fans $ REQ Roofing: Unsafe Exterior Ladder $4.954 J REQ Electrical Service and Distribution: Aged $ REQ Controls and nstrumentation: Refrigerant Leak Dete $24,279 REQ Fi re Protection Specialities: mproper Fire Extinguls $5,743 REQ-4565 Cooling Generation Systems: Unrelicl:Jle Operation $ J REQ Other Plumbing Systems: Aged Desiccant Filter $9,257 REQ Plumbing FL,tures: Worn Laboratory and Surgical Si $28,425 REQ nterior Construction: Configuration $96, REQ-6497 Ceiling Rnishes : Aged Acoustic Panels $ REQ Other Plumbing Systems: Mercury Recovery Not ns $ REQ Distribution Systems: Worn Piping $ REQ-6304 Emergency Ughting and Power: Emergency Lights $15,285 REQ-6630 Exterior Windows : Aged Wood Syslem $ REO-6579 Parking Lots : Replace Wearing Course $39,151 REO-6446 Roofing : Damaged Built-Up System $99,253 REO-6405 Domestic Water Distribution: Aged and Leaking $25,434 REO-6399 Sanitary Waste : Deteriorating Piping $ J REQ Emergency Power Condition $300, REQ Exterior Wall Condition $250, REO nterior Floor Condition $250, REO-5194 Electrical Service and Distribution: mproper Storag $ REQ Lighting and Branch Wiring: Occupancy Sensors ns $18, Total: $1,649, KANEOHE BAY MEDCAUDENTAL CLiN Kaneohe Bay, H ADA : Not Met FMO: MetiNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-6260 Plumbing Fi xtures : Sinks Non ADAAG Compliant $1,311 REO-6580 Elevators and Urts : Aged an d Worn Hydraulic Eleva $246, REO Disabled Pariking $200, REO Di sabled Acoess $200,000 J 2013 REO-6259 Plumbing Fixtures : Non ADAAG Compliant $11, Total: $659,999 Facility Operations & Maintenance Action 10 Meet Standard Cost to meet standard FY nterior Doors: Refinish Frames REQ-6320 $10,083 u.s. Navy Report on nspections 01 MTaty Medlcat Treatment Facilities. Apperdix, Page

119 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NHC Hawaii (N68098) 3089 KANEOHE BAY MEDCAUDENTAL CLiN Kaneohe Bay, H ADA: Not Met FMQ:MetJNA Facility Operations & Maintenance Action to Meet Standard Cost to m88t standard FY REQ-5264 Light and Branch Wiring. Exterior Ught Aged $10,699 REQ-5058 Comm and Sec: Rre Alarm Obsolete $107,494 J REQ-6431 Exterior Doors: Paint Deteriorated $2,99t REQ-6256 Rain Water Drainage: nsufficient on Second Roor $2,505 REQ-6341 Ceiling Rnlshes : Acoustic Aged $151,358 REQ-6315 Floor Finishes: Aged VCT $199,600 REQ-6297 Wall Finishes: Aged Paint At nterior Walls $230,700 REQ-6293 Floor Finishes : Aged Carpet $98,175 J REQ-6295 Exlerior Windows: Aged Aluminum System $767,258 REQ RooHng : Single Ply Membrane End of Life $29,952 REQ-6252 Plumbng Fixtures: Drinking Fountains Deteriorated $19,852 REQ-6306 Exteri or Walls: Aged Rnlshas and Deteriorated $37,503 REQ Roofing: Leaking Pre-Engineered Metal Standing Se $1,117,818 REQ Exterior Wall Condition $245, REQ Exterior Window Condition $98, REQ Sidewalk Condition $78, REQ Stair Condition $278, REQ Handrail Condition $145, REQ nterior Wall Leaks $1,000, REQ-S6251 Parking Lot Condition $700, REQ-4563 Light and Branch Wiring: Occupancy Sensors ns tall $13, REQ-S322 Emerg Ught and Pwr Sys : Upgrade Exits to LED $15,074 J 2013 REQ-4S86 Light and Branch Wiring : T -12 Fluorescent $143, REO-5231 Comm and Sec: Telecom Wiring Support (N EC) $21, Tola : $5,5 23,353 Activity: NMC San Diego (N00259) Hospital San Diego, CA ADA: MetJNA FMO: MetJNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ-1280 Plumbng Fixtures: Drinking Fountains Deteriorated $99,031 REQ-2207 Plumbng Fixtures: nsufficient Restrooms $226,095 Total : $315,126 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-1S Other Plumbng Systems: Aged Dental Vacuum Pu $58,341 1 REQ-1894 nterior Doors: Label, Frame, Hardware, GAP Failur $577,119 REO ER HVAC System $1,369,872 J REO-2340 nterior Doors: FRP Doors Not Compliant $504,889 REQ-2350 Disribution Systems : Ventilation Lacking in T Closet $290,426 REO Lighting and Branch Wiring: Various ssues $16,338 REO Floor Finishes Trip Hazard at GH-38F3 Doorway $265 REO Emergency Ught and Power System s: nsufficient E $73,569 REQ Fire Pumps Do Not Meet NFPA Flow Test Requirem $264,588 REO Communication and Security: Security System Lack $11,085 REO-5059S ER nterior Wall Systems $1,835,190 REO-16S85 ER Utilities for Temp. Modular Facilities - Minor Con $88,790 U.S. Navy Report on nspections of Mloary Medicat Treatment Facilities. Apperdix 1 Pe490f 57

120 A. Detailed Military Departments' MTF Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NMC San Diego (N00259) Hospital San Diego, CA ADA MetiNA FMOMetlNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO ER Electric Power and Lighting $2,058,376 J REO Leaking Water Closets $338,135 REO nterior Door Condition $900,000 J REO Distribution Systems: Reported AC Problems in Pat $11, REO ER Plumbing System $1,483,802 REO Controls and nstrumentation: Aged Pneumatics $11,508 20tO REO-9003 Windows: 1st Floor R-Block $48,437 REO-169G8 Wall Finishes. Large Hole in Wall $946 REO ER Structural Siaib Repair $112, 140 REO ER Exterior Closure $34,204 REO ER Communications, Securi ty and Alarm Systems $4B6,234 REO Lighting and Branch Wiring: Emerg. Room Rxture $305,604 REO Floor Finishes : Holes in Composition Flooring $3,897 REO Mental Health 1 N Mechanical/Plumbing Repairs $141,223 REO-2565 Ceiling Rnishes: Acoustic Spline System Aged $9,854,552 20tO REO ER Rre Protection System $219,9B7 REO HVAC Condition $3,000, REO Domestic Water Condition $300, REO-563G6 HVAC Acceptable $2,000, REO-533B8 Domeslic Water Distrirution : NOP solation Valves $250, REO Renovate Mycology Suite $268,21B 2011 REO-5636B Electrical System Condition $1,BOO,OOO 2011 REO-5352 B Electric Service & Dlstrirution $1,5B9, REO Remove & Replace Spline Ceiling $ REO Maln Operating Room Floors and Paint Aged & in N $250, Total: $30,559, Dental Clinic San Diego, CA ADA MetlNA FMO MetiNA Americans with Disaibilities Act Action to Meet Standard Cost to meet standard FY REO Plumbing Fixtures: Aged and Non Accessible Drinki $3,158 REO Exterior Doors: Entry Doors Not Accessible, Aged $13,9B2 Total: $17,140 Facility Operations & Mai ntenance Action to Meet Standard Cost to meet standard FY REO-4397 Distributi on Syslems: Aged Air Handling Unit $36,229 REO Floor Finishes: Aged Carpet Doctor's Offices $4,450 REO Distribution Systems: Aged Rooop Exhaust Fan $6,880 REO-l01S1 Heat Generating Systems: Aged H HW Expansion T $2,334 REO 175B3 VCT Floors Aged and Wom $42,595 j REO Plumbing Fixtures: Aged Head Rxtures $14,255 REO llb77 Exterior Doors: Damaged, Deteriorated - Loading 0 $13, REO Lighting and Branch Wiring: Aged Ughting and Circ $30,923 REO-l0092 Domestic Water Distribution: No nspection Tag $637 REO Roof: End of Useful Ufe $3 1,54B REO 1159B Heat Generating Systems: Dam aged Pipe nsulation $1,570 REO nterior Construction: Firewall Lacking n Electrical $5,921 REO Electrical Service and Distrirution : Aged Service an $126,030 U.S. Navy Report on nspections of Mlrtary Moo".1 Treatment Facilities, Appenclx 1 Page 50 of 57

121 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC San Diego (N00259) Navy Medicine West 10 Dental Clinic San Diego, CA ADA MetlNA FMO:MetlNA Facili1 Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Plumbing Rxtures: Antiquated Sink $2,442 j REO-8303 Communications and Security: Rre Alarm Obsolete $30,259 REO Emergency Power Load $12, REO Facility Sprinklered $125, REQ nterior Door Condition $92, REO Emergency Power Condition $12, REQ Fire Door Condition $25,000 20t 1 Total: $615,137 2 South Clinic San Diego, CA ADA: MetlNA FMOMetlNA Amelicans with Disabilities Act Action to Meet Standard Cost to meet standard FY REO-1470 Plumbing Rxtures : Sinks Piping Not Protected $2,531 REO-1382 Plumbing Fixtures: Drinking Fountains Deteliorated $21,332 Total: $23,863 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO REQ-t201 HVAC Support for existing T nfrastructure $t72,213 nterior Doors: Plastic Larrinate Chipped $42,186 J REO-991 nterior Doors: Refinish Frames $6,208 REQ-t7746 Exhaust and Vent System : Stained DuctworklDiffus $43,025 20tO REO Unprotected Penetrations in Fire and Smoke Barrier $107,594 j 20tO REQ Uninterruptible Power Supply System $304,121 REO-1396 Floor Finishes : Aged VCT $331,213 REO-12tt Light and Branch Wiring : Exterior and Roof Outlets $8 12 REQ-2214 Exterior Doors: Aged Storefront $99,029 REQ-2445 Ceiling Rnishes: Acoustic Spline System Aged $1,338,024 REO Electrical Service and Distribution $273,269 20tl Total: $2,717, Health Clinic Miramar, CA ADA : MetlNA FMO: MetlNA Fadlity Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ Electrical S9Vice and Distribution : Switchboards Ag $160,933 REQ Floor Finishes : Aged VCT $127,472 REQ-8269 Other Electrical Systems: No Exit Sign For Egress $3,153 REO-4351 Exterior Walls : Masonry Cracks - North West Comer $25,184 REO-4347 Pedestrian Paving: Walkways settled and cracked $21,366 REO-8274 Lighting and Branch Wiring: Antiquated Mech. Rm. $7,785 REO HVAC Condition $1,200, Total: $1,545, Medical Clinic Miramar, CA ADA : MetlNA FMO : MetlNA Amelicans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ-8850 Communications and Security: nsufficient FA Audi $1,702 Total : $1,702 Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY U.S. Navy Report on tnspectlons of Mlitary Medicat Traalment Facilities, Apperdix 1 Page 51 of 57

122 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NMC San Diego (N00259) 2496 Medical Clinic Miramar, CA ADA MetlNA FMQ. MeliNA Facility Operations & Maintenance Action to Meet Standard Cost to meat standard FY REO-9320 Plumbing Rxtures: No Eyewash Station in Pharmac $6, 174 REO nterior Doors : Exit and Smoke Doors Non-Conformi $281,485 REO-8852 Lighting and Branch Wiring : Receptades Not Groun $457 Total : $288,096 3 North Clinic San Diego, CA ADA: MeliNA FMQMellNA Americans with Disabilities Acl Ac tion 10 Meel Standard COS to meal slandard FY REO-l021 Plumbing Fixlures: Drinking Fountains Delerioraled $21,332 REO-225 Plumbing Fi.<1ures: Non ADAAG Complianl $17,994 Total: $39,J26 Facility Operalions & Main tenance Action 10 Meel Standard Cosllo meal standard FY REO General Surgery nlerior Conslruction $439,775 REO-4572 Lighl and Branch Wiring : Exterior and Roof Oullets $812 REO General Surgery Plumbing $686,525 REO-S0726 General Surgery Roof Opening & Supporls $4,694 REO General Surgery nterior Finishes $376,950 REO Windows : 1st Floor M-Block $58,342 REO lighting and Branch Wiring: Non GFC Receptades $130 REO General Surgery Fire Protection $72,275 REO-S0753 General Surgery / Eleclrical Syslems & Communic $779,800 REO General Surgery Floor Resloration $47,425 REO-972 Exlerior Walls: Replace Expansion Joints $26,795 REO-807 Ceiling Rnlshes : Acoustic Spline System Aged $1,428,862 J REO -86 Exhaust and Venl System : Stained Ductwork/Diffus $44,722 REO-4622 Electrical Service and Distribution : Access to Panel $3,078 REO-l 083 Floor Finishes : Aged VCT $321,187 REQ General Surgery Electric Power and lighting $499,100 REQ General Surgery HVAC $592,725 REQ Electrical Service and Distribution $247, Total: $5,630, Dental Clinic San Diego, C A ADA: MetlNA FMQNot Mel Americans with Disabilities Act Action to Meet Standard Cos to meal standard FY REO Plumbing Fi.<1ures : Aged and Non Accessible Drinki $9,843 REQ Plumbing Fixtures: Aged Locker Room RxlUres $1 18, 149 Total: $127,992 Facility Operations & Maintenance Action 10 Meet Siandard Cosllo meal standard FY REO nterior Constructi on: HPPA Regs - Design of Octa $16,670 REQ Other Electrical Systems: nsuffident Exit Signs $7,074 REQ Controls & nstrumentation: Aged Controls $449,020 REO Distribution Systems: Aged Utility Fans $39,061 REO Distribution Sys tems: Damaged nsulalion on AHU $13,371 REO Di stri bution Systems : nadequate Seismic $7,898 REO Plumbing Fixtures: Aged Utility Sink $19,231 REQ Emergency Power Load $25,744 u.s. Navy Report on nspections of Mrnary Medical Tr eatment Facilities, Appendix 1 Page 52 of 57 1

