FY’17 Budget Overview - Green Mountain Care...

FY’17 Budget OverviewImproving Community Health

Through Prevention and Local Access to the Right Care

NMC’s vision is to be nationally recognized for excellence and value as we partner to improve the wellness of our community and become a destination of choice for patients, staff, & providers.

Caring for Our Community

NMC provides exceptional care for our community – 55,000 people in northwestern VT.

Our top priority health needs:

• Mental Health & Substance Abuse

• Obesity• Smoking• Cancer• Suicide• Domestic &

Sexual Abuse

The growth in our community is among those over 65, with that sector growing even faster than the VT and US trends

2

Strategically Positioning NMC for the Future:

Board of Directors, Medical Staff, hospital staff, and community stakeholders established our strategic positioning and a new strategic plan, focused on:

• Providing Exceptional Care

• Valuing our Staff and our Medical Staff

• Achieving a Sustainable Operating Model

• Strategic Positioning:• Primary Care• Mental Health &

Addiction• Surgical Specialists• Medical Specialists• Population Health

3

Local Access to the Right CareThrough Strategic Partnerships

Active discussions with UVMMC include the possibilities of:

• Endocrinology (adult/pediatric)

• ENT

• Neurology

• Rheumatology

• Allergy

• Wound

• Potential post-op follow up visits.

4

Leading the Way in Primary Prevention

RiseVTis a community collaborative to

embrace healthier lifestyles, improve the

quality of life, and lower healthcare costs where we live, work,

learn, and play.

Lowering Obesity Is Crucial to Improved Health

Franklin County = 27% Vermont=23%

5

Making Promising Progress On Population Health

Primary Care & Care Management Year to Date GoalHCAHPS Care Transition from hospital to home, with continuing care support

61.88 61.63%

% change in avoidable visits with charge level of 1,2, or 3 (of 6 levels)

-21.02%5% reduction in avoidable visits

Readmission to NMC for all-cause conditions 6.99% < 9.2 %

Average length of stay for admitted patients, excluding swing beds and observation patients

2.91 < 3.23

Screening for Clinical Depression and Follow-up Plan 69.23% 61.39%

Adult Weight Screening & Follow-up52% 73.54%

Falls: Screening for Fall Risk 43% 39.99%

Blood Pressure Screening37% 59.58%

Lifestyle Medicine Clinic Pilots Year to Date Goal

Average weight-loss per at-risk cohort participant 9 pounds 8 pounds

Average waist circumference reduction per at-risk cohort participant

1.5 inches 1.5 inches

Average cholesterol reduction per at-risk cohort participant

12.0 point decrease

13.3 point decrease

Average systolic/diastolic blood pressure reduction per at-risk cohort participant

2.25 systolic1.06 diastolic

12 systolic 6 diastolic

FY'16 Population Health Projects:Progress over 9 Months

Wellness Specialist Embedded in School Year to Date GoalNumber of students walking or biking to/from school in targeted at-risk school

22% increase(32% up from 10%)

20% increase

Number of staff involved in wellness program in targeted at-risk school

Now at 100% 25% increase

Number of student and staff using school walking path in targeted at risk school

Now at 100% 30% increase

Healthy Roots Expansion Year to Date GoalFood distribution sites providing gleaned healthy fresh local foods

10 5

Pounds of healthy food gleaned from local farms and consumed by vulnerable populations

2,853 1,500

Local counties served by online farmers’ market with fresh local food

1 - had to rebuildFranklin County

2

Grand Isle residents served by online farmers’ market 0 100

Grand Isle growers/producers participating in online farmers’ market

0 8

Growers using the “season extending” cold storage site 7 6

Continued Reduction in Tobacco Use Year to Date GoalPercent of F/GI adult non-smokers not exposed to second hand smoke

No new BRFS Data yet

55%

Percent of adult tobacco users in F/GI making a quit attempt in year

No new BRFS Data yet

62%

Municipalities addressing youth prevention through advertising, or other point of sale/retail options

Swanton, Enosburg future possibilites

1

Status on the 24 indicators shared with GMCB in 2015:

6

Pursuing Alignment with International Best Practiceto Increase Sustainability & Impact of RiseVT

We are aligning with EPODE, an international evidence-based methodology for lowering childhood obesity.

RiseVT scored a promising 85 on EPODE’s initial

review, ranking us in their top 10 internationally.

