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Table of Contents
Executive Summary                                                          3-5

Financial and Operational Study                                            6 - 15

    • Total Profit Margin                                                  6
    •   Total Operating Profit Margin                                      7
    •   Days Net Patient Revenue in Accounts Receivable (AR)               8
    •   Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)   9
    •   Total Labor Cost as a Percentage of Net Operating Revenues         10
    •   Average Age of Plant and Equipment                                 11
    •   Metric Trend by Peer Group                                         12 – 13
    •   Quartiles by Peer Group                                            14 - 15


Introduction to Healthcare Management Partners                             16 - 20

Clients Our Professionals Have Served                                      21 - 22

Firm Leadership                                                            23 - 26

Contact Information                                                        27




                                                October 2010                         2
Executive Summary – Overview
Healthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its senior
executives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignments
across the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools are
necessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMP
MetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparable
facilities and against “1st Quartile” or “High Performing” competitors.

Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive study
comparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groups
selected include the following:

       1.   All General Acute Care Hospitals Regardless of Ownership or Sponsorship
       2.   All Investor Owned General Acute Care Hospitals
       3.   All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations
       4.   All State and Local Government Owned General Acute Care Hospitals
       5.   Free Standing Children’s Hospitals
       6.   All Non-Federal Major Teaching Hospitals

Using proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period or
statistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals,
specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensed
beds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer group
comparisons for dozens of standard industry metrics.

This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustrate
the benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess the
relative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or create
new peer groups and compare them to state, local or national benchmarks.


                                                          October 2010                                                          3
Executive Summary – Key Terms
All hospitals: Represents over 3,000 short-term general acute care hospitals.

Investor Owned hospitals: Represents short-term general acute care hospitals owned a for-profit chain or owned
individually.

Not-for-profit hospitals: Represents short-term general acute care hospitals identified as ‘not-for profit’ (e.g.,
501c3).

State and Local owned hospitals: Represents short-term general acute care hospitals controlled by state or local
government.

Children’s hospitals: Represents Children’s hospitals regardless of ownership type.

Major Teaching hospitals: Represents hospital and health system members of the Association of American
Medical Colleges. For health system members, ‘flagship’ medical centers were included while smaller affiliate
community teaching hospitals were excluded.

Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for the hospitals within
the peer groups. The first quartile contains the top 25% of the best performing hospitals in an applicable peer group,
the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains those
hospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%.

Mean Value: The mean value is the average of all amounts within a defined group. For example, 8 would be the
mean value in an array of the numbers: 2, 4, 10, and 16.




                                                      October 2010                                                       4
Executive Summary – Hospital Performance Metrics

                                        A measure of overall hospital profitability presented as a percentage. A negative percentage
Total Profit Margin
                                        indicates an overall loss, while a positive percentage indicates profitability.

                                        A measure of operating profitability presented as a percentage. A negative percentage
Total Operating Profit Margin
                                        indicates overall loss, while a positive percentage indicates profitability.

                                        A measure of labor productivity. This metric divides labor costs by operating revenues. A
Total Labor Cost as a Percentage of
                                        higher percentage compared to its peers indicates that a hospital uses more labor to produce its
Total Operating Revenues
                                        revenue.
                                     Measures the number of full-time equivalent (FTE) employees used for each occupied bed.
Full-Time Equivalent (FTE) Staff per
                                     Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital
Adjusted Occupied Bed (AOB)
                                     uses more labor to treat its patients.
                                     Measures the number of days it typically takes to collect accounts receivable. A higher
Average Days Net Patient Revenue in
                                     percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as
Accounts Receivable (AR)
                                     its peers.
                                        Measures the average age of the hospital including capital improvements and major equipment
Average Age of Plant                    purchases. A higher age compared to its peers indicates that the hospital has deferred the
                                        replacement of its capital when compared to its peers, which can lead to further distress.

Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal
Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management
when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in
the Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations.
Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, and
hospitals where the computed metric is more than 2 standard deviations from the mean.

                                                             October 2010                                                              5
Total Profit Margin
                                                        6-Year Metric Trend
10.00%
 9.00%
 8.00%
 7.00%
 6.00%
 5.00%
 4.00%
 3.00%
 2.00%
 1.00%
 0.00%
                  2004                2005                    2006                2007               2008                2009

           All       Investor Owned          Not-For-Profit       State and Local Govt. Owned     Childrens      Major Teaching

                                                     Peer Quartiles - FY 2009
      20.00%
      17.00%
      14.00%
      11.00%
       8.00%
       5.00%
       2.00%
      -1.00%
      -4.00%
      -7.00%
     -10.00%
                                                                                State and Local
                          All         Investor Owned          Not-For-Profit                         Childrens       Major Teaching
                                                                                 Govt. Owned
   1st Quartile          13.40%          19.16%                  11.42%             9.94%            17.11%             12.03%
   2nd Quartile          4.85%           10.43%                  4.04%              3.56%             8.96%              5.65%
  3rd Quartile           0.57%            4.30%                  0.15%              -0.03%            4.09%              1.54%
   4th Quartile          -6.80%          -4.48%                  -7.04%             -7.07%            -5.18%            -7.25%


                                                                October 2010                                                          6
Total Operating Profit Margin
                                                        6-Year Metric Trend
 7.00%
 6.00%
 5.00%
 4.00%
 3.00%
 2.00%
 1.00%
 0.00%
-1.00%
-2.00%
-3.00%
-4.00%
-5.00%
-6.00%
                  2004                2005                    2006                2007               2008               2009

           All       Investor Owned          Not-For-Profit       State and Local Govt. Owned     Childrens     Major Teaching

                                                     Peer Quartiles - FY 2009
      25.00%
      20.00%
      15.00%
      10.00%
       5.00%
       0.00%
      -5.00%
     -10.00%
     -15.00%
     -20.00%
                                                                                State and Local
                           All        Investor Owned          Not-For-Profit                        Childrens       Major Teaching
                                                                                 Govt. Owned
   1st Quartile          12.32%          20.03%                   9.60%             5.89%            13.11%             9.85%
   2nd Quartile          2.24%           10.48%                   1.71%             -1.86%            3.60%             1.98%
   3rd Quartile          -2.91%              2.85%               -2.54%             -7.38%            -3.56%           -3.08%
   4th Quartile          -11.94%         -7.79%                  -10.89%           -16.15%           -13.01%           -12.77%


                                                                October 2010                                                         7
Days Net Patient Revenue in Accounts Receivable (AR)
                                                            6-Year Metric Trend
63.00
61.00
59.00
57.00
55.00
53.00
51.00
49.00
47.00
45.00
                  2004                    2005                    2006                  2007                2008                2009

           All           Investor Owned          Not-For-Profit          State and Local Govt. Owned     Childrens      Major Teaching

                                                         Peer Quartiles - FY 2009
        80.00
        75.00
        70.00
        65.00
        60.00
        55.00
        50.00
        45.00
        40.00
        35.00
        30.00
                                                                                       State and Local
                           All             Investor Owned         Not-For-Profit                            Childrens       Major Teaching
                                                                                        Govt. Owned
   1st Quartile           33.71                  35.31                   32.36              36.74            36.30              34.74
   2nd Quartile           44.91                  45.42                   43.26              49.30            46.34              44.70
   3rd Quartile           53.16                  53.21                   50.64              59.47            53.29              51.48
   4th Quartile           70.26                  70.09                   65.65              78.31            72.15              68.09


                                                                    October 2010                                                             8
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)
                                                           6-Year Metric Trend
7.00

6.50

6.00

5.50

5.00

4.50

4.00

3.50
                  2004                2005                     2006                  2007               2008                 2009

           All           Investor Owned       Not-For-Profit          State and Local Govt. Owned     Childrens      Major Teaching

                                                      Peer Quartiles - FY 2009
         8.00
         7.50
         7.00
         6.50
         6.00
         5.50
         5.00
         4.50
         4.00
         3.50
         3.00
                                                                                    State and Local
                           All            Investor Owned       Not-For-Profit                            Childrens       Major Teaching
                                                                                     Govt. Owned
   1st Quartile            3.45                3.21                   3.61               3.42              3.79               4.59
   2nd Quartile            4.37                3.93                   4.55               4.44              5.32               5.39
   3rd Quartile            5.12                4.51                   5.27               5.28              6.99               6.03
   4th Quartile            6.48                5.76                   6.55               6.61              7.78               7.21


                                                                 October 2010                                                             9
Total Labor Cost as a Percentage of Net Operating Revenues
                                                        6-Year Metric Trend
55.00%
53.50%
52.00%
50.50%
49.00%
47.50%
46.00%
44.50%
43.00%
41.50%
40.00%
                  2004                2005                    2006                2007               2008               2009

           All       Investor Owned          Not-For-Profit       State and Local Govt. Owned     Childrens     Major Teaching

                                                     Peer Quartiles - FY 2009
      65.00%
      60.00%
      55.00%
      50.00%
      45.00%
      40.00%
      35.00%
      30.00%
                                                                                State and Local
                          All         Investor Owned          Not-For-Profit                        Childrens       Major Teaching
                                                                                 Govt. Owned
   1st Quartile          37.97%          34.05%                  40.16%            41.26%            36.38%            41.26%
   2nd Quartile          45.71%          39.04%                  46.99%            49.08%            42.20%            47.39%
  3rd Quartile           51.58%          44.26%                  52.13%            54.76%            49.55%            52.08%
   4th Quartile          59.40%          53.87%                  59.19%            62.18%            58.19%            59.05%


                                                                October 2010                                                         10
Average Age of Plant and Equipment
                                                                          6-Year Metric Trend
 11.50
 11.00
 10.50
 10.00
  9.50
  9.00
  8.50
  8.00
  7.50
  7.00
  6.50
  6.00
  5.50
  5.00
                       2004                        2005                         2006                        2007                         2008                         2009