123 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC San Diego (N00259) Navy Medicine West 3230 Dental Clinic San Diego, CA ADA MetlNA FMQ.Not Met Facility Operations & Maintenance AcUon to Meet Standard Cost to maet standard FY REO n terior Finishes: Aged/Deteriorated Paint $294,009 REO Furnishings: Casework Aged $617,342 J REO Lighting and Branch Wiring: Aged Circuitry $194,534 REO Floor Finishes: VCT and Sheet Vinyl Damage $657,534 REO 7183 HVAC Repair Water Chiller $649,128 REQ Ught and Branch Wiring : Exterior and Rool Outlets $954 REQ Electrica Service and Distribution : Aged Service an $499,000 REQ Lighting and Branch Wiring: Ughting Equip. Ughting $288,554 REQ Emergency Power Condition $2,972 REQ Ceiling Finishes: Aged and Deteriorated Spline $485,429 REQ Elevators & Lilts : Aged Hydraulic Elevators $371,269 REQ Rool Construction : No Fall Protection $26,159 RE Q Other Elec Systems : Master Clock Obsolete $31,858 REQ nterior Wall Condition $485,429 REQ Communications and Security: Fire Alarm Obsolete $205,929 REQ'8399 Other Electrical Systems: Aged Generator $50,881 REO nlarior Construction : Changerooms Aged, nadequa $275,688 REQ Partitions: ray Rooms Not Shielded $55,846 REQ Exterior Walls : EHorescence, Water Penetration - N $60,950 REQ nterior Wall Coverings $52, REO nterior Door Condition $69,955 J 2011 Total: $5,973, Medical Clinic San Diego, CA ADA: Not Met FMO: MeliNA Facility Operalions & Maintenance Action to Meet Standard Cost to maet standard FY REO 4774 Ughting and Branch Wiring : GFC Receptades Req $4,368 REQ-6457 Domestic Water Distribution : Antiquated Domestic $48,495 REO Bldg 3300 Mech. General Reqmt's Demolition & $1,382,862 REO 2698 Dlstiribution Systems: Aged Deteriorated Exhaust Fa $8, REO 5234 Floor Finishes : Replace VC T $175,854 REO 2898 Sprinklers : Aged $9,086 RE Light and Branch: Duplex Receptade Not GFC Typ $1,462 REO Bldg 3300 Energy Management Control Systems $247,706 REO Bldg 3300 HVAC Testing and Balance $158,251 RE Keying system, doors $ REO-4776 Sprinklers : Plugged $ REO Ad ded 50 Ton Chiller with Pump CONSTRUCTON $73,318 REO Bldg 3300 HVAC P PNG $156,561 REO 5237 Extenor Doors: Emergency Doors Not Automated $18,833 RE Lighting and Branch Wiring : Antiquated Basement L $8,260 REO 4950 Plumbing Fixtures: Eyewash Stations Do Not Compj $2,488 REO-4913 Distribution Systems: Aged Air Handling Units $362,261 REO Communications and Security: Aged PA Sys tem $123,452 REO 720t Distribution Systems: Anquated Steam Piping $154,877 REQ-4896 Electrical Service and Distribution : Disconnect Switc $4,354 REQ Bldg 3300 Repair ceiling and interior architectural lin $297,297 REQ-4891 Communications and Security: Aged Fire Alarm Sys $129,032 u.s. Navy Report on nspections of Mlitary Mooical Tfeatmmt Facilities, Appendix 1 Pogo 53 of 57 J J J J

124 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC San Diego (N00259) Navy Medicine West 3300 Medical Clinic San Diego, CA ADA : Not Met FMD: MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-5189 Floor Finishes: Aged Carpet $133,778 REO nterior Signage Condition $25,000 Total : $3,535, Health Clinic San Diego, CA ADA Not Met FMD MetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO REO REO-4697 REO-S0567 REO REO-5339 REO REO-S05S7 REO REO-180n REO-7398 REO-7243 Communications and Security: Aged PA System Bldg 506 HVAC & Mech Systems $23,310 $491,527 20tO Ceiling: AC T (panels only) Damaged $116,068 J Roofing built-up $261,359 Fire Sprinkler System Wet Pipe $164, nterior Doors: Aged/Operational ssues $34,218 Electrical Service and Distribution : Aged Service an Repaint Parking Spaces Other Electrical Systems: Aged Emergency Ughts Communications and Security: Fire Alarm Obsolete $162,144 $0 $3,392 $62,298 Ext Stairs and FE : Deteriorated at Mechanical Shelt $2,687 Floor Finishes: Aged VCT, Carpet & Tile $167,758 REO-5208 Exterior Stairs and FE : Non-Ccmpliant Handrails at $5,909 REO Plumbing Fixtures: Broken Aged Service Janitor Sin $5,310 REQ Other Electrical Systems: Aged Generator $59,247 REO Bldg 506 Air Handl er $163, REO nterior Painting, Cabinets & Countartops $238, REO Lighting: nterior lighting restoration $82, Total : $2,044, Medical Clinic E Centro, CA ADA : MetiNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY RE Roof Condition $300,000 REO Exterior Window Condition $80,000 Total: $360, Dental Clinic San Diego, CA ADA MetiNA FMOMetiNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO-8976 Electrical Service and Distribution: Aged Service an $162,144 REO Ex terior Windows : Aged, Single Pane Metal Frame $22,865 REO Communications and Security: Fire Ala rm Obsolete $71, REO-8330 Electrical Service and Distribution: mproper Storag $1,568 REO Plumbing Fixtures: Broken Aged Janitor Sink $3,540 REO Fire Door Condition $92, REO nterior Floor Condition $15, REO nterior Doo r Condition $4, REO Roof Condition $515, Total: $889,036 u.s. Navy Report on nspections of MlnOfY Mod"al Treatment Facilities, Appendix 1 Page 54 of 57

125 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC San Diego (N00259) Navy Medicine West 596 Medical Clinic San Diego, CA ADA : MetJNA FMQ:MetJNA Americans with Disabilities Act Action to Meet Standard Cost to maet standard FY RE Plumbing Fixtures: Aged $2 10,824 Total : $210,824 Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REO-4854 Lighting and Branch Wiring: Duplex Receptacle Not $548 REO-4725 Plumbing Fixtures: Non-Compliant Emergency Eye $3,084 REO-4752 Electrical Service and Distribution : Antiquated Systa $116,748 REO-4850 Floor Finishes : Aged Carpet $32,252 REO-4920 nlerior Doors: Damaged and Wom $104,566 REQ Electrical Service and Distribution: nsufficient Switc $20,746 REO-4879 Floor Finishes : Aged/Deteriorated Ceramic Tile $52,498 REO-4898 Communications and Security: Aged Fire Alarm Sys $139,812 REO Exterior Walls: Damaged Metal Window Sill and Ja $10,546 1 REO-4821 Electrical Service and Distribution : mproper Storag $1,686 REO Ceiling Rnishes: Acoustic Tile Damaged $336,123 REO Parking Lot Condition $435, REO Roof Dralnage $500, Total : $1,753,609 J 6 Light-Care Rehabilitation San Diego, CA ADA: MetJNA FMQMetJNA Americans with Disabilities Act Action to Meet Standard Cost 10 meet standard FY REO Communications and Security : Aged Fire System $277,176 Total: $277,176 Facility Operations & Maintenance Action to Meet Standard Cost to maet standard FY REO-367 Ughting and Branch Wiring: Duplex Receptacles No $1,018 REQ-934 nterior Doors: Refinish Frames $7,351 REO Distribution System : Aged Deteriorating Hot Water $70,505 REO Distribution and Vent System : Stained Ductwork/Diff $36,458 REO-7224 Wall Finishes : Sharp Corner at Base of nterior Stai $844 REO Electrical Service and Distribution : mproper Storag $ 1,497 REO-580 Exhaust and Vent System: Exhaust Fans Aged $12,260 REO-672 Emergency Ught and: Exit Sign Required For Egres $2, REO-9t7 Exteri or Doors: Non-Compliant Exit Doors $9,280 REQ-2t56 Ceiling Rnishes: ACT Damaged $19,379 REO-2119 Distribution Systems: Condensate Pump Aged $10,678 20tO REO nd fl bldg 6 Rre Protection System $48, REQ nd nelectric Power & Lighting Systems $186, REQ nd nhvac System $556, REQ nd Exterior Closure $26,460 J 2011 REQ nd Electrical Systems $228, REO nd fl bldg 6 Spadlity Plumbing $243, REQ nd nterior Fini shes $189,735 20tl REQ nterior Floor Condition $1,300, REQ nd fllnterior Construction $138, Total : $3,089,248 U.S. Navy Report on nspections of Mlttary MOOical Treatment Facilities, Appendix 1 Page

126 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Activity: NMC San Diego (N00259) Navy Medicine West 600 Dental Clinic San Diego, CA ADA MetlNA FMQMetlNA Americans with Disabilities Act Acon to Meet Standard Cost to meet standard FY REO Plumbing Fixtures : Aged and Non Accessible Drinki $4,927 REO 785 ntenor Construcllon: Change rooms Aged, nadequ $232,220 Total: $237,147 Fadlity Operations & Maintenance Action to Meet Standard Cost to meet standard FY REO 1 t849 Domestic Water Distribution : Aged Water So ftener $6,651 REO Other Electrical Systems: nsuflident Exil Signs $7,074 REO nterior Construction: HPPA Regs Design of Octa $7,600 REO Lighting and Branch Wiring : Aged Circuitry $58,962 L REQ Communications and Security: Aged P.A. System $22,345 20tO REO l t921 Domestic Water Distribution : No n spection Tags $637 REO l t778 Roof Openings: Skylight Deteriorated, Damaged $10,013 REO l t776 nterior Doors: Exit and Smoke Doors Non Conformi $34,780 REO l t628 Light and Branch Wiring : Exterior and Roof Outlets $5,264 1 REO Communications and Security: Fire Alarm Obsolete $62,298 REO Other Electrical Systems: Fixtures Not dentified $29,150 J REO Eleclricai Service and Distribution: Aged Service an $189,399 REO Lighting and Branch Wiring: Aged Exterior Fixtures $16,831 J REO Plumbing Fixtures: Aged Locker Room Fixtures $30,410 REO Plumbing Fixtures: Antiquated Mop Sink $3,210 REQ 777 Partitions : ray Room Not Shielded $15,896 REO 779 Roofing : EPDM Aged Typical $167,349 REO F loor Finishes : Deteriorated VAT $197,255 REO Floor Finishes: Aged Carpet Doctor'S Offlces $26,265 J REO Exterior Window Condition $65,000 20t 1 REO Exterior Door Condition $25, REQ HVAC Acceptable $315,091 20t 1 REO Par1<ing Lot Condition $220, Total: $1,536, Medical Clinic Coronado, CA ADA MetlNA FMOMetlNA Fadlity Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-4758 Exterior Walls : Damaged Metal Panels $15,962 REO 8576 Roof Construction: No Fall Protection $7,707 REO-4763 Exlenor Doors: Deterloraled $3,164 REO-4693 Exterior Walls : Aged Finish and Deteriorated $2,534 REO 5128 lighting and Branch Wiring: Rooftop Oudets Leckin $2, 704 REQ-4714 Roofing: Rashing Deteriorated $15,564 REO 7464 Distribution Systems : Aged Circulating Pumps $6,183 REQ Communications and Security: Aged Non Addressa $41,049 REQ 5099 Distribution System : Deteriorated nsulation $6,741 REQ-4759 Floor Finishes : Stained Carpet $58,787 REO Exterior Door Condition $125, REQ Par1<ing Lot Condition $273, REQ Roof Condition $978, REO Fire Door Condition $210, REO Exterior Window Condition $76, U.S. Navy Report on nspections of "'trtmy Medicat Treatment Facilities. Apperdix 1 Page J

127 A. Detailed Military Departments' MTF nspection Reports --2. TAB NAVY (continued) MTF Report Summary Region: Navy Medicine West Activity: NMC San Diego (N00259) 601 Medical Clinic Coronado, CA ADA : MeUNA FMOMeUNA Facility Operations & Maintenance Action to Meet Standard Cost 10 meet standard FY Total: $1,822, Medical Clinic, Clemente sland, CA ADA: MeUNA FMO MeUNA Americans with Disabilities Act Action to Meet Standard Cost to meet standard FY REQ-7391 Fittings: Signage Not Braille $848 REQ-4755 nterior Doors: Lack ADA Compliant Hardware $2,801 REQ-7328 Communication and Sec: Occupant Waming Device $4,547 Total: $8,196 Facility Operations & Maintenance Action to Meet Standard Cost 10 meet standard FY REQ-4756 Roofing: Aged Built-Up to EPDM $81,319 Total: $81, Medical Clinic San Diego, CA ADA MeUNA FMOMeUNA Facility Operations & Maintenance Action to Meet Standard Cost to meet standard FY REQ-4833 Floor Finishes : Deteriorated Carpet $136,121 REQ-S0548 Supplimental Air Conditioning: Opthalmology Laser $25,438 REQ-876 Lighting and Branch Wiri ng: Receptacles Not Groun $3,046 REQ-848 Electrical Service and Distribution : Motor Starters Ar $27,361 REQ-4547 nterior Doors: Non-Compliant at Mechanical Room $1,661 REQ-798 Emergency Ught and Power: Obstructed Exit Signs $1,358 REQ-7227 Distribution Systems: Stained DuctwoM<lDiffusers $56,037 REQ-797 Other Electrical Systems: No Exit Sign For Egress $3,011 REQ-878 Lighting and Branch Wiring : Receptacles Are not G $2, REQ-S0549 Pnuematic HVAC Control System $900,164 REQ-796 Communications and Securi ty : Rre Alarm Pull Stati $ 1, REQ-676 Electrical Service and Distribution : nsufficient Powe $4,951 REQ Electrical Service and Distribution: Backup electrical $161,407 REQ-5S050 Replace Roof $376,597 REQ GWB Walls : Open Penetration $291 REQ Exterior Doors: Deteriorated Rnishes $2,557 REQ-4937 nterior Doors: Refinish Frames $12,038 REQ-354 Electrical Service and Distribulion : mproper Closure $387 REQ-4852 Ceiling Rnishes: ACT (panels only) Damaged $282,505 REQ Site Devefopment: Pave Parking Lot $ Total: $1,979,195 u.s. Navy Report on nspections of Mlrtary MOO". i Treatment Facilities, Apper<lix 1 Page