7

C B P S P R E V E N T I O N N E T W O R K 8

The EPODE Model

Companies

Media

Schools

HealthProfessionnals

InfancyProfessionnals

LocalAssociations

Extra-curricularActivities

Other LocalActors

Localstakeholders

IndependentScientific

Committee InstitutionnalSupport

PrivatePartners

(Sponsors,NGOs...)

EPODECENTRAL

COORDINATIONMAYOR ElectedRepresentatives

LOCALPROJECTMANAGERLOCAL

STEERINGCOMMITTEE

Central level

Local level

8

PresenterPresentation NotesIn each country or region, EPODE promotes the involvement of a multi-level and multiple stakeholders approach at central level (endorsement from ministries, support from health groups, NGOs, and private partners) and benefits from the expertise and guidance of an independent scientific advisory board that provides general recommendations related to the implementation and the transferability of the methodology in other contexts. To put the EPODE methodology into practice, a central coordination team, using social marketing and organisational techniques, trains and coaches a local project manager appointed in each community by the local political leader (e.g. the Mayor) able to champion the programme. The role of the local project manager is to mobilize a multifaceted local steering committee and, by peer-to-peer dynamics, a diversity of local stakeholders especially in schools, pre-schools, extracurricular organizations and social network of associations, which are key settings to implement activities with children and families. So, the city or town is at the heart of the system. The social mobilization group dynamics, involving a wide diversity of local stakeholders should play a role in impacting on local living conditions of the family, in order to facilitate the adoption of healthier lifestyles.

Advice to national or central EPODE coordination:Do not want to measure everything;Create an “Evaluation and Monitoring” Roadmap; describe each step to be taken by central and local organisation;Continuous deliberation with EPODE coordination team and other EPODE cities on indicators and measurement of indicators;Create an “Evaluation and Monitoring of EPODE” Evaluation Course;Identify experts in community health promotion evaluation in each EPODE country;appoint an Evaluation Counsellor in the central coordination team;decide on the measurement of common indicators (give advice to communities)Ask for statistics to support evaluation set-up and in analysing the dataEstablish a local evaluation group responsible for the evaluation of the programme; key-stakeholders should be involved in this group to secure sustainability.

EPODE is a coordinated, capacity-building approach for communitiesEPODE’s goal is to enable community stakeholders to implement effective and sustainable strategies to prevent childhood obesity at local levelBy changing the social lifestyle norms and behaviours especially in the field of nutrition and physical activity Encouraging changes in the local environment to be less obesogenic

In the Epode methodology we have four pillars. The first one is: creating a political commitment. If we want to prevent obesity, we need a very strong political will at all level from national (parlimentaries, institutions..) to local level (mayors, governors deputy mayors). This is the first point. The second one is to mobilize resources: human and financial resources. The third is to have coordination and support services (as for example social marketing and communication expertise).The fourth: to have an evidence-based evaluation for what we are doing. All these four pillars are to implement effective and sustainable strategies to prevent childhood obesity through a bottom-up and top-down multistakeholder approach (démarrage animation).

Therefore in each country or region, the EPODE methodology promotes the involvement of multiple stakeholders at central level (endorsement from ministries, support from health groups, NGOs, and private partners) and the programme benefits from the expertise and guidance of an independent expert committee.

To put the EPODE methodology into practice, a central coordination team, using social marketing and organisational techniques, trains and coaches a local project manager appointed in each community by the mayor (or other local leader able to champion the programme). The role of the local project manager is to mobilize a wide diversity of local stakeholders, especially in schools, pre-schools, extracurricular organizations and social network of associations, which are key settings to implement activities with children and families. For this purpose, the local project manager coordinates a multifaceted local steering committee of local representatives from various fields (elected representatives, heads of municipal services, school professionals, and local partners). This committee meets on a regular basis to make key decisions, foster the implementation of activities and actions, and generate peer-to-peer dynamics.

Pursuing Collaboration to Bring RiseVT & EPODE Statewide for Broader Impact and Improved Sustainability

We are establishing a charter for a key stakeholders group to explore bringing RiseVTstatewide, including:

• NMC• UVM Medical Center• VAHHS• Brattleboro Memorial• OneCare VT• Blue Cross/Blue Shield• VT Department of Health

RiseVT directly aligns with Vermont’s 3-4-50 campaign.