                 All          Investor Owned                Not-For-Profit             State and Local Govt. Owned                   Childrens             Major Teaching

                                                                      Peer Quartiles - FY 2009
             18.00
             16.00
             14.00
             12.00
             10.00
              8.00
              6.00
              4.00
              2.00
              0.00
                                                                                                           State and Local
                                  All                Investor Owned              Not-For-Profit                                          Childrens              Major Teaching
                                                                                                            Govt. Owned
      1st Quartile                3.63                      2.12                       4.90                       4.55                       4.55                       6.11
      2nd Quartile                7.70                      4.83                       8.65                       8.31                       6.85                       9.02
Notes:3rd Quartile               10.59                       8.23                       11.28                      10.99                      8.30                     11.25
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• ExcludesQuartile
      4th Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed 15.92 comprised of sub13.26beds.
                                 15.39                      12.96                       15.75                       beds are                  acute                    15.57


                                                                                   October 2010                                                                                   11
Metric Trend by Peer Group
Year                                                                2009                 2008                 2007                 2006                2005                 2004
Total Profit Margin
All                                   2.98%        2.26%                                                     4.56%                4.24%                3.86%               3.28%
Investor Owned                        7.22%        6.20%                                                     6.57%                6.46%                6.39%               5.79%
Not-For-Profit                        2.11%        1.08%                                                     4.31%                3.79%                3.45%               2.83%
State and Local Government Owned      1.53%        1.86%                                                     3.40%                3.37%                2.64%               2.22%
Childrens                             5.52%        3.81%                                                     9.36%                7.28%                7.17%               6.46%
Major Teaching                        2.83%        0.85%                                                     5.20%                4.82%                3.75%               3.20%
Total Ope rating Profit Margin
All                                   -0.10%       -0.59%                                                   -0.21%               -0.38%               -0.29%               -0.81%
Investor Owned                        6.26%        5.67%                                                    5.16%                4.87%                4.86%                4.43%
Not-For-Profit                        -0.54%       -1.29%                                                   -0.79%               -1.07%               -0.76%               -1.46%
State and Local Government Owned      -4.97%       -4.82%                                                   -4.02%               -3.75%               -4.16%               -4.22%
Childrens                             -0.57%       -0.51%                                                   0.17%                -1.60%               0.03%                -1.91%
Major Teaching                        -1.21%       -2.82%                                                   -2.17%               -2.15%               -2.88%               -3.27%
Days Ne t Patie nt Re ve nue in Accounts Re ce ivable (AR)
All                                    50.52        53.55                                                     54.66                55.28               54.62                56.31
Investor Owned                         51.21        54.36                                                     55.61                57.77               57.08                57.91
Not-For-Profit                         48.04        51.18                                                     52.08                52.45               51.95                53.89
State and Local Government Owned       56.15        59.44                                                     61.10                60.88               59.92                61.77
Childrens                              52.85        54.83                                                     56.89                56.66               57.89                55.18
Major Teaching                         49.98        52.89                                                     52.44                52.88               52.94                54.40
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                     12
Metric Trend by Peer Group
Year                                 2009      2008      2007                                                                      2006                2005                 2004
Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB)
All                                                                  4.86                 4.86                 4.82                 4.82                 4.77                4.78
Investor Owned                                                       4.37                 4.43                 4.39                 4.40                 4.29                4.28
Not-For-Profit                                                       5.00                 4.97                 4.93                 4.94                 4.88                4.89
State and Local Government Owned                                     4.95                 4.97                 4.93                 4.92                 4.94                4.99
Childrens                                                            6.11                 6.40                 6.44                 6.32                 6.40                6.35
Major Teaching                                                       5.83                 5.78                 5.71                 5.75                 5.70                5.66
Total Labor Cost as a Percentage of Net Operating Revenues
All                                                                48.69%              49.54%               49.61%               49.67%               49.79%               50.45%
Investor Owned                                                     42.93%              43.97%               44.17%               44.42%               44.85%               45.25%
Not-For-Profit                                                     49.66%              50.47%               50.54%               50.59%               50.53%               51.44%
State and Local Government Owned                                   51.90%              52.59%               52.46%               52.36%               52.85%               52.88%
Childrens                                                          47.25%              47.39%               47.10%               46.73%               48.21%               48.10%
Major Teaching                                                     50.16%              51.31%               50.73%               50.82%               50.75%               51.45%
Average Age of Plant and Equipment
All                                                                  9.34                 9.32                 9.35                 9.40                9.47                 9.05
Investor Owned                                                       7.11                 6.42                 6.29                 6.06                6.18                 5.58
Not-For-Profit                                                      10.17                10.22                10.25                10.30               10.32                 9.63
State and Local Government Owned                                    10.01                10.25                10.46                10.77               10.64                10.38
Childrens                                                            8.55                 8.57                 9.24                 9.01                8.45                 8.75
Major Teaching                                                      10.60                10.62                10.79                10.44               10.47                 9.44
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                     13
Quartiles by Peer Group
Peer Group Summary by Quartile (Quartile Grouping)
For the Year 2009
                                                                       All                                       Investor Owned                                Not-For-Profit
Metric
                                                      1st         2nd       3rd      4th             1st           2nd        3rd        4th     1st           2nd      3rd          4th
Overall Profit Margin                              13.40% 4.85% 0.57% (6.80%)                      19.16%       10.43% 4.30%           (4.48%) 11.42%         4.04% 0.15%          (7.04%)
Operating Profit Margin                            12.32% 2.24% (2.91%) (11.94%)                   20.03%       10.48% 2.85%           (7.79%) 9.60%          1.71% (2.54%)       (10.89%)
Total Labor Cost as a % of Net Operating Rev.      37.97% 45.71% 51.58% 59.40%                     34.05%       39.04% 44.26%          53.87% 40.16%         46.99% 52.13%         59.19%
Days Net Patient Revenue in AR                      33.71        44.91     53.16 70.26              35.31        45.42       53.21      70.09 32.36           43.26 50.64           65.65
FTEs per AOB                                         3.45        4.37      5.12      6.48           3.21          3.93       4.51        5.76   3.61           4.55 5.27             6.55
Average Age of Plant and Equipment                   3.63        7.70      10.59 15.39              2.12          4.83       8.23       12.96 4.90             8.65 11.28           15.75
                                                          State and Local Government                                 Childrens                               Major Teaching
Metric
                                                      1st         2nd       3rd      4th             1st           2nd        3rd         4th         1st      2nd      3rd          4th
Overall Profit Margin                               9.94% 3.56% (0.03%) (7.07%)                    17.11%        8.96% 4.09%            (5.18%)    12.03%     5.65% 1.54%          (7.25%)
Operating Profit Margin                             5.89% (1.86%) (7.38%) (16.15%)                 13.11%        3.60% (3.56%)         (13.01%)     9.85%     1.98% (3.08%)       (12.77%)
Total Labor Cost as a % of Net Operating Rev.      41.26% 49.08% 54.76% 62.18%                     36.38%       42.20% 49.55%           58.19%     41.26%    47.39% 52.08%         59.05%
Days Net Patient Revenue in AR                      36.74        49.30     59.47 78.31              36.30         46.34      53.29       72.15      34.74     44.70 51.48           68.09
FTEs per AOB                                         3.42        4.44      5.28      6.61           3.79          5.32       6.99         7.78       4.59      5.39 6.03             7.21
Average Age of Plant and Equipment                   4.55        8.31      10.99 15.92              4.55          6.85       8.30        13.26       6.11      9.02 11.25           15.57
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                       14
Quartiles by Peer Group
Peer Group Summary by Quartile (Peer Grouping)
For the Year 2009
                                                                            1st Quartile                                                          2nd Quartile
Metric                                                                                                  Major                                                                 Major
                                                   All         IO         NFP         GSL     Childrens          All                 IO         NFP         GSL      Childrens
                                                                                                       Teaching                                                              Teaching
Overall Profit Margin                            13.40%      19.16%      11.42% 9.94%           17.11% 12.03% 4.85%                10.43%       4.04% 3.56%            8.96% 5.65%
Operating Profit Margin                          12.32%      20.03%       9.60% 5.89%           13.11% 9.85% 2.24%                 10.48%       1.71% (1.86%)          3.60% 1.98%
Total Labor Cost as a % of Net Operating Rev.    37.97%      34.05%      40.16% 41.26%          36.38% 41.26% 45.71%               39.04%      46.99% 49.08%          42.20% 47.39%
Days Net Patient Revenue in AR                    33.71       35.31       32.36      36.74       36.30   34.74  44.91               45.42       43.26      49.30       46.34   44.70
FTEs per AOB                                      3.45        3.21         3.61       3.42       3.79    4.59   4.37                3.93         4.55       4.44        5.32   5.39
Average Age of Plant and Equipment                3.63        2.12         4.90       4.55       4.55    6.11   7.70                4.83         8.65       8.31        6.85   9.02
                                                                             3rd Quartile                                                          4th Quartile
Metric                                                                                           Major                                                                              Major
                                                   All         IO         NFP         GSL     Childrens    All      IO     NFP      GSL Childrens
                                                                                                Teaching                                                                          Teaching
Overall Profit Margin                             0.57%       4.30%      0.15% (0.03%) 4.09% 1.54% (6.80%) (4.48%) (7.04%) (7.07%) (5.18%)                                         (7.25%)
Operating Profit Margin                          (2.91%)      2.85%     (2.54%) (7.38%) (3.56%) (3.08%) (11.94%) (7.79%) (10.89%) (16.15%) (13.01%)                               (12.77%)
Total Labor Cost as a % of Net Operating Rev.    51.58%      44.26%     52.13% 54.76% 49.55% 52.08% 59.40% 53.87% 59.19% 62.18% 58.19%                                             59.05%
Days Net Patient Revenue in AR                    53.16       53.21      50.64   59.47   53.29    51.48   70.26   70.09    65.65    78.31    72.15                                  68.09
FTEs per AOB                                       5.12        4.51       5.27    5.28    6.99    6.03    6.48     5.76    6.55     6.61     7.78                                    7.21
Average Age of Plant and Equipment                10.59        8.23      11.28   10.99    8.30    11.25   15.39   12.96    15.75    15.92    13.26                                  15.57
Notes:
• Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population).
• Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds.