128 D STATE COMPONENT: NAVY...,. FACLTY BLDG # BLDG NAME BLDG ADA OPERATON AND MANTENANCE TOTAL COST REF. TO CORRECT NOTES DEFCENCY DEFCENCY,"'0 == Q. s: 5:...,.,. N"'...,....,9 >g t= Z >s: - r') - o..., s."'... = ==...,. -==...,. t!) 9 Q. r') E... '" == "'0 r') =: o == "'0 o...,. "' '"

129 A COMPONENT: NAVY MEDCAL TREAlMENT FACLllES (MTF) TOTAL COST BLDG BLDG REF. D STATE FACLTY BLDG NAME ADA OPERAnON AND MANTENANCE TO CORRECT # FUNcnON NOTES DEFCENCY MET NOT COST TO MET NOT CATEGORY COST TO... MET CORRECT MET OF REPARS CORRECT t:: DEFCENCY (1 THRU4) DEFCENCY Q,. 26 MD NNMC Bethesda 5 Administrative Building 5 F MD NNMC Bethesda 7 MedicalA-iospdal B.. 24, , ,456,378,, 28 MD NNMC Bethesda 8 Hospdal B 1,2,3 6,184,269 6,184,269 N MD NNMC Bethesda 9 Hospital (Service Block of Repl B 1,2.3 23, ,413,083 Hospital) SC SC NH Beaufort NH Beaufort 1 Hospital 598 Dispensary and Dental Clinic - MCAS B ,2,3 1.2,3 11, ,799, SC NH Beaufort 670 Medical Clinic - Parris sland E 2,3 251, > 33 SC NH Beaufort 674 Dental Clinic Parris sland 0 216,454 1,2,3 1,958, NC NH Cam p Lejeune 15 Mainside Denial Medical Clinic E NC NH Camp Lejeune 326 Substance Abuse Rehab Program E -= r':) NC NH Camp Lejeune 460 Hadnot Point Dental Clinic D 1.2, ,933 o '" = 37 NC NH Camp Lejeune 65 Occupational and Preventative E ::t Medicine = NC NH Camp Lejeune AS100 Medical Denial Clinic New River E 1, ,959 ; 39 NC NH Camp Lejeune BB118 Courthouse Bay Medical Dental Clinic E 3 36, NC NH Cam p Lejeune FC308 French Creek MedlcailUental Clinic E 1,2,3 270, ,148 "t: '" 41 NC NH Camp Lejeune G770 Geiger MedicailUental Clinic E r':) 42 NC NH Camp Lejeune H Sports Medicine and Dental Clinic E ,500 ::t 43 NC NH Camp Lejeune M128 Camp Johnson MedicallDental Clinic E 15,919 1, ,023 o 44 NC 45 NC NH Camp Lejeune NH Camp Lejeune NH100 Hospdal TC805 Camp Geiger Smart Clinic B E 1.2, ,593,532 29, , CU NH Guanlanamo Bay 2040 Occ Health and ndustrial Hygiene E , CU NH Guantanamo Bav 276 Gym F , , CU NH Guantanamo Bay H1 Hospital B 27,607 1,2.3 7,443,210 7, > t:;:l "t:..3::... = = n> "t: o :4 '"

130 D STATE FACLTY BLDG # BLDG NAME BLDG FUNCTON ADA OPERATON AND MANTENANCE TOTAL COST REF. TO CORRECT NOTES DEFCENCY t;; n>... e.: n> $:.. a:.... N:=:... > t;:lt;; Z.g > g,-..,n> = o... = "' Sa: = n> =... "0 '" n> o = o a

131 TOTAL COST REF. TO CORRECT NOTES n>... =.: n> Q.., N "......,;j >.g > g,-,n> (') o... = "' ::t. g...,;j n> = -e= "C '" n> (')... c" =.., o... '"

132 COMPONENT: NAVY A MEDCAL TREATMENT FACLTES (MTf) TOTAL COST BLDG BLDG REF. 10 STATE FACLTY BLDG NAME ADA OPERATON AND MANTENANCE TO CORRECT # FUNCTON NOTES DEFCENCY MET NOT COST TO MET NOT CATEGORY COST TO rd MET CORRECT MET OF REPARS CORRECT S DEFCENCY (1 THRU4) DEFCENCY :!: rd 102 ME NHCNE H NACC Portsmouth B 1,3 2, , VA NMC Portsmouth 1806 MedicaiJ1)ental Clinic - Yorldown E 11,469 1,2,3 520, ,451 S: 104 VA NMC Portsmouth 2 Charelle Heanh Care Cenler A 163,020 1,2 22, , VA NMC Portsmouth 277 MedicaiJ1)ental Clinic - NNSY E 477, , , VA NMC Portsmouth 285 MedicaiJ1)ental Clinic - Oceana E 1, , VA NMC Portsmouth 3 Medical Support Fac F 12, , ,521 > 108 VA NMC Portsmouth 3505 Branch Healthcare Clinic - lillie E 1.2 3, , t::e Creek Z.g 109 VA NMC Portsmouth 390 MedlcaiJ1)ental Clinic - Northwest E > 110 VA NMC Portsmouth 504 MedicaiJ1)enlal CliniC - Dam Neck E 111 VA NMC Portsmouth CD2 Medical Clinic - Norfolk E,-...rD ,351 r') == o VA 113 VA 114 FL 115 WA 116 WA 117 WA 118 WA 119 WA NMC Portsmouth NMC Portsmouth NOM Pensacola NH Bremerton NHBremerton NH Bremerton NHBremerton NH Bremerton CD3 CD Denial Clinic - Norfolk Oenlal Support Center - Norfolk Robert E. Mnchell Cenler Naval HospHal Bremerton Family Practice Clinic Medical Dental Clinic OispensarytUenlal Clinic NHB Health and Education Center D D A B E E 0 A "' WA NH Bremerton 940 Medical Clinic E 122 AZ NH Camp Pendleton 1175 HeaHh Clinic Yuma E ,797 o 120 WA NHBremerton 506 Denial Clinic 1 56,478 56,478 rd /':) =: 123 CA NH Camp Pendleton Dental Clinic D 400 1,2,3 143, == 124 CA NH Camp Pendleton Medical Clinic E "'0 125 CA NH Camp Pendleton 1402 Naval Medical Clinic Port Hueneme E o 126 CA NH Camp Pendleton 1591 Branch Dental Clinic 29 Palms E ""! 1: 127 CA NH Camp Pendleton 17 Medical Clinic E ,200 gs: = -3 rd.e == "' '" ==

133 COMPONENT: NAVY A MEDCAL TREATMENT FACLTlES (MTF) > D STATE FACLTY BLDG # BLDG NAME BLDG FUNCT10N ADA OPERAT10N AND MANTENANCE TOTAL COST TO CORRECT DEFCENCY REF. NOTES 1'1>...-,.. MET NOT COST TO MET NOT CATEGORY COST TO MET CORRECT MET OF REPARS CORRECT t:: 1'1> DEFCENCY (1 THRU4) DEFCENCY Q CA NH Camp Pendleton 2Et{)5 Heah Clinic E 85 1,2 40,508 40,593, 129 CA NH Camp Pendleton 22 Medical Clinic Administrative Omces E 1,2,3 168, ,003 N"-; 130 CA NH Camp Pendleton Heah Clinic E. '"'" CA NH Camp Pendleton 3Et{)5 Medical Clinic E 1 41,436 41,436 > 132 CA NH Camp Pendleton 3Et{)5 Dental Clinic D = 133 CA NH Camp Pendleton 3Et{)5 Health Clinic E Z.g 134 CA NH Camp Pendleton 4Et{)5 Heah Clinic E > 135 CA NH Camp Pendleton 4Et{)5 Heah Clinic E 136 CA 137 CA 138 CA 139 CA 140 CA NH Camp Pendleton NH Camp Pendleton NH Camp Pendleton NH Camp Pendleton NH Camp Pendleton 5 Dispensary 5Et{)5 Denial Clinic Et{)5 Medical Clinic Et{)5 HeaHh Clinic SN Medical Clinic 59SN E D E E E 3,618 1,2,4 437, ,24f 1,2 4,412 4, CA NH Camp Pendleton 6Et{)5 HeaHh Clinic E C 1:1 142 CA NH Camp Pendleton 914 Dental Clinic 914 D 1,2 300, ,000 "0'" 143 CA NH Camp Pendleton Hospal B 1'1> () 144 M NH Guam 1 Dental Clinic and Family Services D 1 171, , '"'" o 145 M NH Guam 1 Hospttal B 1,624,524 1,2,3 12,963,287 14,587,811 1:1 146 M NH Guam 6 Medical Clinic E 215, , , CA NH Lemoore 11 Medical HeaHh Clinic E "0 148 NV NH Lemoore 299 Medical HeaHh Clinic E o "' 149 CA NH Lemoore 926 Dental Clinic D 1,2 367, , CA NH Lemoore 937 Naval Hospttal Lemoore B 1,2-55,556 55,55E - '"'",.-...1'1> () 1:1 o '"'" 1:1 "' ::-. --3

134 D STATE FACLTY BLDG # BLDG NAME BLDG FUNCTON ADA OPERATON AND MANTENANCE TOTAL COST REF. TO CORRECT NOTES DEFCENCY METNOT MET CORRECT o DEFCENCY >... c:.: Q. > S" Z., >'-<,.-.. n :l 8 =: =... '" a::.,... o ""0 '"

135 TOTAL COST REF. - ADA OPERATON AND MANTENANCE TO CORRECT NOTES o DEFCENCY COST TO c:: CORRECT C.,. N.., > 0=0 2. > <"' -<9 - n = o= -'" g. =...,..e = "C -n... o = o "' -

136 TOTAL COST REF. ADA OPERATON AND MANTENANCE TO CORRECT NOTES ;;:; 2!.g CODE CATEGORY OF REPARS : > 1 BULDNG SYSTEMS AND ENVELOPES 2 LFE SAFETY AND FRE PROTECnON n>... e: n> Q.. Ṇ e: >,-.n> 3 NTERlMlFUNCnONAL CONDTONS o... = 4 STEJMEDCAL CAMPUS = (} 5 ADA REF NOTES: c 1-3 a [ADD ANY SUPPORnNG NOTES, EPLANAnONS, OR OTHER NFORMAnON AS APPROPRATE] n> "C BULDNG FUNCTON: n> n A MEDCAL TREATMENT-REGONAL MEDCAL CENTER g. B MEDCAL TREATMENT-HOSPTAL ONCLUDES COMMUNTY HOSPTALS) C MEDCAL == RESEARCH o DENTAL CLNC "C E MEDCAL CLNC o F OTHER (SPECFY) a S,e... = (}

137 A. Detailed Military Departments' MTF nspection Reports --3. TAB AR FORCE Executive Swnmary Report on nspections of Military Medical Treatment Facilities Report Organization: Executive Summary Military ServicerrMA Report o Military Medical Treatment Facilities (MTF) (TMA lead) o Military Quarters (OUSD(&EH&CS lead) Military Medical Treatment Facilities All Air Force military treatment facilities have been inspected law the LOA5 approved MTF checklist. The attached table reflects the AF Medical Service funding requirements to fully comply with facility operation standards and the Americans with Disabilities Act. Number of Facilities 182 Americans with Disabilities Act lada) Facility Operations* & Maintenance Component Met Standard Not Met Standard Met Standard Not Met Standard Air Force *ncludes deficiencies found m the followmg categones: BUlldmg Systemsl Envelope, LifelFire Safety, nterior conditions, and Site Conditions Cost to bring inspected facilities to standard: $445K Component Americans with Facility Operations & Disabilities Act (ADA) Maintenance Air Force $445K $0.00 Part 1: Military Medical Treatment Facilities Swnmary of Past nspections - The AF Health Facilities Division and major command medical staff have regularly visited MTFs worldwide to review adequacy ofspace, patient access, and reliability of infrastructure delivery systems. Deficiencies identified though these visits or those identified locally are continually prioritized and remediated as funds become available. The Air Force Surgeon General has consistently supported O&M investment in the AFMS facility inventory Sustainment, Restoration, and Modernization: FY05 $201M, FY06 $325M, FY07 $349M, FY08 $229M, and FY09 $347M. Current nspection ProtocollProcess - Medical Facility Managers at each installation conducted the inspection using the approved checklist. Facility Managers consulted with maintenance source (i.e. Base Civil Engineering or Maintenance Contractor) for each building system inspected. nstallation reports were reviewed by the Health Facilities Division to ensure consistent application of the "Met-Not Met" classification. - 1

138 A. Detailed Military Departments' MTF nspection Reports --3. TAB AR FORCE (continued) Comprehensive ADA compliance is a function of facility age and date of last renovation. n this report we have classified MTFs as "not met" only when gross and obvious access was identified with no attempt to accommodate disabled patients, visitors and staff. Future Plans: A continuous evaluation of incoming Wounded Warriors is conducted to determine immediate requirements to support their needs and to forecast future requirements. The AF Health Facilities Division and major command medical staff will continue to regularly visit MTFs worldwide to review adequacy of space, patient access, and reliability of infrastructure delivery systems. Deficiencies identified though these visits or those identified locally will be continuously prioritized and remediated as funds become available. - 2

