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

Finance Board and Full Board of Directors Meetings Thursday, September 28, 2017 1:00 p.m. Lee Memorial Health System Board of Directors

BOARD OF DIRECTORS OFFICE 239-343-1500 FAX: 239-343-1599 13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912 CAPE CORAL HOSPITAL GULF COAST MEDICAL CENTER HEALTHPARK MEDICAL CENTER LEE MEMORIAL HOSPITAL GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA THE REHABILITATION HOSPITAL LEE PHYSICIAN GROUP LEE CONVENIENT CARE BOARD OF DIRECTORS DISTRICT ONE Stephen R. Brown, M.D. Therese Everly, BS, RRT DISTRICT TWO Donna Clarke Nancy M. McGovern, RN, MSM DISTRICT THREE Sanford N. Cohen, M.D. David Collins DISTRICT FOUR Diane Champion Chris Hansen DISTRICT FIVE Jessica Carter Peer Stephanie Meyer, BSN, RN AGENDA FINANCE AND FULL BOARD OF DIRECTORS MEETINGS September 28, 2017 at 1:00 p.m. Gulf Coast Medical Center Boardroom (Medical Office Building) 13685 Doctors Way, Ft. Myers, FL 33912 1. CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) The Board of Lee Memorial Health System, doing business as Lee Health, Gulf Coast Medical Center & Lee Memorial Hospital/HealthPark Medical Center and the Board of Directors of its subsidiary corporations, including but not limited to Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc. 2. INVOCATION & PLEDGE OF ALLEGIANCE (Chaplain Susan Crowley, MA, BCC) 3. PUBLIC INPUT Agenda Items: Any Public Input is limited to three minutes and a Request to Address the Board of Directors card must be completed and submitted to the Board Staff prior to meeting. Individuals wishing to address the Board on a Non Agenda item must notify the Board Staff of the subject matter at least three (3) days prior to the meeting. 4. PRESIDENT S REPORT (Larry Antonucci, MD, MBA, President & CEO) 1. Hurricane Irma Update (Lisa Sgarlata, Chief Patient Care & Nursing Officer) (Connie Bowles, Coordinator Emergency MGMT/Disaster Preparedness) 5. DYAD DEFINITION & FUNCTION (Scott Nygaard, Chief Medical & Clinical Integration Officer) 6. EMPLOYEE ENGAGEMENT RESULTS (Kristy Rigot, System Director, Recruitment & Employee Relations) 7. LEGISLATIVE PRIORITIES (Approve) (Michael Nachef, Director, Government Relations) FINANCE PORTION - David Collins, Finance Liaison 8. CONSENT AGENDA (Approve) 1. Financial and Statistical Reports ending July 31, 2017 9. FY2018 BUDGET (Approve) (Ben Spence, Chief Financial & Business Services Officer) 1. FY2018 Operating Budget 2. FY2018 Capital Budget 3. FY2018 Room Rates 10. FINANCIAL AND STATISTICAL REPORTS OF AUGUST 31, 2017 (Ben Spence, Chief Financial & Business Services Officer) (Accept) LEE HEALTH BUSINESS Sanford Cohen, M.D., BOARD CHAIRMAN 11. FULL BOARD MEETING MINUTES OF 8/24/17 (Approve) Lee Memorial Health System Board of Directors

AGENDA (Page 2 of 2) FINANCE AND FULL BOARD OF DIRECTORS MEETINGS September 28, 2017 at 1:00 p.m. BOARD OF DIRECTORS OFFICE 239-343-1500 FAX: 239-343-1599 13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912 CAPE CORAL HOSPITAL GULF COAST MEDICAL CENTER HEALTHPARK MEDICAL CENTER LEE MEMORIAL HOSPITAL GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA THE REHABILITATION HOSPITAL LEE PHYSICIAN GROUP LEE CONVENIENT CARE Gulf Coast Medical Center Boardroom (Medical Office Building) 13685 Doctors Way, Ft. Myers, FL 33912 12. MEDICAL STAFF RECOMMENDATIONS (Approve) 1. Lee Memorial Hospital 2. Cape Coral Hospital 3. Gulf Coast Medical Center 4. HealthPark Medical Center 5. Golisano Children s Hospital of SWFL 13. OLD BUSINESS 14. NEW BUSINESS 15. BOARD MEETING CRITIQUE 16. BOARD OF DIRECTORS REPORTS 17. Date of the next Meeting: October 12, 2017 at 1:00 p.m. Planning Board and Full Board of Directors Gulf Coast Medical Center Boardroom 13685 Doctors Way, Ft. Myers, FL 33912 BOARD OF DIRECTORS DISTRICT ONE Stephen R. Brown, M.D. Therese Everly, BS, RRT 18. ADJOURN (Sanford Cohen, M.D., Board Chairman) DISTRICT TWO Donna Clarke Nancy M. McGovern, RN, MSM DISTRICT THREE Sanford N. Cohen, M.D. David Collins DISTRICT FOUR Diane Champion Chris Hansen DISTRICT FIVE Jessica Carter Peer Stephanie Meyer, BSN, RN Lee Memorial Health System Board of Directors

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

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

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

#2772 Rev. 01/17 Hurricane Irma Sept. 9-11, 2017

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

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

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

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

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

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

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

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

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

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

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

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

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

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

2017 Employee Engagement Survey Results September 28, 2017 Lee Memorial Health System Board of Directors Meeting #3400.159 Rev. 10/16

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

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

System Wide Results Overall response rate= 81.2%; 10,748 employees responded Lee Health grand mean = 81.54 Lee Health percentile rank = 98% Employee Engagement Index = 75.86 Positive increases in scores for 19 out of 31 questions You Talk, We Listen, Things Change! 3

100 Lee Health Grand Mean 90 80 78.35 79.94 80.25 81.01 81.43 81.54 72.16 71.96 72.51 75.34 73.85 70 60 50 2005 2006 2007 2009 2010 2012 2013 2014 2015 2016 2017 Grand Mean

100 Lee Health Work Environment Index 90 81.43 81.54 82.48 82.75 83.13 80 75.29 74.92 75.04 77.34 75.94 79.78 70 60 50 2005 2006 2007 2009 2010 2012 2013 2014 2015 2016 2017

100 Lee Health Job Role Index 90 80 77.69 78.04 78.89 79.18 79.52 75.84 73.36 70 70.25 68.58 70.73 69.53 60 50 2005 2006 2007 2009 2010 2012 2013 2014 2015 2016 2017

100 Lee Health Leader Index 90 80 77.26 78.71 80.08 80.54 81.07 81.72 81.43 72.62 73.70 72.64 70 70.48 60 50 2005 2006 2007 2009 2010 2012 2013 2014 2015 2016 2017

100 Lee Health Trifecta Index - Items 90 81.39 82.13 82.89 82.77 83.57 80 77.57 73.49 73.79 77.81 79.66 75.92 77.62 77.66 79.04 79.18 80.12 80.42 80.91 74.43 70 71.83 70.57 72.55 60 50 2005 2006 2007 2009 2010 2012 2013 2014 2015 2016 2017 I would recommend Lee Memorial Health System to friends as a good place to work. I see my job in a positive light and encourage others to consider it as a career. Overall, I am satisfied with my job.

100 90 Lee Health Employee Engagement Index - Items Aggregate score 75.86 80 70 69.27 67.48 65.80 66.90 70.22 67.62 74.38 68.60 65.57 70.14 67.36 75.86 71.26 72.99 73.29 72.11 76.44 77.15 74.52 73.55 77.76 77.86 74.02 74.10 75.00 75.62 60 50 2005 2006 2007 2010 2012 2013 2014 2015 2016 2017 I feel comfortable discussing issues or problems with leaders in my department. I have input in making decisions that affect my job. Work processes are designed in a way that allows me to do my work effectively.

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

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

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

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

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

Questions or comments Thank you! #3400.159 Rev. 10/16

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

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

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

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

Low Income Pool The reduction of federal LIP in FY 15-16 from $2 to $1 billion encouraged State lawmakers in the 2016 legislative session to dedicate $400 million in general revenue to help offset substantial losses to community, safety net, and teaching hospitals, which provide the significant share of healthcare services for the under and uninsured in Florida. The Legislature offset the loss of federal dollars with state general revenue including increases to Medicaid rates that helped to make hospitals whole when combined with the remaining $1 billion LIP program for FY 2015-16. LIP was further reduced to only $608 million for FY 2016-17 and with the funding formula dramatically changed to a new definition of charity care, many hospitals saw great reductions in state reimbursement, including Lee Health hospitals. During the 2017 Session, the State and CMS agreed to again increase LIP funding authorization to $1.5 billion. As a public hospital, Lee Health benefits from new LIP special terms and conditions that create a tier specifically to fund public hospitals that see disproportionately higher volumes of Medicaid and uninsured patients. In previous years, Disproportionate Share Hospital (DSH) payments had been redefined in Florida in order to help offset substantial losses in LIP. In the 2017 Session, DSH payments were cut substantially with the promise of additional LIP funds. Medicaid DSH payments are statutorily required payments intended to offset hospitals uncompensated care costs to improve access for Medicaid and uninsured patients as well as the financial stability of safety-net hospitals. States have broad flexibility in determining which hospitals receive DSH payments and in determining how the payments are calculated. Historically Florida has been disadvantaged compared to other large states with our DSH allocation being around $200 million compared to more than $1 billion for states like Texas and California. Lee Health encourages HHS to use its authority for flexibility to redistribute DSH to appropriately reflect individual states needs. When Congress passed the ACA in 2010, statutory cuts were built into DSH payments assuming that more patients would be insured and less uncompensated care would be occurring. This has not been the case in Florida and safety-net hospitals have been forced to lobby for DSH cut delays. Congress contemplated removing DSH cuts for ACA non-expansion states and increasing DSH rates for traditionally low DSH states, like Florida, during the ACA repeal and replace debate. Lee Health supports delaying or repealing DSH cuts and maintaining state flexibility in DSH payment distribution. 3

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

Potential Affordable Care Act Repeal and Replacement If the ACA is to be repealed and replaced, Lee Health supports a replacement program that does not utilize substantial cuts to Medicaid in order to cut ACA taxes. In the summer of 2017, The United States House of Representatives and United States Senate debated and voted on various plans to repeal and replace the ACA. Most all of their proposals included onerous cuts to Medicaid in order to fund ACA tax cuts. These cuts amounted to nearly 1 trillion dollars in reduced Medicaid spending, along with implementation of per-capita caps that would severely limit growth in the Medicaid program. The Senate Better Care Reconciliation Act did contemplate at least some positive approaches, including removal of ACA Disproportionate Share Hospital (DSH) cuts for non-expansion states and restoration of traditionally low DSH state payments to a national average for at least a four-year period. We view these approaches as positive when not coupled with substantial cuts to the Medicaid program. Lee Health supports repealing ACA DSH cuts and increasing Florida s traditionally low DSH funding. Trauma Funding and Regulation The Lee County Trauma Services District was created by a special act of the Florida Legislature, 2003-357, and is the only trauma service district in the State of Florida governed by a publicly elected board of directors, the same elected body as the Lee Health Board of Directors. The Regional Trauma Center at Lee Memorial Hospital, a State designated Level II Trauma Center, has served as a safety net to the injured patients from Lee, Collier, Charlotte, Hendry and Glades Counties for over 21 years. While the Trauma District has no taxing authority or local tax support, it has demonstrated area-wide leadership in developing an inclusive and collaborative system of injury care. This program of care is tailored to all of Southwest Florida and is guided by the needs of the residents we serve. The Regional Trauma Center at Lee Memorial Hospital received re-verification status three years ago certifying the trauma program complies with trauma care standards consistently and without exception There is no higher compliment to be had from a survey team. We are verified through June 2022. The Lee Health Board of Directors has approved a plan to move our Regional Trauma Center to our Gulf Coast Medical Center Campus by 2021. We encourage all stakeholders to support legislation that maintains the existing high performing trauma system, and funding for the existing trauma programs. Concerns exist over perceived less stringent standards being contemplated by the Florida Department of Health (DOH) and Florida Legislature which could be harmful to the quality of trauma care in our region. Data confirms that better outcomes are achieved when trauma center professionals treat a higher volume of 5

patients. Patient outcomes may be negatively impacted if trauma center patient populations are too far diluted by the opening of more trauma centers. It is our hope DOH will incorporate the suggestions of stakeholders to collaboratively work with providers to improve Florida s trauma system through the rulemaking process. We recommend DOH also engage the Florida Committee on Trauma, Association of Florida Trauma Coordinators and Association of Florida Trauma Program Managers to provide ongoing input from clinical professionals on such rules and standards. The American College of Surgeons (ACS) also recommended to DOH that it reconvene and work with the Florida Trauma System Advisory Council for ongoing collaboration for the best regulatory results. The Florida Trauma System Advisory Council has not been reconvened for the past several years. One of the biggest threats to optimal trauma care has been the recent insurgence of superfluous trauma centers. The findings of a recent study published in the medical journal Annals of Surgery, titled Impact of Volume Change Over Time on Trauma Mortality in the United States, reveal that the lightly regulated and poorly coordinated designation for trauma care centers in states like Florida has created an oversaturated system that dilutes patient volumes, leads to worse outcomes and generally does more harm than good. Many of these centers are charging exorbitant entry fees ( Activation Fees ) of up to $30,000.00 and moving into areas already served by an existing trauma center. Lead author of the aforementioned study, Joshua Brown, MD, a research fellow in the division of trauma and general surgery at the University of Pittsburgh School of Medicine said Siphoning of patients through unregulated growth of unnecessary trauma centers can have a profound detrimental impact on patients. GME - Statewide Medicaid Residency Program Lee Health is a qualified GME participant in the FSU Family Medicine Residency Program and supports continued funding for the GME medical residency program as well as the physician supplemental payment program. The Graduate Medical Education (GME) Statewide Medicaid Residency Program consists a state-wide pool of money used to provide funding to qualified participating hospitals involved in graduate medical education. Additionally, the GME Startup Bonus Program provides $100 million dollars to qualifying hospitals with newly approved residency positions in the statewide supply-and-demand deficit specialties. Supplemental payments are also available for physician educators within these programs. These new resident physicians will meet a critical need as a national physician shortage persists. Thus far, eight Family Practice 6

physicians who have completed their FSU residency program have stayed in the Southwest Florida community to practice. As we go forward, our goal is to retain 75% of the program s graduates in Southwest Florida. Telemedicine/Telehealth Lee Health supports the use of new technologies including telemedicine for improved patient care. Lee Health utilizes telemedicine in a multitude of care delivery scenarios. We implement telemedicine consultations in our children s hospital, home health, mental health through Lee Community Healthcare, and in our emergency departments. The use of this innovative technology allows more patients to receive better outcomes. The Florida Legislature created the Florida Telehealth Advisory Council in 2016. The Council is charged to make recommendations intended to increase the use and accessibility of services provided via telehealth. A report of these recommendations is due to the Governor, the President of the Senate, and the Speaker of the House of Representatives by October 31, 2017. Lee Health supports telemedicine legislation that requires certified clinical care being properly reimbursed. Mental Health/Substance Abuse Mental Health is a major pillar of overall health and wellbeing. Lee Health supports the use of federal, state, and local resources to address the opioid and substance abuse epidemic effecting the nation and SWFL. The substance abuse and mental health crisis has reached a problem of epidemic proportion. In FY 2016, we treated nearly 3,000 patients for substance abuse and 470 for substance overdose. Through June of 2017, we have treated 727 patients for substance overdose. Substance abuse and mental health patients create stress through utilization on our emergency departments, trauma center, and Neonatal Intensive care Unit (NICU) at the Golisano Children s Hospital of SWFL. Most auto-accident patients that arrive in our Trauma Center due to the severity of their injury are impaired. Babies born with opioid withdrawal through dependency obtained during pregnancy are treated in our NICU. Resources are needed to implement a more robust continuum of care after discharge from emergency departments. Need for stability, education, mental health treatment from licensed professionals, and medication assisted treatment are paramount to properly addressing this crisis. Community resources that currently exist must be properly coordinated to support the needs of our region. September 2017 7

Board of Directors Legislative Update Michael Nachef Director, Government Relations Mary Andrews System Director, Government and Community Relations September 28, 2017 #3400.159 Rev. 10/16

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

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

3

4

5

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

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

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

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

Telemedicine/Telehealth Lee Health supports the use of telemedicine to improve patient care and is hopeful that the Florida Legislature will enact legislation requiring that certified clinical care be properly reimbursed. The Florida Legislature created the Florida Telehealth Advisory Council in 2016. The Council is charged to make recommendations intended to increase the use and accessibility of services provided via telehealth. A report of these recommendation is due to the Governor, the President of the Senate, and the Speaker of the House of Representatives by October 31, 2017. Lee Health supports telemedicine legislation that requires certified clinical care being properly reimbursed. 10

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

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

State Legislative Update Strong economic growth over the past 3 years and resolution of the Seminole Compact should account for a $1.2 billion growth in general revenue for FY 18-19. Medicaid base rates were cut $521 million dollars in FY 2017 and not all providers were made whole with LIP. Increasing base Medicaid funding by at least $250.4 million to account for growth in the program will be a top priority. Expect legislation again pertaining to Certificate of Need deregulation, Trauma Center deregulation, changes to scope of practice for various providers, and attempts to address the opioid and substance abuse epidemic. The damage inflicted by Hurricane Irma will cause additional strains on the state budget that had not been forecasted. 13

Thank You

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

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

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

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

Lee Memorial Health System Operating Highlights For the month ended July 31, 2017 Adjusted admits for the month ended July 31, 2017 are 11,180 which is 397 or 3.4% less than budget. Actual inpatient admits for the month are 6,052 which are 202 admits or 3.2% less than budget. Inpatient days are 31,807 or 1.4% lower than budget which resulted in a 5.26 day length of stay. Emergency room visits are 0.9% less than budget at 16,957 and outpatient surgeries of 1,701 are less than budget by 15.8%. Net patient revenue for July reflects a $5.7 million or 4.2% favorable variance to budget. The majority of this variance is due to a rate variance of $10.3 million offset by a negative volume variance $4.6 million. Net Patient Revenue per CMI adjusted admit for the month ended July 31, 2017 is $8,040 vs. budget of $7,505. Total operating expenses before depreciation and interest expense are 1.1% greater than budget. Salaries & Wages are greater than budget at $67.6 million, and above budget on a case mix adjusted admission basis by $102 as well. The majority of this variance ($1.2 million) was due to staff not flexing to the volumes. The average hourly pay rate is $34.48 which is $0.11 higher than budget. Productivity as measured by FTEs/AOB is unfavorable to budget by 3.4% (5.84 actual vs. 5.64 budget). Productive FTE s per adjusted daily admission were 3.9% greater than budget at 27.65 vs. a budget of 26.60. Supply expense is lower than budget by $0.3 million or 1.3%, while on a case mix adjusted admission basis the supply variance is unfavorable at $1,454 actual vs. $1,433 budget. Total operating costs per case mix adjusted admit are greater than budget at $7,091 actual vs. $6,824. For July 2017, the gain from operations is $3.8 million or 2.7% versus a budget of $4.5 million or 3.2%. Excess revenue over expenses is a gain of $22.3 million versus a budget of $10.2 million. The majority of this is due to investment returns being greater than expected. For the month, Cash & Investments increased by $24.5 million to $1,012.9 million. Total sources of cash from operations are $15.3 million and from investments are $16.4 million offset by uses of cash totaling $7.2 million. The majority of the uses of cash were due to cash outflows of $9.8 million for purchases of property, plant & equipment. Days in Accounts Receivable increased from 44.9 days in June to 47.2 days resulting in a $6.3 million decrease in cash. Total Notes & Bonds payable on July 31, 2017 is $681.9 million resulting in the Cash to Debt ratio of 148.5%. Page A.1

LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED EXECUTIVE SUMMARY For the Period Ending July 31, 2017 CURRENT MONTH Budget Actual Prior Year Budget Actual Prior Year Inpatient Volumes: Admits - Adults & Peds 6,254 6,052 5,870-3.2% 3.1% 67,408 67,268 66,603-0.2% 1.0% Patient Days - Adults & Peds 32,247 31,807 30,319-1.4% 4.9% 344,124 341,373 339,242-0.8% 0.6% Short Stay Days 4,699 4,175 4,652-11.2% -10.3% 46,901 47,713 46,438 1.7% 2.7% Total Patient Days plus Short Stay Days 36,947 35,982 34,971-2.6% 2.9% 391,025 389,086 385,680-0.5% 0.9% Average Length of Stay 5.16 5.26 5.17-1.9% -1.8% 5.11 5.07 5.09 0.6% 0.4% Inpatient Surgeries 1,776 1,679 1,511-5.5% 11.1% 18,310 18,467 17,837 0.9% 3.5% Outpatient Volumes: Emergency Room Visits 17,108 16,957 16,660-0.9% 1.8% 185,610 184,442 180,074-0.6% 2.4% Outpatient Surgeries 2,020 1,701 1,794-15.8% -5.2% 20,354 19,608 20,278-3.7% -3.3% Hospital Based Physician Visits 37,971 29,035 28,731-23.5% 1.1% 396,192 343,022 361,930-13.4% -5.2% Physician Visits 74,395 72,092 63,901-3.1% 12.8% 803,519 809,502 695,139 0.7% 16.5% Home Health Visits 7,269 4,535 5,000-37.6% -9.3% 71,277 56,404 56,795-20.9% -0.7% Adjusted Admits 11,577 11,180 10,820-3.4% 3.3% 124,589 124,507 120,746-0.1% 3.1% (overall in/outpat volume indicator) Total Case Mix Index 1.56 1.57 1.55 0.7% 1.3% 1.56 1.56 1.55 0.2% 0.7% Operating Ratios: Net Revenue/Adj Adm CMI 7,505 8,040 7,339 7.1% 9.6% 7,179 7,302 7,067 1.7% 3.3% Operating Exp/Adj Adm CMI 6,824 7,091 6,885-3.9% -3.0% 6,521 6,654 6,397-2.0% -4.0% Supply Exp/Adj Adm CMI 1,433 1,454 1,381-1.4% -5.2% 1,393 1,435 1,380-3.0% -4.0% Wages/Ben - % of Net Oper Rev 55.0% 54.6% 56.9% 0.7% 4.0% 54.7% 54.1% 53.3% 1.1% -1.5% Supplies as a % of Net Oper Rev 18.6% 18.3% 18.3% 1.7% 0.3% 18.9% 19.2% 19.0% -1.5% -1.0% Charity/Bad Debt - % of Gross Rev 6.7% 7.1% 7.9% -4.9% 10.8% 6.8% 6.7% 6.5% 1.6% -1.7% FTEs/AOB 5.64 5.84 5.80-3.4% -0.6% 5.42 5.47 5.34-0.9% -2.5% Productive Hours/Adjusted Admit 152.0 158.0 154.3-3.9% -2.4% 144.6 144.2 141.2 0.3% -2.1% Average Hourly Rate 34.37 34.48 33.04-0.3% -4.3% 34.12 34.40 33.01-0.8% -4.2% Financial Ratios: Operating Margin (%) 3.2% 2.7% 1.4% -14.9% 101.1% 4.9% 4.6% 5.3% -6.2% -13.9% Excess Margin (%) 7.0% 14.1% 15.6% 101.1% -9.2% 8.5% 9.8% 10.5% 14.9% -6.3% Liquidity Ratios: Days Cash on Hand 241.7 248.54 269.31 Cash to Debt (%) 157.2% 148.5% 143.8% Days in Acct Receivable 43.4 47.2 44.4 Income Statement Summary (in Thousands) Total Net Operating Revenue 138,997 139,479 126,195 0.3% 10.5% 1,426,255 1,450,241 1,356,248 1.7% 6.9% Total Operating Expenses 134,526 135,662 124,477-0.8% -9.0% 1,356,335 1,383,555 1,283,777-2.0% -7.8% Consolidated Gain(Loss) from Oper 4,471 3,818 1,718-14.6% 122.2% 69,920 66,686 72,471-4.6% -8.0% Investment Earnings/Non Op Income 5,698 18,510 21,229 224.9% -12.8% 56,656 83,830 77,714 48.0% 7.9% Consolidated Excess Rev over Exp 10,169 22,328 22,947 119.6% -2.7% 126,576 150,516 150,185 18.9% 0.2% Balance Sheet Highlights (In Thousands): Cash & Investments 1,040,707 1,012,901 1,017,657 Bonds & Notes Payable 662,154 681,900 707,727 Act to Bud % Variance Act to Prior % Variance YEAR-to-DATE Act to Bud % Variance Act to Prior % Variance CMI = Case Mix Index Page A.2

LEE HEALTH CONSOLIDATED STATISTICAL SUMMARY For the Period Ending July 31, 2017 Budget Actual Current Month Year-to-Date Prior Year % Variance % Variance Budget Actual Prior Year Act to Bud Act to PY Act to Bud Act to PY Admissions ADULTS 5,614 5,517 5,320-1.7% 3.7% 60,599 61,529 60,140 1.5% 2.3% PEDIATRICS 336 268 258-20.2% 3.9% 3,749 2,985 3,595-20.4% -17.0% NICU 69 69 77 0.0% -10.4% 694 663 700-4.5% -5.3% POST ACUTE 235 198 215-15.8% -7.9% 2,366 2,091 2,169-11.6% -3.6% Total Adult & Peds 6,254 6,052 5,870-3.2% 3.1% 67,408 67,268 66,604-0.2% 1.0% NEWBORNS 528 558 515 5.6% 8.3% 5,081 5,035 5,039-0.9% -0.1% Total Admissions 6,783 6,610 6,385-2.5% 3.5% 72,489 72,303 71,643-0.3% 0.9% Patient Days ADULTS 24,360 24,603 23,372 1.0% 5.3% 266,789 270,604 266,896 1.4% 1.4% PEDIATRICS 1,085 899 936-17.1% -4.0% 12,297 10,407 11,756-15.4% -11.5% NICU 1,611 1,614 1,362 0.2% 18.5% 13,925 13,902 13,172-0.2% 5.5% POST ACUTE 5,191 4,691 4,649-9.6% 0.9% 51,114 46,460 47,418-9.1% -2.0% Total Adult & Peds 32,247 31,807 30,319-1.4% 4.9% 344,124 341,373 339,242-0.8% 0.6% NEWBORNS 1,116 1,241 1,189 11.2% 4.4% 11,453 11,363 11,549-0.8% -1.6% Total Patient Days 33,364 33,048 31,508-0.9% 4.9% 355,577 352,736 350,791-0.8% 0.6% Average Length of Stay ADULTS 4.34 4.46 4.39-2.8% -1.5% 4.40 4.40 4.44 0.1% 0.9% PEDIATRICS 3.23 3.35 3.63-3.9% 7.5% 3.28 3.49 3.27-6.3% -6.6% NICU 23.35 23.39 17.69-0.2% -32.2% 20.06 20.97 18.82-4.5% -11.4% POST ACUTE 22.08 23.69 21.62-7.3% -9.6% 21.60 22.22 21.86-2.9% -1.6% Total Adult & Peds 5.16 5.26 5.17-1.9% -1.8% 5.11 5.07 5.09 0.6% 0.4% NEWBORNS 2.11 2.22 2.31-5.3% 3.7% 2.25 2.26 2.29-0.1% 1.5% Total Length of Stay 4.92 5.00 4.93-1.6% -1.3% 4.91 4.88 4.90 0.5% 0.4% OP Registrations EMERGENCY ROOM 17,108 16,957 16,660-0.9% 1.8% 185,610 184,442 180,074-0.6% 2.4% OP SURGERY CASES 2,020 1,701 1,794-15.8% -5.2% 20,354 19,608 20,278-3.7% -3.3% Subtotal 19,128 18,658 18,454-2.5% 1.1% 205,964 204,050 200,352-0.9% 1.8% Visits HOME HEALTH VISITS 7,269 4,535 5,000-37.6% -9.3% 71,277 56,404 56,836-20.9% -0.8% HOSP BASED PHY VISITS 37,971 29,035 28,731-23.5% 1.1% 396,192 343,022 361,930-13.4% -5.2% PHYSICIAN VISITS 74,395 72,092 63,901-3.1% 12.8% 803,519 809,502 695,139 0.7% 16.5% TRAUMA SERVICES DISTRICT 890 844 525-5.2% 60.8% 11,133 9,934 10,403-10.8% -4.5% Subtotal 120,525 106,506 98,157-11.6% 8.5% 1,282,121 1,218,862 1,124,308-4.9% 8.4% TOTAL OP 139,653 125,164 116,611-10.4% 7.3% 1,488,085 1,422,912 1,324,660-4.4% 7.4% Page A.3