                                                                                   October 2010                                                                                        15
Introduction to Healthcare Management Partners
Who We Are
HMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experience
including CEO, COO and CFO assignments across the spectrum of healthcare service providers. Our senior management has deep
experience in building and operating thriving healthcare organizations. Part of that experience includes taking decisive action in crises
or turnaround situations. This knowledge base gives HMP a unique perspective and all the tools necessary to handle the issues facing
any healthcare provider organization. HMP provides Hospital Contract Management, Turnaround Management and Interim or Crisis
Management services.

Our Approach
Our approach to every assignment is built upon the straightforward application of three simple steps or guiding principles.

Listen – We listen carefully to our clients, their key stakeholders and the marketplace throughout each assignment.

Evaluate – We employ detailed, fact-based analysis to evaluate and validate assumptions, findings and recommended actions.

Implement – We have a bias toward “getting it done.” We take decisive action to quickly convert opportunities or solve problems .


The HMP Difference
  Total commitment to providing C-Level attention throughout each assignment by experienced healthcare executives
  Small, dedicated teams of operating professionals for each assignment
  Absolute integrity of our fact-based approach
  Action-oriented diagnostic and business planning processes
  Proven ability to drive positive outcomes in all sectors of healthcare
  Depth of HMP network, providing critical access to key resources and people
  Commitment to the highest professional standards

                                                             October 2010                                                              16
Introduction to Healthcare Management Partners

Management Services
HMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experience
including CEO, COO and CFO assignments across the spectrum of health services. Examples of specific assignments include serving as
the Chief Executive Officer (CEO) of the following types of healthcare organizations:

  Religious affiliated or sponsored multihospital systems
  Free standing not-for-profit or government owned community hospitals
  University and major teaching hospitals
  Single site and multihospital regional operations for investor owned hospital management companies
  De Novo organizations (start-up) planning, construction and operation of new general acute care hospitals, free-standing heart
  and cancer hospitals, a continuing care retirement community and many other related facilities
  Hospitals that are in bankruptcy or for sale
  Financially distressed skilled nursing facilities
  Home health, hospice and physician practices


“HMP’s senior staff members are professional healthcare service executives who also possess consulting skills,
not professional consultants. We understand and are committed to the provision of quality healthcare services
                     at every provider organization where we have a management role.”




                                                            October 2010                                                        17
Introduction to Healthcare Management Partners
Hospital Contract Management
HMP is positioned to undertake the long-term (3 to 5 years) contract management of hospitals of all sizes and stages of
development. Our executives are experienced in leading the development of new or replacement general acute care or specialty
hospitals or the turnaround and repositioning of existing hospitals. They can effectively lead initiatives in the following areas:
        Strategic Leadership               Clinical Excellence                Operational Excellence               Financial Performance

 Market Positioning                Clinical Process Redesign             Patient Throughput                   Revenue Cycle

 Brand Development                 Evidence‐Based Care                   Emergency Department Clinical        Business Office Consolidation
                                                                         Efficiency
 Service Line Development          Resource Utilization and Cost of      Surgical Services Clinical           Managed Care Contracting
                                   Quality                               Efficiency
 Capital Planning and Investment   Pay for Performance                   Inpatient Length of Stay and Level   Risk Management and Insurance
                                                                         of Care
 Physician Relations               Care and Case Management              Human Resources Management           Budgeting / Financial Planning
                                   Processes
 Physician Integration             Quality and Safety Indicators         Ambulatory Care                      Capital Programs

 Continuum of Care                 Design and Implementation             Hospice and Home Care                Supply Chain
                                   Strategic Plans
 Corporate and Medical Staff       Mission and Vision                    Best Practices and Operating         Financial Reporting and Accounting
 Governance                                                              Metrics

We will be directly accountable to the board of directors and will assume full responsibility to plan, organize, staff, direct and
control the successful and cost effective operations of the hospital.

Because HMP is not a management consulting firm, our contract management executives are free to always bring the best and most
cost-effective solution, from whatever source, to the hospital should outside assistance prove necessary to implement a given
strategic or tactical initiative.


                                                                   October 2010                                                                    18
Introduction to Healthcare Management Partners
Turnaround Management
HMP’s executives have served as chief restructuring officers of healthcare companies through bankruptcies, crisis situations and in the
early stages of high-profile criminal and civil fraud investigations. In each of these situations, their leadership helped these
organizations bolster performance through discipline and carefully planned action.

Some consultants assess your problems and provide a recommended course of action. But HMP executives take the helm of failing
organizations and assume direct responsibility for transforming them. Time and again, they have succeeded in revitalizing providers of
all kinds, from a rural nursing home chain to a 1,000 bed teaching hospital or a 179 bed county owned community hospital.

There are no quick fixes in turnaround management, but HMP has developed a highly effective, streamlined approach for achieving
lasting improvements as soon as possible. We begin by developing a strong knowledge base of your organization. Individuals from
every level of the organization are interviewed: management, medical and nursing staff members, board of directors, employees,
patients and their families. Their input, combined with a depth of healthcare industry knowledge, allows HMP to:

  Stabilize the crises,
  Identify immediate opportunities and challenges,
  Develop a strategic plan, including milestones and deadlines,
  Define expected outcomes,
  Build consensus with all constituents – medical and nursing staffs, management, unions, and the local community,
  Change cultures, and
  Optimize performance.

In all of its healthcare provider turnaround assignments, HMP has successfully designed and executed plans that simultaneously added
patient volume and revenues, reduced costs and improved profitability and cash flow.

From the outset, HMP builds on each organization’s strengths, working side‐by‐side with management, directors and other key
stakeholders to drive desired results. HMP also focuses on winning the support and active participation of the medical and nursing
staffs, which is fundamental for delivering quality healthcare services and improving financial results.

                                                            October 2010                                                             19
Introduction to Healthcare Management Partners
Interim and Crisis Management
HMP serves in interim and crisis management roles when required to help guide providers through periods of crisis or change.
Companies that are underperforming and in crisis, or healthy but in transition, may need additional experienced healthcare industry
leaders to stabilize operations and improve financial performance or maintain continuity in the rapid implementation of critical strategic
initiatives.

Our professionals can offer critical advice or step into key leadership positions such as Chief Restructuring Officer, Chief Financial
Officer, or Chief Executive Officer to provide needed stability during periods of change. Our proven interim management capabilities
add valuable support in crisis situations. We immediately fill critical leadership vacancies and shorten the lead‐time for implementing
specific initiatives. HMP provides much needed leadership and speed to create value in executing crisis management and restructuring
plans.

Our crisis and interim management services include:
  Immediate staffing of critical senior management positions
  Reducing lead‐time for implementing strategic initiatives
  Managing communications processes with Members of the medical and nursing staffs, board members, employees and regulators,
  and if required
  Bankruptcy process planning and administration




                                                              October 2010                                                              20
Clients Our Professionals Have Served

                          Not-For-Profit or Governmental Hospitals or Systems
Baylor College of Medicine       Hahnemann University              New York United Hospital         Southern Chester County
                                 Hospital                          Medical Center                   Medical Center
The Brooklyn Hospital Center     Health Alliance of Cincinnati     Nyack Hospital                   St Vincent’s Catholic Medical
                                                                                                    Centers, New York
Devereux Foundation              National Health Service,          Rahway Hospital                  Temple Health System
                                 United Kingdom
Franciscan Health System         Legacy Health System              Raritan Bay Health System        Tri‐Lakes Medical Center

General Health System            Mercy Health System               Robert Wood Johnson Health       University Hospital
                                                                   Network                          Consortium of Pennsylvania
Good Samaritan Hospital          Natchez Regional Medical          Sisters of Mercy Health System
                                 Center


                                Investor Owned Hospitals or Health Systems
Ameris Health Systems            Health South Corporation          Integrated Healthcare            Shasta Regional Medical
                                                                   Holdings, Inc.                   Center
Doctors Hospital, Houston        Hospital Corporation of           Lakeside Hospital at Bastrop     St. Joseph Hospital, Houston
                                 America
Doctors Hospital, Los Angeles    Hugh Chatham Memorial             LifePoint Hospitals              Tenet Healthcare Corporation
                                 Hospital
HealthPlus                       Hughston Hospital and Clinic      Monroe Hospital, LLC             Vanguard Health Systems

Hospital Partners of America     Integra Healthcare                Promise Healthcare



                                                            October 2010                                                            21
Clients Our Professionals Have Served

                     Senior Care and/or Continuing Care Retirement Communities
Grace Care of Texas                                                    Monarch Landing, Inc.

Jenner’s Pond Continuing Care Retirement Community                     National Senior Campuses (Erickson Retirement Communities)

Life Care Centers of America                                           Sedgebrook, Inc.