139 COM'ONENT: AR FORCE A DCAL TREATNT FACLTES (MTF) D STATE FA OUTY BLDG BLDG NAME BLDG FUi'CTON ADA OPERA TONA\D MANTENANCE TOTAL COST TO CORRECT DEFiCEi'CY (001l) MET NOT cast TO MET NOT CATffiOR'i' COSTTo MET CORRECT MET OF REPARS CORRECT DEFCENCY (1 T-V'lU4) DEFQENCY (50 (5001J) 1 K LTUS AFB 45 ALTUS CUNC $0.000 $0.000 $0.000 ALTUSAFB 45 ALrus DENTAL CLNC $0.000 $0.000 $0.000 ANDERSENAB ANDERSEN OUT AnEN CLNC E $0000 $0.000 $0.000 ANDREWSAFB 1050 MALCOLM GROW MEDCAL CENTER $0.000 $0.000 $0.000 ANDREWSA :.a.l STAGU L $0.000 $odoo $0.000 ANDREWS ArB 1075 ME DCA L CENTER ANNE $ODoo $0.000 $0.000 NDREWSAF M...,N DENTALCUNC D $0.000 $0.000 $ MD ANDREWSAF DENTAL CLNCANNE D $0.000 $0.000 $ r [OK 3 GlJf>.M 4 MD,- MlY 6 MD 7 MD REF. NOTES Sr MEDCA. GROUP '; 1rmn 10 T"LY AVLANO A8 108 UF E SKLLS AND NTERNAL MEDCNE E $0.000 $0.000 $ TALY AVLANQ AB 271 AEROSPACE MEDQNE CUNC E $odoo $0.000 $0.000 s.: 12 TALY "'VLANO AE 1466 PHYSCAL Tf.ERAPY E $0.000 $0.000 $0.000 > 13 la BARKSDALE AF B"-RKSDALE CUNC E $0.000 $0.000 $0.000 UlA 8ARKSDALE AF DENTAL CLNC D $0.000 $0.000 $ la 8ARKSC'.LE AF B 4545 UFE SKLLS SUPPORT CENTER E $0.000 $0.000 $0.000 >0 16 la 8ARKSC'.LE AF B 4548 EVE CUNC E $0.000 (0.000 $ 'll 17lA BARKSC'.LE AF B 4549 FAMLY A[NOC",CY E $0.000 $0.000 $0.000 ;:0"'0 18 CA 8EALE... FB 5700 ALE CUNC E $0.000 $0.000 $ DC 20 CO 0 ;:08 (j 80LUNG...FB OWNOCUNC E $0.000 '1:0.000 $0.000 BUCKLEY AFB TH MEDCAL GROY E $0.000 $0.000 $ "'" CANNONAFB TH MED CAL GROUP CUNC E $ ,5 $0.000 $ Upgrade elev aor cortro ls 22 SC CKRLESTON... FB 364 MEDCAlJDENTAL CLNC E $0.000 $0.000 $0.000 t'!'j 23 MS COLUMBUS AF B 1100 MEDCAL CUNiC E $0.000 $0.000 $ l0l6 COLUMBUS ArB 1004 DENTAL CLNC D $0.000 $ f\l DAVl8-1ONTHN AFB 400 "-MBULATOR'l' HEALTH CARE CUNC E $ , 5 $ f\l DAVl8-MONTHNAFB n39 MENTAL HEAL H CUNC $0.000 $0.000 $ DE DOERAFB H MEDCAL GROY E $0000 $0.000 $ S DE DOVERAFB DENTAL CLNC D $0.000 $0.000 $ DE DOERAFB 263 MENTAL HEALTH E $0000 $0.000 $ T DYESSAFB 9220 MEDCAL CUN C E $0.000 $0.000 $0.000 :Jl (T YESSA 'HY:;JCAL HEf<'\e $0000 $0.000 $0.000 $0.000 g $ Ptlarrra cv..ndoos JYJ1ADA s. 32 CA EDWARDSAFB AEROSPACE MED CNE $0.000 $0.000 $0.000 ::=:. 33CA DWARDSAFB 5513 DENTAL CL NC D $0.000 $0.000 $0.000 Q 34 CA EOWAADSAF FAMLY ADVOCACY E $0.000 $0.000 $ CA =DWARDSAF PHYS CAL THERAPY 3Ji CA EDWARDS AFB $0.000 $0000 $0.000 ;:0 == MENTALHEALTH $0.000 $0.000 $0.000 'll 3 CA EDWARDSAFB 525 ME[CAL CUNC E $0.000 $0.000 $0.000 "'0 38 FL EGUNAFB MEDCAL GROUP B $0.000 $0.000 $0.000 Q 1 39 rrl E GONN8 "' Y. CAL ltha' Y $0.000 $0000 $0.000 :l 40 AK ELSON"'FB H MEDCAL OROY E $0.000 $0.000 $ (BD 8JBWORTHAFB S HM.Dl CALGf<OUP $0.000 $0.000 $0.000 "" 42 AK ELMENDORF AFB (5955 JRDMEDCALGROUP HOSPTAL E $0.000 $0.000 $ WA ARCHLD ArB ND MEDCAL GROUP -$ojjoo $(}:000 $ 'tWA FARCHLD AF DENTAL CLNC D $0.000 $0000 $ \\V FEWARRENAFB 60 MEDCAL CUNC $0.000 $0.000 $0.000 'NA M"CAF H 30 MACA'" H CUNC $0000 $0.000 $0.000 o 'll - =: 'll.c:l. S = 'll c:l."" == '-' "'0 'll n

140 r COM>ONENT: AR FORC E A VEDCAL TREATMENT FACLTES MfFl D STATE FACLTY BLDG BLOO NAME BLDG FUNCTON MET NOT MET ADA OPERATON AND MANTENANCE COST TO MET NOT CATEGORY COSTTO CORRECT MET OF REPARS CO RRE CT DEFCENCY (1THW4) TOTAL COST TO CORRECT DEFCENCY (00 REF. NOTES DECY ($O 47 GE GE LEf<RCl-EN A UTH ASS MED CAL FUGHT E $ $0.000 $ GE GELEf<RCl-EN A8 198 US DENTA LCUNC D $0.000 $0.000 $ T GOODFELLOW AF GOODFELLOW ME DCALJDENTAL CL C E $0.000 $0.000 $ () it GOODfELLOW AFB 1007 MENTAL HEALTH $0000 $0.000 $0.000 t> 51 NO GRANO FORKSAF MEDCAL GROUP CUNC E $0.000 $ $ MA HANSCOM "F TH ME DCAL GROUP E $0000 $0.000 $ MA HANSCOM AF MENTAL HEALTH $0.000 $0.000 $0.000 == t> HCKAM AF8 559 MEDCAL GROUP E $0.000 $0.000 $ Q HCKAM M PHYSCAL THERAPY E $0.000 $0.000 $ HCKAM AF8 MENTAL HEALTHCUNC $0.000 $0.000 $ : UT 58 UT HLLM8 HLLAF8,MEDCAL Cl C oce MEDCAL CLNC E E $0.000 $0.000 $0.000 $0000 $0.000 $ UT HLL "F8 MEN AL HEALTH E $0.000 $0.000 $0.000 BOUT HLLAFB 546 MENT"L HEALTH E $0.000 $0.000 $ fut H LLAF8 547 FAMLY ADVuCACY E $0.000 $0.000 $0.000 >.." Nl! HOLLOMAN M8 14 PR'i'SUL THERAPY $0.000 $0.000 $0.000.g 64 Nl! HOLLOMAN AF8 17 MENTAL HEALTH E $0.000 $0.000 $ HOLLOMAN AFB 20 DENTAL CLN C D $0.000 $0.000 $ ;:;' l/l FL HURLBURT AF MAN CLNC D $0.000 $0.000 $ FL HrnLBrnT MB PHYSCAL THERAPY CLNC D $0.000 $0.000 $0.000 r')t> = 1 68 TURl<FY NC RLKA !lMDGCUNC E $0.000 $0.000 $ J&.PAN KADENAAB MEDCAUDE NTAL CLNC a $ ,3,5 $0.000 $ f> 5L HOLLOMAN A, TH MEDCAL GKUU CUNC E $0000 $0.000 $ J&.PAN 1 ills 72 MS 73 MS 74 fo,j>a 75 KADENAAB KEESLERAF8 :KEE SLERAFB KEESLERAF8 KRTLANDAF8 K1RTLANDAFB MENTAL HEALTH CUN C MEDCAL CENT ER DENTAL CLNC E A 0 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0 000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 $0.000 Replace emerg lights/add strobe ARNOLD HA.LL CLNC 1200 OUTPATENT' FAOLTY OcelA'AT ONL HEALTH SRV S E Q.f> t> ="0 = 76 Nl! K1RTLANDAF DENT"L HEALTH CUNC D $0.000 $0.000 $0000 t> (') 77 KOREA KUNSANAB 405 MAN CLNC E $0.000 $0.000 $ KOREA KUNSANA8 302 UF E SK LLS SUPPORT CENTER E... $0.000 $0.000 $0.000 o 79 T LACKLAND AF B 6418 DUNN DENTAL CLNC D $0.000 $0.000 $ :1 80 T LACKLAND AF RED CLNC $0.000 $0.000 $ T LACKLAND AF OPTOMETRY CLNCMEDCALADMN E $0.000 $0.000 $ T LACKLAND AF WlLF ORO HA.LL MED CAL CENTER fa $0000 $0.000 $ B3T LACKLAND AFB MCKOWN DENTAL CLNC D $0.000 $0.000 $0.000 o 84 AZORES la.es"8 416 lar FORCE CUNC E $0.000 $0.000 $ AZORES la.es AB 588 DENTAL CLNC D $0.000 $0.000 $0.000 a. 8i A LANGLE' AF B 74 AEROSPACE MEDCNE $0.000 $0.000 $ VA LANGLEY Ar8 192 DENTAL CLNC $0.000 $0.000 $ VA LANGLEY AF BETHEL SATELLTE CUNC E $0.000 $0000 $ l9 A :tanclley" ' '-PW -()SPlTAt -18 $0.000 $0000 $ VA LA NClLEY AF8 226 PHYSCAL THERAPY E $0.000 $0.000 $ VA LANGLEV AFB FWCLN C E $0.000 $0.000 $ [T LAUGHUNAF8 375 AL CLNC $0.000 $0.000 $ AR" TLE HOCKAClo MElJ CAL GHUUP $0.000 $0000 $ AR LTTLE RCCKAF8 65 BlOFWRO NMENTAL PHYSCAL E $ $0000 $0.000 THERAPY CA LOS ANClELES AFB Sf MEDCAL GRCU P L--- $0000 _$OOlliL jo.ooo - J > 0-3= t:c -. g 3: al-3 5r

141 A CO M' ONENT: AR FORCE M:DCAL TREATMENT FAcL me sl!! 138 OER [RAMSTEN "'B [301 DENT"'L ajnc $ $0.000 $ o '"'! [ 139 GER [RAM STEN AB. MAN CLNC $0.000 So.oOO SO.OOO [ 1'0 :141 GER [RAMSTEN AB 115 L OGNU ACL $0.000 SO.Ooo $ t<a., tl N"' Y"''-''''L tthp.ey l-linc $0.000 '" So.oOO $ "", ""'" <\ M " NA" 21<1 CLNC... N'>"" E x $0.000 $0.000 $ SEMWCH 144 T RA'oOOLP H...FB 860 UF E SKlliS SUPPOR: CE N'l'E R E """ c E ",.,N""" So.oOO x $0.000 $0.000 $0.000 $UDoO SO.OOO / TORTO D STinE FAC<UTY ELOO; 8 LOO NAME 8LDG ADA OPE RO.T ONAND MA NTE NAN CE FUt>oCT ON DEFCEY RH. NOTES (000) MET NOT C<OSTTO MET NOT CATEGORY COST TO MET C<O RRE CT MET OF REPARS C<ORRECT DEFCEY (1lH'U') DE FC< ENC'f, AL LU<t "''' n u U"N M t 'lolnt c;u NlO $0.000 $0.000 $ "",AL "' "",AL LUKtl\t" lju Lu<C lou..lo $0.000 $0.000 $0.000 LUK,,,,-,, 1 'U MMU"'LAlluN'AL "H'" lol NllO $0.000 $0.000 $ [M L"",. "'" [01< HO-"",,'C8 $0000.o oo $0.000 luu, L ACDLLM B [MAN "'C1" $0.000 $0.000 oooo n> lu 104 MALMSTROM AFB 2040 MEDCAL AC1U $0.000 x $0.000 $0.000 lu<[al," 160 [7RUL "'M"uLA U h H""L lo\ht E $0.000 $0.000 $0.000 n> 103 WA MCCHORO 527 DENT... LaJN C 0 $0.000 $0.000 $ WA MCCHORO 600 MCCHORD MED CAL CUN C E $0.000 SOOOO $0000 e. == 105 KS MCCON'>lE LLAF MEDCAL GROll' E SO.ooo x $0.000 $ : 106 NJ MCGURE Ar MED CAL CLNC E SO.Ooo So.ooo $ J NJ MNOTAFB 194 5TH MEDCAL GROUP E $0.000 $0.000 $0.000 """l= lob Jl.PAN M8AW HO SPT...L 8 $0.000 So.ooo So.ooo ($000) (5000) 109 -"'PAN MSAWA MEDCAL...rnox E x So.ooo x SO.o oo $ G G... MOODY Ar8 MOODY ArB AEROSP...CE MED G1 NE 2300 MEDCAL GROUP E E $0.000 $0.000 $0.000 $0.000 $0.000 $ >'< MTHOME 6000 HOSPT...L B SO.OoO $ $ M' NEWSAF8 340 MEOCALArno E $0.000 $0.000 $0.000.g 11 ' M' NELLSA FB 1300 MKE O'CALLAG Ho\N FEDERAL HOSPTAL 8.. n 11 5 NE OFFUTT 527 AEROMEDCAL SERVCES E $0.000 $0.000 $ NE OFFUTT.000 EHRLNG BERGC U ST CLN C E x $0.000 x $0.000 $ KOREA OSANAE ST MEDCAL GROUP HO SPTAL B $0.000 $0.000 $ FL PATR CK AFB 1361 MAN PHO. RMA CY E $0.000 $0.000 $ FL PATRlCKAFB 1370 MENTAL HEALT-t'TRlCARE E $0.000 $0.000 SO.OOO 120 FL PATRlC1KAFB 1371 DENT... L CLNC E $0.000 $0.000 SO.OOO 121 FL PATRl C1KAFB TH ME CAL GROUP MAN CUNC E x $0.000 $0.000 $ co PETERSON AFB E $0.000 $ PETE EAST PHO.RMCY MEDCAL AN' )( 123 co PETERSON AFB E $ ' co PETERSON MB 959 MEDCAL aj C E $0.000 $0.000 $ POPE AFB 260 DENTAL CLNC 0 $0.000 $0.000 $ POPEAFB RO MEDCAL CL C E $ So.ooo $ POPE AFB. 30 MENTAL HEALTH E SO.OOO $0.000 $ UK RAF "'LCO'llURY 669 RAF ALCONBURY E SO.ooo So.ooO $ UK RAF CROUG HTON 140 RAF CROUGHTON E.oOO x S o.ooo $ UK RAF LAKEN-EATH 922 -«lspt...l ANNE E $0.000 $0.000 SO.OOO 131 UK RAF LAKEN-EATH 926 F U G HT MECN E FAC<UTY E x $ $0.000 $ UK RAF LAKEN-EATH 932 MAN -«lsptal B So.ooO x $0.000 $ UK RAF LAKEN-EATl «lsptal B $ $0.000 SO.OOO 13. UK RAF LAKEN-EATH 944 NTAL 0 $0.0(0 SJ.OOO $(.000 lj5 UK RAF MLlJE N-LL 830 FUGH M.C!NE E $0.000 $0.000 $0 000 $0.000 $0.000 O 3 r')n> tr'js.,-... '" SO.OOO g 3: 136 UK RAF MLDEN-LL '46 DENTAL CL C x So.oOO x $0.000 SO.OOO 137 UK RAF UPWO OD 23 RO.F UPWO 00 C UNC E So.ooo x So.ooO $ "0 145 lj( [RA NJOLPH... FB THMECAL GROUP x So.oOO x $0000 $ s. 5." =... = n> e.'" n> n... o = '-' "0