LEE MEMORIAL HEALTH SYSTEM CONSOLIDATING STATEMENT OF OPERATIONS For the Period Ending July 31, 2017 (in thousands) Current Month Year-to-Date Act to Bud % Act to Prior Budget Actual Prior Year Variance % Variance Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance INPATIENT REVENUE 323,065 309,801 283,049-4.1% 9.5% 3,419,842 3,392,219 3,231,719-0.8% 5.0% OUTPATIENT REVENUE 274,951 262,504 238,695-4.5% 10.0% 2,900,989 2,886,472 2,627,117-0.5% 9.9% TOTAL PATIENT REVENUE 598,015 572,305 521,744-4.3% 9.7% 6,320,831 6,278,691 5,858,837-0.7% 7.2% DED FROM REV-MEDICARE 253,020 228,855 196,925 9.6% -16.2% 2,627,301 2,687,924 2,302,056-2.3% -16.8% DED FROM REV-MEDICAID 72,622 69,154 55,123 4.8% -25.5% 715,007 716,451 599,984-0.2% -19.4% DED FROM REV-CHARITY 21,295 28,006 23,638-31.5% -18.5% 224,697 237,626 201,382-5.8% -18.0% DED FROM REV-HMO/PPO 56,673 60,293 54,058-6.4% -11.5% 595,027 626,104 569,273-5.2% -10.0% DED FROM REV-OTHER 40,038 32,491 51,310 18.8% 36.7% 564,880 413,143 682,893 26.9% 39.5% DED FROM REV-BAD DEBT 19,065 12,505 17,745 34.4% 29.5% 202,889 180,358 182,138 11.1% 1.0% TOTAL DED FROM REV 462,714 431,304 398,799 6.8% -8.2% 4,929,801 4,861,606 4,537,726 1.4% -7.1% NET PATIENT REVENUE 135,301 141,001 122,945 4.2% 14.7% 1,391,030 1,417,085 1,321,110 1.9% 7.3% OTHER OPERATING REVENUE 3,696 (1,522) 3,250-141.2% -146.8% 35,226 33,157 35,138-5.9% -5.6% TOTAL OPERATING REV 138,997 139,479 126,195 0.3% 10.5% 1,426,255 1,450,241 1,356,248 1.7% 6.9% OPERATING EXPENSES PROD SALARIES 58,556 57,532 52,827 1.7% -8.9% 590,741 582,238 529,677 1.4% -9.9% PROD OVERTIME 1,662 1,739 1,780-4.6% 2.3% 17,508 20,296 20,105-15.9% -0.9% CONTRACT LABOR 66 86 582-29.4% 85.3% 1,619 2,290 3,375-41.4% 32.1% NON-PROD SALARIES 5,891 8,214 6,060-39.4% -35.5% 62,279 74,547 66,047-19.7% -12.9% TOTAL SALARIES & WAGES 66,176 67,570 61,250-2.1% -10.3% 672,147 679,371 619,204-1.1% -9.7% FRINGE BENEFITS 10,251 8,565 10,529 16.5% 18.7% 107,932 104,927 103,256 2.8% -1.6% HEALTH CARE ACCESS 1,544 1,631 1,453-5.6% -12.2% 16,228 16,646 14,848-2.6% -12.1% SUPPLIES 25,842 25,493 23,138 1.3% -10.2% 269,955 278,572 257,919-3.2% -8.0% OTHER SERVICES 6,546 6,608 6,261-0.9% -5.5% 68,970 67,155 69,411 2.6% 3.3% PURCHASED SERVICES 12,662 14,496 12,700-14.5% -14.1% 128,375 144,658 131,285-12.7% -10.2% TOTAL OPER EXPENSES 123,021 124,363 115,331-1.1% -7.8% 1,263,608 1,291,330 1,195,923-2.2% -8.0% EBITDA 15,976 15,116 10,864-5.4% 39.1% 162,648 158,912 160,325-2.3% -0.9% DEPRECIATION/AMORT 9,433 9,322 7,338 1.2% -27.0% 75,047 74,569 69,388 0.6% -7.5% INTEREST EXPENSE 2,073 1,976 1,808 4.7% -9.3% 17,681 17,656 18,466 0.1% 4.4% OVERHEAD ALLOCATION (0) (0) 0-31.3% 450.0% 0 0 (0) -49584.2% 4377.8% GAIN(LOSS) FROM OPER 4,471 3,818 1,718-14.6% 122.2% 69,920 66,686 72,471-4.6% -8.0% Page A.4

LEE MEMORIAL HEALTH SYSTEM STATEMENT OF CASH FLOWS For the Period Ending July 31, 2017 (In thousands) Current Month Year to Date Sources of Cash: Gain From Operations 3,818 66,686 Non Operating Revenue (excluding Investment Income) 2,130 9,368 Depreciation & Amortization 9,322 74,569 (Gain)/Loss on Sale of Assets (6) (24) Total Sources of Cash 15,264 150,600 Uses of Cash: Change in Patient Accounts Receivable (6,316) (30,403) Repayments Long Term Debt Principal (1,840) (21,074) Additions to Property, Plant & Equipment, Net (9,794) (158,532) Change in All Other Assets (1,715) 7,133 Change in All Other Liabilities 12,491 (19,862) Total Uses of Cash (7,174) (222,737) Cash Provided (Used) Prior to Investment Income 8,094 (72,137) Cash Provided from Investment Income 16,380 74,462 Cash Provided (Used) 24,470 2,325 Cash Balance, beginning of period 988,431 1,010,576 Cash Balance, end of period 1,012,901 1,012,901 Total Bonds & Notes Payable 681,900 Cash to Debt Ratio 148.5% Page A.5

LEE MEMORIAL HEALTH SYSTEM CONSOLDIATED BALANCE SHEET For the Period Ending July 31, 2017 in Thousands (000's) ASSETS Current Prior Month Prior Year LIABILITIES AND NET ASSETS Current Prior Month Prior Year Current Assets: Current Liabilities: Cash and Cash Equivalents * 25,259 17,613 43,265 Accounts Payable 44,456 37,850 55,692 Short-term Cash Investments * 962,492 945,821 943,046 Current Installments of LT Debt 38,048 38,091 36,321 Assests whose use is restricted 369 364 8,034 Accrued Expenses Net Patient Accounts Receivable 218,571 212,255 188,168 Employee Compensation 36,672 30,905 40,035 Inventory 31,757 31,708 30,660 Interest 4,505 3,744 8,308 Other Current Assets 33,344 33,371 35,049 Other 28,175 30,031 36,744 Estimated Third Party 51,478 53,090 59,307 Total Current Assets 1,271,791 1,241,131 1,248,222 Total Current Liabilities 203,334 193,710 236,408 Noncurrent Assets: NonCurrent Liabilities: Long Term Investments - - - Assests whose use is restricted * 25,150 24,998 24,265 Capital Assets, Net 944,216 943,738 860,229 LT Debt Excluding Current Installments 643,852 645,698 669,661 Other Assets, Net 40,999 39,047 37,300 Other Liabilities 98,847 95,911 82,869 Total Noncurrent Assets 1,010,365 1,007,782 921,794 Total Noncurrent Liabilities 742,700 741,609 752,529 Deferred Outflows of Resources: Deferred Inflows of Resources: Deferred Loss on Debt Refunding 2,609 2,658 5,617 Excess Consideration Provided for Acquisition 102,095 102,354 104,654 Deferred Inflows on Pension 4,428 4,537 5,468 Total Deferred Outflows of Resources 104,704 105,011 110,271 Total Deferred Inflows of Resources 4,428 4,537 5,468 Net Position: Restricted for Non-Expendable 5,992 5,992 5,992 Expendable 33,753 32,738 58,232 Net Investment in Capital Assets 262,316 259,949 154,247 Unrestricted 1,134,337 1,115,391 1,067,411 Total Net Position 1,436,398 1,414,070 1,285,882 Total Assets and Deferred Outflows of Resources 2,386,860 2,353,925 2,280,287 Total Liabilities and Net Position 2,386,860 2,353,925 2,280,287 * Cash & Investments Page A.6

LEE MEMORIAL HEALTH SYSTEM FINANCIAL RATIOS For the Period Ending July 31, 2017 2015 2017 2016 Moody's Financial FYE YTD Median Goals 9/30/2016 07/31/17 PROFITABILITY RATIOS: Operating Margin 3.9% 4.0% 5.2% 4.6% + Excess Margin 6.7% 8.2% 9.9% 9.8% + Operating Cash Flow Margin 10.8% 10.9% 11.6% 11.0% + LIQUIDITY RATIOS: Days Cash on Hand 227.5 240.4 252.6 235.2 + Cushion Ratio (x) 21.0 16.0 16.3 16.6 + Cash to Debt 158.9% 152.2% 143.1% 148.5% + CAPITALIZATION RATIOS: Debt to Capitalization 32.8% 33.7% 36.6% 33.2% (-) Annual Debt Service Coverage (x) 5.5 3.5 5.8 4.3 + Debt to Cash Flow 2.6 3.4 2.5 3.2 (-) NOTE: + = Ratios that should be above the Moody's median (-) = Ratios that should be lower than the Moody's median Page A.7

LEE MEMORIAL HEALTH SYSTEM OPERATING RATIOS For the Period Ending July 31, 2017 (in thousands) Current Month Budget Actual Prior Year Act to Bud % Variance Year-to-Date Act to Prior % Variance Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance AS % NET OPERATING REVENUE Wages and Benefits 55.0% 54.6% 56.9% 0.7% 4.0% 54.7% 54.1% 53.3% 1.1% -1.5% Supplies 18.6% 18.3% 18.3% 1.7% 0.3% 18.9% 19.2% 19.0% -1.5% -1.0% All Other Operating Expenses 14.9% 16.3% 16.2% -9.2% -0.8% 15.0% 15.8% 15.9% -5.2% 0.9% Capital Costs 8.3% 8.1% 7.2% 2.1% -11.8% 6.5% 6.4% 6.5% 2.2% 1.8% EBDITA Margin 11.5% 10.8% 8.6% -5.7% 25.9% 11.4% 11.0% 11.8% -3.9% -7.3% Operating Margin 3.2% 2.7% 1.4% -14.9% 101.1% 4.9% 4.6% 5.3% -6.2% -13.9% Excess Margin 7.0% 14.1% 15.6% 101.1% -9.2% 8.5% 9.8% 10.5% 14.9% -6.3% Per CMI ADJ ADMIT/VISIT Net Operating Revenue 7,710 7,953 7,533 3.2% 5.6% 7,360 7,473 7,255 1.5% 3.0% Total Operating Expenses 6,824 7,091 6,885-3.9% -3.0% 6,521 6,654 6,397-2.0% -4.0% Wages and Benefits 4,239 4,341 4,285-2.4% -1.3% 4,026 4,041 3,865-0.4% -4.6% Supplies 1,433 1,454 1,381-1.4% -5.2% 1,393 1,435 1,380-3.0% -4.0% All Other Operating Expenses 1,151 1,296 1,219-12.6% -6.4% 1,102 1,177 1,153-6.8% -2.1% Capital Costs 638 644 546-0.9% -18.0% 479 475 470 0.7% -1.1% Operating Margin 248 218 103-12.2% 112.3% 361 344 388-4.8% -11.4% Excess Margin 564 1,273 1,370 125.7% -7.1% 653 776 803 18.7% -3.5% LABOR Productive FTE's/Adj Daily Admit 26.60 27.65 27.01-3.8% -2.3% 25.31 25.24 24.72 0.3% -2.1% Average Hourly Rate 34.37 34.48 33.04-0.3% -4.2% 34.12 34.40 33.01-0.8% -4.0% OP Rev % of Total Revenue 46.0% 45.9% 45.7% -0.2% 0.3% 45.9% 46.0% 44.8% 0.2% 2.5% Page A.8

LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED - PAYOR MIX (BASED ON GROSS REVENUE) For the Period Ending July 31, 2017 Current Month Budget Actual Prior Year Budget Year-to-Date Actual Prior Year MEDICARE 34.5% 34.4% 32.2% 34.7% 33.8% 34.4% MEDICARE HMO 13.4% 14.5% 13.9% 13.5% 15.3% 13.7% MEDICAID 3.3% 4.8% 2.5% 3.3% 3.3% 3.2% MEDICAID HMO 9.7% 9.7% 9.8% 9.3% 9.2% 9.2% HMO/PPO 18.0% 21.1% 19.4% 17.9% 18.5% 18.3% COMMERCIAL 4.0% 4.0% 3.1% 4.0% 3.8% 3.9% OTHER 17.1% 11.5% 19.1% 17.3% 16.1% 17.3% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% MEDICARE CASE MIX INDEX 1.68 1.68 1.71 1.67 1.67 1.68 SYSTEM CASE MIX INDEX 1.56 1.57 1.55 1.56 1.56 1.55 (In Thousands) 09/30/16 07/31/17 Variance Gross Accounts Receivable 437,137 491,309 54,172 Net Accounts Receivable 189,413 218,571 29,158 Net Days in Accounts Receivable 44.6 47.2 2.6 Page A.9

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

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

Lee Health System FY 2018 Operating and Capital Budgets Fiscal Year Ending September 30, 2018 #3400.159 Rev. 10/16

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

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

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

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

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

Medicaid and Low Income Pool Low Income Pool Potential Medicaid Disproportionate Share Reduction Medicaid Legislated Hospital Rate Cuts Net Increase +20.3 million - 8.3 million - 10.3 million $ 1.7 million

Inpatient Volume Summary FY 2016 FY 2017 FY 2018 % Admissions Actual Projected Budget Variance Adults 71,329 72,954 73,458 0.7% Pediatrics 4,162 3,540 3,795 7.2% NICU 851 862 876 1.6% Post Acute 2,582 2,574 2,896 12.5% Total Adult & Peds 78,924 79,930 81,025 1.4% Newborns 6,187 5,914 5,911-0.1% Total Admissions 85,111 85,844 86,936 1.3% Patient Days Adults 314,275 320,559 319,634-0.3% Pediatrics 13,596 12,417 12,814 3.2% NICU 16,178 17,295 17,531 1.4% Post Acute 56,861 54,950 60,356 9.8% Total Adult & Peds 400,910 405,221 410,335 1.3% Newborns 14,277 11,980 13,757 14.8% Total Patient Days 415,187 417,201 424,092 1.7% Average Length of Stay Adults 4.41 4.39 4.35-1.0% Pediatrics 3.27 3.51 3.38-3.7% NICU 19.01 20.06 20.01-0.3% Post Acute 22.02 21.35 20.84-2.4% Total Adult & Peds 5.08 5.07 5.06-0.1% Newborns 2.31 2.03 2.33 14.9% Total Average Length of Stay 4.88 4.86 4.88 0.4% Short Stay Days (OBS days) 55,554 55,764 58,963 5.7% Average Daily Census 1,247 1,263 1,286 1.8% Includes OBS days

Outpatient Volume Summary FY 2016 FY 2017 FY 2018 % Actual Projected Budget Variance OP Registrations Emergency Room 214,940 216,142 224,374 3.8% OP Surgery Cases 24,355 23,560 24,315 3.2% Subtotal 239,295 239,702 248,689 3.7% Visits / Encounters Home Health Visits 68,310 67,685 74,236 9.7% Physician Encounters 1,299,470 1,402,148 1,534,704 9.5% Trauma Services District 12,505 12,165 13,075 7.5% Subtotal 1,380,285 1,481,998 1,622,015 9.4% Total Outpatient 1,619,580 1,721,700 1,870,704 8.7%

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

Income Statement Summary Variance FY 2016 FY 2017 FY 2018 Budget '18 vs Proj '17 Actual Projected Budget $ % Net Patient Revenue 1,588,220 1,674,476 1,758,862 84,386 5.0% Other Operating Revenue 42,707 41,555 42,109 554 1.3% Total Operating Revenue 1,630,927 1,716,031 1,800,970 84,939 4.9% Operating Expenses Salaries & Wages 744,854 801,938 847,158 45,220 5.6% Fringe Benefits 120,897 128,050 133,997 5,947 4.6% Health Care Assessment 17,929 19,304 20,455 1,151 6.0% Supplies 310,247 329,737 341,140 11,403 3.5% Other Services 83,875 81,764 80,929 (835) -1.0% Purchased Services 164,191 163,892 178,174 14,282 8.7% Total Operating Expenses 1,441,993 1,524,685 1,601,852 77,167 5.1% EBITDA 188,934 191,346 199,118 7,772 4.1% Depreciation/ Amortization 81,890 92,684 99,818 7,134 7.7% Interest Expense 22,113 22,189 19,010 (3,179) -14.3% Gain (loss) from Operations 84,931 76,473 80,290 3,817 5.0% Operating Margin % 5.2% 4.5% 4.5% Total Non Operating Revenue 85,775 89,695 67,978 (21,717) -24.2% Excess of Revenue/Expenses 170,706 166,168 148,268 (17,900) -10.8%

Financial Ratios LMHS Goals 2018 A MOODY'S MEDIANS AUDIT 2016 PROJ 2017 BUDGET 2018 Profitability Ratios: Operating Margin 4.5% 3.2% 5.2% 4.5% 4.5% + Excess Margin 6.8% 6.1% 9.9% 9.2% 7.9% + Operating Cash Flow Margin 11.2% 10.0% 11.6% 11.2% 11.1% + Liquidity Ratios: Days Cash on Hand 199.7 215.5 252.6 238.4 209.4 + Cushion Ratio 14.2 22.2 16.3 16.3 15.0 + Cash to Debt 135.5% 160.6% 143.1% 148.9% 143.7% + Capital Ratios: Debt to Capitalization (%) 30.4% 33.9% 36.6% 32.8% 29.6% (-) Annual Debt Service Coverage 3.5 5.5 5.8 3.9 4.0 + Debt to Cash Flow 3.4 2.7 2.5 3.1 3.0 (-) Note + = Ratios that should be above the Moody's median (-) = Ratios that should be lower than the Moody's median

Capital Budget & Cashflow ACUTE CARE 13,068,635 SUBS & CORPORATE 772,986 POST ACUTE 506,009 OUTPATIENT 2,522,465 LPG/MSO 787,832 SURGICAL SERVICES 6,151,037 RADIOLOGY 5,954,626 CONTINGENCY 1,500,000 ROUTINE 31,263,590 FACILITIES 12,000,000 INFORMATION TECHNOLOGY 15,040,160 STRATEGIC GROWTH/PROGRAM DEVELOPMENT 21,696,250 TOTAL PROPOSED CAPITAL BUDGET 2018 80,000,000 CASHFLOW FROM OPERATIONS AVAILABLE FOR CAPITAL 213,314,311 CAPITAL BUDGET AS A % OF CASHFLOW 37.5% EXCESS (DEFICIT) 133,314,311

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

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

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested ACUTE CARE 227 Lee Memorial Hospital, Hosp Based Phy 10850000 ENVIRONMENTAL SERVICES Vacuum-Carpet (Upright) 6 3,756 296 Lee Memorial Hospital, Hosp Based Phy 10850000 ENVIRONMENTAL SERVICES Mattress-Bed (Versacare) 30 22,050 297 Lee Memorial Hospital, Hosp Based Phy 10659000 TRANSPORTATION SVS Stretcher with 5th Wheel 1 6,200 298 Lee Memorial Hospital, Hosp Based Phy 10850000 ENVIRONMENTAL SERVICES Scrubber (Focus II 32 BOOST) 1 10,600 311 Lee Memorial Hospital, Hosp Based Phy 10850000 ENVIRONMENTAL SERVICES Other, Aqius Ozone Clean Core Fill Station 6 11,922 469 Lee Memorial Hospital, Hosp Based Phy 10712000 CARDIOVASCULAR SERVICES Holter Monitor, Add 25 Monitors for new holter system 25 45,000 588 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Other, Sewer Drain Cleaning machine 1 800 609 Lee Memorial Hospital, Hosp Based Phy 10600000 NURSING ADMINISTRATION Pulse Oximeter-Table Top, Obstructive Sleep Apnea Risk Screening and Monitor 150 523,500 686 Lee Memorial Hospital, Hosp Based Phy 10678000 EMERGENCY SERVICES Recliner-Patient 4 14,000 687 Lee Memorial Hospital, Hosp Based Phy 10850000 ENVIRONMENTAL SERVICES Other, CCO Clean Core Chemical Free Caddy 1 4,422 720 Lee Memorial Hospital, Hosp Based Phy 10678000 EMERGENCY SERVICES Other, Site-Rite hand held Preview ultrasound 1 8,900 726 Lee Memorial Hospital, Hosp Based Phy 10678000 EMERGENCY SERVICES Cardiac Monitor (MX450) 1 449,500 727 Lee Memorial Hospital, Hosp Based Phy 10678000 EMERGENCY SERVICES Cardiac Monitor (MP5) 2 27,745 964 Lee Memorial Hospital, Hosp Based Phy 10618000 N3 PCU Vital Signs Monitor (VS4 w/ temp), Vital sign machine with temp 3 12,900 973 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Other, Chipping Hammer Routine Cap 1 1,000 977 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Other, Dehumidifiers DRI-EAZ 2 4,050 984 Lee Memorial Hospital, Hosp Based Phy 10614000 ORTHOPEDICS CENTER Vital Signs Monitor (VS4 w/ temp) 3 12,900 992 Lee Memorial Hospital, Hosp Based Phy 10618000 N3 PCU Other, Accucheck Inform 2 2 1,970 1000 Lee Memorial Hospital, Hosp Based Phy 10618000 N3 PCU Doppler-Vascular 1 773 1003 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Other, Clarke Summit 20 Gallon wet vacuum 5 4,500 1007 Lee Memorial Hospital, Hosp Based Phy 10669000 INFUSION CENTER Defibrillator-Complete 1 11,750 1023 Lee Memorial Hospital, Hosp Based Phy 10624000 NEURO Vital Signs Monitor (VS4 w/ temp), SureSigns VS4 NBP, SPO2 with Temperature Probe 1 4,300 1024 Lee Memorial Hospital, Hosp Based Phy 10612000 GENERAL MED/INFECTIOUS DISEASE Vital Signs Monitor (VS4 w/ temp) 3 12,900 1027 Lee Memorial Hospital, Hosp Based Phy 10624000 NEURO Vital Signs Monitor (VS4 w/ temp), SureSigns VS4 NBP, SPO2 with Temperature Probe 1 4,300 1032 Lee Memorial Hospital, Hosp Based Phy 10628000 NEURO PCU Vital Signs Monitor (VS4 w/ temp), SureSigns VS4 NBP, SPO2 with Temperature Probe 1 4,300 1012 Lee Memorial Hospital, Hosp Based Phy 10612000 GENERAL MED/INFECTIOUS DISEASE Pulse Oximeter-Hand Held 3 1,710 1067 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Other, Milwaukee Pro Press Tool 1 3,500 1086 Lee Memorial Hospital, Hosp Based Phy 10659000 TRANSPORTATION SVS Other, Stretcher Mattress 4 4,000 1139 Lee Memorial Hospital, Hosp Based Phy 10641000 SICU NURSING Other, Phillips module cable for Cheetah 2 7,945 1141 Lee Memorial Hospital, Hosp Based Phy 10640000 MICU NURSING Other, Phillips module cable for Cheetah 2 7,945 1142 Lee Memorial Hospital, Hosp Based Phy 10641000 SICU NURSING Doppler-Vascular, Portable hand held 2 1,546 1153 Lee Memorial Hospital, Hosp Based Phy 10640000 MICU NURSING Doppler-Vascular, portable hand held 2 1,546 1274 Lee Memorial Hospital, Hosp Based Phy 10678000 EMERGENCY SERVICES ETCO2 Module (MMS) 14 77,000 1414 Lee Memorial Hospital, Hosp Based Phy 10742000 PULMONARY REHAB Treadmill (Patterson), Replacment treadmills for LMH pulm rehab. 3 13,500 1428 Lee Memorial Hospital, Hosp Based Phy 10742000 PULMONARY REHAB Upper Body Exerciser (SciFit Pro1), Upper Body Cycle 3 13,080 1454 Lee Memorial Hospital, Hosp Based Phy 10760000 PULMONARY DIAGNOSTIC LAB Other, Leak tester for bronchoscope 1 9,701 1460 Lee Memorial Hospital, Hosp Based Phy 10760000 PULMONARY DIAGNOSTIC LAB Other, Vyntus Walk 1 4,000 1524 Lee Memorial Hospital, Hosp Based Phy 10624000 NEURO Pulse Oximeter-Hand Held, MASIMO RAD-5V 1 570 1528 Lee Memorial Hospital, Hosp Based Phy 10850000 ENVIRONMENTAL SERVICES Other, Ultra Violet Light Machine 2 84,580 1532 Lee Memorial Hospital, Hosp Based Phy 10624000 NEURO Pulse Oximeter-Hand Held, MASIMO RAD-5V 1 570 1537 Lee Memorial Hospital, Hosp Based Phy 10628000 NEURO PCU Pulse Oximeter-Hand Held, MASIMO RAD-5V 1 570 1541 Lee Memorial Hospital, Hosp Based Phy 10628000 NEURO PCU Cardiac Monitor (MX450), PHILIPS CARDIAC MONITOR 2 44,745 1548 Lee Memorial Hospital, Hosp Based Phy 10736000 RESPIRATORY CARE Bronchoscope, Bronchoscope 1 31,270 1558 Lee Memorial Hospital, Hosp Based Phy 10736000 RESPIRATORY CARE Laryngoscope (GlideScope), Glidescope 1 14,590 1616 Lee Memorial Hospital, Hosp Based Phy 10736000 RESPIRATORY CARE Other, Medical Equipment Dryer 1 31,500 1684 Lee Memorial Hospital, Hosp Based Phy 10705000 LAB - HISTOLOGY Cryostat, Cryostat 1 25,766 1768 Lee Memorial Hospital, Hosp Based Phy 10622000 NURSING REDESIGN 5N Pulse Oximeter-Hand Held 1 570 1788 Lee Memorial Hospital, Hosp Based Phy 10703000 LAB - GENERAL Other, Rover Device with printer and battery charger 2 6,000 1796 Lee Memorial Hospital, Hosp Based Phy 10703000 LAB - GENERAL Phlebotomy Cart 2 3,564 1802 Lee Memorial Hospital, Hosp Based Phy 10703000 LAB - GENERAL Phlebotomy Cart 2 6,364 1830 Lee Memorial Hospital, Hosp Based Phy 10703000 LAB - GENERAL Other, TEG Hemostasis Analyzers 2 65,875 1836 Lee Memorial Hospital, Hosp Based Phy 10710000 LAB - TRANSFUSION SVS Other, Blood Bank Plasma Freezer 1 11,722 1840 Lee Memorial Hospital, Hosp Based Phy 10710000 LAB - TRANSFUSION SVS Other, Blood Bank Analyzer 1 127,500 1926 Lee Memorial Hospital, Hosp Based Phy 10709000 LAB - DONOR SVS Other, Plasma Freezer 1 9,223 1932 Lee Memorial Hospital, Hosp Based Phy 10703000 LAB - GENERAL Other, Refrigerator - Single door 1 7,320 1931 Corporate Services 11703000 LAB - GENERAL CORPORATE Other, Upgrade to istat 300 Wireless meter 4 6,532 1881 Gulf Coast Hospital, Hosp Based Phy 15647000 GENERAL MED Pulse Oximeter-Hand Held, Oxygen qualification for patients. 2 1,140 1847 Gulf Coast Hospital, Hosp Based Phy 15736000 RESPIRATORY CARE Other, Hamilton -T1 Transport Ventillators and componets 2 53,025 1839 Gulf Coast Hospital, Hosp Based Phy 15801000 FOOD & NUTRITION SERVICES Other, Cold and Hot Well Replacement 1 13,265 1750 Gulf Coast Hospital, Hosp Based Phy 15710000 LAB - TRANSFUSION SVS Other, Blood Bank Analyzer 1 136,500 1751 Gulf Coast Hospital, Hosp Based Phy 15637000 NEURO ICU Other, BIS monitoring 3 28,500 1717 Gulf Coast Hospital, Hosp Based Phy 15703000 LAB - GENERAL Phlebotomy Cart 4 7,128 1720 Gulf Coast Hospital, Hosp Based Phy 15703000 LAB - GENERAL Other, Rover device with printer and battery recharger 1 3,000 1721 Gulf Coast Hospital, Hosp Based Phy 15850000 ENVIRONMENTAL SERVICES Other, Tools/Attachments for King Cobra equipment 1 1,120 1722 Gulf Coast Hospital, Hosp Based Phy 15703000 LAB - GENERAL Other, VerifyNow System 1 15,575 1725 Gulf Coast Hospital, Hosp Based Phy 15703000 LAB - GENERAL Microscope, Microscope 1 6,763 1741 Gulf Coast Hospital, Hosp Based Phy 15710000 LAB - TRANSFUSION SVS Other, Plasma Freezer 1 9,130 1680 Gulf Coast Hospital, Hosp Based Phy 15705000 LAB - HISTOLOGY Other, Solvent recycler 1 21,495 1706 Gulf Coast Hospital, Hosp Based Phy 15703000 LAB - GENERAL Other, Rover device with printer and battery recharger 1 3,000 1713 Gulf Coast Hospital, Hosp Based Phy 15703000 LAB - GENERAL Other, Barcode Scanner and Printer for Osmometer 1 1,336 1595 Gulf Coast Hospital, Hosp Based Phy 15622000 PCU Other, Linen Cart 1 718 1560 Gulf Coast Hospital, Hosp Based Phy 15642000 CARDIAC MED Cardiac Monitor (MX400) 2 40,745 1586 Gulf Coast Hospital, Hosp Based Phy 15642000 CARDIAC MED Oto/Ophthalmoscope-Desk 1 956 1590 Gulf Coast Hospital, Hosp Based Phy 15670000 LABOR & DELIVERY Other, Fetal Heart Monitors 9 187,101 1568 Gulf Coast Hospital, Hosp Based Phy 15614000 ORTHOPEDICS UNIT Table-Overbed, Med/Surg (HillRom) 2 1,744 1570 Gulf Coast Hospital, Hosp Based Phy 15622000 PCU Table-Overbed, Med/Surg (HillRom) 25 21,800 1571 Gulf Coast Hospital, Hosp Based Phy 15646000 WOMENS CARE CENTER Phototherapy System 2 7,200 1577 Gulf Coast Hospital, Hosp Based Phy 15639000 MPCU Cardiac Monitor (MX400) 2 40,745 1579 Gulf Coast Hospital, Hosp Based Phy 15642000 CARDIAC MED Cart-Emergency/Crash 1 2,990 1582 Gulf Coast Hospital, Hosp Based Phy 15688000 CPCU Cardiac Monitor (MX400) 2 40,745 1659 Gulf Coast Hospital, Hosp Based Phy 15628000 NEURO SCIENCE PCU Bladder Scanner 1 8,800 1664 Gulf Coast Hospital, Hosp Based Phy 15705000 LAB - HISTOLOGY Other, Face to face second view station for BX model microscopes 1 6,475 1657 Gulf Coast Hospital, Hosp Based Phy 15628000 NEURO SCIENCE PCU Oto/Ophthalmoscope-Desk 1 956 1675 Gulf Coast Hospital, Hosp Based Phy 15705000 LAB - HISTOLOGY Cryostat, Cryostat 1 26,000 1677 Gulf Coast Hospital, Hosp Based Phy 15705000 LAB - HISTOLOGY Other, Autospy saw 1 1,349 1549 Gulf Coast Hospital, Hosp Based Phy 15646000 WOMENS CARE CENTER Phototherapy System, GE Blue Spot PT Lite 2 7,600 1551 Gulf Coast Hospital, Hosp Based Phy 15622000 PCU Cardiac Monitor (MX400) 1 22,745 1552 Gulf Coast Hospital, Hosp Based Phy 15642000 CARDIAC MED Cardiac Monitor (MX400) 1 22,745 1546 Gulf Coast Hospital, Hosp Based Phy 15670000 LABOR & DELIVERY Other, Hill Rom Prima Procedural Light 3 6,000 1547 Gulf Coast Hospital, Hosp Based Phy 15614000 ORTHOPEDICS UNIT Oto/Ophthalmoscope-Desk 1 956 1538 Gulf Coast Hospital, Hosp Based Phy 15646000 WOMENS CARE CENTER Bladder Scanner 1 8,800 1535 Gulf Coast Hospital, Hosp Based Phy 15614000 ORTHOPEDICS UNIT Scale-Stand On 1 2,800