Linden Ponds, Inc.                                                     St. Edward Mercy Health Systems (Ft. Smith, AR)

Mercy Hospitals of Texas                                               St. Johns Nursing Home (St. Louis, MO)


                                              Law and Accounting Firms
Bird Marella LLP                  Deloitte                             Kantrow, Spaht, Weaver & Blitzer   Patton Boggs

Bradley Arant Boult Cummings      Gearhiser, Peters, Lockaby, Cavett   KPMG                               Ramirez International, Inc.
LLP                               & Elliott, PLLC
Brown McCarroll LLP               Hogan & Hartson LLP                  Latham & Watkins                   Whiteford Taylor Preston, LLP

Fulbright & Jaworski LLP          Hooper, Lundy & Bookman              Mancuso & Franco PC                Schiavetti, Corgan, Soscia,
                                                                                                          DiEdwards and Nicholson, LLP
Decosimo                          Jones Day                            Milbank, Tweed, Hadley and         Waller Lansden Dortch & Davis
                                                                       McCloy LLP


                                                Other Providers / Payors
Blue Cross of Tennessee           Best Choice Home Health              Community Behavioral Health        Columbia Home Care
                                                                       Network of PA



                                                              October 2010                                                                22
Firm Leadership
                             Scott Phillips
                             Title                                  Managing Director

                             Education                              B.S. from University of Florida
                                                                    CPA
                             Boards & Organizations                 American Bankruptcy Institute Healthcare Subcommittee Chair
                             Telephone                              267.207.2929
                             Mobile                                 267.804.3885
                             E-Mail                                 sphillips@hcmpllc.com

Scott has more than 30 years of healthcare industry management and consulting experience. Prior to founding HMP in 1997, he served as the
president and chief executive officer of a 636-bed academic medical center, as national partner and regional healthcare practice director for Touche
Ross & Co., and as the chief financial officer of a faith-based multihospital system operating 12 hospitals across seven states.
Scott has significant management and consulting experience with government, tax-exempt and investor owned healthcare service providers. He
understands the organization and delivery of high-quality health services, including the role of corporate and medical staff governance during
difficult periods of transition. Scott has executive level experience with mergers, acquisitions and turnaround situations, including restructuring in
bankruptcy. In all of his many healthcare provider turnaround assignments, he has successfully designed and implemented plans that simultaneously
added patient volume and revenues while conserving cash and reducing unit costs. He understands this approach builds on the organization’s
strengths and attracts the support of the local community and medical and nursing staffs, which is essential for the long-term provision of quality
healthcare services.
Over the past several years, Scott has served as the chairman and CEO of an investor owned healthcare provider with operations in 15 states and
chief executive officer of a publicly traded medical staffing company with more than 2,000 employees. Both turnaround assignments included the
crises management of complex organizations in the early stages of high-profile criminal and civil fraud investigations by multiple federal agencies.
Scott has expert knowledge of the bankruptcy process as well as its implications and obligations on an operating provider of healthcare services. He
recently led the successful financial turnaround and Chapter 9 reorganization of a 179-bed county-owned hospital.
Recently he was the financial advisor to 18 tax-exempt continuing care retirement communities with more than 20,000 residents in twelve states,
affected by the bankruptcy and sale of Erickson Retirement Communities.
Scott graduated from the University of Florida with a Bachelor of Science in accounting. He is a licensed certified public accountant and member of
numerous professional organizations. He is currently serving Leader Special Projects, Healthcare Committee, American Bankruptcy Institute.


                                                                   October 2010                                                                     23
Firm Leadership
                              Michael Morgan
                              Title                                  Managing Director
                              Education                              MBA from University of Central Oklahoma
                                                                     B.S. from University of Science and Arts of Oklahoma
                              Boards & Organizations                 Fellow of American College of Healthcare Executives
                              Telephone                              713.968.6521
                              Mobile                                 214.701.9990
                              E-Mail                                 mmorgan@hcmpllc.com

Michael is a former hospital chief executive officer with more than 30 years of experience in healthcare management. He brings expertise and talent
for turning around ailing healthcare providers and optimizing healthy organizations.
In his 25-year career at the Sisters of Mercy Health System, Michael was responsible for turning around five of the system’s 19 hospitals. He served
as president and chief executive officer for several Sisters of Mercy hospitals, including St. John’s Mercy Health Care, which has over $800 million
in operating revenues, employs more than 8,000 individuals and includes the system’s flagship 957-bed teaching hospital. As the CEO, he has set
successful new strategies, improved clinical and administrative operations and changed organizational cultures. His trademark is developing capable
management teams that in turn increase service quality, employee and medical staff satisfaction, patient volume, profitability and maximize cash
flow.
After leaving the Sisters of Mercy system, Michael served as the chief restructuring officer and CEO for a two-hospital, investor owned system in
Texas. In eight months, he led the successful turnaround, emergence from bankruptcy and recapitalization of the hospitals by a physician-led limited
partnership. He led the turnaround of a chain of five nursing homes in Texas and the bankruptcy turnaround of a two-campus, acute-care hospital in
Mississippi. He was the oversight Managing Director for a two-campus rehab and specialty hospital chapter 11 bankruptcy. He also recently served
as the CRO for three individual CCRC’s under a large CCRC management company bankruptcy, and provided financial advisory services for a large
investment banking group on a 500-bed hospital system.
Michael holds a Bachelor of Science in business administration from the University of Science and Arts of Oklahoma and a Master of Science in
business administration from the University of Central Oklahoma. He is a fellow of the American College of Healthcare Executives and has served
as an officer or director of numerous hospitals and business organizations, including a 280,000-member for-profit health insurance plan.




                                                                  October 2010                                                                    24
Firm Leadership
                                 Bruce Buchanan
                                 Title                                  Managing Director
                                 Education                              MBA from George Mason University
                                                                        MHSA from University of Michigan
                                                                        B.A. from Princeton University

                                 Boards & Organizations                 Fellow of American College of Healthcare Executives
                                 Mobile                                 602.363.1140
                                 Fax                                    866.794.9501
                                 E-Mail                                 bbuchanan@hcmpllc.com


Bruce has more than 30 years of experience in the healthcare field and is a senior healthcare executive with a successful track record in both the not-
for-profit and investor owned sectors. He possesses multimarket experience at the hospital and health system chief executive officer level. He has
deep experience and expertise in revenue growth, physician collaboration/integration, organizational development, productivity improvement and
quality enhancement.
Before joining HMP, Bruce served as CEO of Phoenix Baptist Hospital, where he turned around the distressed 236-bed teaching hospital by reducing
operating costs while enhancing the quality of care. Bruce led a similar turnaround of Northeast Baptist Hospital in San Antonio, including recruiting
new physicians, doubling the hospital’s physical space and growing market share. He also served as president and CEO of Atlanta Medical Center
and Mercy Health System Oklahoma and its Mercy Health Center in Oklahoma City. Bruce also held senior management positions with Hillcrest
Healthcare System and Saint Joseph Hospital and worked for Invalesco Group as an operations consultant to healthcare organizations.
Most recently with HMP, Bruce served as Chief Restructuring Officer for a rehabilitation hospital company with two facilities. He successfully led
the company through a Chapter 11 bankruptcy process and a Section 363 sale to a new, privately held owner. He also served as CEO of a county
hospital and guided it through a Chapter 9 bankruptcy, which resulted in all unsecured creditors receiving three year notes for full payment plus
interest.
Bruce has a Bachelor of Arts in sociology from Princeton University, a Master of Health Services Administration from University of Michigan, and a
Master of Business Administration from George Mason University. He is board-certified in healthcare management and a Fellow in the American
College of Healthcare Executives. He also is a member of the Turnaround Management Association.




                                                                   October 2010                                                                      25
Firm Leadership

                              Derek Pierce
                              Title                                   Managing Director

                              Education                               B.S. from Samford University

                              Telephone                               205.202.0459

                              Mobile                                  615.584.0719

                              E-Mail                                  dpierce@hcmpllc.com

Derek has over 20 years of professional experience focused solely in the healthcare industry, having served as chief financial officer, chief
restructuring officer, director of reimbursement, court-appointed examiner, Medicare auditor, Medicare cost report preparer, forensic accountant,
compliance consultant, financial auditor, and financial advisor. He has audited, managed and consulted with all types of healthcare providers,
including government owned, community not-for-profit, academic, and investor owned entities.
Most recently, Derek served as the restructuring chief financial officer of a two-campus, not-for-profit hospital in Chapter 11 bankruptcy. In addition
to his CFO responsibilities, he led the Section 363 sale process and conducted a forensic review into the circumstances that led to the hospital’s
bankruptcy filing. Throughout the project, Derek worked closely with senior lenders, debtor-in-possession lenders and the applicable federal loan
program to a successful plan of reorganization.
Starting his career with the Medicare fiscal intermediary as a Medicare auditor, Derek developed deep expert knowledge of the patient revenue cycle,
third-party contracting, and Medicare and Medicaid rules and regulations. He is expert in the areas of corporate and regulatory compliance and
forensic accounting in conjunction with the defense of civil and criminal fraud claims or allegations. He led teams conducting forensic analysis in
support of settlement negotiations with the government at both Hospital Corporation of America (HCA) and HealthSouth Corporation, two of the
largest and most complex civil fraud settlements in history.
In his career, Derek has led or participated in interim management and consulting assignments for more than 40 healthcare providers, including
Baptist Memorial Health Care, National Health Service (United Kingdom) Washington Hospital Center, Lifepoint Hospitals, Tampa General
Hospital, Legacy Health System and IASIS Healthcare.
Prior to joining HMP as a managing director, Derek was a Director with Alvarez & Marsal in its New York-based healthcare practice. Before that,
he was a senior manager with Arthur Andersen in its Atlanta-based healthcare consulting practice.
Derek is a graduate of Samford University with a Bachelor of Science in accounting and is a member of numerous professional associations.