142 A R FORCE 12/ A 1'0 PJEDCAL i (MTF) BLDG FACUTY BLDG NAMe ADA OPERATONANO MANTENANCE STATE la..oo FUNCTON... 1 [JL 1 L scon AFB 1ffi AEROPl4EDCAL STAGNG FAG :!1; - TOTAL COSl CORREC ""o::fclef\ REF. NOTES 1ft i'e'" AR FORCE tonc l.qqq :;gg PJ=A [!N" "SlCAL 1 l-t: R",PY 1 LF t: '5KLLS CE NTE x $ :4 A. p'ng ElNCDON- A M EDCALT REATMENT--REOONALMEDtCAL CENTER B MEDCAL T REATMENT-HOSPTA L (NCt..UOES COMMUNl1l' -OSPTALS) C MEOCALRESEARCH o DENTAL CUN C E MEDCALC Ut-iC F OTt-ER (SPECtFY) HO line eel! S The A ir Force WoundedWCilTlor (A FW 2) ServiCe/Gail Center s a central ized toll-(ree ptlone nunber ( ) that OlSdedWifTlors, fill'tll les and carepers can call '" ;ny l 1rT1110 gel h efp frcn1 trawled, prctesslonal A FWl Case Managers dl ng the rocofery, rehabll8llon an d re Wll 917atlon protess. Sendee t embers, fles and caregivers can also lhe MET) NOT COSTTO "'ET NOT CATEGORY COSTTO MET CORRECT MET OF REPARS CORRECT CEFCENCY (1 T-t;!U4) DE FlC ENC"'t ($000) ($ 000) $0.00 Oce MEO CLNC DOO MED1CAUOENfAL ajnc x x $ SCO]!AFB 1530 SCO_TT "'EOCA CUNiC - x:.000 sc 15:: acc l-ealth CUNC x.000 sconafs DENrAL CLNC x- x.000 Tf-Kl"'AS KORTZ CLiN c: :K.000 (D 154JNC l6.r;vmqljr,,!qhn O N 2805 KlECKER DENTALCUf\lC 1551SC SHAW "'B 11<145 OELCUNC OJ x 0000 :.:l mlse jshawa;e- - J'll'B rlmlncunc - x x & i 16HAVY AF B r0:51 LAB. --" _"L EN RO\tAENT HEA-LTH V x -$0.000 x $0.000 $0.000 (D DiiiJ :Q.. 1!W QlmrA'ti)CZ;E;g' x DiiiJ SHEPPARD AFB ;w- FUORfSOROEON COl\iC _x :K Q.Q a: 'AB 161 "'SEC CUN' m.l x 100 ialf x.000 s: ialf 1 JOUTPATENT CLNC.000 > Tl '<ER AFB il4ancunc &OD &0.000 t;d:.:l ffl FSCERAFB _ l-ealtc ENTE R idi -D > E F8 TER x O.o,.0-00,"'.... 'NDA LLAi"1l!MENTA.L HEALTH CU NC m3'" TYr::t'iACLh4E DlCAL cunc.0.01[0 x g -OSAFA" rnr:.00' x l.ooo $0.00 :.:l 18610K \lan(;e A FB 1811 VANCE CUN x rnj rOK 7ANCE \FB 1811 MENTAL HEALTH!JlQ (j(d jnlc "'0 509TH MEDCAL GROUP lj :;j 1900H OCClRATlO"",,,L t-ealth CUNC OH OHT-PATTER80N TTY """'NK PRtr.tAC '1920H \/RGHT-PATTERSON 1 (1330 MEDCAL CENTER g a: 193.JAPAN QKOT... AS MAN HOSPTAL.00 x 194 P"'N m.j!q : fo.ooo = 195 JAPAN OKOTAAB Q ME DA,QQ & g. TALS f $ ' 1, <45.1;w:L0 =... (D = '-" "0 (D CATEGORY Of REpARS (") 1 BULDNG SYSTEMS AND EWELOPES... LFE SAFETY At-D o FRE PROT ECTON NTERlMlFLNCTONAL STE/MEDCAL = AOA a (AODANY SUPPORTNG NO TES, EPLANATONS, OR OTHER NFORMATfONAS APPROPRATE! o '"f :;j -= Q..f.>

143 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY Annual nspection of Army Medical Treatment Facilities and Quarters Housing Warriors in Transition 18 December 2009

144 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) 11lis page is left blank 2

145 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) 2009 nspection of Medical Treatment Facilities and Medical Hold Housing Table ofcontents PREFACE The Army Approach to Warrior Care and Transition EECUTVE SUMMARy.... CONCLUSON NTRODUCTON Terms of Reference/Facilities Used to House Personnel Current nspection Protocol/Process Description of Hotline Contacts Pertaining to Housing Facilities nspection Reports " 12 Historical Summary of Past nspections Military Quarters nspection Findings as of31 Oct Future Facility Master Plan..... Conclusion ofwt Housing nspection nspections of Military Medical Treatment Facilities (MTFs) Annual Army Medical Treatment Facilities nspection Results.. MEDCOM Future Plans. APPEND.. REFERENCES Service Definitions/Terms of Reference

146 B. DetaiJed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) Preface - The Army Approach to Warrior Care and Transition As of 20 10, the Army has been continuously engaged in combat operations for nine years. The current conflict is the third longest conflict in American history, after the Revolution and Vietnam. t is also the first extended conflict since the Revolution to use an All Volunteer Force. n February of 2007, substandard housing and other bureaucratic problems were revealed at Walter Reed Army Medical Center. These problems were indicative of a system unable to cope with the consequences of modern conflict and the unintended effects of world-class battlefield healthcare (e.g. high survivability rates, greater numbers of wounded in action., and effective evacuation systems). The strain of multiple deployments required the Army to work together with the Department of Defense (DoD) and the Department of Veterans Affairs (V A) to ensure the well-being of the All Volunteer Force. n the spring of 2007, Secretary Gates established the Senior Oversight Committee (SOC) for the Wounded,, and njured (W) to ensure that recommendations and mandates from Presidential Corrunissions and legislation were addressed. This SOC was organized into 8 lines of action (LOA). The "Line of Action 5" mission was to ensure adequate facilities that are able to deliver the care Service members and veterans have earned and deserve. n accordance with existing laws and regulations, LOA 5 also established standards for inspection of quarters used by W Service members. The Army pledged never to leave a fallen comrade - neither on the battlefield nor lost in bureaucracy. Tle problems at Walter Reed Army Medical Center and others discovered through Presidential Commission reports and Congressional testimony prompted the Army to make dramatic changes across the entire Army. The Army responded decisively with the Army Medical Action Plan (AMAP), a strategy with the goal of"... [providing] a continuum of integrated care and services from point of injury, illness or disease to return to duty or transition from active duty." The AMAP, implemented through a department-wide Execution Order (EORD), reflects the Army's commitment to overhaul, adapt, and improve the management and care of wounded, ill, and injured Soldiers previously in the Medical Hold and Medical Holdover units. n June 2007, nstallation Management Command (MCOM) conducted a barracks survey and found that the barracks housing Medical Hold and Holdover Soldiers were generally rated in good condition. However, these condition ratings were based on standards for able-bodied Soldiers and did not account for special needs. Although the physical condition of the facilities was adequate, these barracks generally did not meet the provisions of the Uniform Federal Accessibility Standards (UFAS) Military barracks were excluded from these accessibility requirements due to the precondition that Soldiers had to meet certain functional levels of fitness. The AMAP replaced the often under-resourced Medical Hold and Medical Holdover units with 36 Warrior Transition Units (WTUs) and 9 Community Based Warrior Transition Units (CBWTUs), under the command and control of the installation Medical Treatment Facility (MTF) commander. Medical Hold and Medical Holdover personnel are now referred to as Warriors in Transition (WTs) to capture the Army 's commitment to both the wounded, ill, and injured Soldiers and their Families. The AMAP gave wounded, injured, and ill Soldiers a new mission., codifted in the WT Mission Statement: " am a Warrior in Transition. My job is to heal as transition back to duty or continue serving the nation as a Veteran in my community. This is not a status but a mission. will succeed in this mission because am a Warrior and am Army Strong." The WTU's mission is to focus on the care, treatment, and compassionate disposition of its WTs. The WTU is a patient-centered organization wherein every WT and Family member is supported by a "Triad of Care" consisting of a squad leader, a primary care manager (usually a physician), and a nurse case manager. 4

147 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) The AMAP (now implemented within the Anny as the Warrior Care and Transition Program) drives not only institutional change, but also unique facilities requirements in order to provide an optimal environment for the WT's mission of healing. These requirements include" Americans with Disabilities Act and Architectural Barriers Act Accessibility Guidelines, 23 July 2004" compliant unit workspaces, barracks, and family housing, and the establishment of Soldier and Family Assistance Centers (SFAC) to provide "one stop" support services to WTs and their Families. deally, all WT facilities are located in close proximity to one another in a campus-like setting and are all near the Medical Treatment Facility. This vision cannot be completely and uniformly realized across the Anny until military construction projects are funded and executed. n the interim, existing facilities have been renovated to provide supportive environments for WTs, their families, and caregivers. On 18 September 2007, the Office of the Secretary of Defense published the DoD Housing nspection Standards for Medical Hold and Medical Holdover Personnel, as required by section 3307 of the U.S. Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act, 2007 (Pub. L ). This memo described the housing standards for baseline accommodations and the special features and services to be provided to Medical Hold and Medical Holdover military personnel. The Army aggressively renovated and modified existing facilities to provide interim facilities that meet DoD standards within the limits of existing funding. The Anny is committed to providing quality interim housing facilities for its WTs today, while it strives to establish facilities that better meet the needs of its wounded, ill, and injured Soldiers in the future. The Anny has planned and programmed permanent WTU Complexes to provide healing environments in which to live, environments which are capable of accommodating all types of disability limitations and conditions, as well as Family members and non-medical attendants. The planned WTU Complexes are composed of standardized housing facilities, an administrative facility to adequately accommodate the WTU leaders and caretakers, and a Soldier Family Assistance Center where Soldiers and Family members can receive services consolidated in one location. These standardized WTU Complexes will ensure that facilities are located in a manner that makes it convenient for WTs and their Family members and non-medical attendants to receive the care and support they need. The goals offundamental and systematic facility improvements that optimize the healing and rehabilitation of WTs are necessary so that the Army can adequately recruit, prepare, sustain, and reset its All Volunteer Force. 5

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149 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) Executive Summary Army mplementation of the DoD Housing nspection Standards for Medical Hold and Holdover Personnel The US Army nstallation Management Command (MCOM) was tasked to inspect quarters housing medical hold and holdover personnel using standards and checklists developed by the Wounded, Tl and njured Senior Oversight Committee, Line of Action (LOA) 5 Working Group. These DOD standards are intended to ensure that the Army's Wounded, J, and njured Warriors in Transition live in adequate housing thereby avoiding any repetition of thp w"lter Reed, Building 18 situation. These DOD housing standards establish baseline and special m_.v. eqc:iements so that accommodations and services are provided as an integral part of the WT's medical treatment plan. As the Army addressed the substandard housing issues at Walter Reed, it found that the substandard housing situation was a symptom of a much larger WT housing problem across Army installations where WTs are stationed and cared for. The Aiv1AP was developed and implemented to address the management, command and control, care, and housing ofwts by consolidating them into 36 WTUs and assigning them to renovated interim housing that: exceeds or meets the applicable quality standards; is appropriate for their expected duration of treatment; supports non-medical attendants, ifauthorized; supports accompaniment by their dependents; and is appropriate for their pay grade. The summary of the results of the inspections are shown in the fouowing table The cells for the Military Quarters reflect only how the currently assigned/attached WTs were accommodated. They do not depict the condition of unassigned WT housing necessary to accommodate the growth LO the WT population, dispersed WTs, or inbound WTs with special needs.,..., Hau.ing AmJ ACAFH L.adgng lind... eannct..., a...d.. nd... Pncud lf,clvor VA... houdle m o o o o Conclusion The Army moved aggressively to ensure that WTs are in the best available interim facilities to meet their medical needs. The WT's primary care provider, case manager, and WTU chain of command 7