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1470 Gulf Coast Hospital, Hosp Based Phy 15628000 NEURO SCIENCE PCU Cardiac Monitor (MX450) 1 305,000 1386 Gulf Coast Hospital, Hosp Based Phy 15678000 EMERGENCY SERVICES Other, Cheetah Philips Cable 1 4,945 1271 Gulf Coast Hospital, Hosp Based Phy 15678000 EMERGENCY SERVICES TeleBox/Lead (CCH-GCMC-HPMC), Mobile Telemetry Pack 1 225,000 1296 Gulf Coast Hospital, Hosp Based Phy 15636000 INTENSIVE CARE UNIT Other, continious cardiac output 3 68,100 1309 Gulf Coast Hospital, Hosp Based Phy 15636000 INTENSIVE CARE UNIT Other, primaflo Fluid Warmer 2 5,410 1313 Gulf Coast Hospital, Hosp Based Phy 15678000 EMERGENCY SERVICES Cardiac Monitor (MP5), Portable Monitor 6 64,745 1365 Gulf Coast Hospital, Hosp Based Phy 15678000 EMERGENCY SERVICES Oto/Ophthalmoscope-Desk 2 1,912 1188 Gulf Coast Hospital, Hosp Based Phy 15637000 NEURO ICU Other, phillips modules- 3 10,945 1185 Gulf Coast Hospital, Hosp Based Phy 15850000 ENVIRONMENTAL SERVICES Other, The Doodle Scrub with Skate 2 1,956 1194 Gulf Coast Hospital, Hosp Based Phy 15636000 INTENSIVE CARE UNIT Other, chetetah monitor module 2 7,945 1197 Gulf Coast Hospital, Hosp Based Phy 15636000 INTENSIVE CARE UNIT Defibrillator-Complete 1 11,750 852 Gulf Coast Hospital, Hosp Based Phy 15668000 DIALYSIS Dialysis System 1 14,750 947 Gulf Coast Hospital, Hosp Based Phy 15639000 MPCU Vital Signs Monitor (VS4 w/ temp), NA 2 8,600 948 Gulf Coast Hospital, Hosp Based Phy 15688000 CPCU Vital Signs Monitor (VS4 w/ temp) 2 8,600 719 Gulf Coast Hospital, Hosp Based Phy 15636000 INTENSIVE CARE UNIT Vein Illuminator/Viewer (Accuvein AV400) 1 4,543 732 Gulf Coast Hospital, Hosp Based Phy 15620000 MED SURG Bladder Scanner 1 8,800 738 Gulf Coast Hospital, Hosp Based Phy 15620000 MED SURG Doppler-Vascular 1 773 743 Gulf Coast Hospital, Hosp Based Phy 15620000 MED SURG Table-Overbed, Med/Surg (HillRom) 2 1,744 859 Gulf Coast Hospital, Hosp Based Phy 15668000 DIALYSIS Other, scale with stabilization bars 1 1,891 628 Gulf Coast Hospital, Hosp Based Phy 15668000 DIALYSIS Cardiac Monitor (MX400), on rolling stand 1 22,745 637 Gulf Coast Hospital, Hosp Based Phy 15636000 INTENSIVE CARE UNIT Cardiac Monitor (X2), transport monitors 4 38,295 470 Gulf Coast Hospital, Hosp Based Phy 15712000 CARDIOVASCULAR SERVICES Stress Test w/ Treadmill (GE) 2 76,000 474 Gulf Coast Hospital, Hosp Based Phy 15688000 CPCU Vein Illuminator/Viewer (Accuvein AV400) 1 4,543 499 Gulf Coast Hospital, Hosp Based Phy 15628000 NEURO SCIENCE PCU Seizure Pads (Hill-Rom P855E7) 4 3,560 418 Gulf Coast Hospital, Hosp Based Phy 15634000 CARDIAC OBSERVATION Vein Illuminator/Viewer (Accuvein AV400) 1 4,543 422 Gulf Coast Hospital, Hosp Based Phy 15736000 RESPIRATORY CARE Other, Ventilator-Adult (Servo-U) 8 398,890 407 Gulf Coast Hospital, Hosp Based Phy 15711000 CARDIAC CATH Cath/EP X-Ray System: Single Plane (Philips FD20) 1 2,435,000 465 Gulf Coast Hospital, Hosp Based Phy 15677000 VASCULAR ACCESS NURSING Other, Mobile PICC supply cart 1 1,800 414 Health Park Medical Center, Hosp Based Phy 20711000 CARDIAC CATH C-Arm (GE OEC 9900) 1 218,024 415 Health Park Medical Center, Hosp Based Phy 20711000 CARDIAC CATH Pacemaker, Temporary Pacemaker 1 7,495 416 Health Park Medical Center, Hosp Based Phy 20711000 CARDIAC CATH Other, Rolling Full Size Lead Shields 1 5,670 509 Health Park Medical Center, Hosp Based Phy 20712000 CARDIOVASCULAR SERVICES Pulse Volume Recorder (ERGO IDC) 1 40,000 589 Health Park Medical Center, Hosp Based Phy 20638000 3W - CARDIOLOGY PCU Pulse Oximeter-Hand Held 1 570 590 Health Park Medical Center, Hosp Based Phy 20638000 3W - CARDIOLOGY PCU Cardiac Monitor (MP5) 4 44,745 591 Health Park Medical Center, Hosp Based Phy 20625000 6W - PCU Bladder Scanner 4 35,200 593 Health Park Medical Center, Hosp Based Phy 20691000 DISCHARGE NURSES Warming Cabinet-Floor 1 9,572 594 Health Park Medical Center, Hosp Based Phy 20691000 DISCHARGE NURSES Recliner-Patient 4 12,400 603 Health Park Medical Center, Hosp Based Phy 20625000 6W - PCU Scale-Stand On 2 5,600 607 Health Park Medical Center, Hosp Based Phy 20625000 6W - PCU Cardiac Monitor (MP5) 6 64,745 608 Health Park Medical Center, Hosp Based Phy 20625000 6W - PCU Patient Lift (SaraPlus), 1 SaraPlus 1 7,300 498 Health Park Medical Center, Hosp Based Phy 20675000 CENTRAL SUPPLY Other, 3 - Medela Symphony Plus Breast Pumps 3 4,758 520 Health Park Medical Center, Hosp Based Phy 20642000 CARDIAC DECISION UNIT TeleBox/Lead (CCH-GCMC-HPMC) 5 27,850 522 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES TeleBox/Lead (CCH-GCMC-HPMC) 20 155,000 526 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Bladder Scanner 1 8,800 528 Health Park Medical Center, Hosp Based Phy 20642000 CARDIAC DECISION UNIT Defibrillator-AED Complete 3 4,700 530 Health Park Medical Center, Hosp Based Phy 20642000 CARDIAC DECISION UNIT Vital Signs Monitor (VS4 w/ temp) 6 25,800 554 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Recliner-Patient 14 43,400 555 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Slit Lamp 1 4,300 560 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Scale-Chair 1 2,500 566 Health Park Medical Center, Hosp Based Phy 20697000 HEART CENTRAL Other, LMH 697.10 needs PIIX ix plus new tele boxes 1 1,580,000 572 Health Park Medical Center, Hosp Based Phy 20697000 HEART CENTRAL TeleBox/Lead (CCH-GCMC-HPMC) 30 164,250 586 Health Park Medical Center, Hosp Based Phy 20638000 3W - CARDIOLOGY PCU Doppler-Vascular 4 3,092 302 Health Park Medical Center, Hosp Based Phy 20626000 MED/SURG 7W Vital Signs Monitor (VS4 w/ temp) 2 8,600 864 Health Park Medical Center, Hosp Based Phy 20736000 RESPIRATORY CARE Blood Gas Analyzer (i-stat), Rapidpoint 500 Blood Gas Analyzers 2 21,300 835 Health Park Medical Center, Hosp Based Phy 20736000 RESPIRATORY CARE Cart-Procedure, Davi Cart Bronch cart 1 3,930 819 Health Park Medical Center, Hosp Based Phy 20670000 LABOR & DELIVERY Stirrups-Allen w/cart 1 7,000 831 Health Park Medical Center, Hosp Based Phy 20673000 ANTEPARTUM Doppler-Vascular 1 773 746 Health Park Medical Center, Hosp Based Phy 20736000 RESPIRATORY CARE Bronchoscope 1 29,000 757 Health Park Medical Center, Hosp Based Phy 20736000 RESPIRATORY CARE Bronchoscope 1 29,000 649 Health Park Medical Center, Hosp Based Phy 20712000 CARDIOVASCULAR SERVICES Vital Signs Monitor (VS4 w/ temp) 2 8,600 876 Health Park Medical Center, Hosp Based Phy 20736000 RESPIRATORY CARE Proc/Lightsource/Print/Monitor, Evis Exera Video System 1 42,000 1068 Health Park Medical Center, Hosp Based Phy 20850000 ENVIRONMENTAL SERVICES Other, Aqueous Ozone Clean Core Fill Station 6 15,922 1066 Health Park Medical Center, Hosp Based Phy 20850000 ENVIRONMENTAL SERVICES Other, CCO Clean Core Chemical Free Caddy 1 4,422 972 Health Park Medical Center, Hosp Based Phy 20711000 CARDIAC CATH Defibrillator-Complete, Cardiac Defibrillators needed for Cath Lab 3 32,250 1200 Health Park Medical Center, Hosp Based Phy 20626000 MED/SURG 7W Pulse Oximeter-Hand Held 2 1,140 1208 Health Park Medical Center, Hosp Based Phy 20627000 MED/SURG 8W Pulse Oximeter-Hand Held 2 1,140 1218 Health Park Medical Center, Hosp Based Phy 20626000 MED/SURG 7W Cardiac Monitor (MP5) 1 14,745 1220 Health Park Medical Center, Hosp Based Phy 20627000 MED/SURG 8W Cardiac Monitor (MP5) 1 14,745 1224 Health Park Medical Center, Hosp Based Phy 20620000 6TH FLOOR OBSERVATION UNIT Warming Cabinet-Table Top 1 5,500 1187 Health Park Medical Center, Hosp Based Phy 20627000 MED/SURG 8W Bladder Scanner 1 8,800 1228 Health Park Medical Center, Hosp Based Phy 20626000 MED/SURG 7W Pulse Oximeter-Table Top 1 4,905 1164 Health Park Medical Center, Hosp Based Phy 20618000 CPCU Other, Scale 1 3,120 1171 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Vital Signs Monitor (VS4 w/ temp) 1 4,300 1177 Health Park Medical Center, Hosp Based Phy 20626000 MED/SURG 7W Bladder Scanner 1 8,800 1132 Health Park Medical Center, Hosp Based Phy 20618000 CPCU Vital Signs Monitor (VS4 w/ temp) 4 17,200 1308 Health Park Medical Center, Hosp Based Phy 20642000 CARDIAC DECISION UNIT Blood Gas Analyzer System (i-stat) 2 18,708 1301 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Defibrillator-Complete 3 32,250 1323 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Other, Cheetah Monitor Cable- EPIC Integration 1 4,945 1326 Health Park Medical Center, Hosp Based Phy 20301000 FAMILY EDUCATION/SUPPORT Other, Infant Smart Scale- Olympic - Table top- Model #60 1 3,743 1328 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Other, Prevue+ 1 8,900 1314 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Blood Gas Analyzer (i-stat), I-Stat 1 9,614 1316 Health Park Medical Center, Hosp Based Phy 20678000 EMERGENCY SERVICES Blood Gas Analyzer System (i-stat) 2 22,000 1294 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Pulse Oximeter-Hand Held 3 1,710 1272 Health Park Medical Center, Hosp Based Phy 20659000 TRANSPORTATION SVS Other, Hovermat 1 1,905 1266 Health Park Medical Center, Hosp Based Phy 20645000 OHICU Warming Cabinet-Floor, Same as warming cabinet that is currently in SICU. 1 10,072 1398 Health Park Medical Center, Hosp Based Phy 20627000 MED/SURG 8W Vital Signs Monitor (VS4 w/ temp) 1 4,300 1404 Health Park Medical Center, Hosp Based Phy 20627000 MED/SURG 8W Pulse Oximeter-Table Top 1 4,905 1374 Health Park Medical Center, Hosp Based Phy 20850000 ENVIRONMENTAL SERVICES Other, Motorized Cart Mover 1 11,037 1378 Health Park Medical Center, Hosp Based Phy 20850000 ENVIRONMENTAL SERVICES Other, Double Chamber Compactor 10 133,500 1380 Health Park Medical Center, Hosp Based Phy 20850000 ENVIRONMENTAL SERVICES Other, Three tote Transporter 1 10,850 1415 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Other, verticle band saw 1 3,179 1412 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Vital Signs Monitor (VS4 w/ temp) 3 12,900 1461 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Pulse Oximeter-Table Top 1 4,905 1493 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Other, gantry lift with chain fall 1 2,962

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1500 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Copier (IR4235) 1 4,814 1473 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Glucometer 1 1,280 1476 Health Park Medical Center, Hosp Based Phy 20618000 CPCU Glucometer 1 985 1477 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Warming Cabinet-Floor 1 9,572 1484 Health Park Medical Center, Hosp Based Phy 20675000 CENTRAL SUPPLY Cart-Procedure, System Standard Procedure Carts 5 7,500 1670 Health Park Medical Center, Hosp Based Phy 20639000 SPCU-HPF Cardiac Monitor (MP5) 7 74,745 1715 Health Park Medical Center, Hosp Based Phy 20636000 MICU - HP Other, Portable suction unit 1 1,000 1744 Health Park Medical Center, Hosp Based Phy 20677000 VASCULAR ACCESS NURSING Other, Site Rite 8 with 20mL wand - 2 units please 2 60,280 1761 Health Park Medical Center, Hosp Based Phy 20645000 OHICU Other, istat machines - 3 units please 1 11,850 1762 Health Park Medical Center, Hosp Based Phy 20801000 FOOD & NUTRITION SERVICES Other, Double Deck Gas Convection Oven 1 12,620 1805 Health Park Medical Center, Hosp Based Phy 20637000 SICU - HP Other, Upgrade of Monitors for new OHICU 1 10,000 1809 Health Park Medical Center, Hosp Based Phy 20624000 THORACIC ICU Other, Upgrade of Monitors for new TICU 1 21,000 1815 Health Park Medical Center, Hosp Based Phy 20636000 MICU - HP Other, 2nd Monitor for Central Station 1 6,000 1816 Health Park Medical Center, Hosp Based Phy 20637000 SICU - HP Other, 2nd Monitor for Central Station 1 6,000 1818 Health Park Medical Center, Hosp Based Phy 20645000 OHICU Other, 2nd Monitor for Central Station 1 6,000 1819 Health Park Medical Center, Hosp Based Phy 20636000 MICU - HP Other, Phillips Module & Cable for Cheetah Monitor - 9 9 28,945 1789 Health Park Medical Center, Hosp Based Phy 20653000 MET NURSES Cardiac Monitor (MP2), Portable monitor MP2-2 units please 2 21,245 1791 Health Park Medical Center, Hosp Based Phy 20624000 THORACIC ICU Cardiac Monitor (MP2), Portable monitor MP2-2 units please 2 21,245 1793 Health Park Medical Center, Hosp Based Phy 20636000 MICU - HP Wheelchair-Staxi, Wheelchair same as transport model 1 1,700 1794 Health Park Medical Center, Hosp Based Phy 20637000 SICU - HP Wheelchair-Staxi, Wheelchair same as transport model 1 1,640 1771 Health Park Medical Center, Hosp Based Phy 20637000 SICU - HP Other, EV1000 with clearsight - 6 units 6 136,200 1772 Health Park Medical Center, Hosp Based Phy 20636000 MICU - HP Other, EV1000 with clearsight - 6 units 1 22,700 1785 Health Park Medical Center, Hosp Based Phy 20703000 LAB - GENERAL Other, Rover device with printer and battery charger 2 9,000 1786 Health Park Medical Center, Hosp Based Phy 20645000 OHICU Other, Intellibridge Modules and cables 10 31,945 1842 Health Park Medical Center, Hosp Based Phy 20710000 LAB - TRANSFUSION SVS Other, Blood Bank Analzyer 1 133,500 1872 Health Park Medical Center, Hosp Based Phy 20703000 LAB - GENERAL Other, Molecular Analzyer - Torch 1 162,500 1887 Health Park Medical Center, Hosp Based Phy 20624000 THORACIC ICU Bladder Scanner, Latest model bladder scanner 1 8,800 1912 Health Park Medical Center, Hosp Based Phy 20703000 LAB - GENERAL Refrigerator-Two Door (Lab), 2-door Reagent 52 cu ft 1 7,121 1913 Health Park Medical Center, Hosp Based Phy 20703000 LAB - GENERAL Freezer (Lab), 2 Door Reagent 1 7,121 1916 Health Park Medical Center, Hosp Based Phy 20703000 LAB - GENERAL Other, Vein Finder 1 4,543 1918 Health Park Medical Center, Hosp Based Phy 20705000 LAB - HISTOLOGY Other, Faxitron Biovision 1 79,900 1935 Health Park Medical Center, Hosp Based Phy 20670000 LABOR & DELIVERY Wheelchair-Ultra Light 4 10,400 1936 Health Park Medical Center, Hosp Based Phy 20646000 WOMENS CARE CENTER Wheelchair-Staxi 4 6,560 1937 Health Park Medical Center, Hosp Based Phy 20638000 3W - CARDIOLOGY PCU Cardiac Monitor (MP5), 2 south Interventional Unit 1 490,000 1923 Cape Coral Hospital, Hosp Based Phy 25709000 LAB - DONOR SERVICES Other, Apheresis System 1 75,000 1893 Cape Coral Hospital, Hosp Based Phy 25710000 LAB - TRANSFUSION SVS Other, Plasma Freezer 1 8,130 1888 Cape Coral Hospital, Hosp Based Phy 25704000 LAB - MICROBIOLOGY Incubator-Microbiology, Incubator - CO2 1 16,259 1889 Cape Coral Hospital, Hosp Based Phy 25710000 LAB - TRANSFUSION SVS Other, Single door refrigerator 1 7,285 1873 Cape Coral Hospital, Hosp Based Phy 25704000 LAB - MICROBIOLOGY Incubator-Microbiology 1 1,693 1876 Cape Coral Hospital, Hosp Based Phy 25704000 LAB - MICROBIOLOGY Other, 3-door refrigerator 2 20,906 1878 Cape Coral Hospital, Hosp Based Phy 25704000 LAB - MICROBIOLOGY Other, Single door refrigerator 1 6,612 1844 Cape Coral Hospital, Hosp Based Phy 25710000 LAB - TRANSFUSION SVS Other, Blood Bank Analyzer 1 133,500 1860 Cape Coral Hospital, Hosp Based Phy 25703000 LAB - GENERAL Centrifuge-Table Top, Fixed Angle Centrifuge 1 3,400 1867 Cape Coral Hospital, Hosp Based Phy 25704000 LAB - MICROBIOLOGY Other, Biological Safety Cabinet 1 11,277 1869 Cape Coral Hospital, Hosp Based Phy 25704000 LAB - MICROBIOLOGY Other, Molecular Instrument - TORCH 1 163,500 1848 Cape Coral Hospital, Hosp Based Phy 25703000 LAB - GENERAL Freezer (Lab), Double door freezer 1 10,500 1853 Cape Coral Hospital, Hosp Based Phy 25703000 LAB - GENERAL Microscope, Microscope 1 7,983 1856 Cape Coral Hospital, Hosp Based Phy 25703000 LAB - GENERAL Other, Thermal Printer for Osmometer 1 738 1781 Cape Coral Hospital, Hosp Based Phy 25703000 LAB - GENERAL Other, Rover device with printer and battery charger 2 6,000 1681 Cape Coral Hospital, Hosp Based Phy 25705000 LAB - HISTOLOGY Other, Face to face second view station for microscope 1 5,475 1690 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Scale-Wheelchair, In-floor Flush patient scale 1 6,086 1691 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Transilluminator, Bard Site Right 8000 Prevue 1 8,900 1692 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Other, Cheetah module and cable 1 4,945 1693 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Cardiac Monitor (X2), Central Telemetry Monitor 1 66,000 1636 Cape Coral Hospital, Hosp Based Phy 25624000 3W PROGRESSIVE CARE Doppler-Vascular, 3W PCU does not have a doppler for use on unit 1 799 1567 Cape Coral Hospital, Hosp Based Phy 25736000 RESPIRATORY CARE Other, Transport Ventilator 1 24,990 1508 Cape Coral Hospital, Hosp Based Phy 25955000 EMPLOYEE HEALTH SVS Other, Request for Lab Analizer for QuantiFERON Testing 1 113,909 1453 Cape Coral Hospital, Hosp Based Phy 25850000 ENVIRONMENTAL SERVICES Mattress-Bed (Versacare), Replacement mattresses 3 2,400 1101 Cape Coral Hospital, Hosp Based Phy 25625000 3N CDU / CARDIAC PCU TeleBox/Lead (CCH-GCMC-HPMC), Monitoring device 2 10,500 1124 Cape Coral Hospital, Hosp Based Phy 25617000 LEE PAIN SERVICE Vital Signs Monitor (VS4 w/ temp) 6 25,800 1145 Cape Coral Hospital, Hosp Based Phy 25675000 CENTRAL SUPPLY Cart-Procedure, ENT Cart needed for floor procedure 1 13,500 1212 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Vein Illuminator/Viewer (Accuvein AV400), Vein Finder 1 4,543 1205 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Other, Welch Allyn Vital Signs Monitor 10 43,000 1186 Cape Coral Hospital, Hosp Based Phy 25736000 RESPIRATORY CARE Bronchoscope, UBUS Bronchoscope 1 53,365 987 Cape Coral Hospital, Hosp Based Phy 25644000 ICU Other, AccuVein - Vein Illuminator with Rolling Stand 1 4,543 974 Cape Coral Hospital, Hosp Based Phy 25736000 RESPIRATORY CARE Ventilator-BiPAP V60, Non-invasive ventilators 3 43,461 1063 Cape Coral Hospital, Hosp Based Phy 25644000 ICU Other, Philips cable for Cheeta integration 1 4,945 878 Cape Coral Hospital, Hosp Based Phy 25627000 4W ORTHO/GENERAL SURGERY Vital Signs Monitor (VS4 w/ temp) 3 12,900 939 Cape Coral Hospital, Hosp Based Phy 25618000 2W MED/SURG - TELE Scale-Stand On 1 2,800 926 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Other, Philips module for MP30 5 27,500 933 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES Pacemaker, Medtronic Transvenous Pacer 2 14,090 905 Cape Coral Hospital, Hosp Based Phy 25620000 2E MED/SURG - TELE TeleBox/Lead (CCH-GCMC-HPMC) 2 12,100 912 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES ETCO2 Module (MMS) 1 5,500 922 Cape Coral Hospital, Hosp Based Phy 25678000 EMERGENCY SERVICES TeleBox/Lead (CCH-GCMC-HPMC), Portable tele boxes 5 27,850 695 Cape Coral Hospital, Hosp Based Phy 25651000 SPECIAL CARE NURSERY Other, Meter Phototherapy 1 1,526 718 Cape Coral Hospital, Hosp Based Phy 25651000 SPECIAL CARE NURSERY Other, Scale: Infant 1 4,900 759 Cape Coral Hospital, Hosp Based Phy 25625000 3N CDU / CARDIAC PCU Pulse Oximeter-Hand Held, Rad 5 w/ boot cover 4 2,280 750 Cape Coral Hospital, Hosp Based Phy 25625000 3N CDU / CARDIAC PCU Vital Signs Monitor (VS4 w/ temp) 4 17,200 832 Cape Coral Hospital, Hosp Based Phy 25618000 2W MED/SURG - TELE Vital Signs Monitor (VS4 w/ temp) 2 8,600 768 Cape Coral Hospital, Hosp Based Phy 25625000 3N CDU / CARDIAC PCU Cardiac Monitor (MP5) 4 44,745 839 Cape Coral Hospital, Hosp Based Phy 25618000 2W MED/SURG - TELE Bladder Scanner 1 8,800 288 Cape Coral Hospital, Hosp Based Phy 25624000 3W PROGRESSIVE CARE Cardiac Monitor (MP5), wall mounted type MP5 appropriate for a PCU 5 60,745 289 Cape Coral Hospital, Hosp Based Phy 25626000 4N NEUROSCIENCE / MED/SURG TELE Cardiac Monitor (MP5), Needed if 4N transitions to a PCU level unit 6 64,745 314 Cape Coral Hospital, Hosp Based Phy 25850000 ENVIRONMENTAL SERVICES Other, CleanCore Fill Station 10 24,870 315 Cape Coral Hospital, Hosp Based Phy 25850000 ENVIRONMENTAL SERVICES Other, Clark MA10 12E Floor Scrubber 2 1,532 372 Cape Coral Hospital, Hosp Based Phy 25740000 CARDIAC REHAB Other, NuStep T5 Recumbent Cross Trainer 05001-HB 1 6,073 547 Cape Coral Hospital, Hosp Based Phy 25712000 CARDIOVASCULAR SERVICES Other, Case Cart Stress Test System 1 32,000 551 Cape Coral Hospital, Hosp Based Phy 25712000 CARDIOVASCULAR SERVICES Vital Signs Monitor (VS4 w/ temp) 1 4,300 571 Cape Coral Hospital, Hosp Based Phy 25697000 HEART CENTRAL Other, Tele-monitoring for 9 OB Patients 1 325,000 645 Cape Coral Hospital, Hosp Based Phy 25730000 PHARMACY Other, Refrigerator - pharmaceutical grade 1 7,293 653 Cape Coral Hospital, Hosp Based Phy 25646000 WOMENS CARE CENTER Cart-Procedure, OB HEMORRHAGE CART WITH SCALE 1 4,870 463 Cape Coral Hospital, Hosp Based Phy 25651000 SPECIAL CARE NURSERY Infant Warmer (GIRAFFE) 3 84,382 1379 Golisano Children's Hospital of Southwest Florida 60850000 ENVIRONMENTAL SERVICES Other, Double Chamber Compactor 7 82,950 1325 Golisano Children's Hospital of Southwest Florida 60736000 RESPIRATORY CARE Other, Transcutaneous Monitoring System 2 27,600