9

Enhancing Access & Improving Quality in Response to Need:Laser-Focused on Outcomes

• Recruited a 3rd Physician for our addiction practice and preparing to collaborate with a new HUB in Franklin County

• Preserved access to Pediatrics• Achieved “Most Wired” status• Achieved “Baby Friendly” status (1 of only 2 in VT)• Recognition from UVMMC for STEMI excellence• Achieved National “Avatar” patient satisfaction awards• Redesigned current and future workflows using LEAN• Earned Quorum “Best Overall Performance” for 4 straight years

10

Actively Partnering in Healthcare Reform:Improving Quality, Bending the Cost Curve

• Actively engaged in Vermont Care Organization

• Leading role in the Unified Community Collaborative (community governance setting priorities and resources) and the Regional Clinical Performance Council (community connectedness and operationalizing priorities)

• Leading voice for the integration of prevention

• Using the Accountable Communities for Health initiative to ensure linkages among population health efforts

• Partnering with UVMMC (appropriate medical clinics)

• Partnering with BC/BS (Accountable Blue, Ambulatory Surgery, RiseVT)

11

Containing Hospital Costs, Investing in Access to Care:

• Hospital revenue growth over the last 5 years has averaged 1.1%;

• Physician practice revenue growth over the last 5 years has averaged 22.3%;

• In 2012 NMC had five physician services that represented $7.2 Million in NPR

• Orthopedics

• OB/GYN

• Primary Care

• General Surgery

• Ophthalmology12

Investing In Access to Local Care:

13

Chart1

FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012






Hospital Net Patient Revenue

Orthopedics

OB/GYN

Georgia Health Center

Primary Care

Associates in Surgery

Ophthalmology

Urology

Cardiology Services

Pulmonology Services

Comprehensive Pain

Dermatology

Pediatrics

NMC Revenue Growth2012 thru 2017in Millions

77740

3323

1367

990

793

593

150

0

0

0

0

0

0

78040

4049

1946

1165

831

622

621

0

0

0

0

0

0

78921

4036

2287

1314

1839

472

805

22

373

132

1097

0

0

81949

4421

2403

1527

1915

623

1021

690

498

207

1335

0

0

80704

5020

2520

1656

1948

592

1038

694

584

186

1118

798

1704

81586

5007

2438

1481

1784

551

1094

682

645

192

1326

1207

3080

Sheet1

Northwestern Medical Center, Inc.

Net Patient Revenue Detail

(Numbers In thousands)

FY2012FY2013FY2014FY2015FY2016FY2017

Northwestern Orthopedics3,3234,0494,0364,4215,0205,007

Northwestern OB/GYN1,3671,9462,2872,4032,5202,438

Northwestern Georgia Health Center9901,1651,3141,5271,6561,481

Northwestern Primary Care7938311,8391,9151,9481,784

Northwestern Associates in Surgery593622472623592551

Northwestern Ophthalmology1506218051,0211,0381,094

Northwestern Urology--22690694682

Northwestern Cardiology Services--373498584645

Northwestern Pulmonology Services--132207186192

Northwestern Comprehensive Pain--1,0971,3351,1181,326

Northwestern Dermatology----7981,207

Northwestern Pediatrics----1,7043,080

Physician Practice Net Patient Revenue7,2169,23412,37714,64017,85819,487

28.0%34.0%18.3%22.0%9.1%

22.28%

Hospital Net Patient Revenue77,74078,04078,92181,94980,70481,586

0.4%1.1%3.8%-1.5%1.1%

0.99%

Total Net Patient Revenue84,95687,27491,29896,58998,562101,073

Net Patient Revenue Growth2.73%4.61%5.80%2.04%2.55%

Average Net Patient Revenue Growth3.54%

Sheet2




FY2012FY2013FY2014FY2015FY2016FY2017

Hospital Net Patient Revenue$ 77,740$ 78,040$ 78,921$ 81,949$ 80,704$ 81,586

Orthopedics$ 3,323$ 4,049$ 4,036$ 4,421$ 5,020$ 5,007

OB/GYN$ 1,367$ 1,946$ 2,287$ 2,403$ 2,520$ 2,438

Georgia Health Center$ 990$ 1,165$ 1,314$ 1,527$ 1,656$ 1,481

Primary Care$ 793$ 831$ 1,839$ 1,915$ 1,948$ 1,784

Associates in Surgery$ 593$ 622$ 472$ 623$ 592$ 551

Ophthalmology$ 150$ 621$ 805$ 1,021$ 1,038$ 1,094

Urology$ - 0$ - 0$ 22$ 690$ 694$ 682

Cardiology Services$ - 0$ - 0$ 373$ 498$ 584$ 645

Pulmonology Services$ - 0$ - 0$ 132$ 207$ 186$ 192

Comprehensive Pain$ - 0$ - 0$ 1,097$ 1,335$ 1,118$ 1,326

Dermatology$ - 0$ - 0$ - 0$ - 0$ 798$ 1,207

Pediatrics$ - 0$ - 0$ - 0$ - 0$ 1,704$ 3,080

Sheet2

Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics

NMC Growth in Access to Physicians2012 thru 2017in Millions

Sheet3


Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics



Improving Access, Preventing Higher Cost Acute Care:

To improve local access to care NMC has stabilized key basic medical services to the community by adding these services:

• Urology• Cardiology• Pulmonology• Comprehensive Pain• Dermatology• Pediatrics

In the 2017 budget these six key services represent over $7.1 Million in Net Patient Revenue

14

Investing in Access to Local Care:

15

Chart1

FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012FY2012






Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics


3323

1367

990

793

593

150

0

0

0

0

0

0

4049

1946

1165

831

622

621

0

0

0

0

0

0

4036

2287

1314

1839

472

805

22

373

132

1097

0

0

4421

2403

1527

1915

623

1021

690

498

207

1335

0

0

5020

2520

1656

1948

592

1038

694

584

186

1118

798

1704

5007

2438

1481

1784

551

1094

682

645

192

1326

1207

3080

Sheet1




FY2012FY2013FY2014FY2015FY2016FY2017














28.0%34.0%18.3%22.0%9.1%

22.28%


0.4%1.1%3.8%-1.5%1.1%

0.99%




Sheet2




FY2012FY2013FY2014FY2015FY2016FY2017


Orthopedics$ 3,323$ 4,049$ 4,036$ 4,421$ 5,020$ 5,007

OB/GYN$ 1,367$ 1,946$ 2,287$ 2,403$ 2,520$ 2,438


Primary Care$ 793$ 831$ 1,839$ 1,915$ 1,948$ 1,784


Ophthalmology$ 150$ 621$ 805$ 1,021$ 1,038$ 1,094

Urology$ - 0$ - 0$ 22$ 690$ 694$ 682




Dermatology$ - 0$ - 0$ - 0$ - 0$ 798$ 1,207

Pediatrics$ - 0$ - 0$ - 0$ - 0$ 1,704$ 3,080

Sheet2

Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics


Sheet3


Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics



Containing Hospital Costs - Intentional Due Diligence:

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

FY2012 FY2013 FY2014 FY2015 FY2016 FY2017


16

Chart1

FY2012

FY2013

FY2014

FY2015

FY2016

FY2017



77740

78040

78921

81949

80704

81586

Sheet1




FY2012FY2013FY2014FY2015FY2016FY2017














28.0%34.0%18.3%22.0%9.1%

22.28%


0.4%1.1%3.8%-1.5%1.1%

0.99%




Sheet2




FY2012FY2013FY2014FY2015FY2016FY2017


Orthopedics$ 3,323$ 4,049$ 4,036$ 4,421$ 5,020$ 5,007

OB/GYN$ 1,367$ 1,946$ 2,287$ 2,403$ 2,520$ 2,438


Primary Care$ 793$ 831$ 1,839$ 1,915$ 1,948$ 1,784


Ophthalmology$ 150$ 621$ 805$ 1,021$ 1,038$ 1,094

Urology$ - 0$ - 0$ 22$ 690$ 694$ 682




Dermatology$ - 0$ - 0$ - 0$ - 0$ 798$ 1,207

Pediatrics$ - 0$ - 0$ - 0$ - 0$ 1,704$ 3,080

Sheet2

Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics


Sheet3


Orthopedics

OB/GYN


Primary Care


Ophthalmology

Urology

Cardiology Services


Comprehensive Pain

Dermatology

Pediatrics



History of Lower Rate Increases – Intentional Due Diligence:

• Historical Increases for NMC have been the lowest in Vermont from 2011 thru 2016

• Rate decrease in 2016 of 10%, 1.5% used to invest in the future of Population Health, build Wellness and Prevention, remaining 8.5% resulted in rate decreases

• Initial proposed increase in 2017 is 2.9%

• We have identified opportunities to reduce this increase

17

History of Lower Rate Increases – Intentional Due Diligence:

18

Chart1

201120112011

201220122012

201320132013

201420142014

201520152015

201620162016

201720172017

CAH

PPS

NMC

Rate Increase

Annual Rate Increases

0.0535

0.0565

0.018

0.06975

0.0692

0.063

0.055875

0.0734

0.029

0.061

0.0582

0.039

0.0469625

0.0586

0.064

0.03575

0.0336

-0.1

0.032

0.005

0.029

Sheet1

TotalTotal

Hospital Rate Increases2004200520062007200820092010201120122013201420152016Since 2011

Rutland Regional Medical Center8.0%2.0%8.0%5.3%8.5%9.6%5.5%5.5%9.8%10.3%4.8%8.40%3.70%89.40%42.50%

UVM Medical Center8.0%8.5%8.0%7.5%5.5%10.0%6.0%5.7%5.9%9.4%4.4%7.80%6.00%92.70%39.20%

Grace Cottage Hospital3.5%3.6%11.0%4.4%8.7%5.0%5.0%5.5%10.6%6.5%6.0%5.00%5.00%79.80%38.60%

Porter Medical Center7.0%6.5%5.0%6.0%7.4%8.7%6.7%6.5%10.3%5.0%6.0%5.00%5.30%85.40%38.10%

Gifford Medical Center8.8%5.3%3.6%4.8%6.4%7.9%5.8%5.8%7.0%6.1%7.6%5.60%5.80%80.50%37.90%

North Country Hospital9.3%7.1%4.8%4.6%6.5%7.0%4.0%4.4%5.1%4.6%8.0%8.30%4.80%78.50%35.20%

Southwestern VT Medical Center4.9%6.0%8.8%7.0%7.0%10.7%5.0%6.0%5.5%6.8%7.2%4.50%3.80%83.20%33.80%

Central Vermont Medical Center6.7%5.5%6.4%4.3%8.0%9.6%6.8%5.2%6.0%5.0%6.9%5.90%4.70%81.00%33.70%

Northeastern VT Regional Hospital8.0%0.0%8.5%6.5%6.5%9.2%6.0%4.8%7.5%6.5%5.6%5.00%3.20%77.30%32.60%

Mount Ascutney Hospital10.7%6.5%5.3%5.5%5.3%10.5%6.1%6.5%3.5%7.0%5.0%3.22%5.70%80.82%30.92%

Springfield Hospital8.8%4.8%8.0%4.1%4.3%3.8%6.1%3.8%5.8%6.0%4.6%5.45%2.80%68.35%28.45%

Brattleboro Memorial Hospital4.7%6.6%8.7%5.1%6.3%7.5%7.1%6.0%7.4%5.2%5.8%2.70%-1.40%25.70%25.70%

Copley Hospital8.0%8.0%0.0%4.9%4.5%6.0%6.0%5.5%6.0%3.0%6.0%0.00%-4.00%53.90%16.50%

Northwestern Medical Center2.6%2.5%4.5%7.0%10.5%10.7%5.2%1.8%6.3%2.9%3.9%6.40%-10.00%54.30%11.30%

Sheet2

TotalTotal


Rutland Regional Medical CenterPPSA8.0%2.0%8.0%5.3%8.5%9.6%5.5%5.5%9.8%10.3%4.8%8.40%3.70%-5.10%84.30%37.40%

UVM Medical CenterPPSB8.0%8.5%8.0%7.5%5.5%10.0%6.0%5.7%5.9%9.4%4.4%7.80%6.00%0.00%92.70%39.20%

Grace Cottage HospitalCAHC3.5%3.6%11.0%4.4%8.7%5.0%5.0%5.5%10.6%6.5%6.0%5.00%5.00%5.00%84.80%43.60%

Porter Medical CenterCAHD7.0%6.5%5.0%6.0%7.4%8.7%6.7%6.5%10.3%5.0%6.0%5.00%5.30%3.70%89.10%41.80%

Gifford Medical CenterCAHE8.8%5.3%3.6%4.8%6.4%7.9%5.8%5.8%7.0%6.1%7.6%5.60%5.80%3.90%84.40%41.80%

North Country HospitalCAHF9.3%7.1%4.8%4.6%6.5%7.0%4.0%4.4%5.1%4.6%8.0%8.30%4.80%3.50%82.00%38.70%

Southwestern VT Medical CenterPPSG4.9%6.0%8.8%7.0%7.0%10.7%5.0%6.0%5.5%6.8%7.2%4.50%3.80%3.90%87.10%37.70%