150 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) ensures that WTs are properly assigned to adequate housing based on their unique medical condition and changing functional status. Where facility deficiencies have been identified, the Army has taken the requisite corrective actions by either relocating the Soldier (and providing necessary transportation services) or making an immediate facility correction. As WTs relocate to new housing facilities, and as new WTs with special needs arrive, the Garrison Conunanders, Public Works Directorates, and WTU Commanders jointly manage the process, and conduct follow-up facility inspections on a regular basis and as needed. 8

151 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) ntroduction Pursuant to the Deputy Secretary of Defense Memorandum "000 Housing nspection Standards for Medical Hold and Medical Holdover PersoU1el," dated 18 September, 2007, MCOM and MEDCOM inspected quarters, housing, medical hold and holdover personnel. MCOM and MEDCOM used the standards in the 0 00 memorandum which were developed by the Wounded, and njured Senior Oversight Committee, LOA 5 Working Group. The results ofthe inspections are captured in this report. Activities determined and reported whether a facility met or did not meet established standards in a given category. Terms of ReferencelFacilities Used to House Personnel DoD-owned Military Family Housing - Housing owned by the u.s. Army for occupancy by eligible members with dependents and funded with family housing dollars. DoD-owned Unaccompanied Personnel Housing - Housing owned by the U.S. Anny for occupancy by permanent party single military personnel and funded with Operation & Maintenance (O&M) funding. Leased or Contracted Housing or Lodging on the Economy - Leased housing is private sector housing leased by the Army for occupancy by families, unaccompanied persou1ej, or transient personnel. DoD/Army-owned Lodging (including Fisher Houses) - DoD/Army-owned Lodging is transient housing that is managed by non-appropriated fund personnel and provides housing support for transient personnel on temporary duty or travel orders, as well as to personnel and dependents on permanent change of station orders. Housing Assignment - WTs are given the highest priority and are then assigned on a first come, first served basis appropriate for their unique conditions. Support for Personnel in Non-Governmental Housing - The Patient Administrative Department at each activity is used as the medium to obtain medical support for a Soldier residing at home by communicating or linking the Soldier to Case Management or other appropriate offices within the hospital and by answering general questions. Current nspection ProtocollProcess The Medical Command's Warn or Transition Command and MCOM coordinated the inspection as required by section 3307 ofthe U.S. Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriation Act, 2007 (Pub. L ). Each WTU, working closely with the Triad of Leadership (MTF/GarnsoniSenior Commander) was instructed to assess the adequacy, suitability, and quality of housing for WTs. The DPW was also responsible for 9

152 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) identifying technical deficiencies, corrective actions, and associated costs. nstructions included explanations of Assigrunent Standards, Baseline Standards, and Special Medical Standards which reflected the DOD standards contained in the 18 September 2007 memo. The WTUs were provided the following spreadsheets with two parts; the first to count WT personnel adequately or inadequately housed and the second part explain the deficiencies, corrective action, and costs to correct facilities that are inadequate. The WTUs detennined how to conduct the inspections and reported the number of WT (assigned or attached), their type of housing assigned and whether their quarters were adequate or inadequate. Medical Facility npatient, privately-owned, and CBWTU WT housing were not inspected because these privately owned or rented quarters are assumed to be adequate housing and the Military can not modify privately own/acquired housing. These inspections were conducted in the month of October 2009 and offer a snapshot in time of the housing of WTs. Description of Hotline Contacts Pertaining to Housing Facilities After the Walter Reed Building 18 crisis, in February 2007, the Acting Secretary of the Anny and the Chief of Staff of the Anny directed the creation of The Wounded Soldier and Family Hotline (WSFH) ( ) to operate 24 hours, 7 days a week. The purpose was to offer wounded and injured Soldiers and family members a way to seek help to resolve medical issues and to provide a channel for infonnation about Soldiers' medical issues directly to senior Anny Leadership in order to improve how the Anny serves the medical needs of our Soldiers and their Families. The hotline is now run by MEDCOM. There were only three hot line contacts from two Soldiers and a spouse pertaining to facility issues in 2008; and all issues were resolved. There were no reported hotline calls pertaining to facilities in t is logical that there are very few calls to the National Hotline because as each new WT arrives at the WTU they are given an WTU orientation handbook that tells the WT that any deficiencies in housing facilities are to be reported through their chain of command and a work order is to be 10

153 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) placed with the local Department of Public Works on the installation, where WTU housing work orders get top priority for repair. lfthe DPW is unable to fix the deficiency in a timely manner then the Army has directed that the WT is immediately reassigned to adequate housing. The Wounded Soldier & Family Hotline is still available and posted on each WTU website. 11

154 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) nspection Reports The nspection Reports for Military Quarters are included C & P Tn C D & P y....or.-...., : G 12

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165 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) ).... C D Jl 0....nr.-. G...,.,.,.a...-«m D Z25 D. Z25,., TMU.u C... S D S C.a D 5:l 23

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167 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY ( continued)...l:...7 zwii... WALTD... G a T.t. C K '... SM 'll SM 'll! C Tllt a a 211 Historical Summary of Past nspections On 18 September 2007, the Office of the Secretary of Defense published the DoD Housing nspection Standards for Medical Hold and Medical Holdover Personnel, as required by section 3307 of the US Troop Readiness, Veteran's Care, Katrina Recovery, and raq Accountability Appropriations Act, 2007 (Pub. L ) The Army used this guidance to assign WTs to housing and to inspect their WTU personnel housing in 2008 and Army leadership directed the senior commanders on Army installations to make WT facilities and furnishings top priorities for repairs and improvements. While this assignment policy resulted in WTs assigned to the best available interim facilities that met the standards for their condition and status, these interim facilities were not always in keeping with the ideal healing environment where all the WTs' housing, care, administrative management, command and control, as well as easily 25

168 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) accessible WT and Family Support Services are collocated on a campus like environment close to the MTF. While the CWTent interim phase required the renovation of existing housing facilities to meet DOD Standards and minimum accessibility standards, some of these same facilities are often inconveniently dispersed and require additional time for WTs to be transported back and forth to locations where healing and Family Support Services are provided. This is inefficient and not conducive to the healing mission of the WT. The most modem housing facility may not always be the best facility for the 'NT's medical condition due to its structural floor plan, location relevant to the MTF, WTU, SF AC, as well as other installation facilities and services like the Post Exchange, library, and commissary. Contracts valued at $162M in FY07 and $100M in FY08 were used for renovations to mitigate the dispersion of WT housing to the extent existing facilities were available to provide some "campus" collocation convenience. The 25 December 2008 WT housing inspection report showed no WT in inadequate housing. This is due to the Army's aggressive vigilance of WT housing by the WTJ Chain of Command and installation DPW, and proper assigrunent of housing based on the recommendations of the primary care provider and case manager. Similar fmdings are also reflected in the Great Plains Regional Medical Command nspector General (G) November January 2009 report: Special nspection of Facilities Used to Housing Recovering Service Members (Warrior in Transition). This report noted that WTs reported that if their assigned quarters were not in compliance that they were immediately placed in quarters that were in compliance with their injuries. The G report also reported "most WT housing was in compliance with baseline standards at the time of inspection. The few that weren't had minor deficiencies that were discovered and repaired immediately due to on the spot work orders submitted by representatives ofthe inspection team from DPW." On 14 October 2009, MCOM provided further guidance for WT housing in a memo: Unaccompanied Personnel Housing (1JPH) for Waniors in Transition (WT) Policy. This policy provided guidance in addition to AR for the specific purpose of managing and providing quality housing for unaccompanied WTs and outlined MCOM and WTU responsibilities. Military Quarters nspection Findings as of 31 OCT 2009 Section 3307 ofthe U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and raq Accountability Appropriations Act, 2007 (Pub. L ), requires inspections of military medical treatment facilities and quarters housing WTs. The purpose of each inspection is "to ensure that tjle facility or quarters concerned meets acceptable standards for the maintenance and operation of medical facilities, quarters housing medical hold personnel, or quarters housing medical holdover personnel, as applicable." The Amly completed the 2009 inspection of WTU housing using standards established in the 18 September 2007 Office ofthe Secretary of Defense memo "DoD Housing nspection Standards for Medical Hold and Medical Holdover Personnel." 26

169 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) This October 2009 inspection of WTU housing using the DOD Housing nspection Standards for Medical Hold and Holdover Personnel (WTs) showed that all WTs were adequately housed as of 31 October There were no WTs in inadequate housing as of31 October All minor deficiencies noted during this inspection were inunediately corrected by the local installation DPW. These results are a snapshot in time because many WTs process in and transition out of the WTU on a daily basis and may be reassigned housing based a change in their medical status and functional ability. The WTU and instahation DPWs, working closely with the Garrison Commanders and Senior nstallation Commanders continue ongoing inspections to ensure that these standards continue to be met. Future Facility Master Plan The Army's vision of the permanent phase is to construct campuses that support the full range of facilities and services required for the WT to heal. The MCOM Facility Master Plan in support of the AMAP provides for the establishment of WTU Complexes composed of3 functional elements: WT barracks housing, administrative facilities, and SFAC facilities in campus-like arrangements close to the MTF where an optimal healing environment and services can be provided to WTs and their Families. n FY08, the Army requested $1.2B for WT Complexes in twenty locations. n FY08, the Army and used $124M in GWOT Supplemental funds for seven WT Complexes. The American Recovery and Reinvestment Act of 2009 allowed the Army to invest $loom in two WT complexes. n FY09, an OCO Request enabled the Army to start five more WTU Complexes for $425M. The FYO Budget Request contained an additional thirteen WTU Complexes for $504M. The planned adequate WT barracks space will meet the " Americans with Disabilities Act and Architectural Barriers Act Accessibility Guidelines" (ADAAG) and the Uniform Federal Accessibility Standards (UFAS) in order to accommodate a wide range of WT medical conditions and disabilities. The Architectural and Transportation Barriers Compliance Board (Access Board) revised its accessibility guidelines for buildings and facilities covered by the Americans with Disabilities Act of 1990 (ADA) and the Architectural Barriers Act of 1968 (ABA). These guidelines cover new construction and alterations and serve as the basis for enforceable standards issued by other Federal agencies. The ADA applies to places of public accommodation, commercial facilities, and State and local government facilities. The ABA covers facilities designed, built, altered with Federal funds or leased by Federal agencies. As a result of this revision and update, the guidelines for the ADA and ABA are consolidated in one Code of Federal Regulations part. The consolidated ADA and ABA guidelines replace the Americans with Disabilities Accessibility Guidelines (ADAAG) and the Uniform Federal Accessibility Standards (UFAS), respectively. The new document is the "Americans with Disabilities Act and Architectural Barriers Act Accessibility Guidelines, 23 July 2004". 27

170 B. Detailed Military Departments' MHH nspection Reports--l. TAB ARMY (continued) The administrative facility will provide space for the command and control element of the WTUs in charge of WT management (including the WT nurse case managers). The Soldier and Family Assistance Centers (SFACs) will provide "one stop shop" garrison Family Support Services for WTs and their Family members/non-medical assistants. The Army continues to work and coordinate the actions required to identify current WT populations and specific housing locations where Special Facility Requirements are necessary or needed. Conclusion of WT Housing nspection The Army has moved aggressively to ensure that WTs are in the best facilities available to meet their medical needs. Where facility deficiencies have been identified, the Army has taken the requisite corrective actions by either relocating the soldier (providing necessary transportation services) or making an immediate facility correction. As WTs relocate to new housing facilities, and as new WTs with special needs arrive, the Garrison Commanders, Public Works Directorates, and WTU Commanders jointly manage the process, and conduct follow-up facility inspections as needed. The Army's goal is to provide a comprehensive living and healing environment for it's wounded, ill, and injured. The Army specifically envisions a set of standardized housing facilities with an appropriate number of rooms capable of accommodating au types of disability limitations and conditions, as well as Family members and non-medical attendants, an administrative facility to accommodate the WTU leaders and caretakers adequately, and a facility where Soldiers and Family members can receive services consolidated in one location. The Army also envisions that all ofthese facilities to be located close to the MTF in a manner that makes it convenient for WT or their Family members and non-medical attendants to receive the care and support they need. As such, the Army is committed to providing the best housing facilities possible for its WTs today, while it strives to establish facilities that better meet the needs of its wounded, ill, and injured Soldiers in the future. 28