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1368 Golisano Children's Hospital of Southwest Florida 60659000 TRANSPORTATION SVS Other, Stretcher Mattress 2 2,000 1478 Golisano Children's Hospital of Southwest Florida 60651000 PH3 NEONATAL ICU Blood Gas Analyzer System (i-stat) 5 56,000 1481 Golisano Children's Hospital of Southwest Florida 60651000 PH3 NEONATAL ICU Cardiac Monitor (MP2), for in house transport 3 29,495 1529 Golisano Children's Hospital of Southwest Florida 60850000 ENVIRONMENTAL SERVICES Other, Ultra Violet Light 2 84,580 1886 Golisano Children's Hospital of Southwest Florida 60652000 GCHSWF TRANSPORT / VASCULAR ACCESS Other, Re-Mount Ped/Neo Critical Care Ambulance 1 250,000 2085 Lee Community HealthCare 70372000 LCH OB/GYN Cardiac Monitor (MP2), TEST 1 3,333 ACUTE CARE Total 13,068,635 POST ACUTE 1533 The Rehab Hosptial 34635000 REHAB NURSING Vital Signs Monitor (VS4 w/ temp) 4 17,200 1585 The Rehab Hosptial 34635000 REHAB NURSING Recliner-Patient 6 27,000 1562 The Rehab Hosptial 34635000 REHAB NURSING Other, EvacuSled 20 18,380 1694 The Rehab Hosptial 34751000 REHAB HOSP - PT Table-Hi/Low, Barihab SKS 1 28,500 1695 The Rehab Hosptial 34752000 REHAB HOSP - OT Other, SVI Sanet Vision Integrator 1 11,000 1716 The Rehab Hosptial 34752000 REHAB HOSP - OT Other, Tran-Sit Car Transfer Simulator 1 9,500 1450 The Rehab Hosptial 34635000 REHAB NURSING Other, Bariatric Patient Lift 1 7,736 1136 The Rehab Hosptial 34635000 REHAB NURSING Bladder Scanner 1 8,800 1173 Health Park Care Center 90605000 NURSING- SNF Patient Lift (MaxiMove) 1 8,100 1165 Health Park Care Center 90605000 NURSING- SNF Oxygen Concentrator, 10L Oxygen Concentrators 4 3,596 1708 Health Park Care Center 90850000 ENVIRONMENTAL SERVICES Burnisher (Walk Behind) 1 1,700 1710 Health Park Care Center 90950000 ADMINISTRATION SERVICES - HPCC Other, Evacu Sled LMH Skilled Nursing Unit 18 16,340 1701 Health Park Care Center 90850000 ENVIRONMENTAL SERVICES Other, Clean Core Caddy 1 4,422 1703 Health Park Care Center 90850000 ENVIRONMENTAL SERVICES Other, Clean Core Fill Station 1 2,987 855 Health Park Care Center 90737000 HPCRC PHYSICAL THERAPY Parallel Bars 1 8,015 756 Health Park Care Center 90737000 HPCRC PHYSICAL THERAPY Bike-Recumbent (NuStep) 1 6,200 873 Health Park Care Center 90738000 HPCRC OCCUPATIONAL THERAPY Other, ACP/Hanger Omnicycle 1 7,650 877 Health Park Care Center 90738000 HPCRC OCCUPATIONAL THERAPY Other, Treatment Table 1 2,459 1020 Health Park Care Center 90605000 NURSING- SNF Vital Signs Monitor (VS4 w/ temp) 2 8,600 1029 Health Park Care Center 90830000 PLANT OPERATIONS Other, Zenith APS 7000 40 80,500 1009 Health Park Care Center 90801000 FOOD & NUTRITION SERVICES Dishwasher, Commercial Dishwasher - Hobart Model AM15-2 1 16,800 1001 Health Park Care Center 90950000 ADMINISTRATION SERVICES - HPCC Copier (IR4225) 2 11,538 281 Home Health 91671000 ACCESS MEDICAL SOUTH Vehicle-Plant Ops Truck, Isuzu NPR Gas DB204 2 120,000 286 Home Health 91671000 ACCESS MEDICAL SOUTH Other, Vertical Compressor 1 630 1892 Home Health 91737000 PHYSICAL THERAPY Other, ACP Modality Equipment 10 28,350 1635 Home Health 91700000 HEALTHY START Copier (IR4245), old model, very slow, satff dissatisfaction. 1 4,936 1516 Home Health 91671000 ACCESS MEDICAL SOUTH Other, Stainless Steel Medical Equipment Cleaning Table 1 1,550 1482 Home Health 91737000 PHYSICAL THERAPY Ultrasound-Estim/Combo, ComboCare Units 5 5,000 1120 Home Health 91737000 PHYSICAL THERAPY Other, Coaguchek XS Meter 40 23,560 924 Skilled Nursing Unit 95737000 PHYSICAL THERAPY Pulse Oximeter-Hand Held, 3 yellow boot covers with 3 units 3 1,710 921 Skilled Nursing Unit 95738000 OCCUPATIONAL THERAPY Vital Signs Monitor (VS4 w/ temp) 1 4,300 1894 Skilled Nursing Unit 95737000 PHYSICAL THERAPY Other, ACP Modalities, Portable FX2Pro 10 8,950 POST ACUTE Total 506,009 OUTPATIENT 1128 Lee Memorial Hospital, Hosp Based Phy 10737000 REHABILITATION SERVICES Training Simulator, Car Transfer Simulator 1 12,940 1130 Sanctuary and OP Surgery Center 13756000 SPINE CENTER Copier (IR6265) 1 12,350 1127 Sanctuary and OP Surgery Center 13756000 SPINE CENTER Vital Signs Monitor (VS4 w/ temp) 2 8,600 1156 Sanctuary and OP Surgery Center 13725000 RADIOLOGY - MRI Other, Breast MRI CAD software 1 171,000 1269 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Vital Signs Monitor (VS4 w/o temp), Philips VS4 Vital signs Monitor plus roll cart 2 7,200 1275 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Table-Hi/Low, Metron Elite Patterson Medical 9612-05 storm grey 3 8,611 1279 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Other, SciFIT Pro 2 UBE/lowerbody 1 4,951 1289 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Other, MicroFET 2 manual muscle tester 2 1,976 1299 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Other, Shuttle MVP Elite Plus #3400 1 8,700 1320 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Moist Heat Therapy Pack, Hydrocollator 1 2,361 1322 Sanctuary and OP Surgery Center 13725000 RADIOLOGY - MRI Wheelchair-Bariatric, MRI safe wheelchair 1 2,935 1634 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Other, Red Cord Trainer 1 6,925 1643 Sanctuary and OP Surgery Center 13746000 REHABILITATION SERVICES-SANCTUARY Other, Lojer mobile speed pulley 1 2,500 263 Sanctuary and OP Surgery Center 13726000 RADIOLOGY - CT SCAN CT Scanner, 64-slice (Siemens) 1 1,225,000 730 Plantation Sleep Lab 14732000 ASTHMA/COPD MANAGEMENT Other, English & Spanish education materials, 2-12 years. 1 2,228 753 Gulf Coast Hospital, Hosp Based Phy 15746000 REHABILITATION SERVICES-GCMC Other, Set of Graston Tools Instrument Set 1 1,815 758 Gulf Coast Hospital, Hosp Based Phy 15746000 REHABILITATION SERVICES-GCMC Other, Upright Bicycle 1 4,371 740 Gulf Coast Hospital, Hosp Based Phy 15746000 REHABILITATION SERVICES-GCMC Other, Sectional Wall Storage System 1 5,280 733 Gulf Coast Hospital, Hosp Based Phy 15746000 REHABILITATION SERVICES-GCMC Other, 2 Performa 3-sect X Treatment Tables w/power Flex 2 6,163 766 Gulf Coast Hospital, Hosp Based Phy 15746000 REHABILITATION SERVICES-GCMC Other, Forma Splint Pan 1 1,051 770 Gulf Coast Hospital, Hosp Based Phy 15746000 REHABILITATION SERVICES-GCMC Other, Performa Traction Table and Stool 1 4,340 1331 Riverwalk Imaging 17721000 RADIOLOGY - ULTRASOUND Stretcher-OB/Gyn, Ultrasound 1 6,571 1306 Riverwalk Imaging 17795000 RADIOLOGY - ADMIN RIVERWALK Copier (IR4235) 1 4,456 1427 Riverwalk Sports Medicine 18746000 RIVERWALK SPORTS-RIVERWALK Other, Trapeze Table - Pilates equipment 1 5,512 1455 Riverwalk Sports Medicine 18746000 RIVERWALK SPORTS-RIVERWALK Other, RealEyes xdvr Review DS 1 7,200 1459 Riverwalk Sports Medicine 18746000 RIVERWALK SPORTS-RIVERWALK Table-Hi/Low, Bariatric high/low table 2 6,875 1464 Riverwalk Sports Medicine 18746000 RIVERWALK SPORTS-RIVERWALK Vital Signs Monitor (VS4 w/ temp) 1 4,300 1408 Women & Childrens Medical Plaza 19746000 REHAB SVCS WOMEN & CHILDREN'S MED POther, 72-inch Interactive Bubble Tube 1 2,425 1425 Women & Childrens Medical Plaza 19746000 REHAB SVCS WOMEN & CHILDREN'S MED POther, Bioness Integrated Therapy System (BITS ) 1 23,485 1209 Women & Childrens Medical Plaza 19746000 REHAB SVCS WOMEN & CHILDREN'S MED POther, Evidence-Based Therapeutic Listening 1 705 1227 Women & Childrens Medical Plaza 19746000 REHAB SVCS WOMEN & CHILDREN'S MED POther, Probe for Madsen Otoflex 1 1,305 1219 Bass Road 21746000 REHABILITATION SERVICES-BASS RD Other, Graston instruments 1 1,815 1210 Bass Road 21746000 REHABILITATION SERVICES-BASS RD Other, US/ESTIM combo neo units 2 12,139 1191 Bass Road 21746000 REHABILITATION SERVICES-BASS RD Other, Microfet2 handheld dynamometer 1 1,171 1405 Bass Road 21727000 WOMENS BREAST CENTER Mammography 2D to 3D Upgrade (Hologic) 1 235,000 651 Bass Road 21712000 CARDIOVASCULAR SERVICES Vital Signs Monitor (VS4 w/ temp) 1 4,300 1072 Bass Road 21617000 LEE PAIN SERVICE Other, RF Reusable Electrode-5cm 10 10,000 1075 Bass Road 21617000 LEE PAIN SERVICE Other, RF Reusable Electrode-10cm 10 10,000 290 Bass Road 21617000 LEE PAIN SERVICE Vital Signs Monitor (VS4 w/ temp) 3 12,900 291 Bass Road 21617000 LEE PAIN SERVICE Vital Signs Monitor (VS4 w/ temp) 2 8,600 1922 Bass Road 21708000 LAB - OUTREACH SERVICES Vehicle-Lab (Nissan Versa), Courier 2 37,000 1859 Bass Road 21746000 REHABILITATION SERVICES-BASS RD Other, Adjustable treatment tables 4 3,280 1282 Surfside Outpatient Center 23727000 WOMENS BREAST CENTER Stereotactic Table:Prone Affirm 3D (Hologic) 1 300,000 962 Plantation Wound Care 24616000 LEE WOUND CARE CLINIC Other, 3 exam chairs 3 21,444 968 Plantation Wound Care 24616000 LEE WOUND CARE CLINIC Other, Replacement of 13 year old TCOM 1 49,324 908 Cape Coral Hospital, Hosp Based Phy 25746000 REHABILITATION SERVICES-CCH OP Parallel Bars 1 2,436 910 Cape Coral Hospital, Hosp Based Phy 25746000 REHABILITATION SERVICES-CCH OP Other, Dynamometer 1 791 899 Cape Coral Hospital, Hosp Based Phy 25746000 REHABILITATION SERVICES-CCH OP Other, RealEyes Binocular Video Goggles 1 7,200 889 Cape Coral Hospital, Hosp Based Phy 25746000 REHABILITATION SERVICES-CCH OP Total Body Exerciser (SciFit Pro2) 1 4,951

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 886 Cape Coral Hospital, Hosp Based Phy 25746000 REHABILITATION SERVICES-CCH OP Table-Hi/Low, Performa X-frame with Power Flex 1 2,459 1354 Cape Coral Hospital, Hosp Based Phy 25737000 REHABILITATION SERVICES Training Simulator, Car Transfer Simulator 1 13,740 1417 Med Plaza I 28781000 LMH CARDIOLOGY - MED PLAZA 1 Pulse Oximeter-Hand Held 1 570 957 Med Plaza I 28781000 LMH CARDIOLOGY - MED PLAZA 1 Copier (IR4235) 1 4,814 935 Med Plaza I 28781000 LMH CARDIOLOGY - MED PLAZA 1 Wheelchair-Ultra Light, standard wheelchair w/ footrests 1 1,600 1251 Lee Center for OP Rehab 37739000 REHABILITATION SERVICES - CITY CENTER P Other, Seating and positioning chair 1 4,150 1254 Lee Center for OP Rehab 37739000 REHABILITATION SERVICES - CITY CENTER P Other, 6' x 10' floor mat 1 676 1485 Lee Center for OP Rehab 37746000 REHABILITATION SERVICES-CITY CENTER ADOther, Performa 350 series table, taupe 1 2,046 1486 Lee Center for OP Rehab 37746000 REHABILITATION SERVICES-CITY CENTER ADOther, Deluxe skeleton 1 1,038 1487 Lee Center for OP Rehab 37746000 REHABILITATION SERVICES-CITY CENTER ADOther, Hydraulic Butcher Block table 1 1,678 1488 Lee Center for OP Rehab 37746000 REHABILITATION SERVICES-CITY CENTER ADOther, Tuffy Bariatric wheelchair 1 800 1489 Lee Center for OP Rehab 37746000 REHABILITATION SERVICES-CITY CENTER ADOther, 6'x 8' high-lo table 1 4,679 1168 College Parkway MRI 38725000 COLLEGE PARKWAY - MRI Wheelchair-Bariatric, MRI safe Wheel Chair 1 2,255 1501 Bass Rd 41784000 LMH CARDIOLOGY - BASS RD Dose Calibrator, Nuclear Isotope dose calibrator neded 1 10,672 1729 Bass Rd 41784000 LMH CARDIOLOGY - BASS RD Pulse Volume Recorder (ERGO IDC), Ankle Brachial Index Vascular Scanner 1 40,000 1633 Metro Pkwy 42783000 LMH CARDIOLOGY - METRO PKWY Vital Signs Monitor (VS4 w/ temp), Telemetry monitor 1 4,300 339 Metro Pkwy 42783000 LMH CARDIOLOGY - METRO PKWY Pulse Volume Recorder (ERGO IDC), Replacement of Vasoguard 1 40,000 1077 The Children's Rehabilitation Center 43746000 THE CHILDREN'S REHABILITATION CENTER OOther, Evidence-Based Therapeutic Listening 1 705 1170 The Children's Rehabilitation Center 43746000 THE CHILDREN'S REHABILITATION CENTER OOther, Cardio Kids Elementary Indoor Cycle 1 1,795 1158 The Children's Rehabilitation Center 43746000 THE CHILDREN'S REHABILITATION CENTER OOther, Keiser M3i Indoor Cycle 1 2,195 1144 The Children's Rehabilitation Center 43746000 THE CHILDREN'S REHABILITATION CENTER OOther, Fiber Optic Spray Harness 1 723 1148 The Children's Rehabilitation Center 43746000 THE CHILDREN'S REHABILITATION CENTER OOther, Interactive Fiber Optic Light Source 1 2,247 1095 The Children's Rehabilitation Center 43746000 THE CHILDREN'S REHABILITATION CENTER OOther, Rifton Tricycle 1 2,124 1246 Pediatric Orthopedic Rehab 44746000 REHAB SVCS PEDIATRIC ORTHOPEDIC Table-Performa, Performa 350 Series Table 1 3,875 1248 Pediatric Orthopedic Rehab 44746000 REHAB SVCS PEDIATRIC ORTHOPEDIC Other, PTS BFR Tourniquet Instrument and Cuff Set 1 5,094 1770 Lee Rehab & Wellness Center 46963000 WELLNESS CENTER - FT MYERS Other, Leg press 1 6,332 1383 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Climber 1 7,207 1446 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Assault Airbike 1 799 1432 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Glut Hamstring Developer 1 695 1335 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Upright Bike 2 9,093 1344 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Leg Press 1 6,332 1324 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Synchro 2 13,573 1333 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Recline Bike 1 4,687 1465 Bonita Bay Therapy Outpatient Center 48746000 REHAB SVCS BONITA BAY THERAPY OUTPATOther, Graston Technique Instrument Set 1 1,815 1467 Bonita Bay Therapy Outpatient Center 48746000 REHAB SVCS BONITA BAY THERAPY OUTPATVital Signs Monitor (VS4 w/ temp) 1 4,300 1192 YMCA Therapy Outpatient Center 49746000 REHABILITATION SERVICES - YMCA Other, Rifton Medium Activity Chair 1 3,248 1125 YMCA Therapy Outpatient Center 49746000 REHABILITATION SERVICES - YMCA Other, Pure Tone And Tympanometry Screener 1 3,866 1512 Golisano Children's Hospital of Southwest Florida 60737000 REHABILITATION SERVICES Other, Video Imaging Chair - Powered 1 7,905 1518 Golisano Children's Hospital of Southwest Florida 60737000 REHABILITATION SERVICES Other, VitalStim Plus Electrotherapy System 1 2,659 1022 Ortho Center of Florida Creekside 65746000 REHABILITATION SERVICES-CREEKSIDE Other, Vectra Neo e-stim, US, Laser combo unit 1 8,423 1031 Ortho Center of Florida Creekside 65746000 REHABILITATION SERVICES-CREEKSIDE Other, Dolphin Neurostim 1 816 OUTPATIENT Total 2,522,465 LPG/MSO 1033 LPG Specialists - Physicians, Admininstration 50354000 GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Fundus Camera Canon CR-2 AF 1 48,786 1042 LPG Specialists - Physicians, Admininstration 50354000 GCHSWF PEDIATRIC SURGERY SPECIALTIES Slit Lamp 2 28,000 1049 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, 20 D, 28 D and 78 D lenses 3 2,700 1051 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Autorefractor 1 10,162 1052 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Autolensometer 1 3,902 1083 LPG Specialists - Physicians, Admininstration 50391000 LPG CARDIOLOGY - CAPE CORAL Other, Glucometer 1 1,280 969 LPG Specialists - Physicians, Admininstration 50354000 GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Headlight with battery pack for procedures 1 1,500 997 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Slit Lamp 1 4,690 1004 LPG Specialists - Physicians, Admininstration 50382000 LPG PULMONOLOGY - HP - GCH (Based) Defibrillator-AED Complete, AED 1 3,700 834 LPG Specialists - Physicians, Admininstration 50352000 LPG ENDOCRINOLOGY Other, Continuous Glucose Monitor 2 1,078 391 LPG Specialists - Physicians, Admininstration 50382000 LPG PULMONOLOGY - HP - GCH (Based) Other, Niox Vero machine 1 2,150 304 LPG Specialists - Physicians, Admininstration 50326000 LPG ADULT INFECTIOUS DISEASE Stretcher with 5th Wheel 1 6,200 271 LPG Specialists - Physicians, Admininstration 50326000 LPG ADULT INFECTIOUS DISEASE Vital Signs Monitor (VS4 w/ temp) 1 4,300 428 LPG Specialists - Physicians, Admininstration 50306000 LPG SURGERY - RIVERWALK Vital Signs Monitor (VS4 w/ temp) 2 8,600 675 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Vital Signs Monitor (VS4 w/ temp), increased volumes 2 8,600 678 LPG Specialists - Physicians, Admininstration 50346000 GCHSW PEDIATRIC CARDIOLOGY Copier (IR4235) 1 4,814 679 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, infant scale 1 3,125 494 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Copier (IR4235) 1 4,456 1622 LPG Specialists - Physicians, Admininstration 50321000 GCHSWF PEDIATRIC NEUROLOGY Other, Green Series 777 Integrated Wall System 7 6,796 1604 LPG Specialists - Physicians, Admininstration 50321000 GCHSWF PEDIATRIC NEUROLOGY Vital Signs Monitor (VS4 w/ temp), Replacement of OMRON HEM-907XL 1 4,300 1728 LPG Specialists - Physicians, Admininstration 50321000 GCHSWF PEDIATRIC NEUROLOGY Other, Equipment to assess ADHD 12 12,000 1804 LPG Specialists - Physicians, Admininstration 50304000 LPG PULMONOLOGY - LMH - CCH (Based) Oto/Ophthalmoscope-Desk 5 4,780 1087 LPG Specialists - Physicians, Admininstration 50355000 GCHSWF PEDIATRIC SPECIALISTS - COLLIER Other, Tonometer 1 3,840 1160 LPG Specialists - Physicians, Admininstration 50320000 GCHSWF PEDIATRIC SPECIALISTS Other, Developmental Testing Kit for NICU graduates 1 1,391 1214 LPG Specialists - Physicians, Admininstration 50354000 GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Bovie Cautery Device 1 2,250 1199 LPG Specialists - Physicians, Admininstration 50354000 GCHSWF PEDIATRIC SURGERY SPECIALTIES Other, Earwell Moldable device to correct ear deformity 1 2,000 1439 LPG Specialists - Physicians, Admininstration 50406000 LPG NEUROLOGY EMG (Sierra Summit) 1 23,000 1452 LPG Specialists - Physicians, Admininstration 50373000 LPG CARDIOLOGY - SANCTUARY (GC) Table-Treatment (Exam), Add exam beds 3 6,195 1423 LPG Specialists - Physicians, Admininstration 50406000 LPG NEUROLOGY EEG (ARC) 1 25,000 1334 LPG Primary 52348000 LPG OBSTETRICS AND GYNECOLOGY Other, reuseable plastic tray for Hysterscope 1 585 1676 LPG Primary 52348000 LPG OBSTETRICS AND GYNECOLOGY Other, Exam bed 1 2,193 1679 LPG Primary 53357000 LPG FAMILY-INTERNAL MEDICINE - SOUTH Other, Ritter 253 LED Light/mobile stand 1 1,200 1673 LPG Primary 53353000 LPG OCCUPATIONAL HEALTH Other, CLINITEK URINALYSIS 1 800 1674 LPG Primary 53357000 LPG FAMILY-INTERNAL MEDICINE - SOUTH Other, Welch Allyn GS600 Minor Procedure Light w/stand 2 1,574 1658 LPG Primary 53372000 LPG OB BASS ROAD Other, Colposcope with video 2 22,272 1667 LPG Primary 53372000 LPG OB BASS ROAD Other, Ultrasound machine 1 148,260 1668 LPG Primary 53367000 LPG CONVENIENT CARE - PINE ISLAND RD Other, EXAM TABLE 1 2,192 1615 LPG Primary 53357000 LPG FAMILY-INTERNAL MEDICINE - SOUTH Other, Hyfrecator 1 1,250 1597 LPG Primary 53308000 LPG FAMILY-INTERNAL MEDICINE - COLLEG Vital Signs Monitor (VS4 w/ temp), Philips Automated BP Cuff/SureSigns V53 1 4,300 1599 LPG Primary 53308000 LPG FAMILY-INTERNAL MEDICINE - COLLEG EKG (Philips TC50) 1 12,000 1591 LPG Primary 53357000 LPG FAMILY-INTERNAL MEDICINE - SOUTH Spirometer 1 4,000 1514 LPG Primary 53338000 LPG FAMILY MEDICINE - CLAYTON CT EKG (Philips TC50) 3 36,000 1557 LPG Primary 53357000 LPG FAMILY-INTERNAL MEDICINE - SOUTH Doppler-Vascular, EDAN SD6 Ultrasonic Tabletop Doppler 1 1,224 1511 LPG Primary 53389000 LPG ALLERGY Domestic Refrigerator 1 1,500 1471 LPG Primary 53343000 LPG PEDIATRICS - LEHIGH Other, SPOT Vision tester 1 6,310 1689 LPG Primary 53305000 LPG FP/IM BONITA BAY Pulse Oximeter-Hand Held 1 570 1359 LPG Primary 53367000 LPG CONVENIENT CARE - PINE ISLAND RD Other, Exam table 1 2,065 1418 LPG Primary 53308000 LPG FAMILY-INTERNAL MEDICINE - COLLEG Pulse Oximeter-Hand Held, Rad-5v Pulse oximeter with protective boot 5 2,950 1435 LPG Primary 53394000 LPG FAMILY-INTERNAL MEDICINE - SANCTUEKG (Philips TC50) 2 24,000