                                                                    October 2010                                                                      26
Contact Information



   Philadelphia                      New York                           Houston
• Contact: Scott Phillips       • Contact: Nihal Shah           • Contact: Mike Morgan
  Managing Director               Director                        Managing Director
• Address:                      • Address:                      • Address:
  One Liberty Place               1185 Avenue of the Americas     5100 Westheimer
  1650 Market Street              30th Floor                      Suite 200
  36th Floor                      New York, NY 10036              Houston, TX 77056
  Philadelphia, PA 19103        • Phone: 212.461.4243           • Phone: 713.968.6521
• Phone: 267.804.3885           • Fax: 212.461.4252             • Fax: 866.422.6176
• Fax: 215.689.4386




  Birmingham                            Phoenix                   London, UK
• Contact: Derek Pierce         • Contact: Bruce Buchanan       • Contact: Tim Bolot
  Managing Director               Managing Director               Managing Director
• Address:                      • Address:                      • Address:
  2001 Park Place, Suite 1400     243 E. Glenn Drive              Bolt Partners LLP
  Birmingham, AL 35203            Phoenix, AZ 85020               192 Haverstock Hill,
• Phone: 205.202.0459           • Mobile: 602.363.1140            Belsize Park,
• Fax: 615.523.1835             • Fax: 866.794.9501               London NW3 2AJ
                                                                • Phone: +44 (0)20 7435 7349



                                            October 2010                                       27

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HMP Metrics™ Report October, 2010