171 B. Detailed Military Departments' MHH nspection Reports--2. T AB NAVY Executive Summary Navy Medical nspector General Report on nspections of Military Quarters Housing Medical Hold and Medical Holdover Personnel (nspections performed July 2009) Military Quarters Housing Medical Hold and Holdover Personnel Number of Facilities nspected: 71 Assignment Baseline Special Medical Component Met Not Met Met Not Met Met Not Met Standard* Standard* Standard* Standard* Standard* Standard* Navy * Represents the number of medical hold or holdover personnel whose quarters have or have not met the housing standard. ecial Medical $0 Per the Bureau of Medicine and Surgery (B UMED) memo dated 09 June 2009 and the National Defense Authonzation Act ofjanuary 16, 2008, Bureau ofmedicine and Surgery (BUl\1ED) medical activities were tasked, in coordination with Commander N avy nstallation Command (CNC) and Commander Headquarters Marme Corps (CMC), to inspect quarters houslog medical hold and holdover personnel, usmg standards and checklists developed by the Senior OverSight Committee's Line of Action (LOA) 5 Working Group. AU nspected quarters housing medical hold or holdover personnel met applicable quality standards ofassignment and were appropriate for the service member's medical condition. nspection Reports Report Organization: 1. Service Defmitions/ Terms of Reference 2. Assignment of Personnel to Quarters for Medical Hold and Holdover Status 3. Facilities Used to House Personnel 4. Military Quarters Housing Medical Hold and Holdover Personnel Appendix 1: Quarters Housing Medical Hold and Holdover Checklist 1. Service Definitions/Terms of Reference: npatient - An mdividual, other than a transient patient, who S admitted (placed under treatment or observation) to a bed in a Medical Treatment Facility that has authorized or designated beds for inpatient medical or dental care. A person is considered an mpatient status if formally admitted as an inpatient with the expectation that he or she will remain at least overnight and occupy a bed even though it later develops that the patient can be discharged or transferred to another hospital or does not actually use a hospital bed overnight. This does not include a patient administratively admitted to the hospital for the purposes of a same day surgery procedure. Outpatient - An mdivldual recelvlog healthcare services for an actual or potential disease, mjury, or life style-related problem that does not require admission to a medical treatment fu.cility for Enclosure (1)

172 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) in pa tient care. Medical Hold - Enlisted personnel housed in a Medical Hold Company (MHC) under the cognizance of the MTF whose current condition precludes them from returning to full duty. Medical Holdover - Retention of reservists on active duty to receive medical treatment for serviceconnected injuries, illnesses and/or disease until determined Fit for Duty by the Benefit ssuing Authority (BA), Senior Medical Officer (SMO) and/or Medical Status Review Officer (MSRO), or until final disposition is determined by the PEB. Assignment - DoD Housing nspection Standards for Medical Hold and Holdover Personnel included in SECDEF Memo dtd September 18, 2007 state that Medical Hold and Holdover personnel shall be assigned/refetred to housing that exceeds or meets the applicable quality standards. Additionally this housing should be appropriate to their expected duration of treatment; supports a non-medical attendant, if authorized; supports accompaniment by their dependents; and appropriate for their pay-grade. Baseline - DoD Housing nspection Standards for Medical Hold and Holdover Personnel included in SECDEF Memo ded September 18, 2007 state that housing must be in good ovetall condition with no major problems with any of the building systems. Additionally, it is important for personnel to be able to adequately control the temperature of their housing unirs and there shall be no mold, exposed lead-based paint, unsealed asbestos, inadequate air circulation, and any other environmentally / sa fety / health hazard. Special Medical Requirements - DoD Housing nspection Standards for Medical Hold and Holdover Personnel included in SECDEF Memo dtd September 18,2007 state that Medical Hold and Holdover personnel may have certain medical conditions that result in various functional limitations. For these members, it is essential that special accommodations and services be provided as an integral part of their medical treatment plan as determined by the primary care physician, patient, and chain of command. Medical Evaluation Board (MEB) - A body of physicians attached to one of the medical treatment facilities (MPs) whose commander or commanding officer (CO) has been expressly designated to hold "convening authority" (CA) for MEBs to identify members whose physical and/ or mental qualification to continue on full duty is in doubt or whose physical and/or mental limitations preclude their return to full duty within a reasonable period of time. They are convened to evaluate and report through on the diagnosis; prognosis for return to full duty; plan for further treatment, rehabilitation, or convalescence; estimate of the length of further disability; and medical recommendation for disposition of such members. Department of the Navy Disability Evaluation System (DES) - A case usually enters the Department of the Navy DES when a Medical Evaluation Board (MEB) is dictated for the purpose of evaluating the diagnosis and treatment of a member who is unable to return to military duty because the member's condition most likely is permanent, and/or any further period of temporary limited duty (LD) or LMDU is unlikely to return the member to full duty. A condition is considered permanent when the nature and degree of the condition render the member unable to continue naval service within a reasonable period of time (normally 8-12 months or less). Note: The term "permanent" does not necessarily mean the condition is unfitting. Physical Evaluation Board (PEB) - The PEB provides three stages of review (a documentary review, a 2 Enclosure (1)

173 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) due process hearing upon demand, and appeal by petition) for a Service member whose physical conditions have been referred to it by a medical evaluation board (MEB) of an MF that believes that the member's physical condition raises questions about his ability to perform the duties of his or her office, grade, rank or rating. Referral of a Medical Evaluation Board report to the PEB can come from two sources; i.e. Limited Duty board reports referred for PEB evaluation by service headquarters, and Medical Board reports submitted directly to the PEB by a medical treatment facility (MTF). Distinguishing "Fit for Duty" from "Fitness for Continued Naval Service" "Fit for Duty" refers to a pronouncement by a physician or by an NffiB chat a patient previously on light or LMDU has healed from the injury or illness that necessitated the member's serving in a medically restricted duty status. "Ftness for Continued Naval Service" is a finding made exclusively by the Department of the Navy PEB in determining an active duty service member's ability to continue serving in th(; Navy or Marine Corps. 2. Assignment of Personnel to Quarters for Medical Hold and Holdover Status: The disposition and assignment of personnel post inpatient status is contingent on the member's medical status, recommendation of treating physician, treatment requirements, family status, and service component. The following is the BUNffiD Medical Hold and Holdover Status as of 25 June Military Quarters Hous.ing Medical Hold Personnel and Militar) Quarters Hou.j Medical Holdover Personnel DoD DoD Owned Leased or DoD/NAF Privadzed Privately Number of Owned Unaccompanied Contracted Owned Family Owned or. Personnel Military Personnel Housng Housing or Lodgjng HOUSing or Privately Housed Family Lodging on the (includes Lodging Rented Housing Communiry Fisher Houses) Housing" Number of -,,-ersonnel /658 0/ / x = MH and Holdover Rooms/Housmg Units Y =Total number of MH and Holdover ** =Standards do not apply to private homes 3. Facilities Used to House Personnel: Military Medical Treatment Facility (MTF) - A facility established for the purpose of furnishing medical and/or dental care to eligjble individuals. This does not include battalion aid stations, post/base in or out processing facilities, or soldier readiness processing (SRP) facilities unless they are an integral part of the MTF. DoD Owned Military Family Housing - Housing owned by the U.S. l\avy for occupancy by eligible members with dependents and funded '.Virh Family Housing, Navy and Marine Corps (FH, N&MC) dollars. 3.Enclosure (1)

174 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) DoD Owned Unaccompanied Personnel Housing - Housing owned by the U.S. Navy for occupancy by permanent party single military personnel and funded with O&M, N. Leased or contracted Housing or Lodging on the community - Leased housing is private sector housing leased by the Navy for occupancy by families, unaccompanied personnel, or rransient personnel. DoD/NAP owned Lodging (including Fisher Houses) - DoD /NAF owned Lodging is rransiem housing with management by non-appropriated fund personnel to provide housing support for transient personnel whether on temporary duty or travel orders, or personnel and dependents on peananent change of station orders. Housing Assignment - Personnel are assigned on a first come first served basis upon receipt of an application or official request of housing using waiting list procedures that ensure equitable access to housing for all families, bachelors, and rransients. Personnel with medical conditions will be assigned to housing that is appropriate for their unique conditions. Privati2ed Family Housing or Lodging - Housing obtained through implementation of military housing privatization authorities (10 USC 2871 et seq). Housing is owned and operated by a private entity and rented to eligi ble military personnel on a preferential basis. Personnel are referred (vice assigned) to the housing and lease directly from the private entity. Support for Persorme1 in Non-Governmental Housing - The Patient Adrninisrrative Department at each activity is used as the medium to obtain medical support for a member residing at home by communicating or linking to Case Management or other appropriate offices within the hospital and also for answering general questions. Administratively, if the member is undergoing an MEB or PEB, the Patient Administrative Department communicates with the member as often as necessary to ensure proper and efficient submission of any MEB or PEB. 4. Military Quarters Housing Medical Hold and Holdover Persorme1: Summary of Past nspections: The material condition of housing quarters maintained by CNrC, CMC and BUMED are monitored and reported using a cenrrally managed continuous inspection process described in NAVFAC MO 322, nspection of Shore Facilities. n general, Sustainment Restoration and Modernization (SRM) requirements identified during the inspection process are documented in a vleb accessible database. The Navy and Marine Corps are moving from an installation implemented inspection system to centrally funding inspections by professional engineering teams. nspecrions will be completed for all class type 2 real property assets on a specified schedule based on type and significance of facility using a single service wide set of evaluation criteria that are consistent wi th all applicable codes and standards. Facility asset condition is evaluated using the industry standard metric Facility Condition ndex (FCl) which is calculated as total unfunded SRM requirement divided by asset Plant Replacement Value (prv). The calculated FCr is consistent with the Quality factor Q as defined by OSD and is the reporting metric common to all service branches. 4 t:a:e(1)

175 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) Additionally, to specifically support the mspection process for the Wounded Warrior and Medical Hold/Holdover facilities, a detailed check-list was created using the DEPSECDEF Housing Standards and is used by the inspection team to perfocm the semi-annual Reonal Medical nspector General mspections and the annual Wounded Warrior/Medical Hold/Holdover housing facilities nspection conducted by the Navy and the Manne Corps. At the activity level, housing and facility management personnel conduct inspections as requred (daily, weekly, monthly, quarterly, etc). Navy housing staffs perform regular and recurring mspections to ensure that standards are maintained for a quality living environment in pecmanent party and transient housing facilities. nspectors ensure that resident living areas are kept clean and that all amenities such as furnshings, linen and appliances are adequate and in good condition. Housing inspectors report maintenance, repau:, and safety items to facility maintenance personnel for correction and schedule wo rk to minlffiize disruption to residents. Facility Managers participate in facility inspections, fire and safety inspections and revew deficiencies identified by mamtenance personnel (government or contractor) while perfocmmg preventative maintenance inspections (PMs). BUMED, CMC and CNC have the authority at the local level to correct known requrements or deficiences up to a ce rtain threshold. BUMED, CMC and CNC have documented process for submssion of spec al projects over this threshold. Current nspection Protocol/Process: The housing standards for this nspection were developed by a LOA 5 sub working group staffed with representatives from OSD H&CS, Air Force, Army, Navy, and Marine Corps. The inspection checklist contains questions separated into three categories outlined in the housng standards: ASSignment, Baseline and SpeCal Medical. Due to the inspecljon being based on the medical condition of the military service member, BUMED took the lead on the military quarters housing medical hold and holdover personnel inspections, and was requested to coordinate with BUMED facility managers, when BUMED was the facility owner or to coordinate with CNC and CMC when they were the facility owners, respectively. All final inspections were submitted through BVMED. Teams typically meluded medical case managers, housing managers, facility managers, engineers of various disciplines, ennee[lng techmclans and tradesmen ofvarious backgrounds. The teams were advised to perfocm a visual inspection of each housing facility after reviewing requirements generated n VFA, re curring service calls identified in DMLSS or MA.,,(MO and regularly scheduled PMs. Activity responses were vaned. Most actrvities ndicated that ther medical hold space met the standard, and as a result, no actions or estimates were required. Other activities mdicated that ther housng met the standard, but recognized that deficiencies existed in the facility and provded estimates accordngly. n all cases when a facility did not meet the standard, renovations were underway to correct the deficiency. The results are reported n the three categories of "Assignment", "Baseline" and "Special Medical" and are mcluded below: 5 Eocosure (1)

176 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) Findings: National Naval Medical Center (NNMC) Bethesda, MD Assignment Baseline Special Medical Facility M/NM Action/Cost M/NM Action/ M/NM Action/ to meet Cost to Cost to Standard meet meet Standard Standard 1 Mercy Hall, Bldg 65/0 $0 65/0 $0 65/0 $0 50 National Naval Medical Center (NNMC) Bethesda, MD (cont.) Military Quarters Housing Medical Hold Personnel and Military Quarters Hou8i Medical Holdover Personnel Owned Leased or DoD/NAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Petsonnel Family Housing Lodging on (includes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housing Nwnber 0/68 65 / 68 0/ 68 0/ 68 0/ 68 3/ of personnel Comments: NNMC Bethesda completed Mercy Hall renovations with associated site enhancements to correct Americans with Disability Act (ADA) and Uniform Federal Accessibility Standards (UFAS) deficiencies in December ADA/UPAS compliance included providing accessible public and occupant room toilets, drinking fountains, new exterior and interior doors, and corridors. A new elevator serving all floors is operational NNMC Bethesda construcred an ADA compliant ramp providing direcr access to Mercy Hall from the Naval Exchange area. Additionally, NNMC Bethesda awarded a FY09 BUMED Special Project to modernize the Heating and Air Conditioning System allowing individual unit temperature control. Construction started in June 2009 with an expected completion date of March. NH BremertonlNaval Station Bremerton Assignment Baseline Special Medical MNM ction/cost MNM Action! iwnm Actionl o meet Cost to Cost to Standard meet meet Standard Standard 1 1 Boone Rd lid $0 110 $ /O $ D Scorpion ve 110 $0 1/0 $0 110 $0 6 En::ia;ure (1)

177 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) NH BremertonlNaval Station Bremerton (cont.) Military Quarters Housing Medical Hold Personnel and Military Quarters Housin Medical Holdover Personnel DoD DoD Owned Leased or DoDNAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Personnel Family Housing Lodging on (includes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housing lnumber 0/ /2 0/2 0/2 0/2 2 of lpersonnel Conunents: None. NHCamp Pendleton. CAlMCBCamp PelldJeton Assignment Baseline Special Medical MlNM Action/Cost MNM Action! MNM Action/ o meet Cost to icost to tandard 1m e e t meet tandard Standard *1 Bldg H-49 22/0 $0 22/0 $0 22/0 $0 2 H-96 9/0 $0 9/0 $0 9/0 $ $0 110 $0 110 $ Psuan 110 $0 110 $0 110 $ Taegu Dr 110 $0 110 $0 110 $ Suzuki Dr 1/0 $0 110 $0 110 $ Ellison Ct 110 $0 1/0 $0 /O $ Hamilton 1/0 $0 110 $0 110 $ C Davis Ct lo $0 110 $0 1/0 $ Edgar Ct 110 $0 110 $0 110 $ Angeles St 1/0 $0 110 $0 110 $ Hagaru Ct 110 $0 110 $0 110 $ Quinn St 110 $0 110 $0 110 $ Redwood St 110 $0 1/0 $0 110 $ Boxwood St 1/0 $0 110 $0 110 $ Rodriguez Ct 1/0 $0 110 $0 110 $ B Walker Wy 1/0 $0 110 $0 1/0 $0 7 Fncia;ure (1)