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 1437 LPG Primary 53357000 LPG FAMILY-INTERNAL MEDICINE - SOUTH Table-Treatment (Exam), Ritter 204 Manual Exam Table 10 18,750 1468 LPG Primary 53339000 LPG PEDIATRICS - PAGE FIELD Pulse Oximeter-Hand Held, Hand Held 1 570 1469 LPG Primary 53343000 LPG PEDIATRICS - LEHIGH Pulse Oximeter-Hand Held, hand held 3 1,710 1193 LPG Primary 53362000 LPG GME PROGRAM Bilimeter 1 6,333 1196 LPG Primary 53347000 LPG PEDIATRICS - BONITA Audiometer 1 3,114 1230 LPG Primary 53347000 LPG PEDIATRICS - BONITA EKG (Philips TC50) 1 12,000 1231 LPG Primary 53340000 LPG OBGYN - PI ROAD Other, Colposcope 1 8,457 1232 LPG Primary 53339000 LPG PEDIATRICS - PAGE FIELD EKG (Philips TC50) 1 12,000 1235 LPG Primary 53387000 LPG PEDIATRICS - CAPE EKG (Philips TC50) 1 12,000 1236 LPG Primary 53385000 LPG FAMILY-INTERNAL MED - PI ROAD Pulse Oximeter-Hand Held 1 570 1241 LPG Primary 53340000 LPG OBGYN - PI ROAD Doppler-Fetal Heart, Fetal Heart Monitor for New provider 1 870 1222 LPG Primary 53343000 LPG PEDIATRICS - LEHIGH EKG (Philips TC50) 1 12,000 1223 LPG Primary 53385000 LPG FAMILY-INTERNAL MED - PI ROAD Oto/Ophthalmoscope-Desk, expansion of primary care office 10 9,560 1226 LPG Primary 53340000 LPG OBGYN - PI ROAD Doppler-Fetal Heart 1 870 1176 LPG Primary 53339000 LPG PEDIATRICS - PAGE FIELD Audiometer, replacement audiometer 1 3,114 1183 LPG Primary 53387000 LPG PEDIATRICS - CAPE Audiometer 1 3,114 1115 LPG Primary 53362000 LPG GME PROGRAM Vital Signs Monitor (VS4 w/ temp) 1 4,300 293 LPG Primary 53372000 LPG OB BASS ROAD Other, Ultrasound machine 1 148,260 385 LPG Primary 53389000 LPG ALLERGY Spirometer 1 4,000 797 LPG Primary 53339000 LPG PEDIATRICS - PAGE FIELD Other, Tempstable refrigeration 1 4,300 1513 Lee Community HealthCare 70383000 LEE COMMUNITY HEALTHCARE - DUNBAR Defibrillator-AED Complete 1 3,400 1522 Lee Community HealthCare 70395000 LEE COMMUNITY HEALTHCARE-CAPE CORADefibrillator-AED Complete 1 3,700 LPG/MSO Total 787,832 SUBS & CORP 1826 Corporate Services 11920000 PATIENT BUSINESS OFFICE Other, Check folder/sealer 1 8,595 1055 Corporate Services 11863000 SUPPLY CHAIN MANAGEMENT Other, Ambulatory Pain Pump System Replacement 200 764,391 SUBS & CORP Total 772,986 RADIOLOGY 856 Lee Memorial Hospital, Hosp Based Phy 10724000 RADIOLOGY - SPEC PROCEDURES Doppler-Vascular 1 773 846 Lee Memorial Hospital, Hosp Based Phy 10724000 RADIOLOGY - SPEC PROCEDURES Cart-Medication (6 drawer), Lab Draw Supply Cart 1 2,000 849 Lee Memorial Hospital, Hosp Based Phy 10724000 RADIOLOGY - SPEC PROCEDURES Warming Cabinet-Table Top, Blanket Warmer 1 6,193 851 Lee Memorial Hospital, Hosp Based Phy 10720000 RADIOLOGY - DIAGNOSTICS Detector-Large (Canon) 1 75,000 735 Lee Memorial Hospital, Hosp Based Phy 10720000 RADIOLOGY - DIAGNOSTICS RF Room (Siemens Agile Max), LMH Room 3 1 850,000 747 Lee Memorial Hospital, Hosp Based Phy 10721000 RADIOLOGY - ULTRASOUND Ultrasound-Gen Rad/Vascular (GE Logiq E9), Multi-Campus Siemens 3 450,000 763 Lee Memorial Hospital, Hosp Based Phy 10720000 RADIOLOGY - DIAGNOSTICS C-Arm Tech Vision Monitor (only)/ge OEC9900), Multi-Campus 13 45,500 1143 Lee Memorial Hospital, Hosp Based Phy 10720000 RADIOLOGY - DIAGNOSTICS Other, Hardware/Software- Dose Registry 1 8,000 776 Gulf Coast Hospital, Hosp Based Phy 15722000 RADIOLOGY - NUCLEAR MEDICINE Siemens Nuclear Med (Dual-head) 1 1,025,000 779 Gulf Coast Hospital, Hosp Based Phy 15720000 RADIOLOGY - DIAGNOSTICS CR to DR Upgrade, 2 CR Rad Room Upgrades 2 250,000 783 Gulf Coast Hospital, Hosp Based Phy 15720000 RADIOLOGY - DIAGNOSTICS Other, Cradle Charger for Portable Batteries (2) 2 3,000 789 Gulf Coast Hospital, Hosp Based Phy 15720000 RADIOLOGY - DIAGNOSTICS Other, C-Arm Laser Aimer 1 3,634 793 Gulf Coast Hospital, Hosp Based Phy 15720000 RADIOLOGY - DIAGNOSTICS C-Arm (GE OEC 9900) w/printer (B&W), Flat panel 1 210,000 796 Gulf Coast Hospital, Hosp Based Phy 15720000 RADIOLOGY - DIAGNOSTICS Other, Mobile Grid Holder on Wheels 1 5,000 803 Health Park Medical Center, Hosp Based Phy 20720000 RADIOLOGY - DIAGNOSTICS RF Room (Siemens Agile Max) 1 1,146,876 843 Health Park Medical Center, Hosp Based Phy 20722000 RADIOLOGY - NUCLEAR MEDICINE Siemens Nuclear Med (Dual-head) 1 999,735 829 Health Park Medical Center, Hosp Based Phy 20725000 RADIOLOGY - MRI MRI Door Magnetic Screener, Walk by 1 16,000 871 Health Park Medical Center, Hosp Based Phy 20726000 RADIOLOGY - CT SCAN Cardiac Monitor (MX450), With Pulse Oximetry (2) 2 44,745 773 Cape Coral Hospital, Hosp Based Phy 25720000 RADIOLOGY - DIAGNOSTICS Other, Mobile Grid Holder on Wheels 1 5,000 737 Cape Coral Hospital, Hosp Based Phy 25725000 RADIOLOGY - MRI MRI (Philips 1.5T), CCH Additional Funds 1 808,170 RADIOLOGY Total 5,954,626 SURGICAL SERVICES 844 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 482,267 840 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, ORTHO POWER TRAY INSERTS 1 92,088 842 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 68,434 857 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, SYSTEM - KERRISON INSTRUMENT UPGRADE 1 48,957 854 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, SYSTEM - NEW SURGEON CONTINGENCY 1 100,000 344 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, CRANI EXTRAS 1 2,320 345 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, GOLD TIP CERVICAL KERRISONS 2 1,282 346 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, EXTRA LONG DRILL ATTACHMENT 1 1,000 348 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, CASPAR HEADREST 1 6,400 356 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, DR. SPRINGER KNEE EXTRAS 1 2,678 357 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, STULBERG POSITIONER 2 8,626 358 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, SYNTHES SMALL FRAG 1 68,843 359 Lee Memorial Hospital, Hosp Based Phy 10665000 PERI-ANESTHESIA CARE UNIT Scale-Bariatric Stand-on 1 3,300 360 Lee Memorial Hospital, Hosp Based Phy 10665000 PERI-ANESTHESIA CARE UNIT Other, ULTRASONIC DOPPLER FLOW DETECTORS 1 800 361 Lee Memorial Hospital, Hosp Based Phy 10665000 PERI-ANESTHESIA CARE UNIT Other, BIPAP MACHINE 1 15,688 362 Lee Memorial Hospital, Hosp Based Phy 10680000 ENDOSCOPY Colonoscope-Pedi 1 42,000 363 Lee Memorial Hospital, Hosp Based Phy 10665000 PERI-ANESTHESIA CARE UNIT Other, BARIATRIC BESIDE COMMODE 1 599 364 Lee Memorial Hospital, Hosp Based Phy 10680000 ENDOSCOPY Other, 26" FULL HD LCD MONITOR 1 6,972 365 Lee Memorial Hospital, Hosp Based Phy 10680000 ENDOSCOPY Other, SCOPE BUDDY 1 2,774 273 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Table-OR, 4085 1 44,038 274 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Injector-Table (Med Rad) 1 38,500 275 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Sonosite EDGE (General Imaging), II Review DS 1 75,000 277 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, OMNI RETRACTOR - GENERAL 1 24,187 245 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, PNEUMATIC DERMATOME - ENT 1 10,500 246 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, HEADLIGHT WITH EXTRA BATTERY - ENT 1 3,300 318 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, XENON LIGHTSOURCE 1 4,750 320 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, BK LAP PROBE 1 23,895 321 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM ESU-Force Triad 1 19,500 322 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, BULLDOG CLAMP TRAY 2 3,400 324 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, PURSE STRING 1 750 325 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, BLOOMSTON INSTRUMENT TRAY 1 2,704 327 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, ICG COMPONENTS 1 28,295 328 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Tray-GYN Laparoscopy 1 7,000 329 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, LAVH RETRACTOR TRAY - GYN ONC 1 2,500 331 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, LAVH TRAY - GYN ONC 1 7,100 333 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Table-OR, 4085 4 176,152 335 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Other, METRX TRAYS 1 5,739 337 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Tray-ACF 1 8,598 929 Corporate Services 11674000 STERILE PROCESSING Other, 3M ATTEST READER 6 5,970 858 Corporate Services 11674000 STERILE PROCESSING Other, CASE CARTS 10 31,190 887 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, ACUFEX TRAYS 1 16,402 888 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, REMB TRAY 2 72,366

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 890 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, EXTREMITY TRAY 1 3,262 892 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Arthroscope, WITH CAMERA, LENS, CORD 2 33,492 893 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, FUNDUS GRASPER 2 1,021 898 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, VEIN FINDER 1 4,600 1948 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 30,415 1952 Sanctuary and OP Surgery Center 13664000 SURGERY CENTER SANCTUARY Other, SYSTEM-WIDE REMB UPGRADES 1 86,611 1950 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 307,679 1946 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 114,056 1958 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, SYSTEM - KERRISON INSTRUMENT UPGRADE 1 49,781 1942 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, SYSTEM - ORTHO POWER TRAY INSERTS 1 58,751 901 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Table-OR, 4085 1 44,038 906 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM ESU-Standard 8 83,960 907 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM ESU-Force Triad 2 42,550 867 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, HANA TABLE 1 105,708 868 Gulf Coast Hospital, Hosp Based Phy 15665000 PERI-ANESTHESIA CARE UNIT Other, MINI DOPPLERS 2 1,790 255 Gulf Coast Hospital, Hosp Based Phy 15665000 PERI-ANESTHESIA CARE UNIT Other, Need MMS modules- not etco2 modules 15 82,500 366 Gulf Coast Hospital, Hosp Based Phy 15735000 ANESTHESIA Other, Sonosite POC US 1 31,194 367 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Waste Mgmnt Sys. (Neptune) 2 40,000 369 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, M7 SHAVER HAND PIECE 1 61,217 371 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, TRAY FUSION NAVIGATION SET S7 MEDTRONIC - ENT 1 11,664 386 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, SHUNT PASSER 1 800 388 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, HIP PADS FOR JACKSON TABLE 1 4,017 389 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, CERVICAL MGMT BASE 1 6,303 390 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, OBSERVER / ASSIST ARM FOR SCOPE (16_772GC) 1 13,694 393 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, INFRARED FOR MICROSCOPE (16_772GC) 1 148,532 394 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM CORE Sumex System, SUMEX DRILL 4 99,052 397 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, WILSON GEL SETS 1 1,099 404 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Tourniquet w/ Rolling Cart 1 12,500 405 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, MARTIN ARM 2 6,940 373 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, TRAY FACIAL FRACTURE 1 4,118 374 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, FACIAL OSTEOTOMY TRAY 1 9,000 376 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, AQUILEX 1 19,000 377 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, TRAY HYSTEROSCOPE MYOSURE 1 7,000 378 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, ULTRASONIC ASPIRATOR - MALIS 1 26,830 379 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, NEURO POSITIONING EQUIPMENT 1 46,537 381 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Tray-Craniotomy Instr. 1 7,750 382 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, DORO STEALTH ATTACHMENT 1 12,590 383 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, METRX TUBE SET 1 5,542 384 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, FORAMINOTOMY RONGUERS 1 2,715 433 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, MINI DOPPLERS WITH NON-DISP PROBE 2 1,790 436 Gulf Coast Hospital, Hosp Based Phy 15665000 PERI-ANESTHESIA CARE UNIT Other, NERVE STIMULATORS 3 2,259 443 Gulf Coast Hospital, Hosp Based Phy 15665000 PERI-ANESTHESIA CARE UNIT Cardiac Monitor (MP2) 1 9,850 445 Gulf Coast Hospital, Hosp Based Phy 15680000 ENDOSCOPY Colonoscope-Pedi 1 42,000 446 Gulf Coast Hospital, Hosp Based Phy 15680000 ENDOSCOPY Gastroscope 1 38,304 447 Gulf Coast Hospital, Hosp Based Phy 15680000 ENDOSCOPY Cart-Motorized Endo Call 1 15,500 448 Gulf Coast Hospital, Hosp Based Phy 15680000 ENDOSCOPY Other, BOUGIE 2 8,524 449 Gulf Coast Hospital, Hosp Based Phy 15680000 ENDOSCOPY Other, SPACE SAVER SCOPE RACK 1 580 450 Gulf Coast Hospital, Hosp Based Phy 15680000 ENDOSCOPY Other, VEINFINDER 1 4,043 408 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, LEAD MAN 2 1,026 410 Gulf Coast Hospital, Hosp Based Phy 15660000 OPERATING ROOM Other, ARM TABLE 1 2,206 454 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TAVR TRAY 1 14,000 510 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY ACL CRUCIATE TOOLBOX INST 1 12,431 511 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY GRAFT STATION MASTER SET 1 5,981 514 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Tray-ACMI Basic Cysto, AND TUR TRAYS 1 114,560 501 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, SHUTT UNIVERSAL STRESS POST 1 829 504 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY CHONDRO PICKS 1 2,029 505 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY MENISCECTOMY 1 10,443 506 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY ARTHROSCOPY INSTRUMENTS 1 20,000 507 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY ARTHROSCOPY CAMERA/LENS/CORD 1 17,758 508 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY TRANSFIX ACL RECONSTRUCTION 1 11,214 475 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM ESU-Standard 2 19,500 476 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Table-OR, STERIS 4085 1 44,038 479 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, ROBOT INSTRUMENTS 1 2,810 481 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, DENTAL HAND PIECES AND ATTACHMENTS 1 7,500 482 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, LIGHT CORD 1 1,404 483 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, SUCTION COAGULATOR 1 821 484 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, BATTERY OPERATED LIGHT SOURCE 1 584 493 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, TRAY RETRACTOR LAP NATHANSON HP 1 6,667 525 Health Park Medical Center, Hosp Based Phy 20665000 PERI-ANESTHESIA CARE UNIT Other, MINI DOPPLERS 4 3,260 529 Health Park Medical Center, Hosp Based Phy 20665000 PERI-ANESTHESIA CARE UNIT Other, VEINFINDER WITH FLEXIBLE ARM 1 4,600 258 Health Park Medical Center, Hosp Based Phy 20735000 ANESTHESIA Ultrasound - ECHO (Philips EPIQ7 3D) 5 925,510 259 Health Park Medical Center, Hosp Based Phy 20665000 PERI-ANESTHESIA CARE UNIT Other, ETCO2 module 6 33,000 261 Health Park Medical Center, Hosp Based Phy 20735000 ANESTHESIA ETCO2 Module (MMS) 1 5,500 694 Health Park Medical Center, Hosp Based Phy 20735000 ANESTHESIA Other, BIS MONITOR 1 10,000 697 Health Park Medical Center, Hosp Based Phy 20735000 ANESTHESIA Other, HEAD BUTLER WITH BED CLAMPS 1 850 699 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Heart Lung Bypass Unit 4 680,216 701 Health Park Medical Center, Hosp Based Phy 20735000 ANESTHESIA Cardiac Monitor (MP5) 2 24,745 543 Health Park Medical Center, Hosp Based Phy 20680000 ENDOSCOPY Other, ENDO FLUSH PUMP 1 1,789 715 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, SYNTHES BROKEN SCREW REMOVAL SET 1 19,636 1117 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, MOBILE STORAGE CARTS 1 3,814 1947 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 76,037 1944 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, SYSTEM - ORTHO POWER TRAY INSERTS 1 13,070 1951 Health Park Medical Center, Hosp Based Phy 20660000 OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 68,449 1949 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, SYSTEM-WIDE REMB UPGRADES 1 14,514 1945 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, SYSTEM - UPGRADE VIDEO LIGHT SOURCES 1 53,226 1943 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, ORTHO POWER TRAY INSERTS 1 27,595 1957 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, SYSTEM - KERRISON INSTRUMENT UPGRADE 1 29,774 712 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, JUMBO MAYO STAND 2 1,582 713 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Laparoscope 10mm, 30 DEGREE 2 6,000 755 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Microscope-Neuro 1 300,000 752 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, WILSON FRAME PAD SET 1 1,023 837 Cape Coral Hospital, Hosp Based Phy 25680000 ENDOSCOPY Scope Washer D w/leak Test 1 54,086 808 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Tray-Urology Camera 3 54,000 799 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, RIGID CYSTOSCOPE, LONG 2 13,106

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 802 Cape Coral Hospital, Hosp Based Phy 25660000 OPERATING ROOM Other, RIGID CYSTOSCOPE, SHORT 1 6,553 826 Cape Coral Hospital, Hosp Based Phy 25680000 ENDOSCOPY Colonoscope-Pedi 1 42,200 533 Cape Coral Hospital, Hosp Based Phy 25665000 PERI-ANESTHESIA CARE UNIT Sonosite X-Porte (Needle Guidance) 1 63,081 SURGICAL SERVICES Total 6,151,037 FACILITIES 1857 Lee Memorial Hospital, Hosp Based Phy 10801000 FOOD & NUTRITION SERVICES Other, Walkin Cooler and Freezer Replacement 1 395,000 1975 Lee Memorial Hospital, Hosp Based Phy 10737000 REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 563 (Design) - LMH 1 25,000 1976 Lee Memorial Hospital, Hosp Based Phy 10737000 REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 564 (Design) - LMH 1 25,000 1977 Lee Memorial Hospital, Hosp Based Phy 10737000 REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 565 (Design) - LMH 1 25,000 1978 Lee Memorial Hospital, Hosp Based Phy 10610000 ER HOLDING UNIT Air Handler Unit, Plant Ops - AHU 339 (Design) - LMH 1 25,000 1979 Lee Memorial Hospital, Hosp Based Phy 10737000 REHABILITATION SERVICES Air Handler Unit, Plant Ops - AHU 665 (Design) - LMH 1 25,000 1985 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Air Handler Unit, Plant Operations - AHU 114 - LMH 1 220,691 1994 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Code Compliance/Life Safety, gas farm controllers and manifold upgrade 1 25,000 1995 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, UTILITY PIPING REPLACEMENT 1 125,000 1996 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, COOLING TOWER SUPPORTS AND CATWALK REPLACEMENTS 1 250,000 1997 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, REPLACEMENT OF MRI CHILLER UNIT 1 10,000 1998 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, COOLING TOWER CONDENSER PIPING REPLACEMENT 1 450,000 2039 Lee Memorial Hospital, Hosp Based Phy 10660000 OPERATING ROOM Infrastructure, Surgery Services - OR Electrical Upgrades - LMH 1 250,000 2041 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Air Handler Unit, Plant Operations - RTU ED X-ray - LMH 1 65,000 2042 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Air Handler Unit, Plant Ops - IT Data Ctr Liebert Replacement - LMH 1 240,000 2043 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, Plant Operations - 5 North Roof Replacement - LMH 1 325,000 2044 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, Plant Ops - Clinial Lab Roof Replacement - LMH 1 102,481 2045 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Air Handler Unit, Plant Operations - RTU 402 - LMH 1 197,127 2047 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Air Handler Unit, Plant Operations - AHU 767 - LMH 1 350,000 2048 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Air Handler Unit, Plant Operations - AHU 989 Replacement - LMH 1 65,000 2049 Lee Memorial Hospital, Hosp Based Phy 10830000 PLANT OPERATIONS Infrastructure, Plant Ops - Kalwall Panels Main Entrance - LMH 1 150,000 2050 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Infrastructure, Plant Ops - Modernize Service Elevator #8 - LMH 1 350,000 2051 Corporate Services 11904000 PROPERTY MANAGEMENT Infrastructure, LPG/Outpatient Renovation/Coordination 1 462,000 2052 Corporate Services 11904000 PROPERTY MANAGEMENT Code Compliance/Life Safety, Property Management Life Safety 1 40,000 2053 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Other, Facilities Office Renov Add'l Funds 1 50,000 2063 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Other, System Project Coordination 1 300,000 2064 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO ADA, Code requried updating to ADA requirements 1 200,000 2046 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Infrastructure, Nurse Call - Upgrade Wescom to CAS - LMH 1 175,000 2078 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Code Compliance/Life Safety, Replace Exhaust Fans 12, 9, 11, 20 - HPMC 1 40,000 2038 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Infrastructure, HPCC - Phase 4 Continuation 1 200,000 1980 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 14 (Design) - HPMC 1 25,000 1981 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 39 (Design) - CCH 1 25,000 1982 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 25 (Design) - CCH 1 25,000 1983 Corporate Services 11800000 FACILITIES MANAGEMENT ADMINISTRATIO Air Handler Unit, Plant Ops - AHU 26 (Design) - CCH 1 25,000 1965 Corporate Services 11948000 FACILITY PLNG & CONSTRUCTION Code Compliance/Life Safety, Major Facilities Capital Budget Code Compliance 1 400,000 1966 Corporate Services 11827000 FACILITIES ASSET MANAGEMENT Furniture, To fund capital furniture in FY2018 1 655,277 1967 Corporate Services 11827000 FACILITIES ASSET MANAGEMENT Signage, TO FUND SIGNAGE IN FY2018 1 200,000 1968 Corporate Services 11826100 FACILITIES WAREHOUSE Other, STORAGE RACKS FOR WAREHOUSE 1 10,000 1969 Corporate Services 11826100 FACILITIES WAREHOUSE Other, SPECIALTY EQUIPMENT FOR WAREHOUSE 1 15,000 1971 Corporate Services 11948000 FACILITY PLNG & CONSTRUCTION Sitework 1 500,000 1972 Corporate Services 11948000 FACILITY PLNG & CONSTRUCTION Infrastructure, Major Facilities Capital Infrastructure 1 900,000 1973 Corporate Services 11948000 FACILITY PLNG & CONSTRUCTION Building Controls/Energy Management, Major Facilities Capital Energy Management 1 350,000 630 Cancer Center 12730000 PHARMACY - CANCER Expand Space, Sterile Product Mixing Area 1 653,250 2028 Gulf Coast Hospital, Hosp Based Phy 15830000 PLANT OPERATIONS Infrastructure, COOLING TOWER PIPING 1 100,000 2029 Gulf Coast Hospital, Hosp Based Phy 15830000 PLANT OPERATIONS Code Compliance/Life Safety, REDESIGN OF SOUTH TOWER EXHAUST 1 200,000 2031 Gulf Coast Hospital, Hosp Based Phy 15830000 PLANT OPERATIONS Infrastructure, ICE MACHINE REPLACEMENT 1 35,000 2003 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, REPLACE HOT WATER HEATERS MAIN HOSPITAL KITCHEN 1 40,000 2004 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, BOILER ROOM SUPPLY FAN REPLACEMENT 1 20,000 2035 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Fan Coil Unit, FCU 5 - HPMC - (IT) 1 75,000 2037 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Building Controls/Energy Management, Plant Ops - MOB HVAC Controls, VAVs, PIBs - GCMC 1 250,000 2000 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, ENTRANCE A OUTSIDE DOORS AND CONTROLS 1 20,000 2001 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, PATIENT BATHROOM FACUET REPLACEMENT 1 15,000 2006 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, PIPING REPLACEMENT 1 30,000 2013 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Air Handler Unit, AHU 8 Replacement - HPMC 1 447,409 2019 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, REPLACEMENT OF HOT WATER HEATERS AND 1 35,000 2020 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, CONTINUING REPLACEMENT OF ICE MACHINES 1 60,000 2021 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Code Compliance/Life Safety, Exhaust Fan Replacement 1 4,000 2022 Health Park Medical Center, Hosp Based Phy 20830000 PLANT OPERATIONS Infrastructure, REPLACEMENT OF OR DOORS 1 60,000 2014 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Fan Coil Unit, PATIENT ROOM FCU REPLACEMENT 1 50,000 2015 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Air Handler Unit, REPLACEMENT OF COILS IN AHUS 1 38,000 2016 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Infrastructure, REPLACEMENT OF DUCTWORK 1 25,000 2017 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Infrastructure, VARIABLE SPEED DRIVES FOR PUMPS IN PLANT 1 12,000 2018 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Code Compliance/Life Safety, BED STORAGE LIFT 1 75,000 2007 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Air Handler Unit, AHU 19 Replacement - CCH 1 339,000 2008 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Air Handler Unit, AHU 18 Replacement - CCH 1 325,000 2009 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Air Handler Unit, AHU 38 Replacement - CCH 1 60,000 2010 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Code Compliance/Life Safety, FIRE DAMPER REPLACEMENT 1 30,000 2011 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Code Compliance/Life Safety, REPLACE EXTERIOR DOORS 1 30,000 2012 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Code Compliance/Life Safety, REPLACEMENT OF SUPPLY FANS 1 & 2 1 40,000 1984 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Air Handler Unit, AHU #16 Replacement - CCH 1 21,000 2005 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Air Handler Unit, AHU 40 Blower Assembly Replacement - CCH 1 36,000 2025 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Infrastructure, REPLACEMENT OF PUMP ON DOMESTIC WATER PUMP 1 2,500 2026 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Building Controls/Energy Management, UPGRADE ELE CONTROL VALVES FOR COOLING TOWER 1 38,000 2027 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Infrastructure, CHILLED WATER PUMP 1 30,000 2032 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Sitework, UPGRADE PARKING LOT LIGHTING 1 75,000 2065 Cape Coral Hospital, Hosp Based Phy 25830000 PLANT OPERATIONS Code Compliance/Life Safety, SURGERY SERVICES DOORS AND FRAME REPLACEMENT 1 100,000 1999 LMH Child Development Centers 35967000 LMH DAY CARE CTR Fan Coil Unit, DAY CARE AC UNIT MINI SPLIT 1 15,000 2002 HP Child Development Centers 36967000 HP DAY CARE CTR Infrastructure, REPLACE WINDOWS 1 5,000 2066 CCH Child Development Center 45967000 CCH DAY CARE CTR Other, ROOM DIVIDERS FOR LARGE ROOM 1 50,000 646 CCH Child Development Center 45967000 CCH DAY CARE CTR Other, Replace 4-14 A/C unit 4 42,000 1745 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Pool vacuum 1 2,184 1748 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Pool heater 1 7,915 1739 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Other, Pool chemical controllers 1 13,582 1986 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Air Handler Unit, AHU #44 EVAP COIL REPLACEMENT W/UV LIGHT 1 24,960 1987 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Air Handler Unit, REPLACEMENT OF CONDENSING UNIT 43 1 18,301 1989 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Air Handler Unit, REPLACEMENT OF CONDENSING UNIT 42 1 39,592 1990 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Air Handler Unit, REPLACEMENT OD CONDENSING UNIT 45 1 9,588 1992 Wellness Center of Cape Coral 47963000 WELLNESS CENTER OF CAPE CORAL Sitework, REPLACEMENT OF POOL PUMP 1 19,143

FY2018 Capital Budget Requests CapReq Entity Cost Center Cost Center Name Capital Request Description Qty Total Requested 2023 LPG Primary 53338000 LPG FAMILY MEDICINE - CLAYTON CT Air Handler Unit, FPCC - Air Handlers 1 20,000 2033 LPG Primary 53344000 LPG INTERNAL MEDICINE - LABELLE Air Handler Unit, LaBelle - Package Units 1 20,000 2034 LPG Primary 53309000 LPG FAMILY-INTERNAL MEDICINE - BASS RDAir Handler Unit, LPG Bass - 5 Split Systems 1 27,000 2040 Lee Community HealthCare 70368000 LEE COMMUNITY HEALTHCARE - N FT MYERAir Handler Unit, LCH NFM - Package Units 1 14,000 2024 Health Park Care Center 90950000 ADMINISTRATION SERVICES - HPCC Infrastructure, REPLACEMENT OF PATIENT ROOM PTAC UNITS 1 8,000 INFORMATION SYSTEMS FACILITIES Total 12,000,000 2067 Corporate Services 11938000 I/S INFORMATION TECHNOLOGY SVCS GEAC Replacement, Conversion for all General Financial Applications 1 4,000,000 2069 Corporate Services 11938100 I/S DATA NETWORK SERVICES Office Automation Refresh 1 1,104,860 2070 Corporate Services 11938000 I/S INFORMATION TECHNOLOGY SVCS EPIC, Inpatient and Ambulatory Licenses 1 1,180,800 2072 Corporate Services 11938100 I/S DATA NETWORK SERVICES IS Infrastructure 1 4,795,000 2073 Corporate Services 11938100 I/S DATA NETWORK SERVICES EPIC, Infrastructure Upgrades 1 1,880,000 2074 Corporate Services 11938000 I/S INFORMATION TECHNOLOGY SVCS Other, Best Care Collaborative IT Needs 1 102,500 2079 Corporate Services 11938000 I/S INFORMATION TECHNOLOGY SVCS Diagnostic/Imaging, Workstation Replacements (Radiology/Cardiology) 1 675,000 2086 Corporate Services 11938000 I/S INFORMATION TECHNOLOGY SVCS Strategic Innovation/Optimization 1 1,020,000 2087 Corporate Services 11938000 I/S INFORMATION TECHNOLOGY SVCS Software Upgrades 1 282,000 STRATEGIC GROWTH/NEW DEVELOPMENT INFORMATION SYSTEMS Total 15,040,160 2056 Corporate Services 11988000 OVERHEAD CENTER Strategic Growth/New Development Projects 12,096,250 Next Gen ACO/ Medicaid Provider Service Network Infrastructure 5,000,000 LeeSar Expansion 4,600,000 STRATEGIC GROWTH/NEW DEVELOPMENT Total 21,696,250