  • 1.
  • 2. Table of Contents Executive Summary 3-5 Financial and Operational Study 6 - 15 • Total Profit Margin 6 • Total Operating Profit Margin 7 • Days Net Patient Revenue in Accounts Receivable (AR) 8 • Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 9 • Total Labor Cost as a Percentage of Net Operating Revenues 10 • Average Age of Plant and Equipment 11 • Metric Trend by Peer Group 12 – 13 • Quartiles by Peer Group 14 - 15 Introduction to Healthcare Management Partners 16 - 20 Clients Our Professionals Have Served 21 - 22 Firm Leadership 23 - 26 Contact Information 27 October 2010 2
  • 3. Executive Summary – Overview Healthcare Management Partners (HMP) is a hospital and healthcare services management firm. For decades, all of its senior executives have been building and operating thriving healthcare organizations, including CEO, COO and CFO assignments across the spectrum of healthcare services providers. This knowledge base gives HMP a unique perspective on what tools are necessary to handle the issues facing any healthcare provider organization, and is what prompted HMP to create HMP MetricsTM. Our executives understand the value of being able to measure hospital performance relative to comparable facilities and against “1st Quartile” or “High Performing” competitors. Utilizing the last six years of publicly available hospital Medicare cost report data, HMP has conducted an extensive study comparing performance within six hospital peer groups. We can easily create custom peer groups and metrics. These groups selected include the following: 1. All General Acute Care Hospitals Regardless of Ownership or Sponsorship 2. All Investor Owned General Acute Care Hospitals 3. All Not-For-Profit General Acute Care Hospitals, including Institutions Sponsored by Religious Organizations 4. All State and Local Government Owned General Acute Care Hospitals 5. Free Standing Children’s Hospitals 6. All Non-Federal Major Teaching Hospitals Using proprietary filters, data contained in the HMP Metrics database has been “scrubbed” to exclude partial period or statistically aberrant data elements for individual hospitals or health systems. It also excludes Federal Government hospitals, specialty hospitals (e.g., long-term acute care) and general acute care hospitals for which 30% or more of its total licensed beds are comprised of sub-acute beds. This data validation process produces highly accurate and defensible peer group comparisons for dozens of standard industry metrics. This report measures several commonly used metrics to further stratify these hospital types into quartiles in order to illustrate the benchmarks for poor to exceptional performance for each of the metrics. With this information, one can quickly assess the relative financial well-being of any facility in any of these groups. HMP can easily create custom reports and mix or create new peer groups and compare them to state, local or national benchmarks. October 2010 3
  • 4. Executive Summary – Key Terms All hospitals: Represents over 3,000 short-term general acute care hospitals. Investor Owned hospitals: Represents short-term general acute care hospitals owned a for-profit chain or owned individually. Not-for-profit hospitals: Represents short-term general acute care hospitals identified as ‘not-for profit’ (e.g., 501c3). State and Local owned hospitals: Represents short-term general acute care hospitals controlled by state or local government. Children’s hospitals: Represents Children’s hospitals regardless of ownership type. Major Teaching hospitals: Represents hospital and health system members of the Association of American Medical Colleges. For health system members, ‘flagship’ medical centers were included while smaller affiliate community teaching hospitals were excluded. Quartile Rankings: Quartile rankings were assigned based on the mean values calculated for the hospitals within the peer groups. The first quartile contains the top 25% of the best performing hospitals in an applicable peer group, the second quartile contains those hospitals falling in the 26% to 50% range, the third quartile contains those hospitals falling in the 51% to 75% range, and finally the fourth quartile contains those hospitals falling below 76%. Mean Value: The mean value is the average of all amounts within a defined group. For example, 8 would be the mean value in an array of the numbers: 2, 4, 10, and 16. October 2010 4
  • 5. Executive Summary – Hospital Performance Metrics A measure of overall hospital profitability presented as a percentage. A negative percentage Total Profit Margin indicates an overall loss, while a positive percentage indicates profitability. A measure of operating profitability presented as a percentage. A negative percentage Total Operating Profit Margin indicates overall loss, while a positive percentage indicates profitability. A measure of labor productivity. This metric divides labor costs by operating revenues. A Total Labor Cost as a Percentage of higher percentage compared to its peers indicates that a hospital uses more labor to produce its Total Operating Revenues revenue. Measures the number of full-time equivalent (FTE) employees used for each occupied bed. Full-Time Equivalent (FTE) Staff per Similar to the previous ratio, a higher percentage compared to its peers indicates that a hospital Adjusted Occupied Bed (AOB) uses more labor to treat its patients. Measures the number of days it typically takes to collect accounts receivable. A higher Average Days Net Patient Revenue in percentage compared to its peers indicates that the hospital's revenue cycle is not as efficient as Accounts Receivable (AR) its peers. Measures the average age of the hospital including capital improvements and major equipment Average Age of Plant purchases. A higher age compared to its peers indicates that the hospital has deferred the replacement of its capital when compared to its peers, which can lead to further distress. Source: Metrics are based on data extracted from Medicare cost reports filed each year with the Federal Government. Accuracy of the data contained in the Medicare cost reports is certified by hospital management when the report is filed. Any changes resulting from desk or field audits by Medicare and subsequently included in the Hospital Cost Report Information System (HCRIS) database have also been reflected in the calculations. Excludes partial-year Medicare cost reports, hospitals where 30% or more of total inpatient beds are non-acute, and hospitals where the computed metric is more than 2 standard deviations from the mean. October 2010 5
  • 6. Total Profit Margin 6-Year Metric Trend 10.00% 9.00% 8.00% 7.00% 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% 2004 2005 2006 2007 2008 2009 All Investor Owned Not-For-Profit State and Local Govt. Owned Childrens Major Teaching Peer Quartiles - FY 2009 20.00% 17.00% 14.00% 11.00% 8.00% 5.00% 2.00% -1.00% -4.00% -7.00% -10.00% State and Local All Investor Owned Not-For-Profit Childrens Major Teaching Govt. Owned 1st Quartile 13.40% 19.16% 11.42% 9.94% 17.11% 12.03% 2nd Quartile 4.85% 10.43% 4.04% 3.56% 8.96% 5.65% 3rd Quartile 0.57% 4.30% 0.15% -0.03% 4.09% 1.54% 4th Quartile -6.80% -4.48% -7.04% -7.07% -5.18% -7.25% October 2010 6
  • 7. Total Operating Profit Margin 6-Year Metric Trend 7.00% 6.00% 5.00% 4.00% 3.00% 2.00% 1.00% 0.00% -1.00% -2.00% -3.00% -4.00% -5.00% -6.00% 2004 2005 2006 2007 2008 2009 All Investor Owned Not-For-Profit State and Local Govt. Owned Childrens Major Teaching Peer Quartiles - FY 2009 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% -5.00% -10.00% -15.00% -20.00% State and Local All Investor Owned Not-For-Profit Childrens Major Teaching Govt. Owned 1st Quartile 12.32% 20.03% 9.60% 5.89% 13.11% 9.85% 2nd Quartile 2.24% 10.48% 1.71% -1.86% 3.60% 1.98% 3rd Quartile -2.91% 2.85% -2.54% -7.38% -3.56% -3.08% 4th Quartile -11.94% -7.79% -10.89% -16.15% -13.01% -12.77% October 2010 7
  • 8. Days Net Patient Revenue in Accounts Receivable (AR) 6-Year Metric Trend 63.00 61.00 59.00 57.00 55.00 53.00 51.00 49.00 47.00 45.00 2004 2005 2006 2007 2008 2009 All Investor Owned Not-For-Profit State and Local Govt. Owned Childrens Major Teaching Peer Quartiles - FY 2009 80.00 75.00 70.00 65.00 60.00 55.00 50.00 45.00 40.00 35.00 30.00 State and Local All Investor Owned Not-For-Profit Childrens Major Teaching Govt. Owned 1st Quartile 33.71 35.31 32.36 36.74 36.30 34.74 2nd Quartile 44.91 45.42 43.26 49.30 46.34 44.70 3rd Quartile 53.16 53.21 50.64 59.47 53.29 51.48 4th Quartile 70.26 70.09 65.65 78.31 72.15 68.09 October 2010 8
  • 9. Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) 6-Year Metric Trend 7.00 6.50 6.00 5.50 5.00 4.50 4.00 3.50 2004 2005 2006 2007 2008 2009 All Investor Owned Not-For-Profit State and Local Govt. Owned Childrens Major Teaching Peer Quartiles - FY 2009 8.00 7.50 7.00 6.50 6.00 5.50 5.00 4.50 4.00 3.50 3.00 State and Local All Investor Owned Not-For-Profit Childrens Major Teaching Govt. Owned 1st Quartile 3.45 3.21 3.61 3.42 3.79 4.59 2nd Quartile 4.37 3.93 4.55 4.44 5.32 5.39 3rd Quartile 5.12 4.51 5.27 5.28 6.99 6.03 4th Quartile 6.48 5.76 6.55 6.61 7.78 7.21 October 2010 9
  • 10. Total Labor Cost as a Percentage of Net Operating Revenues 6-Year Metric Trend 55.00% 53.50% 52.00% 50.50% 49.00% 47.50% 46.00% 44.50% 43.00% 41.50% 40.00% 2004 2005 2006 2007 2008 2009 All Investor Owned Not-For-Profit State and Local Govt. Owned Childrens Major Teaching Peer Quartiles - FY 2009 65.00% 60.00% 55.00% 50.00% 45.00% 40.00% 35.00% 30.00% State and Local All Investor Owned Not-For-Profit Childrens Major Teaching Govt. Owned 1st Quartile 37.97% 34.05% 40.16% 41.26% 36.38% 41.26% 2nd Quartile 45.71% 39.04% 46.99% 49.08% 42.20% 47.39% 3rd Quartile 51.58% 44.26% 52.13% 54.76% 49.55% 52.08% 4th Quartile 59.40% 53.87% 59.19% 62.18% 58.19% 59.05% October 2010 10
  • 11. Average Age of Plant and Equipment 6-Year Metric Trend 11.50 11.00 10.50 10.00 9.50 9.00 8.50 8.00 7.50 7.00 6.50 6.00 5.50 5.00 2004 2005 2006 2007 2008 2009 All Investor Owned Not-For-Profit State and Local Govt. Owned Childrens Major Teaching Peer Quartiles - FY 2009 18.00 16.00 14.00 12.00 10.00 8.00 6.00 4.00 2.00 0.00 State and Local All Investor Owned Not-For-Profit Childrens Major Teaching Govt. Owned 1st Quartile 3.63 2.12 4.90 4.55 4.55 6.11 2nd Quartile 7.70 4.83 8.65 8.31 6.85 9.02 Notes:3rd Quartile 10.59 8.23 11.28 10.99 8.30 11.25 • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • ExcludesQuartile 4th Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed 15.92 comprised of sub13.26beds. 15.39 12.96 15.75 beds are acute 15.57 October 2010 11
  • 12. Metric Trend by Peer Group Year 2009 2008 2007 2006 2005 2004 Total Profit Margin All 2.98% 2.26% 4.56% 4.24% 3.86% 3.28% Investor Owned 7.22% 6.20% 6.57% 6.46% 6.39% 5.79% Not-For-Profit 2.11% 1.08% 4.31% 3.79% 3.45% 2.83% State and Local Government Owned 1.53% 1.86% 3.40% 3.37% 2.64% 2.22% Childrens 5.52% 3.81% 9.36% 7.28% 7.17% 6.46% Major Teaching 2.83% 0.85% 5.20% 4.82% 3.75% 3.20% Total Ope rating Profit Margin All -0.10% -0.59% -0.21% -0.38% -0.29% -0.81% Investor Owned 6.26% 5.67% 5.16% 4.87% 4.86% 4.43% Not-For-Profit -0.54% -1.29% -0.79% -1.07% -0.76% -1.46% State and Local Government Owned -4.97% -4.82% -4.02% -3.75% -4.16% -4.22% Childrens -0.57% -0.51% 0.17% -1.60% 0.03% -1.91% Major Teaching -1.21% -2.82% -2.17% -2.15% -2.88% -3.27% Days Ne t Patie nt Re ve nue in Accounts Re ce ivable (AR) All 50.52 53.55 54.66 55.28 54.62 56.31 Investor Owned 51.21 54.36 55.61 57.77 57.08 57.91 Not-For-Profit 48.04 51.18 52.08 52.45 51.95 53.89 State and Local Government Owned 56.15 59.44 61.10 60.88 59.92 61.77 Childrens 52.85 54.83 56.89 56.66 57.89 55.18 Major Teaching 49.98 52.89 52.44 52.88 52.94 54.40 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 12
  • 13. Metric Trend by Peer Group Year 2009 2008 2007 2006 2005 2004 Full-Time Equivalent (FTE) Staff per Adjusted Occupied Bed (AOB) All 4.86 4.86 4.82 4.82 4.77 4.78 Investor Owned 4.37 4.43 4.39 4.40 4.29 4.28 Not-For-Profit 5.00 4.97 4.93 4.94 4.88 4.89 State and Local Government Owned 4.95 4.97 4.93 4.92 4.94 4.99 Childrens 6.11 6.40 6.44 6.32 6.40 6.35 Major Teaching 5.83 5.78 5.71 5.75 5.70 5.66 Total Labor Cost as a Percentage of Net Operating Revenues All 48.69% 49.54% 49.61% 49.67% 49.79% 50.45% Investor Owned 42.93% 43.97% 44.17% 44.42% 44.85% 45.25% Not-For-Profit 49.66% 50.47% 50.54% 50.59% 50.53% 51.44% State and Local Government Owned 51.90% 52.59% 52.46% 52.36% 52.85% 52.88% Childrens 47.25% 47.39% 47.10% 46.73% 48.21% 48.10% Major Teaching 50.16% 51.31% 50.73% 50.82% 50.75% 51.45% Average Age of Plant and Equipment All 9.34 9.32 9.35 9.40 9.47 9.05 Investor Owned 7.11 6.42 6.29 6.06 6.18 5.58 Not-For-Profit 10.17 10.22 10.25 10.30 10.32 9.63 State and Local Government Owned 10.01 10.25 10.46 10.77 10.64 10.38 Childrens 8.55 8.57 9.24 9.01 8.45 8.75 Major Teaching 10.60 10.62 10.79 10.44 10.47 9.44 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 13