178 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) NH Camp Pendleton, CAMCB Camp Pendleton (cont.) Military Quarters Housing Medical Hold Personnel and Military_Quarters Housing Medical Holdover DoD DoD Owned Leased or DoD/NAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Personnel Family Housing Lodging on (ncludes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housing lnumber /of personnel 0/46 32/ 46 0/ 46 0/46 14/ 46 0/46 46 Comments: The Marine Corps recognizes the need to provide the best care available to its ill, injured, and or wounded service members and is constructing a Wounded Warrior Barracks at Camp Pendleton containing 100 rooms compliant with the Americans with Disabilities Act (ADA) guidelines and the new DoD Medical Hold/Holdover Housing nspection Standards. The MLCON project was included in the FY08 Presidential Budget submission with anticipated building occupancy date in April/May. The toral cost for the project is estimated at $25.9M. Upon completion of th.is MLCON project, H49 will be transitioned to the new facility. The previous report identified cosmetic improvements for H-49. All improvements have been completed as of February Naval Medical Center (NMC) San Diego, CANaval Base San Diego Assignment Baseline Special Medical MfNM ActionlCost MfNM Actionl Cost MlNM ctionl o meet to meet Cost to Standard Standard meet tandard 1 NMCSD - Bldg /0 $0 100/0 $0 100/0 $0 2 NAVSTABLDG 3150 Vesta Hall 17/0 $0 17/0 $0 17/0 $0 3 NAVSTABLDG Do=elly Hall 9/0 $0 9/0 $0 9/0 $0 4 NAVSTA BLDG 3203 Copp Hall 7/0 $0 7/0 $0 7/0 $0 Naval Medical Center (NMC) San Diego, CANaval Base Sail Diego (cont.) Military Quarters Housing Medical Hold Personnel and Milita uarters Hous Medical Holdover Personnel 8 Encb;ure (1)

179 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) DoD DoD Owned Leased or DoD/NAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Personnel Family Housing Lodging on (includes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housing Number 0/ /133 0/133 0/133 0/133 0/ of lersonnel Comments: None NHC Hawa;i/MCB Hawa;ilNavai Station Pearl Harbor Assignment Baseline Special Medical MfNM Action!Cost to meet Standard MfNM Action! Cost to meet Standard MlNM Action! Cost to meet Standard BEQ /0 $ $ $0 2708A Cushman 110 $0 110 $0 110 $0 (Hana Lake) 6390A Nueku St 110 $0 1/0 $0 110 $0 (Hawaii Loa) 7381 Birch Cir 1/0 $0 110 $0 110 $0 (Manana) Daly Rd 1/0 $0 110 $0 110 $0 (Ulupau) 2678B Kapalu P (Pa 110 $0 110 $0 1/0 $0! Honua) i NHC Hawaii/MCB HawaiiNaval Station Pearl Harbor (cont.) Military Quarters Housing Medical Hold Personnel and Military Quarters Housing Medical Holdover DoD DoD Owned Leased or DoDNAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Personnel Family Housing Lodging on (includes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housing Number of 0/21 16/ /21 5/21 0/21 21 personnel Comments: BEQ 7046 is a relatively new barracks with 20 rooms on the ground floor assigned to the Wounded Warrior Battalion West, Hawaii Detachment. Three rooms were renovated to be wheelchair 9 Enclosure (1)

180 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) accessible and are used to house one person per room. The remaining 17 rooms are in a 2xO configuration with the capacity of housing two persotulel in one room. This facility is in excellent condition and adequately supports the Wounded Warriors' Special Medical Requirements. No recommended improvements have been identified for this facility. A contract is being pursued for FY0 for grounds maintenance. Currently the barracks is shared with 3'd Marine Regiment and the grounds are maintained by the tenants of the facility. All on base housing units occupied by Wounded Warriors were found to be in compliance with the DoD Medical Hold/Holdover Housing nspection Standards and supported the individual Wounded Warrior's Special Medical Requirements and duration of treatment. Discrepancies such as screen door repair, plumbing, painting, and extermination were addressed with Forest City, PPV housing management for correction. n summaty, all facilitie s inspected were maintained in accordance with DoD standards and met the special needs of the residents. NH Camp Le;euneMarine CO1JS Base (MCB) Camp Le;eune Assignment Baseline Special Medical Facility M/N Action/Cost M/N Action/Cost M/N Action/Cost M to meet M to meet M to meet Standard Standard Standard 1 H-14 30/0 $0 30/0 $0 30/ 0 $0 (Wounded Warriors Battalion) 2 FC / 0 $0 21 / 0 $0 21 / 0 $0 (French Creek) 3 BEQ / 0 SO 18/ 0 $0 18 / 0 go Brig (RSU and DSG) 4 BEQ French 2/ 0 $0 2/ 0 $0 2/ 0 $0 Creek 478 RSU Montana 1/0 $0 1/0 $0 1/0 $0 St Louisiana 1/0 go 1/0 $0 1/ 0 $0 St Virginia 1/ 0 $0 1/ 0 $0 1/ 0 $0 St Michigan 1/ 0 go 1/ 0 SO 1/ 0 $0 Ave Sttanz Ct 1/ 0 $0 1/ 0 $0 1/ 0 $ East 1/ 0 $0 1/0 $0 1/ 0 $0 Peleliu Dr Barker Ct 1/0 $0 1/0 $0 1/ 0 $ /0 $0 1/0 $0 1/0 $0 Matanikau Wood Ct 1/0 $0 1/0 $0 1/ 0 $ / 0 $0 1/ 0 $0 1/0 $0 10 Enc!a;UE (1) :,,

181 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) LeCaptain Ct LeCaptain Ct / O $0 / O SO / O $ Simpson Ct /O SO / O SO / O $ West Peleliu / O $0 /O SO / O $ H offman /O $0 / O $0 /O $0 Ct /O $0 /O SO / O 50 BOURainville Tarawa /O $0 / O $ 0 /O $0 Blvd H aga ru D r. / O $0 / O SO / O $ Chosin /O $0 /O $0 / O $0 Cir Bemak St / O $0 / O SO /O $0 NH Camp LeieullelMarine Corps Base (MCB) Camp Lejeune (conll Mllitaty Quarters Housing Medical Hold PersolUlel and Military Quarters Housin Medical Holdover Persormel DoD DoD Owned Leased or DaD/NAF Priv atiz ed Privately Owned Unaccompanied Contracted Owned Family Owned Military Family Housing Personnel Housing Housing or Lodging on the Community Lodging (includes Fisher Houses) Housing or Lodging or Privately Rented Housing Number of Persorme1 Housed Number 0/90 71 / 90 0/90 0/ 90 19/90 0/90 90 of personnel Comments: There were no major findings and only a few minor findings during the inspection. The minor fi ndings were as follows: si nk faucet dripping, malfunctioning of a front door lock, pest control treatment needed, and condensation around an A/C vent, loose towel bar as well as peeling paint These minor findings have been fo rwarded to the appropriate parties for correction (work orders). Reserve Support Unit (RSU) BEQ 1042 has been submitted as an M-2 Major Repair Project in FY which will correct washer and drye r ratio deficiency as per UPC Navy and Marine Corps Bachelor Housing Standards. Charter Ca ble is in the process o f correcting all cable drop discrepancies and is scheduled to be completed by 30 September fu:\a;= (1)

182 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) NHC Great Lakes luna VSTA Great Lakes L " Assignment Baseline Special Medical Facility M/NM Action/Cost M/NM Action/ M/NM Action/ to meet Cost to Cost to Standard meet meet Standard Standard 1 Admiral Boorda 75 / 0 $0 75/0 $0 75/0 $ 0 Hall, Bldg 30&34 2 Ship 5, Bldg /0 SO 99 / 0 $0 99/ 0 $0 NHC Great Lakes, luna VSTA Great Lakes, L (cont.) Militaty Quarters Housing Medical Hold Personnel and MilitaryQuarters HousinJ Medical Holdover Personnel Owned Leased or DoD/NAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Personnel Family Housing Lodging on (ncludes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housing Number 0/ / 174 0/ 174 0/ 174 0/ 174 0/ of personnel Comments: Previously, Medical Hold recruits were housed in Building 7121 (Ship 17). They were relocated to building 7102 (Ship 5) in order to be closer to Building 1007, Tranquility Branch Health Clinic, for convenience to the patients being seen for follow-up appointments. Overall, the barracks housing medical hold and holdover personnel are adequate. NAVSTA Great Lakes will continue to house any Sailor in a medical hold sratus at Admiral Boorda Hall. NAVSTA Great Lakes completed its project to upgrade the HVAC system (so occupants may individually control their room temperature) on 24 July NHJacksonviUe, FL/NASJacksonviUe, FL/NA VSTA Mayport, FL Assignment Baseline Special Medical Facility M/NM Action/Cost M/NM Action/ M/NM Action/ to meet Cost to Cost to BEQ 822 (NAS) Standard meet meet Standard Standard 3/ 0 $0 3/0 $0 3/0 $0 829B Enterprise 1/0 $0 1/ 0 $0 1/ 0 SO (NAVSTA) 809A Edison 1/0 SO 1/ 0 $0 1/ 0 $0 (N AVSTA) 12 Encb;ure (1)

183 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) NHJacksonviUe, FL/NASJacksonviUe, FL/NAS Mayport, FL (cont.) Military Quarters Housing Medical Hold Personnel and Military Quarters Hous Medical Holdover Personnel DoD DoD Owned Leased or DoD/NAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Personnel Housing or Lodging Housing or Personnel Family Housing Lodging on (includes or Privately Housed Housing the Fisher Lodging Rented Community Houses) Housine: Nwnber 0/ 50 3/ 50 (NAS) 0/50 0/50 2/50 45/50 50 (NAVSTA) of personnel Comments: None. NHPensacola, FUNASP ensacola, Fl AssiJlnment Baseline Special Medical Facility M / NM Action/Cost M / NM Action/ Cost M / NM Action/ to meet to meet Cost to Standard Standard meet Standard 1 Bldg 3251 (N AS) 13/ 0 SO 13/0 $ 0 13/0 $0 NH Pensacola, FUNAS Pensacola, FL (com) Military Quarters Housing Medical Hold Personnel and DoD Owned Military Family Housing Mili Quarters Housinj Medical Holdover Personnel DoD Owned Leased or DoD/NAF Privatized Privately Number Unaccompanied Contracted Owned Family Owned of Personnel Housing or Lodging Housing or Personnel Housing Lodging on (includes or Privately Housed the Fisher Lodging Rented Community Houses) Housing Number 0/13 13/ 13 0/ 13 0/ 13 0/13 0/ of personnel Comments: None. NMC Portsmouth, V AlNaval Station Norfolk/Norfolk Naval Shipyard - Scott Annex/Naval Amphibious Base little Creek, Norfolk VA Assie:nment Baseline SptriU Medical Facility M/NM Action/Cost M/NM M/NM Action/ ion/ to meet Cost to ost to meet Standard?eet Standard Standard 13 F.nda;ure (1)

184 B. Detailed Military Departments' MHH nspection Reports--2. TAB NAVY (continued) 1 NMC Pot1srmuth, 13/0 $ 0 13/0 $0 13/0 $0 Bldg NMC 4/ 0 $0 4/ 0 $0 4/ 0 SO Portsmouth 3 NAVSTA 26/0 SO 26 / 0 $ 0 26/ 0 $ 0 Norfolk S30 4 NAVSTA 1/0 $0 1/0 $0 1/0 $0 Norfolk R63 5 NAVSTA 5/0 $ 0 5/0 5/0 $ 0 Norfolk $0 Asl 6 NAVSTA 5/0 SO 5/0 5/ 0 $0 Norfolk $0 A52 7 NAVSTA Norfolk /O $ 0 1/0 $0 1/0 $0 8 NAVSTA N orfolk 1/0 $0 /O $0 1/0 $0 9 NAVSTA Norfolk 2/0 $0 2/0 $0 2/0 $0 10 NAVSTA Norfolk 1/0 $0 /O $ 0 J/O $ Ocean view Ave Apt 2 /O $0 1/0 $0 /O $0 Lake Wright 12 Q uality Suites, 1/0 $0 1/0 $0 J/O $ 0 Room 571 NMC Portsnwuth, V AlNaval Station NorfolkNorfolk Naval Shipyard - Scott Annex!Naval Amphibious Base Little Creek, Norfolk VA (amt.) Military Quarters Housing Medical Hold Personnel and Military Quarters Housin; Medical Holdover Personnel DoD DoD Owned Leased or DoD/NAF Privatized Privately Number Owned Unaccompanied Contracted Owned Family Owned of Military Family Housing Personnel Housing Housing or Lodging o n the Lodging (includes Fisher Housing or Lodging or Privately Rented Personnel Housed Community Houses) Housing Number 0/ 61 17/ 61 0/ 61 42/61 2/ 60 0/ of personnel Comments: N o material findings were identified. Minor discrepancies were recorded and discussed with responsible housing and facilities staff and the results were forwarded to the D irector for Ad ministration (oversees the maimenance and habitability of the medical hold and holdover barracks - NMC Portsmouth.: Bldg 282 and Bldg 2, 5'" Floor)..Minor fi ndings rela ted to stains on noor tiles and overall floo r dinginess as well as standing water underneath 14 E'nda;ure (1)