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

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

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

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

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

Lee Memorial Health System Operating Highlights For the month ended August 31, 2017 Adjusted admits for the month ended August 31, 2017 are 12,301 which is 655 or 5.6% higher than budget. Actual inpatient admits for the month are 6,582 which are 354 admits or 5.7% greater than budget. Inpatient days are 33,000 or 3.0% higher than budget which resulted in a 5.01 day length of stay. Emergency room visits are 1.1% higher than budget at 17,220 and outpatient surgeries of 1,989 are greater than budget by 5.8%. Net patient revenue for August reflects a $6.1 million or 4.5% favorable variance to budget. The majority of this variance is due to a volume variance of $7.7 million offset by a negative rate variance $1.5 million. Net Patient Revenue per CMI adjusted admit for the month ended August 31, 2017 is $7,313 vs. budget of $7,494. Total operating expenses before depreciation and interest expense are 6.8% greater than budget. Salaries & Wages are greater than budget at $69.2 million, and above budget on a case mix adjusted admission basis by $88 as well. The majority of this variance ($3.7 million) was due to staff not flexing to the volumes as well as payments made per physician agreements. The average hourly pay rate is $34.01 which is $0.37 lower than budget. Productivity as measured by FTEs/AOB is unfavorable to budget by 2.6% (5.78 actual vs. 5.63 budget). Productive FTE s per adjusted daily admission were 0.8% lower than budget at 26.15 vs. a budget of 26.35. Supply expense is higher than budget by $1.5 million or 5.8%, while on a case mix adjusted admission basis the supply variance is favorable at $1,380 actual vs. $1,397 budget. Total operating costs per case mix adjusted admit are less than budget at $6,803 actual vs. $6,820. For August 2017, the gain from operations is $3.0 million or 2.0% versus a budget of $4.3 million or 3.1%. Excess revenue over expenses is a gain of $7.7 million versus a budget of $10.0 million. For the month, Cash & Investments decreased by $2.0 million to $1,010.9 million. Total sources of cash from operations are $12.1 million and from investments are $4.0 million offset by uses of cash totaling $18.1 million. The majority of the uses of cash were due to cash outflows of $17.9 million for purchases of property, plant & equipment. Days in Accounts Receivable decreased from 47.2 days in July to 46.5 days resulting in a $4.9 million increase in cash. Total Notes & Bonds payable on August 31, 2017 is $680.3 million resulting in the Cash to Debt ratio of 148.6%. Page A.1

LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED EXECUTIVE SUMMARY For the Period Ending August 31, 2017 CURRENT MONTH Budget Actual Prior Year Budget Actual Prior Year Inpatient Volumes: Admits - Adults & Peds 6,228 6,582 6,200 5.7% 6.2% 73,636 73,850 72,803 0.3% 1.4% Patient Days - Adults & Peds 32,024 33,000 31,028 3.0% 6.4% 376,149 374,373 370,270-0.5% 1.1% Short Stay Days 4,667 4,338 4,620-7.0% -6.1% 51,568 52,051 51,058 0.9% 1.9% Total Patient Days plus Short Stay Days 36,691 37,338 35,648 1.8% 4.7% 427,717 426,424 421,328-0.3% 1.2% Average Length of Stay 5.14 5.01 5.00 2.5% -0.2% 5.11 5.07 5.09 0.8% 0.3% Inpatient Surgeries 1,711 1,751 1,723 2.4% 1.6% 20,020 20,218 19,560 1.0% 3.4% Outpatient Volumes: Emergency Room Visits 17,027 17,220 17,305 1.1% -0.5% 202,637 201,662 197,379-0.5% 2.2% Outpatient Surgeries 1,880 1,989 2,067 5.8% -3.8% 22,234 21,597 22,345-2.9% -3.3% Hospital Based Physician Visits 39,926 31,535 32,308-21.0% -2.4% 436,118 374,557 394,238-14.1% -5.0% Physician Visits 85,821 79,853 75,405-7.0% 5.9% 889,339 889,355 770,544 0.0% 15.4% Home Health Visits 7,269 5,112 6,212-29.7% -17.7% 78,546 61,516 63,007-21.7% -2.4% Adjusted Admits 11,646 12,301 11,749 5.6% 4.7% 136,237 136,806 132,492 0.4% 3.3% (overall in/outpat volume indicator) Total Case Mix Index 1.56 1.58 1.56 1.4% 1.4% 1.56 1.56 1.55 0.3% 0.7% Operating Ratios: Net Revenue/Adj Adm CMI 7,494 7,313 7,114-2.4% 2.8% 7,206 7,304 7,071 1.4% 3.3% Operating Exp/Adj Adm CMI 6,820 6,803 6,657 0.3% -2.2% 6,547 6,668 6,421-1.9% -3.9% Supply Exp/Adj Adm CMI 1,397 1,380 1,479 1.2% 6.6% 1,393 1,431 1,389-2.7% -3.0% Wages/Ben - % of Net Oper Rev 55.7% 55.5% 53.7% 0.4% -3.3% 54.8% 54.2% 53.3% 1.1% -1.7% Supplies as a % of Net Oper Rev 18.2% 18.5% 20.2% -1.6% 8.7% 18.9% 19.1% 19.1% -1.5% -0.1% Charity/Bad Debt - % of Gross Rev 6.8% 7.4% 7.5% -9.4% 0.7% 6.8% 6.7% 6.6% 0.6% -1.5% FTEs/AOB 5.63 5.78 5.69-2.6% -1.5% 5.44 5.50 5.37-1.1% -2.4% Productive Hours/Adjusted Admit 150.6 149.4 147.5 0.8% -1.3% 145.1 144.7 141.8 0.3% -2.0% Average Hourly Rate 34.38 34.01 32.26 1.1% -5.4% 34.15 34.36 32.94-0.6% -4.3% Financial Ratios: Operating Margin (%) 3.1% 2.0% 2.2% -33.9% -8.9% 4.7% 4.4% 5.1% -7.9% -13.8% Excess Margin (%) 6.9% 5.1% 3.7% -25.8% 37.0% 8.4% 9.4% 9.9% 12.0% -5.0% Liquidity Ratios: Days Cash on Hand 241.7 233.40 256.56 Cash to Debt (%) 157.2% 148.6% 145.3% Days in Acct Receivable 44.2 46.5 42.7 Income Statement Summary (in Thousands) Total Net Operating Revenue 139,831 145,663 134,256 4.2% 8.5% 1,566,087 1,595,905 1,490,504 1.9% 7.1% Total Operating Expenses 135,516 142,693 131,251-5.3% -8.7% 1,491,851 1,526,248 1,415,028-2.3% -7.9% Consolidated Gain(Loss) from Oper 4,315 2,971 3,005-31.2% -1.1% 74,235 69,657 75,476-6.2% -7.7% Investment Earnings/Non Op Income 5,667 4,681 2,061-17.4% 127.1% 62,323 88,511 79,775 42.0% 11.0% Consolidated Excess Rev over Exp 9,982 7,652 5,066-23.3% 51.0% 136,558 158,168 155,251 15.8% 1.9% Balance Sheet Highlights (In Thousands): Cash & Investments 1,040,707 1,010,909 1,025,735 Bonds & Notes Payable 662,154 680,265 706,120 Act to Bud % Variance Act to Prior % Variance YEAR-to-DATE Act to Bud % Variance Act to Prior % Variance CMI = Case Mix Index Page A.2

LEE HEALTH CONSOLIDATED STATISTICAL SUMMARY For the Period Ending August 31, 2017 Budget Actual Current Month Year-to-Date Prior Year % Variance % Variance Budget Actual Prior Year Act to Bud Act to PY Act to Bud Act to PY Admissions ADULTS 5,554 5,983 5,614 7.7% 6.6% 66,153 67,512 65,754 2.1% 2.7% PEDIATRICS 351 298 266-15.1% 12.0% 4,100 3,283 3,861-19.9% -15.0% NICU 92 73 81-20.7% -9.9% 786 736 781-6.4% -5.8% POST ACUTE 231 228 239-1.3% -4.6% 2,597 2,319 2,408-10.7% -3.7% Total Adult & Peds 6,228 6,582 6,200 5.7% 6.2% 73,636 73,850 72,804 0.3% 1.4% NEWBORNS 521 585 586 12.3% -0.2% 5,602 5,620 5,625 0.3% -0.1% Total Admissions 6,749 7,167 6,786 6.2% 5.6% 79,238 79,470 78,429 0.3% 1.3% Patient Days ADULTS 24,062 25,077 23,756 4.2% 5.6% 290,851 295,681 290,652 1.7% 1.7% PEDIATRICS 1,126 1,081 869-4.0% 24.4% 13,422 11,488 12,625-14.4% -9.0% NICU 1,656 1,758 1,560 6.2% 12.7% 15,581 15,660 14,732 0.5% 6.3% POST ACUTE 5,181 5,084 4,843-1.9% 5.0% 56,295 51,544 52,261-8.4% -1.4% Total Adult & Peds 32,024 33,000 31,028 3.0% 6.4% 376,149 374,373 370,270-0.5% 1.1% NEWBORNS 1,150 1,341 1,382 16.6% -3.0% 12,602 12,704 12,931 0.8% -1.8% Total Patient Days 33,174 34,341 32,410 3.5% 6.0% 388,751 387,077 383,201-0.4% 1.0% Average Length of Stay ADULTS 4.33 4.19 4.23 3.3% 0.9% 4.40 4.38 4.42 0.4% 0.9% PEDIATRICS 3.21 3.63 3.27-13.1% -11.0% 3.27 3.50 3.27-6.9% -7.0% NICU 18.00 24.08 19.26-33.8% -25.0% 19.82 21.28 18.86-7.3% -12.8% POST ACUTE 22.42 22.30 20.26 0.6% -10.0% 21.68 22.23 21.70-2.5% -2.4% Total Adult & Peds 5.14 5.01 5.00 2.5% -0.2% 5.11 5.07 5.09 0.8% 0.3% NEWBORNS 2.21 2.29 2.36-3.9% 2.8% 2.25 2.26 2.30-0.5% 1.7% Total Length of Stay 4.92 4.79 4.78 2.5% -0.3% 4.91 4.87 4.89 0.7% 0.3% OP Registrations EMERGENCY ROOM 17,027 17,220 17,305 1.1% -0.5% 202,637 201,662 197,379-0.5% 2.2% OP SURGERY CASES 1,880 1,989 2,067 5.8% -3.8% 22,234 21,597 22,345-2.9% -3.3% Subtotal 18,907 19,209 19,372 1.6% -0.8% 224,871 223,259 219,724-0.7% 1.6% Visits HOME HEALTH VISITS 7,269 5,112 6,212-29.7% -17.7% 78,546 61,516 63,048-21.7% -2.4% HOSP BASED PHY VISITS 39,926 31,535 32,308-21.0% -2.4% 436,118 374,557 394,238-14.1% -5.0% PHYSICIAN VISITS 85,821 79,853 75,405-7.0% 5.9% 889,339 889,355 770,544 0.0% 15.4% TRAUMA SERVICES DISTRICT 1,015 1,030 1,133 1.5% -9.1% 12,148 10,964 11,536-9.7% -5.0% Subtotal 134,031 117,530 115,058-12.3% 2.1% 1,416,151 1,336,392 1,239,366-5.6% 7.8% TOTAL OP 152,937 136,739 134,430-10.6% 1.7% 1,641,022 1,559,651 1,459,090-5.0% 6.9% Page A.3

LEE MEMORIAL HEALTH SYSTEM CONSOLIDATING STATEMENT OF OPERATIONS For the Period Ending August 31, 2017 (in thousands) Current Month Year-to-Date Act to Bud % Act to Prior Budget Actual Prior Year Variance % Variance Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance INPATIENT REVENUE 319,312 326,885 299,452 2.4% 9.2% 3,739,154 3,719,103 3,531,171-0.5% 5.3% OUTPATIENT REVENUE 277,798 284,006 267,993 2.2% 6.0% 3,178,787 3,170,478 2,895,110-0.3% 9.5% TOTAL PATIENT REVENUE 597,110 610,890 567,445 2.3% 7.7% 6,917,941 6,889,581 6,426,282-0.4% 7.2% DED FROM REV-MEDICARE 251,179 237,947 209,020 5.3% -13.8% 2,878,480 2,925,871 2,511,076-1.6% -16.5% DED FROM REV-MEDICAID 72,928 78,967 61,676-8.3% -28.0% 787,935 795,418 661,659-0.9% -20.2% DED FROM REV-CHARITY 21,198 26,743 23,668-26.2% -13.0% 245,895 264,368 225,051-7.5% -17.5% DED FROM REV-HMO/PPO 55,530 63,178 59,855-13.8% -5.6% 650,558 689,282 629,129-6.0% -9.6% DED FROM REV-OTHER 40,644 42,998 63,914-5.8% 32.7% 605,525 456,141 746,807 24.7% 38.9% DED FROM REV-BAD DEBT 19,359 18,638 18,762 3.7% 0.7% 222,248 198,996 200,900 10.5% 0.9% TOTAL DED FROM REV 460,839 468,472 436,895-1.7% -7.2% 5,390,640 5,330,078 4,974,621 1.1% -7.1% NET PATIENT REVENUE 136,272 142,419 130,550 4.5% 9.1% 1,527,301 1,559,504 1,451,660 2.1% 7.4% OTHER OPERATING REVENUE 3,559 3,244 3,706-8.9% -12.5% 38,785 36,401 38,844-6.1% -6.3% TOTAL OPERATING REV 139,831 145,663 134,256 4.2% 8.5% 1,566,087 1,595,905 1,490,504 1.9% 7.1% OPERATING EXPENSES PROD SALARIES 58,429 59,701 53,915-2.2% -10.7% 649,169 641,940 583,591 1.1% -10.0% PROD OVERTIME 1,650 1,685 1,725-2.1% 2.3% 19,158 21,980 21,830-14.7% -0.7% CONTRACT LABOR 66 102 464-54.7% 78.0% 1,686 2,393 3,840-42.0% 37.7% NON-PROD SALARIES 6,097 7,742 5,549-27.0% -39.5% 68,376 82,288 71,595-20.3% -14.9% TOTAL SALARIES & WAGES 66,243 69,230 61,653-4.5% -12.3% 738,389 748,601 680,857-1.4% -9.9% FRINGE BENEFITS 11,651 11,554 10,413 0.8% -11.0% 119,583 116,482 113,670 2.6% -2.5% HEALTH CARE ACCESS 1,530 1,531 1,562-0.1% 2.0% 17,758 18,177 16,409-2.4% -10.8% SUPPLIES 25,398 26,880 27,132-5.8% 0.9% 295,353 305,452 285,051-3.4% -7.2% OTHER SERVICES 6,486 7,147 6,292-10.2% -13.6% 75,457 74,301 75,704 1.5% 1.9% PURCHASED SERVICES 12,706 16,136 15,112-27.0% -6.8% 141,081 160,794 146,397-14.0% -9.8% TOTAL OPER EXPENSES 124,013 132,478 122,164-6.8% -8.4% 1,387,621 1,423,808 1,318,088-2.6% -8.0% EBITDA 15,818 13,185 12,092-16.6% 9.0% 178,466 172,097 172,417-3.6% -0.2% DEPRECIATION/AMORT 9,433 8,425 7,310 10.7% -15.2% 84,479 82,994 76,698 1.8% -8.2% INTEREST EXPENSE 2,070 1,790 1,776 13.5% -0.8% 19,751 19,446 20,242 1.5% 3.9% OVERHEAD ALLOCATION (0) 0 (0) 137.1% 200.0% (0) 0 (0) 20181.6% 3960.0% GAIN(LOSS) FROM OPER 4,315 2,971 3,005-31.2% -1.1% 74,235 69,657 75,476-6.2% -7.7% Page A.4

LEE MEMORIAL HEALTH SYSTEM STATEMENT OF CASH FLOWS For the Period Ending August 31, 2017 (In thousands) Current Month Year to Date Sources of Cash: Gain From Operations 2,971 69,657 Non Operating Revenue (excluding Investment Income) 715 10,083 Depreciation & Amortization 8,425 82,994 (Gain)/Loss on Sale of Assets (16) (40) Total Sources of Cash 12,094 162,694 Uses of Cash: Change in Patient Accounts Receivable 4,902 (25,501) Repayments Long Term Debt Principal (1,586) (22,659) Additions to Property, Plant & Equipment, Net (17,907) (176,439) Change in All Other Assets 644 7,777 Change in All Other Liabilities (4,105) (23,967) Total Uses of Cash (18,052) (240,789) Cash Provided (Used) Prior to Investment Income (5,958) (78,095) Cash Provided from Investment Income 3,967 78,428 Cash Provided (Used) (1,991) 333 Cash Balance, beginning of period 1,012,901 1,010,576 Cash Balance, end of period 1,010,909 1,010,909 Total Bonds & Notes Payable 680,265 Cash to Debt Ratio 148.6% Page A.5

LEE MEMORIAL HEALTH SYSTEM CONSOLDIATED BALANCE SHEET For the Period Ending August 31, 2017 in Thousands (000's) ASSETS Current Prior Month Prior Year LIABILITIES AND NET ASSETS Current Prior Month Prior Year Current Assets: Current Liabilities: Cash and Cash Equivalents * 19,345 25,259 43,265 Accounts Payable 40,475 44,456 55,692 Short-term Cash Investments * 966,375 962,492 943,046 Current Installments of LT Debt 38,037 38,048 36,321 Assests whose use is restricted 369 369 8,034 Accrued Expenses Net Patient Accounts Receivable 213,669 218,571 188,168 Employee Compensation 43,626 36,672 40,035 Inventory 31,782 31,757 30,660 Interest 5,741 4,505 8,308 Other Current Assets 33,228 33,343 35,049 Other 28,159 28,175 36,744 Estimated Third Party 41,364 51,478 59,307 Total Current Assets 1,264,768 1,271,790 1,248,222 Total Current Liabilities 197,402 203,334 236,408 Noncurrent Assets: NonCurrent Liabilities: Long Term Investments - - - Assests whose use is restricted * 25,189 25,150 24,265 Capital Assets, Net 953,714 944,216 860,229 LT Debt Excluding Current Installments 642,228 643,852 669,661 Other Assets, Net 40,704 41,000 37,300 Other Liabilities 100,772 98,847 82,869 Total Noncurrent Assets 1,019,607 1,010,366 921,794 Total Noncurrent Liabilities 743,000 742,700 752,529 Deferred Outflows of Resources: Deferred Inflows of Resources: Deferred Loss on Debt Refunding 2,560 2,609 5,617 Excess Consideration Provided for Acquisition 101,836 102,095 104,654 Deferred Inflows on Pension 4,320 4,428 5,468 Total Deferred Outflows of Resources 104,396 104,704 110,271 Total Deferred Inflows of Resources 4,320 4,428 5,468 Net Position: Restricted for Non-Expendable 5,992 5,992 5,992 Expendable 34,336 33,753 58,232 Net Investment in Capital Assets 273,449 262,316 154,247 Unrestricted 1,130,273 1,134,337 1,067,411 Total Net Position 1,444,049 1,436,398 1,285,882 Total Assets and Deferred Outflows of Resources 2,388,771 2,386,860 2,280,287 Total Liabilities and Net Position 2,388,771 2,386,860 2,280,287 * Cash & Investments Page A.6

LEE MEMORIAL HEALTH SYSTEM FINANCIAL RATIOS For the Year-to-Date Ending August 31, 2017 2016 2017 2016 Moody's Financial FYE YTD Median Goals 9/30/2016 08/31/17 PROFITABILITY RATIOS: Operating Margin 3.2% 4.0% 5.2% 4.4% + Excess Margin 6.1% 8.2% 9.9% 9.4% + Operating Cash Flow Margin 10.0% 10.9% 11.6% 10.8% + LIQUIDITY RATIOS: Days Cash on Hand 215.5 240.4 252.6 234.6 + Cushion Ratio (x) 22.2 16.0 16.3 16.6 + Cash to Debt 160.6% 152.2% 143.1% 148.6% + CAPITALIZATION RATIOS: Debt to Capitalization 33.9% 33.7% 36.6% 33.0% (-) Annual Debt Service Coverage (x) 5.5 3.5 5.8 4.4 + Debt to Cash Flow 2.7 3.4 2.5 3.1 (-) NOTE: + = Ratios that should be above the Moody's median (-) = Ratios that should be lower than the Moody's median Page A.7

LEE MEMORIAL HEALTH SYSTEM OPERATING RATIOS For the Period Ending August 31, 2017 (in thousands) Current Month Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance Year-to-Date Budget Actual Prior Year Act to Bud % Variance Act to Prior % Variance AS % NET OPERATING REVENUE Wages and Benefits 55.7% 55.5% 53.7% 0.4% -3.3% 54.8% 54.2% 53.3% 1.1% -1.7% Supplies 18.2% 18.5% 20.2% -1.6% 8.7% 18.9% 19.1% 19.1% -1.5% -0.1% All Other Operating Expenses 14.8% 17.0% 17.1% -14.9% 0.4% 15.0% 15.9% 16.0% -6.1% 0.8% Capital Costs 8.2% 7.0% 6.8% 14.8% -3.6% 6.7% 6.4% 6.5% 3.6% 1.3% EBDITA Margin 11.3% 9.1% 9.0% -20.0% 0.5% 11.4% 10.8% 11.6% -5.4% -6.8% Operating Margin 3.1% 2.0% 2.2% -33.9% -8.9% 4.7% 4.4% 5.1% -7.9% -13.8% Excess Margin 6.9% 5.1% 3.7% -25.8% 37.0% 8.4% 9.4% 9.9% 12.0% -5.0% Per CMI ADJ ADMIT/VISIT Net Operating Revenue 7,690 7,480 7,316-2.7% 2.2% 7,389 7,474 7,261 1.2% 2.9% Total Operating Expenses 6,820 6,803 6,657 0.3% -2.2% 6,547 6,668 6,421-1.9% -3.9% Wages and Benefits 4,284 4,148 3,927 3.2% -5.6% 4,048 4,051 3,870-0.1% -4.7% Supplies 1,397 1,380 1,479 1.2% 6.6% 1,393 1,431 1,389-2.7% -3.0% All Other Operating Expenses 1,140 1,274 1,252-11.8% -1.8% 1,105 1,186 1,162-7.3% -2.1% Capital Costs 633 525 495 17.1% -5.9% 492 480 472 2.4% -1.6% Operating Margin 237 153 164-35.7% -6.9% 350 326 368-6.9% -11.3% Excess Margin 549 393 276-28.4% 42.3% 644 741 756 15.0% -2.1% LABOR Productive FTE's/Adj Daily Admit 26.35 26.15 25.82 0.8% -1.3% 25.40 25.32 24.82 0.3% -2.0% Average Hourly Rate 34.38 34.01 32.26 1.1% -5.1% 34.15 34.36 32.94-0.6% -4.1% OP Rev % of Total Revenue 46.5% 46.5% 47.2% -0.1% -1.6% 45.9% 46.0% 45.1% 0.1% 2.1% Page A.8

LEE MEMORIAL HEALTH SYSTEM CONSOLIDATED - PAYOR MIX (BASED ON GROSS REVENUE) For the Period Ending August 31, 2017 Current Month Budget Actual Prior Year Budget Year-to-Date Actual Prior Year MEDICARE 34.1% 33.0% 31.0% 34.6% 33.8% 34.1% MEDICARE HMO 13.2% 15.1% 13.8% 13.5% 15.2% 13.7% MEDICAID 3.3% 5.6% 2.7% 3.3% 3.6% 3.1% MEDICAID HMO 9.6% 10.1% 9.8% 9.3% 9.2% 9.3% HMO/PPO 17.7% 21.0% 20.0% 17.8% 18.8% 18.4% COMMERCIAL 4.0% 4.3% 3.5% 4.0% 3.8% 3.9% OTHER 18.1% 10.9% 19.2% 17.5% 15.6% 17.5% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% MEDICARE CASE MIX INDEX 1.68 1.72 1.73 1.67 1.67 1.68 SYSTEM CASE MIX INDEX 1.56 1.58 1.56 1.56 1.56 1.55 (In Thousands) 09/30/16 08/31/17 Variance Gross Accounts Receivable 437,137 474,477 37,340 Net Accounts Receivable 189,413 213,669 24,256 Net Days in Accounts Receivable 44.6 46.5 1.9 Page A.9

Board of Directors Financial Update FY 2017 period ending 08/31/17 Presented on 9/28/17 Financial Services #3400.159 Rev. 10/16

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

Hospital Census For the eleven months ending August 31, 2017 Inpatient Admissions Budget Actual Prior $ Variance Actual to Budget % Variance Actual to Budget $ Variance Actual to Prior % Variance Actual to Prior 73,636 73,850 72,804 214 0.3% 1,046 1.4% Average Length of Stay Budget Actual Prior $ Variance Actual to Budget % Variance Actual to Budget $ Variance Actual to Prior % Variance Actual to Prior 5.11 5.07 5.09 (0.04) -0.8% (0.02) -0.4%

Hospital Census For the eleven months ending August 31, 2017 Case Mix Index Budget Actual Prior $ Variance Actual to Budget % Variance Actual to Budget $ Variance Actual to Prior % Variance Actual to Prior 1.56 1.56 1.55-0.0% 0 0.6% >1.0 = more resource intensive than average <1.0 = less resources intensive than average Average Daily Census (ADC) Budget Actual Prior Change from Prior Year % Change from Prior Year % Variance from Budget Inpatients 1,123 1,118 1,102 16 1.5% -0.4% Observation 154 155 152 3 2.0% 0.6% ADC 1,277 1,273 1,254 19 1.5% -0.3%

Outpatient For the eleven months ending August 31, 2017 Outpatient % of Gross Revenues % % Variance Variance Budget Actual Prior Actual to Budget Actual to Prior 45.9% 46.0% 45.1% 0.1% 0.8% Primary Care Physician Visits $ % Variance Variance $ Variance Actual to Actual to Actual to Budget Actual Prior Budget Budget Prior % Variance Actual to Prior 261,517 254,123 241,443 (7,394) 2.8% 12,680 5.3%

Payor Mix (Based on Gross Revenue) Year to date through 8/31/17 15.6% 22.6% 12.8% 49.0% Medicare Medicaid Commercial/HMO/PPO Other Year to date through 8/31/2016 17.5% 22.3% 12.4% 47.8% Medicare Medicaid Commercial/HMO/PPO Other

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

Net Patient Revenue For the eleven months ending August 31, 2017 Budget Actual Variance to Budget Net Patient Revenue $1,527,301,252 $1,559,503,519 2.1% $ Variance to Budget $32,202,267 Net Patient Revenue per CMI Adjusted Admission $7,206 $7,304 1.4% Case Mix Index (CMI) 1.56 1.56 0.0% Adjusted Admissions 136,237 136,806 0.4% Due to Volume Variance $6,381,915 Due to Rate Variance $25,820,352 Total Variance to Budget $32,202,267

Charity Write-offs & Bad Debt Expense For the eleven months ending August 31, 2017 Budget Actual Variance Charity Write-offs 245,894,883 264,368,482 18,473,599 Bad Debt Expense 222,247,700 198,996,262 (23,251,438) Total Charity Write-offs & Bad Debt Expense 468,142,583 463,364,744 (4,777,839) Gross Patient Revenues 6,917,941,387 6,889,581,130 (28,360,257) Net Patient Revenue 1,527,301,252 1,559,503,519 32,202,267 Charity as a % of Gross Revenue 3.6% 3.8% Bad Debt as a % of Expected Net Revenue 14.6% 12.8%

Salaries For the eleven months ending August 31, 2017 Salaries & Wages Budget Actual $ Variance % Variance Salaries & Wages $ 738,389,122 $ 748,601,331 $ 10,212,209 1.4% Labor Productivity Budget Actual $ Variance % Variance Productive Hours per Adjusted Patient Day 28.41 28.54 0.13 0.5% Adjusted Patient Day 695,926 693,520 (2,406) -0.3% Average Hourly Rate 34.15 34.36 0.21 0.6%

Supplies & Purchased Services For the eleven months ending August 31, 2017 Supplies Budget Actual $ Variance % Variance Other Supplies $ 295,352,849 $ 305,451,961 $ 10,099,112 3.4% Variance Heart Valves $ 3,490,125 Drug Expense $ 1,856,975 Reagents $ 2,105,855 Other Supplies $ 2,646,157 Purchased Services Budget Actual $ Variance % Variance Purchased Services 141,081,459 160,794,223 19,712,764 14.0% Variance IT Maintenance Contracts $ 3,616,599 BioMed Contracts $ 2,187,431 Hospitalists Contracts $ 6,722,606 Other Physician Contracts $ 1,962,984 Consulting $ 4,406,072

Percent of Total Operating Revenue For the eleven months ending August 31, 2017 FYTD 2017 FYTD 2016 15.9% 6.4% 16.0% 6.5% 4.4% 5.1% 19.1% 19.1% 54.2% 53.3% Salaries/Benefits Supplies Salaries/Benefits Supplies Other services Depreciation/Interest Other services Depreciation/Interest Gain from operations Gain from operations