  • 14. Quartiles by Peer Group Peer Group Summary by Quartile (Quartile Grouping) For the Year 2009 All Investor Owned Not-For-Profit Metric 1st 2nd 3rd 4th 1st 2nd 3rd 4th 1st 2nd 3rd 4th Overall Profit Margin 13.40% 4.85% 0.57% (6.80%) 19.16% 10.43% 4.30% (4.48%) 11.42% 4.04% 0.15% (7.04%) Operating Profit Margin 12.32% 2.24% (2.91%) (11.94%) 20.03% 10.48% 2.85% (7.79%) 9.60% 1.71% (2.54%) (10.89%) Total Labor Cost as a % of Net Operating Rev. 37.97% 45.71% 51.58% 59.40% 34.05% 39.04% 44.26% 53.87% 40.16% 46.99% 52.13% 59.19% Days Net Patient Revenue in AR 33.71 44.91 53.16 70.26 35.31 45.42 53.21 70.09 32.36 43.26 50.64 65.65 FTEs per AOB 3.45 4.37 5.12 6.48 3.21 3.93 4.51 5.76 3.61 4.55 5.27 6.55 Average Age of Plant and Equipment 3.63 7.70 10.59 15.39 2.12 4.83 8.23 12.96 4.90 8.65 11.28 15.75 State and Local Government Childrens Major Teaching Metric 1st 2nd 3rd 4th 1st 2nd 3rd 4th 1st 2nd 3rd 4th Overall Profit Margin 9.94% 3.56% (0.03%) (7.07%) 17.11% 8.96% 4.09% (5.18%) 12.03% 5.65% 1.54% (7.25%) Operating Profit Margin 5.89% (1.86%) (7.38%) (16.15%) 13.11% 3.60% (3.56%) (13.01%) 9.85% 1.98% (3.08%) (12.77%) Total Labor Cost as a % of Net Operating Rev. 41.26% 49.08% 54.76% 62.18% 36.38% 42.20% 49.55% 58.19% 41.26% 47.39% 52.08% 59.05% Days Net Patient Revenue in AR 36.74 49.30 59.47 78.31 36.30 46.34 53.29 72.15 34.74 44.70 51.48 68.09 FTEs per AOB 3.42 4.44 5.28 6.61 3.79 5.32 6.99 7.78 4.59 5.39 6.03 7.21 Average Age of Plant and Equipment 4.55 8.31 10.99 15.92 4.55 6.85 8.30 13.26 6.11 9.02 11.25 15.57 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 14
  • 15. Quartiles by Peer Group Peer Group Summary by Quartile (Peer Grouping) For the Year 2009 1st Quartile 2nd Quartile Metric Major Major All IO NFP GSL Childrens All IO NFP GSL Childrens Teaching Teaching Overall Profit Margin 13.40% 19.16% 11.42% 9.94% 17.11% 12.03% 4.85% 10.43% 4.04% 3.56% 8.96% 5.65% Operating Profit Margin 12.32% 20.03% 9.60% 5.89% 13.11% 9.85% 2.24% 10.48% 1.71% (1.86%) 3.60% 1.98% Total Labor Cost as a % of Net Operating Rev. 37.97% 34.05% 40.16% 41.26% 36.38% 41.26% 45.71% 39.04% 46.99% 49.08% 42.20% 47.39% Days Net Patient Revenue in AR 33.71 35.31 32.36 36.74 36.30 34.74 44.91 45.42 43.26 49.30 46.34 44.70 FTEs per AOB 3.45 3.21 3.61 3.42 3.79 4.59 4.37 3.93 4.55 4.44 5.32 5.39 Average Age of Plant and Equipment 3.63 2.12 4.90 4.55 4.55 6.11 7.70 4.83 8.65 8.31 6.85 9.02 3rd Quartile 4th Quartile Metric Major Major All IO NFP GSL Childrens All IO NFP GSL Childrens Teaching Teaching Overall Profit Margin 0.57% 4.30% 0.15% (0.03%) 4.09% 1.54% (6.80%) (4.48%) (7.04%) (7.07%) (5.18%) (7.25%) Operating Profit Margin (2.91%) 2.85% (2.54%) (7.38%) (3.56%) (3.08%) (11.94%) (7.79%) (10.89%) (16.15%) (13.01%) (12.77%) Total Labor Cost as a % of Net Operating Rev. 51.58% 44.26% 52.13% 54.76% 49.55% 52.08% 59.40% 53.87% 59.19% 62.18% 58.19% 59.05% Days Net Patient Revenue in AR 53.16 53.21 50.64 59.47 53.29 51.48 70.26 70.09 65.65 78.31 72.15 68.09 FTEs per AOB 5.12 4.51 5.27 5.28 6.99 6.03 6.48 5.76 6.55 6.61 7.78 7.21 Average Age of Plant and Equipment 10.59 8.23 11.28 10.99 8.30 11.25 15.39 12.96 15.75 15.92 13.26 15.57 Notes: • Excludes partial-year cost reports and those cost reports deemed to be outliers (e.g., values greater than two standard deviations from the mean of the reported population). • Excludes Federal, specialty hospitals and general acute care hospitals for which 30% or more of total licensed beds are comprised of sub acute beds. October 2010 15
  • 16. Introduction to Healthcare Management Partners Who We Are HMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experience including CEO, COO and CFO assignments across the spectrum of healthcare service providers. Our senior management has deep experience in building and operating thriving healthcare organizations. Part of that experience includes taking decisive action in crises or turnaround situations. This knowledge base gives HMP a unique perspective and all the tools necessary to handle the issues facing any healthcare provider organization. HMP provides Hospital Contract Management, Turnaround Management and Interim or Crisis Management services. Our Approach Our approach to every assignment is built upon the straightforward application of three simple steps or guiding principles. Listen – We listen carefully to our clients, their key stakeholders and the marketplace throughout each assignment. Evaluate – We employ detailed, fact-based analysis to evaluate and validate assumptions, findings and recommended actions. Implement – We have a bias toward “getting it done.” We take decisive action to quickly convert opportunities or solve problems . The HMP Difference Total commitment to providing C-Level attention throughout each assignment by experienced healthcare executives Small, dedicated teams of operating professionals for each assignment Absolute integrity of our fact-based approach Action-oriented diagnostic and business planning processes Proven ability to drive positive outcomes in all sectors of healthcare Depth of HMP network, providing critical access to key resources and people Commitment to the highest professional standards October 2010 16
  • 17. Introduction to Healthcare Management Partners Management Services HMP is a hospital and healthcare services management firm. All of its senior executives have decades of healthcare experience including CEO, COO and CFO assignments across the spectrum of health services. Examples of specific assignments include serving as the Chief Executive Officer (CEO) of the following types of healthcare organizations: Religious affiliated or sponsored multihospital systems Free standing not-for-profit or government owned community hospitals University and major teaching hospitals Single site and multihospital regional operations for investor owned hospital management companies De Novo organizations (start-up) planning, construction and operation of new general acute care hospitals, free-standing heart and cancer hospitals, a continuing care retirement community and many other related facilities Hospitals that are in bankruptcy or for sale Financially distressed skilled nursing facilities Home health, hospice and physician practices “HMP’s senior staff members are professional healthcare service executives who also possess consulting skills, not professional consultants. We understand and are committed to the provision of quality healthcare services at every provider organization where we have a management role.” October 2010 17
  • 18. Introduction to Healthcare Management Partners Hospital Contract Management HMP is positioned to undertake the long-term (3 to 5 years) contract management of hospitals of all sizes and stages of development. Our executives are experienced in leading the development of new or replacement general acute care or specialty hospitals or the turnaround and repositioning of existing hospitals. They can effectively lead initiatives in the following areas: Strategic Leadership Clinical Excellence Operational Excellence Financial Performance Market Positioning Clinical Process Redesign Patient Throughput Revenue Cycle Brand Development Evidence‐Based Care Emergency Department Clinical Business Office Consolidation Efficiency Service Line Development Resource Utilization and Cost of Surgical Services Clinical Managed Care Contracting Quality Efficiency Capital Planning and Investment Pay for Performance Inpatient Length of Stay and Level Risk Management and Insurance of Care Physician Relations Care and Case Management Human Resources Management Budgeting / Financial Planning Processes Physician Integration Quality and Safety Indicators Ambulatory Care Capital Programs Continuum of Care Design and Implementation Hospice and Home Care Supply Chain Strategic Plans Corporate and Medical Staff Mission and Vision Best Practices and Operating Financial Reporting and Accounting Governance Metrics We will be directly accountable to the board of directors and will assume full responsibility to plan, organize, staff, direct and control the successful and cost effective operations of the hospital. Because HMP is not a management consulting firm, our contract management executives are free to always bring the best and most cost-effective solution, from whatever source, to the hospital should outside assistance prove necessary to implement a given strategic or tactical initiative. October 2010 18
  • 19. Introduction to Healthcare Management Partners Turnaround Management HMP’s executives have served as chief restructuring officers of healthcare companies through bankruptcies, crisis situations and in the early stages of high-profile criminal and civil fraud investigations. In each of these situations, their leadership helped these organizations bolster performance through discipline and carefully planned action. Some consultants assess your problems and provide a recommended course of action. But HMP executives take the helm of failing organizations and assume direct responsibility for transforming them. Time and again, they have succeeded in revitalizing providers of all kinds, from a rural nursing home chain to a 1,000 bed teaching hospital or a 179 bed county owned community hospital. There are no quick fixes in turnaround management, but HMP has developed a highly effective, streamlined approach for achieving lasting improvements as soon as possible. We begin by developing a strong knowledge base of your organization. Individuals from every level of the organization are interviewed: management, medical and nursing staff members, board of directors, employees, patients and their families. Their input, combined with a depth of healthcare industry knowledge, allows HMP to: Stabilize the crises, Identify immediate opportunities and challenges, Develop a strategic plan, including milestones and deadlines, Define expected outcomes, Build consensus with all constituents – medical and nursing staffs, management, unions, and the local community, Change cultures, and Optimize performance. In all of its healthcare provider turnaround assignments, HMP has successfully designed and executed plans that simultaneously added patient volume and revenues, reduced costs and improved profitability and cash flow. From the outset, HMP builds on each organization’s strengths, working side‐by‐side with management, directors and other key stakeholders to drive desired results. HMP also focuses on winning the support and active participation of the medical and nursing staffs, which is fundamental for delivering quality healthcare services and improving financial results. October 2010 19
  • 20. Introduction to Healthcare Management Partners Interim and Crisis Management HMP serves in interim and crisis management roles when required to help guide providers through periods of crisis or change. Companies that are underperforming and in crisis, or healthy but in transition, may need additional experienced healthcare industry leaders to stabilize operations and improve financial performance or maintain continuity in the rapid implementation of critical strategic initiatives. Our professionals can offer critical advice or step into key leadership positions such as Chief Restructuring Officer, Chief Financial Officer, or Chief Executive Officer to provide needed stability during periods of change. Our proven interim management capabilities add valuable support in crisis situations. We immediately fill critical leadership vacancies and shorten the lead‐time for implementing specific initiatives. HMP provides much needed leadership and speed to create value in executing crisis management and restructuring plans. Our crisis and interim management services include: Immediate staffing of critical senior management positions Reducing lead‐time for implementing strategic initiatives Managing communications processes with Members of the medical and nursing staffs, board members, employees and regulators, and if required Bankruptcy process planning and administration October 2010 20
  • 21. Clients Our Professionals Have Served Not-For-Profit or Governmental Hospitals or Systems Baylor College of Medicine Hahnemann University New York United Hospital Southern Chester County Hospital Medical Center Medical Center The Brooklyn Hospital Center Health Alliance of Cincinnati Nyack Hospital St Vincent’s Catholic Medical Centers, New York Devereux Foundation National Health Service, Rahway Hospital Temple Health System United Kingdom Franciscan Health System Legacy Health System Raritan Bay Health System Tri‐Lakes Medical Center General Health System Mercy Health System Robert Wood Johnson Health University Hospital Network Consortium of Pennsylvania Good Samaritan Hospital Natchez Regional Medical Sisters of Mercy Health System Center Investor Owned Hospitals or Health Systems Ameris Health Systems Health South Corporation Integrated Healthcare Shasta Regional Medical Holdings, Inc. Center Doctors Hospital, Houston Hospital Corporation of Lakeside Hospital at Bastrop St. Joseph Hospital, Houston America Doctors Hospital, Los Angeles Hugh Chatham Memorial LifePoint Hospitals Tenet Healthcare Corporation Hospital HealthPlus Hughston Hospital and Clinic Monroe Hospital, LLC Vanguard Health Systems Hospital Partners of America Integra Healthcare Promise Healthcare October 2010 21
  • 22. Clients Our Professionals Have Served Senior Care and/or Continuing Care Retirement Communities Grace Care of Texas Monarch Landing, Inc. Jenner’s Pond Continuing Care Retirement Community National Senior Campuses (Erickson Retirement Communities) Life Care Centers of America Sedgebrook, Inc. Linden Ponds, Inc. St. Edward Mercy Health Systems (Ft. Smith, AR) Mercy Hospitals of Texas St. Johns Nursing Home (St. Louis, MO) Law and Accounting Firms Bird Marella LLP Deloitte Kantrow, Spaht, Weaver & Blitzer Patton Boggs Bradley Arant Boult Cummings Gearhiser, Peters, Lockaby, Cavett KPMG Ramirez International, Inc. LLP & Elliott, PLLC Brown McCarroll LLP Hogan & Hartson LLP Latham & Watkins Whiteford Taylor Preston, LLP Fulbright & Jaworski LLP Hooper, Lundy & Bookman Mancuso & Franco PC Schiavetti, Corgan, Soscia, DiEdwards and Nicholson, LLP Decosimo Jones Day Milbank, Tweed, Hadley and Waller Lansden Dortch & Davis McCloy LLP Other Providers / Payors Blue Cross of Tennessee Best Choice Home Health Community Behavioral Health Columbia Home Care Network of PA October 2010 22
  • 23. Firm Leadership Scott Phillips Title Managing Director Education B.S. from University of Florida CPA Boards & Organizations American Bankruptcy Institute Healthcare Subcommittee Chair Telephone 267.207.2929 Mobile 267.804.3885 E-Mail sphillips@hcmpllc.com Scott has more than 30 years of healthcare industry management and consulting experience. Prior to founding HMP in 1997, he served as the president and chief executive officer of a 636-bed academic medical center, as national partner and regional healthcare practice director for Touche Ross & Co., and as the chief financial officer of a faith-based multihospital system operating 12 hospitals across seven states. Scott has significant management and consulting experience with government, tax-exempt and investor owned healthcare service providers. He understands the organization and delivery of high-quality health services, including the role of corporate and medical staff governance during difficult periods of transition. Scott has executive level experience with mergers, acquisitions and turnaround situations, including restructuring in bankruptcy. In all of his many healthcare provider turnaround assignments, he has successfully designed and implemented plans that simultaneously added patient volume and revenues while conserving cash and reducing unit costs. He understands this approach builds on the organization’s strengths and attracts the support of the local community and medical and nursing staffs, which is essential for the long-term provision of quality healthcare services. Over the past several years, Scott has served as the chairman and CEO of an investor owned healthcare provider with operations in 15 states and chief executive officer of a publicly traded medical staffing company with more than 2,000 employees. Both turnaround assignments included the crises management of complex organizations in the early stages of high-profile criminal and civil fraud investigations by multiple federal agencies. Scott has expert knowledge of the bankruptcy process as well as its implications and obligations on an operating provider of healthcare services. He recently led the successful financial turnaround and Chapter 9 reorganization of a 179-bed county-owned hospital. Recently he was the financial advisor to 18 tax-exempt continuing care retirement communities with more than 20,000 residents in twelve states, affected by the bankruptcy and sale of Erickson Retirement Communities. Scott graduated from the University of Florida with a Bachelor of Science in accounting. He is a licensed certified public accountant and member of numerous professional organizations. He is currently serving Leader Special Projects, Healthcare Committee, American Bankruptcy Institute. October 2010 23
  • 24. Firm Leadership Michael Morgan Title Managing Director Education MBA from University of Central Oklahoma B.S. from University of Science and Arts of Oklahoma Boards & Organizations Fellow of American College of Healthcare Executives Telephone 713.968.6521 Mobile 214.701.9990 E-Mail mmorgan@hcmpllc.com Michael is a former hospital chief executive officer with more than 30 years of experience in healthcare management. He brings expertise and talent for turning around ailing healthcare providers and optimizing healthy organizations. In his 25-year career at the Sisters of Mercy Health System, Michael was responsible for turning around five of the system’s 19 hospitals. He served as president and chief executive officer for several Sisters of Mercy hospitals, including St. John’s Mercy Health Care, which has over $800 million in operating revenues, employs more than 8,000 individuals and includes the system’s flagship 957-bed teaching hospital. As the CEO, he has set successful new strategies, improved clinical and administrative operations and changed organizational cultures. His trademark is developing capable management teams that in turn increase service quality, employee and medical staff satisfaction, patient volume, profitability and maximize cash flow. After leaving the Sisters of Mercy system, Michael served as the chief restructuring officer and CEO for a two-hospital, investor owned system in Texas. In eight months, he led the successful turnaround, emergence from bankruptcy and recapitalization of the hospitals by a physician-led limited partnership. He led the turnaround of a chain of five nursing homes in Texas and the bankruptcy turnaround of a two-campus, acute-care hospital in Mississippi. He was the oversight Managing Director for a two-campus rehab and specialty hospital chapter 11 bankruptcy. He also recently served as the CRO for three individual CCRC’s under a large CCRC management company bankruptcy, and provided financial advisory services for a large investment banking group on a 500-bed hospital system. Michael holds a Bachelor of Science in business administration from the University of Science and Arts of Oklahoma and a Master of Science in business administration from the University of Central Oklahoma. He is a fellow of the American College of Healthcare Executives and has served as an officer or director of numerous hospitals and business organizations, including a 280,000-member for-profit health insurance plan. October 2010 24
  • 25. Firm Leadership Bruce Buchanan Title Managing Director Education MBA from George Mason University MHSA from University of Michigan B.A. from Princeton University Boards & Organizations Fellow of American College of Healthcare Executives Mobile 602.363.1140 Fax 866.794.9501 E-Mail bbuchanan@hcmpllc.com Bruce has more than 30 years of experience in the healthcare field and is a senior healthcare executive with a successful track record in both the not- for-profit and investor owned sectors. He possesses multimarket experience at the hospital and health system chief executive officer level. He has deep experience and expertise in revenue growth, physician collaboration/integration, organizational development, productivity improvement and quality enhancement. Before joining HMP, Bruce served as CEO of Phoenix Baptist Hospital, where he turned around the distressed 236-bed teaching hospital by reducing operating costs while enhancing the quality of care. Bruce led a similar turnaround of Northeast Baptist Hospital in San Antonio, including recruiting new physicians, doubling the hospital’s physical space and growing market share. He also served as president and CEO of Atlanta Medical Center and Mercy Health System Oklahoma and its Mercy Health Center in Oklahoma City. Bruce also held senior management positions with Hillcrest Healthcare System and Saint Joseph Hospital and worked for Invalesco Group as an operations consultant to healthcare organizations. Most recently with HMP, Bruce served as Chief Restructuring Officer for a rehabilitation hospital company with two facilities. He successfully led the company through a Chapter 11 bankruptcy process and a Section 363 sale to a new, privately held owner. He also served as CEO of a county hospital and guided it through a Chapter 9 bankruptcy, which resulted in all unsecured creditors receiving three year notes for full payment plus interest. Bruce has a Bachelor of Arts in sociology from Princeton University, a Master of Health Services Administration from University of Michigan, and a Master of Business Administration from George Mason University. He is board-certified in healthcare management and a Fellow in the American College of Healthcare Executives. He also is a member of the Turnaround Management Association. October 2010 25
  • 26. Firm Leadership Derek Pierce Title Managing Director Education B.S. from Samford University Telephone 205.202.0459 Mobile 615.584.0719 E-Mail dpierce@hcmpllc.com Derek has over 20 years of professional experience focused solely in the healthcare industry, having served as chief financial officer, chief restructuring officer, director of reimbursement, court-appointed examiner, Medicare auditor, Medicare cost report preparer, forensic accountant, compliance consultant, financial auditor, and financial advisor. He has audited, managed and consulted with all types of healthcare providers, including government owned, community not-for-profit, academic, and investor owned entities. Most recently, Derek served as the restructuring chief financial officer of a two-campus, not-for-profit hospital in Chapter 11 bankruptcy. In addition to his CFO responsibilities, he led the Section 363 sale process and conducted a forensic review into the circumstances that led to the hospital’s bankruptcy filing. Throughout the project, Derek worked closely with senior lenders, debtor-in-possession lenders and the applicable federal loan program to a successful plan of reorganization. Starting his career with the Medicare fiscal intermediary as a Medicare auditor, Derek developed deep expert knowledge of the patient revenue cycle, third-party contracting, and Medicare and Medicaid rules and regulations. He is expert in the areas of corporate and regulatory compliance and forensic accounting in conjunction with the defense of civil and criminal fraud claims or allegations. He led teams conducting forensic analysis in support of settlement negotiations with the government at both Hospital Corporation of America (HCA) and HealthSouth Corporation, two of the largest and most complex civil fraud settlements in history. In his career, Derek has led or participated in interim management and consulting assignments for more than 40 healthcare providers, including Baptist Memorial Health Care, National Health Service (United Kingdom) Washington Hospital Center, Lifepoint Hospitals, Tampa General Hospital, Legacy Health System and IASIS Healthcare. Prior to joining HMP as a managing director, Derek was a Director with Alvarez & Marsal in its New York-based healthcare practice. Before that, he was a senior manager with Arthur Andersen in its Atlanta-based healthcare consulting practice. Derek is a graduate of Samford University with a Bachelor of Science in accounting and is a member of numerous professional associations. October 2010 26
  • 27. Contact Information Philadelphia New York Houston • Contact: Scott Phillips • Contact: Nihal Shah • Contact: Mike Morgan Managing Director Director Managing Director • Address: • Address: • Address: One Liberty Place 1185 Avenue of the Americas 5100 Westheimer 1650 Market Street 30th Floor Suite 200 36th Floor New York, NY 10036 Houston, TX 77056 Philadelphia, PA 19103 • Phone: 212.461.4243 • Phone: 713.968.6521 • Phone: 267.804.3885 • Fax: 212.461.4252 • Fax: 866.422.6176 • Fax: 215.689.4386 Birmingham Phoenix London, UK • Contact: Derek Pierce • Contact: Bruce Buchanan • Contact: Tim Bolot Managing Director Managing Director Managing Director • Address: • Address: • Address: 2001 Park Place, Suite 1400 243 E. Glenn Drive Bolt Partners LLP Birmingham, AL 35203 Phoenix, AZ 85020 192 Haverstock Hill, • Phone: 205.202.0459 • Mobile: 602.363.1140 Belsize Park, • Fax: 615.523.1835 • Fax: 866.794.9501 London NW3 2AJ • Phone: +44 (0)20 7435 7349 October 2010 27