Financial Statements For the eleven months ending August 31, 2017 Current Month (In Thousands) % Variance Budget Actual Prior Year STATEMENT OF OPERATIONS: Act to Bud Act to PY Revenues: Net Patient Revenue 136,272 142,419 130,550 4.5% 9.1% Other Operating Revenue 3,559 3,244 3,706-8.9% -12.5% Total Net Operating Revenue 139,831 145,663 134,256 4.2% 8.5% Expenses: Operating Expenses 124,013 132,478 122,164 6.8% 8.4% Capital Expenses 11,503 10,215 9,087-11.2% 12.4% Total Expenses 135,516 142,693 131,251 5.3% 8.7% Operating Gain 4,315 2,971 3,005-31.1% -1.1% Operating Margin % 3.1% 2.0% 2.2% -33.9% -8.9% Fiscal Year To Date (In Thousands) % Variance Budget Actual Prior Year STATEMENT OF OPERATIONS: Act to Bud Act to PY Revenues: Net Patient Revenue 1,527,301 1,559,504 1,451,660 2.1% 7.4% Other Operating Revenue 38,785 36,401 38,844-6.1% -6.3% Total Net Operating Revenue 1,566,086 1,595,905 1,490,504 1.9% 7.1% Expenses: Operating Expenses 1,387,621 1,423,808 1,318,088-2.6% -8.0% Capital Expenses 104,230 102,440 96,940 1.7% -5.7% Total Expenses 1,491,851 1,526,248 1,415,028-2.3% -7.9% Operating Gain 74,235 69,657 75,476-6.2% -7.7% Operating Margin % 4.7% 4.4% 5.1% -7.9% -13.8%

Gain (Loss) From Operations ( in 000 s ) 18,000 16,500 BUDGET 2017 ACTUAL 2017 ACTUAL 2016 15,000 13,500 12,000 10,500 9,000 7,500 6,000 4,500 3,000 1,500 0 OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP

ADJOURNMENT DATE OF THE NEXT REGULARLY SCHEDULED FINANCE MEETING THURSDAY, November 9, 2017 1:00 P.M. Gulf Coast Medical Center- Boardroom Medical Office Building 13685 Doctors Way Ft. Myers, FL 33912

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

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

FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 LOCATION: Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom, 13685 Doctors Way, Fort Myers, FL 33912 MEMBERS PRESENT: Sanford N. Cohen, M.D., Board Chairman; Donna Clarke, Board Vice Chairman; David Collins, Board Treasurer; Therese Everly, Board Secretary; Steven Brown, M.D., Board Member; Chris Hansen, Board Member; Jessica Carter Peer, Board Member; Stephanie Meyer, BSN, RN, Board Member; Nancy McGovern, RN, MSM, Board Member; Diane Champion, Board Member MEMBERS ABSENT: NOTE: Documents referred to in these minutes are on file by reference to this meeting date in the Office of the Board of Directors and on the Board of Directors website at www.leehealth.org/boardofdirectors, for public inspection. SUBJECT DISCUSSION ACTION FOLLOW-UP MEETING CALLED TO ORDER FULL BOARD OF DIRECTORS MEETING was CALLED TO ORDER at 1:00 p.m. by Sanford Cohen, M.D., Board Chairman. INVOCATION AND PLEDGE OF ALLEGIANCE Rev. Mike Warthen, MDiv, BCC, gave the Invocation, followed by the Pledge of Allegiance. PUBLIC INPUT None at this time. ANNUAL UNITED WAY CAMPAIGN FOR LEE HEALTH Scott Nygaard presented an update on the Annual United Way Campaign for Lee Health with the addition of a brief video. Cliff Smith, President of United Way gave a brief overview of the United Way and thanked Lee Health for their involvement. Jessica Carter Peer arrived at 1:20 p.m. PRESIDENT S REPORT Larry Antonucci, M.D., President & CEO presented the President s Report including items on Patient Safety, CMS Bundle Program, Telemetry & Physician Statistics. He also included two brief videos on Patient Safety and LINK. RECESS MEETING MEETING RECESSED at 1:41 p.m. to Convene Lee County Trauma Services District Meeting. RECONVENE MEETING RECONVENED FULL BOARD MEETING at 2:04 p.m. by Sanford N. Cohen, M.D., Board Chairman. CONSENT AGENDA Dr. Cohen asked for approval of the Consent Agenda. Therese Everly stated she would like the Board Members to vote on the Workshop topics before the next break in December. A motion was made by Donna Clarke to approve the Consent Agenda consisting of: 1. Planning and Full Board Meeting Minutes of 8/10/17 2. 2018 Board Calendar The motion was seconded by David Collins and carried with no opposition. Board Workshop Topics/TBD Lee Memorial Health System Board of Directors

LEE HEALTH FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 Page 2 of 4 SUBJECT DISCUSSION ACTION FOLLOW-UP CORPORATE COMPLIANCE REPORT Shelley Koltnow presented the Corporate Compliance Report. A motion was made by Donna Clarke to accept the Compliance Report for the period April 2017 June 2017. The motion was seconded by Nancy McGovern and carried with no opposition. LPG AND GOLISANO CHIEF ADMINISTRATIVE REPORTS ACUTE CARE REPORTS LEAN EFFECTIVENESS DASHBOARD Kristine Fay, CAO presented highlights of the Lee Physician Group (LPG) Chief Administrative Officer Report. Armando Llechu, CAO presented highlights of the Golisano Children s Hospital Chief Administrative Officer Report. Therese Everly requested an update on Pediatric Behavioral/Mental Health initiatives. Scott Kashman presented a summary of the Acute Care Reports. Jennifer Higgins presented highlights from the Lee Memorial Hospital Report. Wendy Piascik presented highlights from the Cape Coral Report. Holly Muller presented highlights from the Gulf Coast Medical Center Report. Cindy Brown presented highlights from the HealthPark Medical Center Report. Therese Everly requested further explanation of the new CMS mortality metrics reported in Acute Care Report Summary. Stephen Brown requested further information on the roles/responsibilities of the dyads. Also, requested Mental Health data to be reported and stressed the need and importance of mental health services. Nancy Gurnee presented the Lean Effectiveness Dashboard updates and asked Board Members to begin filling out the evaluation form. A motion was made by Nancy McGovern to approve the LPG Chief Administrative Report. The motion was seconded by Therese Everly and carried with no opposition. A motion was made by Nancy McGovern to approve the Golisano Children s Hospital Chief Administrative Report. The motion was seconded by Donna Clarke and carried with no opposition. A motion was made by Nancy McGovern to approve the Acute Care Reports. The motion was seconded by Jessica Carter Peer and carried with no opposition. Pediatric Behavioral/ Mental Health/ Armando llechu/ TBD Mortality Rate/ Marilyn Kole/ 9/7/17 Dyads/ Scott Nygaard/ 9/7/17 Behavioral Health/ Acute Care Reports/ TBD 2017-2018 PRESIDENT/CEO (LARRY ANTONUCCI) EVALUATION Jon Cecil presented the 2017-2018 President/CEO (Larry Antonucci) Evaluation consisting of: 1. Board Policy 40.02H-President/CEO Compensation and Performance Review A motion was made by Donna Clarke to accept Board Policy 40.02H- President/CEO Compensation and Performance Review as published in this packet. The motion was seconded by Nancy McGovern and carried with Therese Everly opposed. 2. 2017-2018 President & CEO Evaluation Form Lee Memorial Health System Board of Directors Therese Everly made the motion to amend metric # 8 Aligned Multispecialty Group Goals to decrease the weight of the Increase the

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

LEE HEALTH FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, August 24, 2017 Page 4 of 4 SUBJECT DISCUSSION ACTION FOLLOW-UP Board Staff for all of their work. Nancy McGovern departed at 5:08 p.m. NEXT REGULAR MEETING The next LEE HEALTH QUALITY, SAFETY & EDUCATION & FULL BOARD OF DIRECTORS MEETING will be held on September 7, 2017, at 1:00 p.m. in the Gulf Coast Medical Center, Medical Office Building, Boardroom 13685 Doctors Way, Fort Myers, FL 33912 ADJOURNMENT The LEE HEALTH SYSTEM FULL BOARD OF DIRECTORS MEETINGS ADJOURNED at 5:11 p.m. by Sanford Cohen, M.D., Board Chairman. Minutes were recorded by Jennifer Zager, Assistant to the Board of Directors Therese Everly Date approved Board Secretary Lee Memorial Health System Board of Directors

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

LEE HEALTH Lee County, Florida M E M O R A N D U M #1 To: From: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Date: September 20, 2017 Subject: Lee Memorial Hospital Medical Staff Recommendations The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Roger Eduardo, M.D. General Surgery d. Zachary Garner, D.O. Gastroenterology e. Kevin Hall, D.D.S. Oral & Maxillofacial Surgery f. Aaron Josephson, D.O. Internal Medicine g. Andrew Levitt, D.P.M. Podiatry h. Andres Melendez-Dedos, M.D. Pain Management i. Bradley Wilson, D.O. Family Medicine j. Nicole Wilson, D.O. Family Medicine 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Anne Guyot, M.D. Teleneurology c. Cathleen Ivy, M.D. Teleradiology 3. M.S. and A.H.P. Reappointments 10-01-17 to 09-30-19 (list attached) 4. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - LMH September 20, 2017 Page 2 of 3 Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate 5. Privilege Request: a. Rodrigo Ruiz-Gamboa, M.D. Class II Moderate Sedation b. Ronnie Word, M.D. Class II Moderate Sedation 6. Leave of Absence: a. Christopher Myer, M.D. Orthopedic Surgery, reinstatement 10-01-17 b. William Rincon, D.O. OB/Gyn, extension through 06-30-18 c. Silvia Velasquez, M.D. Infectious Disease, reinstatement 09-30-17 7. Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary 07-31-17 b. Larry Antonucci, M.D. Medical Administration, Honorary 08-24-17 c. Pierre Bourgon, M.D. Ophthalmology, Honorary 09-29-17 d. Richard H. Davis, M.D. Cardiology, Honorary 08-01-17 e. James H. Fuller, M.D. Otolaryngology, Honorary 07-31-17 f. Mark Greenberg, M.D. - Medical Administration, Honorary 08-24-17 8. Resignation: a. Nancy Schleider M.D. Dermatology, effective 09-30-17 9. First Year Completions Active Status: a. Adelbert Cabrera, M.D. Pathology b. Harvey Esrov, M.D. Diagnostic Radiology c. Michael McCann, D.O. General Surgery d. Rodrigo Ruiz Gamboa, M.D. Vascular Surgery e. Christopher Tann, M.D. Emergency Medicine 10. First Year Completions Associate Status: a. Richard Calhoun, D.P.M. Podiatry b. Karen DeSouza Ferreira Hunt, M.D. Family Medicine c. Adolfo Delgado, M.D. Internal Medicine d. Carmella Fernandez, M.D. Orthopedic Surgery e. Gema Hernandez Santiago, M.D. Family Medicine f. Daniela Kloos, M.D. Internal Medicine g. Jeannette Lopiano, M.D. OB/Gyn h. Timur Mamedov, M.D. Internal Medicine i. Doris Purvis, M.D. Internal Medicine j. Patrin Suppatkul, M.D. Internal Medicine Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - LMH September 20, 2017 Page 3 of 3 11. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Rupert Valbuena, CRNA Medical Anesthesia d. Kisten Walker, CRNA Medical Anesthesia 12. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

LMH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Associate Aloise, Joseph, D.O. General Medicine Associate (R & F) Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Amezaga Urruela, Matxalen, M.D. Rheumatology Associate (R & F) Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Antonucci, Lawrence R., M.D. Medical Administration Honorary Arnold, Paul J., D.O. General Medicine Associate (R & F) Atkinson, Todd S., M.D. Orthopedic Surgery Active Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Badia, Anais A., D.O. Dermatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Boudreaux, Ann F., M.D. General Medicine Associate (R & F) Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Bulczak, Dariusz P., M.D. Diagnostic Radiology Privilege Only Bustillo, Juan C., M.D. Rheumatology Associate (R & F) Butcher, David R., M.D. Nephrology Honorary Bynum, James A., M.D. Orthopedic Surgery Active Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Castellanos, Ronald D., M.D. Urologic Surgery Honorary Centafont, Nicholas F., D.O. General Medicine Honorary Cheng, Janet F., M.D. Dermatology Associate (R & F) Churchill, John A., M.D. Pediatric Orthopedics Associate Cobb, Michael L., M.D. Diagnostic Radiology Privilege Only Collins, Sandra B., M.D. Orthopedic Surgery Active Colon-Soto, Marilu, M.D. Rheumatology Associate (R & F) Conrey, John E., M.D. Nephrology Active Cossu, John L., D.O. General Medicine Associate (R & F) Creech, Fred T., M.D. Dermatology Honorary Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Associate Daller, Meir, M.D. Urologic Surgery Associate Daoud, Mazen, M.D. Dermatology Associate (R & F) David, Nicasio M., M.D. General Medicine Honorary DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Associate Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Associate Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Durando, Dunnett C., D.O. Dermatology Associate (R & F)

LMH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Edleman, Thomas M., D.O. General Medicine Honorary Eichten, David E., D.O. Orthopedic Surgery Active Eisenfeld, Larry S., M.D. Orthopedic Surgery Honorary Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Farmer, Mark E., M.D. Orthopedic Surgery Active Farri, Elias P., D.O. General Medicine Honorary Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only Fernandez, Carmella, M.D. Orthopedic Surgery Associate Fett Desmond, Debra D., M.D. Dermatology Associate (R & F) Fifer, John S., M.D. Orthopedic Surgery Active Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Fiore, Joseph P., M.D. Dermatology Honorary Flores, Antonio J., M.D. Orthopedic Surgery Active Follweiler, Robert A., D.O. Orthopedic Surgery Active Friedman, Mark N., D.O. Neurology Privilege Only Frink, Dennis D., D.O. General Medicine Honorary Fuchs, Paul D., D.O. Orthopedic Surgery Associate Fuller, Donn O., M.D. Orthopedic Surgery Associate Gardner, Ronald D., M.D. Orthopedic Surgery Active Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Goldstein, Alan S., M.D. General Medicine Associate (R & F) Gomeringer, David J., D.O. General Medicine Associate (R & F) Gomez, Eduardo, M.D. Orthopedic Surgery Active Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Greenberg, Mark A., M.D. Medical Administration Honorary Grosflam, Jodi M., M.D. Rheumatology Honorary Gross, Evan D., M.D. Nephrology Active Guzman, Camilo E., M.D. Orthopedic Surgery Active Haiken, Michael, M.D. Dermatology Associate (R & F) Harmon, Daniel J., D.O. Orthopedic Surgery Active Harris, Brian A., M.D. Dermatology Associate (R & F) Harris, Keith A., M.D. Dermatology Associate (R & F) Haseeb, Ateeq A., M.D. Neurology Privilege Only Heligman, David M., M.D. Orthopedic Surgery Associate Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Howard, Joseph G., M.D. General Medicine Associate (R & F) Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Active Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Active Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Associate Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krivenko, Charles A., M.D. Medical Administration Honorary Krynetskiy, Evgeny E., M.D. Orthopedic Surgery Active

LMH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type LaPorta, Thomas F., M.D. Orthopedic Surgery Active Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Active Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Machiz, Stephen, M.D. Urologic Surgery Honorary Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Associate Markovich, George D., M.D. Orthopedic Surgery Associate Martinez, Robert, M.D. Orthopedic Surgery Active Mauney, Lou D., D.O. General Medicine Associate (R & F) Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only Mehalik, John N., M.D. Orthopedic Surgery Active Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Mintz, Mark A., M.D. Urologic Surgery Honorary Monserrate, Pedro E., M.D. Orthopedic Surgery Associate Montecalvo, Raymond M., M.D. Diagnostic Radiology Privilege Only Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Myer, Christopher R., M.D. Orthopedic Surgery Active Nemitz, Jason T., M.D. Orthopedic Surgery Active Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Osborne, Thomas F., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Paletsky, Steven, M.D. Urologic Surgery Associate Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petrini, Mario A., M.D. General Medicine Honorary Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilcher, Mary F., M.D. Dermatology Associate (R & F) Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Reynolds III, Fletcher A., M.D. Orthopedic Surgery Active Richards, Paul J., M.D. Orthopedic Surgery Active Rickards, James S., M.D. Diagnostic Radiology Privilege Only Rinehart, Richard A., D.O. General Medicine Honorary Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Rossin, Richard D., M.D. Diagnostic Radiology Privilege Only Saether, Linda M., M.D. General Medicine Honorary Sagini, Dennis O., M.D. Orthopedic Surgery Active Saludo, Rodolfo M., M.D. General Medicine Honorary Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Schwartz, Jeremy A., M.D. Orthopedic Surgery Active Shannon, F. Brett, D.O. Pediatric Orthopedics Associate Shen, Jason Y., M.D. Neurology Privilege Only Shneker, Bassel F., M.D. Neurology Privilege Only Singer, Thomas J., D.O. Dermatology Associate (R & F)

LMH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Springer, Charles P., M.D. Orthopedic Surgery Active Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Active Taylor, James H., D.O. General Medicine Associate (R & F) Testa, Joseph A., M.D. General Medicine Honorary Van Sickler, Joel T., M.D. Nephrology Active Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only Williams, Jeffrey L., M.D. General Medicine Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Bounds Jr., Donald, P.A. Physician Assistant AHP Bounds, Denise, P.A. Physician Assistant AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Brist, Kristen L., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Campbell-Wigington, Kelly E., ARNP Adv. Reg. Nurse Practitioner AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Chapman, Julie Anne M., ARNP Adv. Reg. Nurse Practitioner AHP Dean, Debra L., P.A. Physician Assistant AHP Disesa, Dianna C., ARNP Adv. Reg. Nurse Practitioner AHP Dolorfino, Jhawn A., P.A. Physician Assistant AHP Donovan, Brittanee L., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Facklam, Arnold W., ARNP Adv. Reg. Nurse Practitioner AHP Featherstone, Wendy L., P.A. Physician Assistant AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Gorfinkel, Roger L., P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Hunsucker, Patricia L., C.N.M. Cert. Nurse Midwife AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Mahoney, Denyse M., P.A. Physician Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP McGeorge, Nancy P., P.A. Physician Assistant AHP Miller, Ashley M., ARNP Adv. Reg. Nurse Practitioner AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP

LMH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Quigley, Lorie A., ARNP Adv. Reg. Nurse Practitioner AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Salaz, Pamela, ARNP Adv. Reg. Nurse Practitioner AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Matthew C., P.A. Physician Assistant AHP Walk, Valerie A., P.A. Physician Assistant AHP Waszkowski, Denise, C.N.M. Cert. Nurse Midwife AHP Wilkinson, Chris A., P.A. Physician Assistant AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP Wright, Arlene T., ARNP Adv. Reg. Nurse Practitioner AHP

LEE HEALTH Lee County, Florida M E M O R A N D U M #2 To: From: Subject: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Cape Coral Hospital Medical Staff Recommendations Date: September 20, 2017 The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Zachary Garner, D.O. Gastroenterology d. Aaron Josephson, D.O. Internal Medicine e. Andrew Levitt, D.P.M. Podiatry f. Sanjeev Manier, M.D. Neurology 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Anne Guyot, M.D. Teleneurology c. Cathleen Ivy, M.D. Teleradiology 3. M.S. and A.H.P. Reappointments 10-01-17 to 09-30-19 (list attached) 4. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - CCH September 20, 2017 Page 2 of 3 5. Privilege Request: a. Rodrigo Ruiz-Gamboa, M.D. Class II Moderate Sedation b. Ronnie Word, M.D. Class II Moderate Sedation 6. Leave of Absence: a. Silvia Velasquez, M.D. Infectious Disease, reinstatement 09-30-17 7. Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary 07-31-17 b. Larry Antonucci, M.D. Medical Administration, Honorary 08-24-17 c. Pierre Bourgon, M.D. Ophthalmology, Honorary 09-29-17 d. James H. Fuller, M.D. Otolaryngology, Honorary 07-31-17 e. Mark Greenberg, M.D. - Medical Administration, Honorary 08-24-17 8. Resignation: a. Christopher Myer, M.D. Orthopedic Surgery, effective 10-01-17 9. First Year Completions Active Status: a. Scott Dunavant, M.D. Emergency Medicine b. Harvey Esrov, M.D. Diagnostic Radiology c. Timur Mamedov, M.D. Internal Medicine d. Michael McCann, D.O. General Surgery e. Rodrigo Ruiz Gamboa, M.D. Vascular Surgery f. Patrin Suppatkul, M.D. Internal Medicine 10. First Year Completions Associate Status: a. Adelbert Cabrera, M.D. Pathology b. Richard Calhoun, D.P.M. Podiatry c. Adolfo Delgado, M.D. Internal Medicine d. Gema Hernandez Santiago, M.D. Family Medicine e. Daniela Kloos, M.D. Internal Medicine f. Shahzaib Mirza, M.D. - Pediatrics g. Doris Purvis, M.D. Internal Medicine 11. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Rupert Valbuena, CRNA Medical Anesthesia d. Kisten Walker, CRNA Medical Anesthesia Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - CCH September 20, 2017 Page 3 of 3 12. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

CCH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Associate Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Antonucci, Lawrence R., M.D. Medical Administration Honorary Arnold, Paul J., D.O. General Medicine Associate (R & F) Atkinson, Todd S., M.D. Orthopedic Surgery Associate Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Baldinger, David R., M.D. Rheumatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Bulczak, Dariusz P., M.D. Diagnostic Radiology Privilege Only Butcher, David R., M.D. Nephrology Honorary Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Cambio, Andrea L., M.D. Dermatology Associate (R & F) Castellanos, Ronald D., M.D. Urologic Surgery Honorary Clark, Jack W., D.O. Rheumatology Associate (R & F) Cobb, Michael L., M.D. Diagnostic Radiology Privilege Only Conrey, John E., M.D. Nephrology Active Creech, Fred T., M.D. Dermatology Honorary Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Associate DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Active Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Friedman, Mark N., D.O. Neurology Privilege Only Fuller, Donn O., M.D. Orthopedic Surgery Active Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Greenberg, Mark A., M.D. Medical Administration Honorary Gross, Evan D., M.D. Nephrology Active Gulati, Ankush, M.D. Nephrology Associate

CCH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Guzman, Camilo E., M.D. Orthopedic Surgery Associate Haseeb, Ateeq A., M.D. Neurology Privilege Only Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Associate Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Associate Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Associate Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krivenko, Charles A., M.D. Medical Administration Honorary LaPorta, Thomas F., M.D. Orthopedic Surgery Active Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Associate Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Associate Martinez, Robert, M.D. Orthopedic Surgery Active Mauney, Lou D., D.O. General Medicine Associate (R & F) Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Mintz, Mark A., M.D. Urologic Surgery Honorary Monserrate, Pedro E., M.D. Orthopedic Surgery Active Montecalvo, Raymond M., M.D. Diagnostic Radiology Privilege Only Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Nemitz, Jason T., M.D. Orthopedic Surgery Associate Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Osborne, Thomas F., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Rickards, James S., M.D. Diagnostic Radiology Privilege Only Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Rossin, Richard D., M.D. Diagnostic Radiology Privilege Only Saether, Linda M., M.D. General Medicine Honorary Sagini, Dennis O., M.D. Orthopedic Surgery Associate Saunders, Darrick T., D.O. Orthopedic Surgery Active Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Shen, Jason Y., M.D. Neurology Privilege Only

CCH REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Shenoy, Ganesh G., M.D. Nephrology Active Shneker, Bassel F., M.D. Neurology Privilege Only Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Active Testa, Joseph A., M.D. General Medicine Honorary Van Sickler, Joel T., M.D. Nephrology Active Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only White, John A., M.D. Orthopedic Surgery Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Dean, Debra L., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Facklam, Arnold W., ARNP Adv. Reg. Nurse Practitioner AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Karlsson, Marten E., P.A. Physician Assistant AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Valerie A., P.A. Physician Assistant AHP Wilkinson, Chris A., P.A. Physician Assistant AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP

LEE HEALTH Lee County, Florida M E M O R A N D U M #3 To: From: Subject: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Gulf Coast Medical Center Medical Staff Recommendations Date: September 20, 2017 The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Luis Brandi, M.D. Pathology b. Roger Eduardo, M.D. General Surgery c. Zachary Garner, D.O. Gastroenterology d. Kevin Hall, D.D.S. Oral & Maxillofacial Surgery e. Aaron Josephson, D.O. Internal Medicine f. Andrew Levitt, D.P.M. Podiatry g. Sanjeev Manier, M.D. - Neurology h. Danielle Matta, D.O. Diagnostic Radiology i. Hazem Matta, D.O. Diagnostic Radiology j. Andres Melendez-Dedos, M.D. Pain Management 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Cathleen Ivy, M.D. Teleradiology 3. Intrasystem Appointment: a. Debra Fett Desmond, M.D. Dermatology b. Mary Pilcher, M.D. Dermatology 4. M.S. and A.H.P. Reappointments 10-01-17 to 09-30-19 (list attached) 5. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - GCMC September 20, 2017 Page 2 of 2 Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate 6. Leave of Absence: a. Christopher Myer, M.D. Orthopedic Surgery, reinstatement 10-01-17 b. Silvia Velasquez, M.D. Infectious Disease, reinstatement 09-30-17 7. Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary 07-31-17 b. Pierre Bourgon, M.D. Ophthalmology, Honorary 09-29-17 c. Richard H. Davis, M.D. Cardiology, Honorary 08-01-17 d. James H. Fuller, M.D. Otolaryngology, Honorary 07-31-17 8. First Year Completions Active Status: a. Adelbert Cabrera, M.D. Pathology b. David Goldstein, M.D. Internal Medicine 9. First Year Completions Associate Status: a. Richard Calhoun, D.P.M. Podiatry b. Karen DeSouza Ferreira Hunt, M.D. Family Medicine c. Carmella Fernandez, M.D. Orthopedic Surgery d. Daniela Kloos, M.D. Internal Medicine e. Timur Mamedov, M.D. Internal Medicine f. Shahzaib Mirza, M.D. Pediatrics g. Guatham Mogilshetty, M.D. - Nephrology h. Chauchau Pham, M.D. - Otolaryngology i. Doris Purvis, M.D. Internal Medicine 10. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Robert McComas, CRNA Anesthesia & Pain Consultants d. Aleisha Rees, PA Surgical Specialists of SW FL 11. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

GCMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Active Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Atkinson, Todd S., M.D. Orthopedic Surgery Associate Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Badia, Anais A., D.O. Dermatology Associate (R & F) Baldinger, David R., M.D. Rheumatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Benitez, Omar, M.D. Urologic Surgery Active Blitz, Barry F., M.D. Urologic Surgery Active Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Butcher, David R., M.D. Nephrology Honorary Bynum, James A., M.D. Orthopedic Surgery Active Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Castellanos, Ronald D., M.D. Urologic Surgery Honorary Centafont, Nicholas F., D.O. General Medicine Honorary Churchill, John A., M.D. Pediatric Orthopedics Associate Clark, Jack W., D.O. Rheumatology Associate (R & F) Collins, Sandra B., M.D. Orthopedic Surgery Associate Conrey, John E., M.D. Nephrology Active Cossu, John L., D.O. General Medicine Associate (R & F) Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Active David, Nicasio M., M.D. General Medicine Honorary DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Associate Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Active Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Durando, Dunnett C., D.O. Dermatology Associate (R & F) Eichten, David E., D.O. Orthopedic Surgery Active Eisenfeld, Larry S., M.D. Orthopedic Surgery Honorary Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Farmer, Mark E., M.D. Orthopedic Surgery Associate Farri, Elias P., D.O. General Medicine Honorary Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only

GCMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Fernandez, Carmella, M.D. Orthopedic Surgery Associate Fernandez-Salvador, Veronique N., M.D. Urologic Surgery Active Fernando, K. Ranjit, M.D. Rheumatology Honorary Fett Desmond, Debra D., M.D. Dermatology Associate (R & F) Fifer, John S., M.D. Orthopedic Surgery Associate Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Flores, Antonio J., M.D. Orthopedic Surgery Associate Follweiler, Robert A., D.O. Orthopedic Surgery Active Friedman, Mark N., D.O. Neurology Privilege Only Fuchs, Paul D., D.O. Orthopedic Surgery Active Fuller, Donn O., M.D. Orthopedic Surgery Associate Gardner, Ronald D., M.D. Orthopedic Surgery Associate Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Gomeringer, David J., D.O. General Medicine Associate (R & F) Gomez, Eduardo, M.D. Orthopedic Surgery Associate Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Gross, Evan D., M.D. Nephrology Active Gulati, Ankush, M.D. Nephrology Active Guzman, Camilo E., M.D. Orthopedic Surgery Associate Haiken, Michael, M.D. Dermatology Associate (R & F) Harmon, Daniel J., D.O. Orthopedic Surgery Active Harris, David S., M.D. Urologic Surgery Active Harrison, Steven A., M.D. Urologic Surgery Active Haseeb, Ateeq A., M.D. Neurology Privilege Only Heligman, David M., M.D. Orthopedic Surgery Active Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Howard, Joseph G., M.D. General Medicine Associate (R & F) Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Active Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Active Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Active Kendall, Maria E., M.D. Dermatology Associate (R & F) Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krynetskiy, Evgeny E., M.D. Orthopedic Surgery Active Langford, Carolyn F., D.O. Urologic Surgery Active LaPorta, Thomas F., M.D. Orthopedic Surgery Active Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Associate Lee, Michael D., M.D. Dermatology Associate (R & F) Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Active Markovich, George D., M.D. Orthopedic Surgery Active Martinez, Robert, M.D. Orthopedic Surgery Associate Mauney, Lou D., D.O. General Medicine Associate (R & F)

GCMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only Mehalik, John N., M.D. Orthopedic Surgery Active Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Menendez, Roxanna M., D.O. Dermatology Associate (R & F) Mintz, Mark A., M.D. Urologic Surgery Honorary Mogilishetty, Gautham, M.D. Nephrology Associate Monserrate, Pedro E., M.D. Orthopedic Surgery Active Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Myer, Christopher R., M.D. Orthopedic Surgery Active Nemitz, Jason T., M.D. Orthopedic Surgery Associate Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Paletsky, Steven, M.D. Urologic Surgery Active Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilcher, Mary, M.D. Dermatology Associate (R & F) Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Reynolds III, Fletcher A., M.D. Orthopedic Surgery Associate Richards, Paul J., M.D. Orthopedic Surgery Associate Rickards, James S., M.D. Diagnostic Radiology Privilege Only Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Sagini, Dennis O., M.D. Orthopedic Surgery Associate Saludo, Rodolfo M., M.D. General Medicine Honorary Saunders, Darrick T., D.O. Orthopedic Surgery Associate Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Schwartz, Brian N., M.D. Urologic Surgery Active Schwartz, Jeremy A., M.D. Orthopedic Surgery Associate Shannon, F. Brett, D.O. Pediatric Orthopedics Active Shen, Jason Y., M.D. Neurology Privilege Only Shenoy, Ganesh G., M.D. Nephrology Active Shneker, Bassel F., M.D. Neurology Privilege Only Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Springer, Charles P., M.D. Orthopedic Surgery Associate Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Active Van Sickler, Joel T., M.D. Nephrology Active VanBeever, Bert F., M.D. Urologic Surgery Honorary

GCMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only Williams, Jeffrey L., M.D. General Medicine Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only Zucker, Ira A., M.D. Urologic Surgery Active ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Brist, Kristen L., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Chapman, Julie Anne M., ARNP Adv. Reg. Nurse Practitioner AHP Dean, Debra L., P.A. Physician Assistant AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Gorfinkel, Roger L., P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Klement, Bradley W., P.A. Physician Assistant AHP Lattray, Amber N., P.A. Physician Assistant AHP Lavenia, Ryann L., CRNA Cert. Reg. Nurse Anesthetist AHP Ledward, Pamela M., P.A. Physician Assistant AHP Mahoney, Denyse M., P.A. Physician Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP Meyer, Diana L., CRNA Cert. Reg. Nurse Anesthetist AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Pirrone, Rosalie, CRNA Cert. Reg. Nurse Anesthetist AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rodriguez, Monica L., C.N.M. Cert. Nurse Midwife AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Shepheard, Bonnie L., C.N.M. Cert. Nurse Midwife AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Matthew C., P.A. Physician Assistant AHP Walk, Valerie A., P.A. Physician Assistant AHP Wilkinson, Chris A., P.A. Physician Assistant AHP

LEE HEALTH Lee County, Florida M E M O R A N D U M #4 To: From: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Date: September 20, 2017 Subject: HealthPark Medical Center Medical Staff Recommendations The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Michael Carr, M.D. Pediatric Urology d. Roger Eduardo, M.D. General Surgery e. Zachary Garner, D.O. Gastroenterology f. Aaron Josephson, D.O. Internal Medicine g. Andrew Levitt, D.P.M. Podiatry h. Mary Mani, M.D. OB/Gyn 2. Telemedicine Appointment Privileges Only: a. Jennifer Bogan, M.D. Teleradiology b. Fouad Butto, M.D. Pediatric Cardiology c. Anne Guyot, M.D. Teleneurology d. Cathleen Ivy, M.D. Teleradiology 3. M.S. and A.H.P. Reappointments 10-01-17 to 09-30-19 (list attached) 4. Withdrawal of Privileges with Reappointment: Omar Benitez, M.D. Urology GCMC Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting laparoscopic radical prostatectomy Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH Both deleting sacral nerve stimulation for urinary control Paul Bretton, M.D. Urology CCH, GCMC, HPMC, LMH James Borden, M.D. Urology CCH, GCMC, HPMC, LMH Scott Caesar, M.D. Urology HPMC William Evans, M.D. Urology CCH, GCMC, HPMC, LMH Steven Paletsky, M.D. Urology GCMC, HPMC, LMH All deleting cryoablation for the prostate Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - HPMC September 20, 2017 Page 2 of 3 5. Privilege Request: a. Rodrigo Ruiz-Gamboa, M.D. Class II Moderate Sedation b. Ronnie Word, M.D. Class II Moderate Sedation 6. Leave of Absence: a. George Kopidakis, M.D. General Surgery, 08-01-17 02-28-19 b. Christopher Myer, M.D. Orthopedic Surgery, reinstatement 10-01-17 c. William Rincon, D.O. OB/Gyn, extension through 06-30-18 d. Silvia Velasquez, M.D. Infectious Disease, reinstatement 09-30-17 7. Change of Status: a. Phillip Andrews, M.D. Otolaryngology, Honorary 07-31-17 b. Larry Antonucci, M.D. Medical Administration, Honorary 08-24-17 c. Pierre Bourgon, M.D. Ophthalmology, Honorary 09-29-17 d. Richard H. Davis, M.D. Cardiology, Honorary 08-01-17 e. James H. Fuller, M.D. Otolaryngology, Honorary 07-31-17 f. Mark Greenberg, M.D. - Medical Administration, Honorary 08-24-17 8. First Year Completions Active Status: a. Harvey Esrov, M.D. Diagnostic Radiology b. Daniela Kloos, M.D. Internal Medicine c. Jeannette Lopiano, M.D. OB/Gyn d. Michael McCann, D.O. General Surgery e. Chauchau Pham, M.D. - Otolaryngology f. Doris Purvis, M.D. Internal Medicine g. Rodrigo Ruiz Gamboa, M.D. Vascular Surgery h. Patrin Suppatkul, M.D. Internal Medicine i. Christopher Tann, M.D. Emergency Medicine 9. First Year Completions Associate Status: a. Adelbert Cabrera, M.D. Pathology b. Richard Calhoun, D.P.M. Podiatry c. Karen DeSouza Ferreira Hunt, M.D. Family Medicine d. Adolfo Delgado, M.D. Internal Medicine e. Gema Hernandez Santiago, M.D. Family Medicine f. Timur Mamedov, M.D. Internal Medicine g. Shahzaib Mirza, M.D. Pediatrics 10. Allied Health Practitioners: a. Eileen Alonso-Rivera, ARNP The Heart & Vascular Institute b. Miguel Gonzalez, ARNP LPG Neurology c. Rupert Valbuena, CRNA Medical Anesthesia d. Kisten Walker, CRNA Medical Anesthesia 11. Allied Health Practitioner Additional Sponsor: a. Jams Bertil, ARNP Dr. Sumeet Shetty Lee Memorial Health System Board of Directors

Memorandum to Board of Directors - HPMC September 20, 2017 Page 3 of 3 12. Allied Health Practitioner Privilege Request: a. Carla Whitt, ARNP Order Controlled Substances Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

HPMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Aggarwal, Puja, M.D. Neurology Privilege Only Ahmad, Tabassum, M.D. Diagnostic Radiology Privilege Only Akrami, Jason A., M.D. Diagnostic Radiology Privilege Only Alfonso, Javier E., M.D. Nephrology Associate Alvi, Fozail I., M.D. Diagnostic Radiology Privilege Only Anderson, Bonnie L., M.D. Diagnostic Radiology Privilege Only Antonucci, Lawrence R., M.D. Medical Administration Honorary Arnold, Paul J., D.O. General Medicine Associate (R & F) Arrillaga, Frances M., M.D. Pediatric Cardiology Privilege Only Asante-Korang, Alfred, M.D. Pediatric Cardiology Privilege Only Atkinson, Todd S., M.D. Orthopedic Surgery Associate Avila, Amanda J., M.D. Neurology Privilege Only Babusis, Algis V., M.D. Diagnostic Radiology Privilege Only Badia, Anais A., D.O. Dermatology Associate (R & F) Balodimas, James D., M.D. Diagnostic Radiology Privilege Only Barrett, Kevin M., M.D. Neurology Privilege Only Beaulieu, Jack G., M.D. Orthopedic Surgery Associate Beltran, Maria R., M.D. Diagnostic Radiology Privilege Only Bloss, Michael F., M.D. Diagnostic Radiology Privilege Only Bobb, Wendell T., M.D. Neurology Privilege Only Boe, Justin, M.D. Diagnostic Radiology Privilege Only Borden, James D., M.D. Urologic Surgery Active Boudreaux, Ann F., M.D. General Medicine Associate (R & F) Bretton, Paul R., M.D. Urologic Surgery Active Browning, Jared C., M.D. Diagnostic Radiology Privilege Only Bulczak, Dariusz P., M.D. Diagnostic Radiology Privilege Only Bustillo, Juan C., M.D. Rheumatology Associate (R & F) Butcher, David R., M.D. Nephrology Honorary Bynum, James A., M.D. Orthopedic Surgery Associate Caesar, Scott R., M.D. Urologic Surgery Active Caldemeyer, Karen S., M.D. Diagnostic Radiology Privilege Only Castellanos, Ronald D., M.D. Urologic Surgery Honorary Centafont, Nicholas F., D.O. General Medicine Honorary Cheng, Janet F., M.D. Dermatology Associate (R & F) Churchill, John A., M.D. Pediatric Orthopedics Active Cobb, Michael L., M.D. Diagnostic Radiology Privilege Only Collins, Sandra B., M.D. Orthopedic Surgery Associate Conrey, John E., M.D. Nephrology Active Cossu, John L., D.O. General Medicine Associate (R & F) Creech, Fred T., M.D. Dermatology Honorary Crouch, John E., M.D. Diagnostic Radiology Privilege Only Curcione, Peter J., D.O. Orthopedic Surgery Associate Daller, Meir, M.D. Urologic Surgery Associate Daoud, Mazen, M.D. Dermatology Associate (R & F) David, Nicasio M., M.D. General Medicine Honorary DeIorio, Richard N., M.D. Orthopedic Surgery Honorary Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Active Delans, Ronald J., M.D. Nephrology Active DeLavallade, Dawn N., M.D. Diagnostic Radiology Privilege Only Devacaanthan, Kanagasabai, M.D. Nephrology Honorary Dhillon, Sanjam, M.D. Diagnostic Radiology Privilege Only Donohoo II, Jay H., M.D. Diagnostic Radiology Privilege Only Dupay Jr., Edward R., D.O. Orthopedic Surgery Associate Dupont, Paul G., M.D. Diagnostic Radiology Privilege Only Durando, Dunnett C., D.O. Dermatology Associate (R & F)

HPMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Edleman, Thomas M., D.O. General Medicine Honorary Eichten, David E., D.O. Orthopedic Surgery Associate Eisenfeld, Larry S., M.D. Orthopedic Surgery Honorary Evans, Blake J., M.D. Urologic Surgery Active Evans, William P., M.D. Urologic Surgery Active Fairchok, Gregory P., M.D. Diagnostic Radiology Privilege Only Faliszek, James E., M.D. Diagnostic Radiology Privilege Only Farmer, Mark E., M.D. Orthopedic Surgery Associate Farri, Elias P., D.O. General Medicine Honorary Fassihi, Amir A., M.D. Diagnostic Radiology Privilege Only Fett Desmond, Debra D., M.D. Dermatology Associate (R & F) Fifer, John S., M.D. Orthopedic Surgery Associate Figueroa Garcia, Alberto R., M.D. Neurology Privilege Only Fiore, Joseph P., M.D. Dermatology Honorary Flores, Antonio J., M.D. Orthopedic Surgery Associate Follweiler, Robert A., D.O. Orthopedic Surgery Associate Friedman, Mark N., D.O. Neurology Privilege Only Frink, Dennis D., D.O. General Medicine Honorary Fuchs, Paul D., D.O. Orthopedic Surgery Associate Fuller, Donn O., M.D. Orthopedic Surgery Associate Gardner, Ronald D., M.D. Orthopedic Surgery Associate Gates, Davis F., M.D. Urologic Surgery Honorary Gauriloff-Rothenberg, Jane B., M.D. Diagnostic Radiology Privilege Only Ghith, Tamim, M.D. Nephrology Active Giovannetti, Mark J., M.D. Diagnostic Radiology Privilege Only Goldstein, Alan S., M.D. General Medicine Associate (R & F) Gomeringer, David J., D.O. General Medicine Associate (R & F) Gomez, Eduardo, M.D. Orthopedic Surgery Associate Goni, Michelle, M.D. Diagnostic Radiology Privilege Only Greenberg, Mark A., M.D. Medical Administration Honorary Grosflam, Jodi M., M.D. Rheumatology Honorary Gross, Evan D., M.D. Nephrology Active Gulati, Ankush, M.D. Nephrology Active Guzman, Camilo E., M.D. Orthopedic Surgery Associate Haiken, Michael, M.D. Dermatology Associate (R & F) Hardin, Joel T., M.D. Pediatric Cardiology Privilege Only Harmon, Daniel J., D.O. Orthopedic Surgery Associate Harris, Brian A., M.D. Dermatology Associate (R & F) Harris, Keith A., M.D. Dermatology Associate (R & F) Haseeb, Ateeq A., M.D. Neurology Privilege Only Heligman, David M., M.D. Orthopedic Surgery Associate Henry, Charles S., M.D. Diagnostic Radiology Privilege Only Highbloom, Barry S., M.D. Diagnostic Radiology Privilege Only Hoang, Vivian, M.D. Neurology Privilege Only Howard, Joseph G., M.D. General Medicine Associate (R & F) Hudson, Thomas D., M.D. Diagnostic Radiology Privilege Only Huhta, James C., M.D. Pediatric Cardiology Privilege Only Humbert, Edward T., D.O. Orthopedic Surgery Associate Jaffe, Andrew T., M.D. Dermatology Associate (R & F) Jean-Charles, Nadie C., M.D. Diagnostic Radiology Privilege Only John, Jonathan B., M.D. Pediatric Cardiology Privilege Only Johnson, Jonathan M., M.D. Neurology Privilege Only Jugan, Michael M., D.O. Orthopedic Surgery Associate Kagan II, Abbott, M.D. Orthopedic Surgery Honorary Kagan, John, M.D. Orthopedic Surgery Associate Kessler, Larry S., M.D. Diagnostic Radiology Privilege Only

HPMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Khan, Syeda S., M.D. Nephrology Active Kim, Howard L., M.D. Neurology Privilege Only Krivenko, Charles A., M.D. Medical Administration Honorary Krynetskiy, Evgeny E., M.D. Orthopedic Surgery Associate Kurtz, Stephanie A., M.D. Pediatric Cardiology Privilege Only LaPorta, Thomas F., M.D. Orthopedic Surgery Associate Lawton, Christopher S., M.D. Diagnostic Radiology Privilege Only Leach, Patrick B., M.D. Orthopedic Surgery Associate Libbey, Robert E., M.D. Nephrology Active Lue, Stanley G., M.D. Neurology Privilege Only Machiz, Stephen, M.D. Urologic Surgery Honorary Maggio, Vijay, M.D. Neurology Privilege Only Malhotra, Neetu, M.D. Nephrology Associate Markovich, George D., M.D. Orthopedic Surgery Associate Martinez, Richard M., M.D. Pediatric Cardiology Privilege Only Martinez, Robert, M.D. Orthopedic Surgery Associate Mauney, Lou D., D.O. General Medicine Associate (R & F) Maze-Rothstein, Galen F., M.D. Neurology Privilege Only Mazhar, Nosheen, M.D. Rheumatology Associate (R & F) McCarron, Audrey P., M.D. Diagnostic Radiology Privilege Only McCormack, Jorge, M.D. Pediatric Cardiology Privilege Only McGehee, Mark A., M.D. Diagnostic Radiology Privilege Only McKenna, Daniel E., M.D. Pediatric Cardiology Privilege Only Mehalik, John N., M.D. Orthopedic Surgery Associate Melitz, Celine, M.D. Diagnostic Radiology Privilege Only Mintz, Mark A., M.D. Urologic Surgery Honorary Miranda-Sousa, Alejandro J., M.D. Urologic Surgery Active Monserrate, Pedro E., M.D. Orthopedic Surgery Associate Montecalvo, Raymond M., M.D. Diagnostic Radiology Privilege Only Moreno, Yvonne C., M.D. Diagnostic Radiology Privilege Only Mouracade, Mary M., M.D. Nephrology Active Mowzoon, Nima, M.D. Neurology Privilege Only Myer, Christopher R., M.D. Orthopedic Surgery Associate Nemitz, Jason T., M.D. Orthopedic Surgery Associate Nwankwo, John I., M.D. Diagnostic Radiology Privilege Only Osborne, Thomas F., M.D. Diagnostic Radiology Privilege Only Otto, Tara M., M.D. Diagnostic Radiology Privilege Only Paletsky, Steven, M.D. Urologic Surgery Associate Patel, Anil G., M.D. Diagnostic Radiology Privilege Only Paydar, Amir, M.D. Diagnostic Radiology Privilege Only Petrini, Mario A., M.D. General Medicine Honorary Petteruti, Joseph L., D.O. General Medicine Honorary Phillips, Karen G., M.D. Diagnostic Radiology Privilege Only Pilcher, Mary F., M.D. Dermatology Associate (R & F) Pilika, Asti, M.D. Diagnostic Radiology Privilege Only Pudasaini, Basudev, M.D. Nephrology Active Qureshi, Javed A., M.D. Diagnostic Radiology Privilege Only Rawal, Bishal B., M.D. Nephrology Active Reynolds III, Fletcher A., M.D. Orthopedic Surgery Associate Richards, Paul J., M.D. Orthopedic Surgery Associate Rickards, James S., M.D. Diagnostic Radiology Privilege Only Rinehart, Richard A., D.O. General Medicine Honorary Riordan, Katherine C., M.D. Neurology Privilege Only Rizzo, Jasper J., D.O. Urologic Surgery Active Rossin, Richard D., M.D. Diagnostic Radiology Privilege Only Saether, Linda M., M.D. General Medicine Honorary

HPMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Sagini, Dennis O., M.D. Orthopedic Surgery Associate Saludo, Rodolfo M., M.D. General Medicine Honorary Schleider, Nancy R., M.D. Dermatology Associate (R & F) Schoenfeld, Lawrence V., M.D. Urologic Surgery Honorary Scholle, Stephen F., M.D. Family Medicine Honorary Schwartz, Jeremy A., M.D. Orthopedic Surgery Associate Shannon, F. Brett, D.O. Pediatric Orthopedics Active Shen, Jason Y., M.D. Neurology Privilege Only Shenoy, Ganesh G., M.D. Nephrology Active Shneker, Bassel F., M.D. Neurology Privilege Only Singer, Thomas J., D.O. Dermatology Associate (R & F) Slone, Richard M., M.D. Diagnostic Radiology Privilege Only Sloves, James H., M.D. Diagnostic Radiology Privilege Only Sombutmai, Chut, D.O. Neurology Privilege Only Sonners, Adina I., M.D. Diagnostic Radiology Privilege Only Springer, Charles P., M.D. Orthopedic Surgery Associate Staib Jr, Neil E., M.D. Diagnostic Radiology Privilege Only Stapleton, Gary E., M.D. Pediatric Cardiology Privilege Only Steinberg, Lon R., M.D. Neurology Privilege Only Stoner, Timothy L., M.D. Diagnostic Radiology Privilege Only Strickland, Michael G., D.O. Urologic Surgery Active Strong, Benjamin W., M.D. Diagnostic Radiology Privilege Only Swartz, Francesca M., D.O. Orthopedic Surgery Associate Taylor, James H., D.O. General Medicine Associate (R & F) Testa, Joseph A., M.D. General Medicine Honorary Van Sickler, Joel T., M.D. Nephrology Active Verhey, Peter T., M.D. Diagnostic Radiology Privilege Only Vidgop, Yelena, M.D. Neurology Privilege Only Wallentin, Cynthia L., M.D. Diagnostic Radiology Privilege Only Whetsell, William M., M.D. Diagnostic Radiology Privilege Only Williams, Jeffrey L., M.D. General Medicine Associate (R & F) Zaman, Mohammed N., D.O. Neurology Privilege Only ALLIED HEALTH Abu Aouf, Dolan K., P.A. Physician Assistant AHP Biel, Allison E., ARNP Adv. Reg. Nurse Practitioner AHP Bounds Jr., Donald, P.A. Physician Assistant AHP Bounds, Denise, P.A. Physician Assistant AHP Boyd, Jonathan E., P.A. Physician Assistant AHP Brist, Kristen L., P.A. Physician Assistant AHP Bryde, Mindy M., P.A. Physician Assistant AHP Campbell-Wigington, Kelly E., ARNP Adv. Reg. Nurse Practitioner AHP Carpenter, Christine D., ARNP Adv. Reg. Nurse Practitioner AHP Chapman, Julie Anne M., ARNP Adv. Reg. Nurse Practitioner AHP Christian, Amber L., P.A. Physician Assistant AHP Dean, Debra L., P.A. Physician Assistant AHP Dolorfino, Jhawn A., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Featherstone, Wendy L., P.A. Physician Assistant AHP Ferreira, Julian, P.A. Physician Assistant AHP Ford, Jason D., ARNP Adv. Reg. Nurse Practitioner AHP Gilbert, Jennifer A., P.A. Physician Assistant AHP Gogineni, Karunasree, P.A. Physician Assistant AHP Gorfinkel, Roger L., P.A. Physician Assistant AHP Hayes, Valencia D., P.A. Physician Assistant AHP

HPMC REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type Hendricks, Jessica J., ARNP Adv. Reg. Nurse Practitioner AHP Hicks, Amy J., ARNP Adv. Reg. Nurse Practitioner AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Hunsucker, Patricia L., C.N.M. Cert. Nurse Midwife AHP Klement, Bradley W., P.A. Physician Assistant AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Mahoney, Denyse M., P.A. Physician Assistant AHP Mallari, Erin E., P.A. Physician Assistant AHP Mitchell, Anastasia D., P.A. Physician Assistant AHP Molloy, Mary, P.A. Physician Assistant AHP Patrizi, Beth A., ARNP Adv. Reg. Nurse Practitioner AHP Quigley, Lorie A., ARNP Adv. Reg. Nurse Practitioner AHP Reich, John R., P.A. Physician Assistant AHP Rios, Kelly J., ARNP Adv. Reg. Nurse Practitioner AHP Rodriguez, Monica L., C.N.M. Cert. Nurse Midwife AHP Rothenberger, Jennifer S., P.A. Physician Assistant AHP Salaz, Pamela, ARNP Adv. Reg. Nurse Practitioner AHP Schaum, Vincent N., P.A. Physician Assistant AHP Scott, Nicole E., P.A. Physician Assistant AHP Shepheard, Bonnie L., C.N.M. Cert. Nurse Midwife AHP Singh, Nadine-Ann O., ARNP Adv. Reg. Nurse Practitioner AHP Tanhehco, Estela Y., ARNP Adv. Reg. Nurse Practitioner AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Walk, Matthew C., P.A. Physician Assistant AHP Walk, Valerie A., P.A. Physician Assistant AHP Waszkowski, Denise, C.N.M. Cert. Nurse Midwife AHP Wilkinson, Chris A., P.A. Physician Assistant AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP Wright, Arlene T., ARNP Adv. Reg. Nurse Practitioner AHP

LEE HEALTH Lee County, Florida M E M O R A N D U M #5 To: From: Board of Directors Nancy A. Taylor, CPMSM, CPCS Director, Centralized Credentialing Services Date: September 20, 2017 Subject: Golisano Children s Hospital of Southwest Florida Medical Staff Recommendations The Facility Medical Executive Committee of the Medical Staff recommends the following physicians and allied health practitioners and certifies they have met the requirements set forth in the bylaws: 1. Associate Staff Appointment: a. Rebecca Appelgren, M.D. - Anesthesiology b. Luis Brandi, M.D. Pathology c. Michael Carr, M.D. Pediatric Urology d. Kevin Hall, D.D.S. Oral & Maxillofacial Surgery 2. Telemedicine Appointment Privileges Only: a. Fouad Butto, M.D. Pediatric Cardiology 3. M.S. and A.H.P. Reappointments 10-01-17 to 09-30-19 (list attached) 4. Leave of Absence: a. William Rincon, D.O. OB/Gyn, extension through 06-30-18 5. First Year Completions Active Status: a. Harvey Esrov, M.D. Diagnostic Radiology 6. First Year Completions Associate Status: a. Adelbert Cabrera, M.D. Pathology b. Shahzaib Mirza, M.D. Pediatrics c. Chauchau Pham, M.D. - Otolaryngology 7. Allied Health Practitioners: a. Rupert Valbuena, CRNA Medical Anesthesia b. Kisten Walker, CRNA Medical Anesthesia Approved by the Board of Directors September 28, 2017 Sanford N. Cohen, M.D., Chairman - Board of Directors Lee Memorial Health System Board of Directors

GCHSWF REAPPOINTMENTS FOR SEPTEMBER 2017 10/01/17-09/30/19 Name Specialty Staff Type MEDICAL STAFF Churchill, John A., M.D. Pediatric Orthopedics Active Del Valle Hernandez, Ernesto J., M.D. Pediatric Orthopedics Active Shannon, F. Brett, D.O. Pediatric Orthopedics Active Badia, Anais A., D.O. Dermatology Associate (R & F) Arrillaga, Frances M., M.D. Pediatric Cardiology Privilege Only Asante-Korang, Alfred, M.D. Pediatric Cardiology Privilege Only Bhatia, Sanjiv, M.D. Pediatric Neurosurgery Privilege Only Decker, Jamie A., M.D. Pediatric Cardiology Privilege Only Duchowny, Michael S., M.D. Pediatric Neurology Privilege Only Hardin, Joel T., M.D. Pediatric Cardiology Privilege Only Huhta, James C., M.D. Pediatric Cardiology Privilege Only Hyslop, Ann E., M.D. Pediatric Neurology Privilege Only Jayakar, Parul B., M.D. Pediatric Genetics Privilege Only John, Jonathan B., M.D. Pediatric Cardiology Privilege Only Kurtz, Stephanie A., M.D. Pediatric Cardiology Privilege Only Lawrence, David K., M.D. Pediatric Cardiology Privilege Only Martinez, Richard M., M.D. Pediatric Cardiology Privilege Only Martir-Negron, Arelis E., M.D. Pediatric Genetics Privilege Only McCormack, Jorge, M.D. Pediatric Cardiology Privilege Only McKenna, Daniel E., M.D. Pediatric Cardiology Privilege Only Miller, Ian O., M.D. Pediatric Neurology Privilege Only Niazi, Toba N., M.D. Pediatric Neurosurgery Privilege Only Ragheb, John, M.D. Pediatric Neurosurgery Privilege Only Rajadhyaksha, Aparna C., M.D. Pediatric Genetics Privilege Only Resnick, Trevor J., M.D. Pediatric Neurology Privilege Only Stapleton, Gary E., M.D. Pediatric Cardiology Privilege Only ALLIED HEALTH Christian, Amber L., P.A. Physician Assistant AHP Edwards, Cynthia M., CRNA Cert. Reg. Nurse Anesthetist AHP Hill, Matthew F., CRNA Cert. Reg. Nurse Anesthetist AHP Komarynski, Mary A., ARNP Adv. Reg. Nurse Practitioner AHP Linzalone, Jennifer, A.A. Anesthesiology Assistant AHP Reich, John R., P.A. Physician Assistant AHP Vega, Julie P., ARNP Adv. Reg. Nurse Practitioner AHP Williams, Ervin R., A.A. Anesthesiology Assistant AHP

OLD BUSINESS Lee Memorial Health System Board of Directors