Central Vermont Medical CenterPPSH6.7%5.5%6.4%4.3%8.0%9.6%6.8%5.2%6.0%5.0%6.9%5.90%4.70%0.00%81.00%33.70%

Northeastern VT Regional HospitalCAHI8.0%0.0%8.5%6.5%6.5%9.2%6.0%4.8%7.5%6.5%5.6%5.00%3.20%3.76%81.06%36.36%

Mount Ascutney HospitalCAHJ10.7%6.5%5.3%5.5%5.3%10.5%6.1%6.5%3.5%7.0%5.0%3.22%5.70%5.40%86.22%36.32%

Springfield HospitalCAHK8.8%4.8%8.0%4.1%4.3%3.8%6.1%3.8%5.8%6.0%4.6%5.45%2.80%0.00%68.35%28.45%

Brattleboro Memorial HospitalPPSL4.7%6.6%8.7%5.1%6.3%7.5%7.1%6.0%7.4%5.2%5.8%2.70%-1.40%3.50%25.70%29.20%

Copley HospitalCAHM8.0%8.0%0.0%4.9%4.5%6.0%6.0%5.5%6.0%3.0%6.0%0.00%-4.00%0.00%53.90%16.50%

Northwestern Medical CenterNMCNMC2.6%2.5%4.5%7.0%10.5%10.7%5.2%1.8%6.3%2.9%3.9%6.40%-10.00%2.90%57.20%14.20%

TotalTotal


Grace Cottage HospitalCAHC3.5%3.6%11.0%4.4%8.7%5.0%5.0%5.5%10.6%6.5%6.0%5.00%5.00%5.00%84.80%43.60%

Porter Medical CenterCAHD7.0%6.5%5.0%6.0%7.4%8.7%6.7%6.5%10.3%5.0%6.0%5.00%5.30%3.70%89.10%41.80%

Gifford Medical CenterCAHE8.8%5.3%3.6%4.8%6.4%7.9%5.8%5.8%7.0%6.1%7.6%5.60%5.80%3.90%84.40%41.80%

North Country HospitalCAHF9.3%7.1%4.8%4.6%6.5%7.0%4.0%4.4%5.1%4.6%8.0%8.30%4.80%3.50%82.00%38.70%

Northeastern VT Regional HospitalCAHI8.0%0.0%8.5%6.5%6.5%9.2%6.0%4.8%7.5%6.5%5.6%5.00%3.20%3.76%81.06%36.36%

Mount Ascutney HospitalCAHJ10.7%6.5%5.3%5.5%5.3%10.5%6.1%6.5%3.5%7.0%5.0%3.22%5.70%5.40%86.22%36.32%

Springfield HospitalCAHK8.8%4.8%8.0%4.1%4.3%3.8%6.1%3.8%5.8%6.0%4.6%5.45%2.80%0.00%68.35%28.45%

Copley HospitalCAHM8.0%8.0%0.0%4.9%4.5%6.0%6.0%5.5%6.0%3.0%6.0%0.00%-4.00%0.00%53.90%16.50%

CAH5.4%7.0%5.6%6.1%4.7%3.6%3.2%78.7%35.4%

Rutland Regional Medical CenterPPSA8.0%2.0%8.0%5.3%8.5%9.6%5.5%5.4%9.8%10.3%4.8%8.40%3.70%-5.10%84.15%37.25%

UVM Medical CenterPPSB8.0%8.5%8.0%7.5%5.5%10.0%6.0%5.7%5.9%9.4%4.4%7.80%6.00%0.00%92.70%39.20%

Southwestern VT Medical CenterPPSG4.9%6.0%8.8%7.0%7.0%10.7%5.0%6.0%5.5%6.8%7.2%4.50%3.80%3.90%87.10%37.70%

Central Vermont Medical CenterPPSH6.7%5.5%6.4%4.3%8.0%9.6%6.8%5.2%6.0%5.0%6.9%5.90%4.70%0.00%81.00%33.70%

Brattleboro Memorial HospitalPPSL4.7%6.6%8.7%5.1%6.3%7.5%7.1%6.0%7.4%5.2%5.8%2.70%-1.40%3.50%25.70%29.20%

PPS5.7%6.9%7.3%5.8%5.9%3.4%0.5%74.1%35.4%

TotalTotal

201120122013201420152016Since 2011

CAH5.4%7.0%5.6%6.1%4.70%3.58%3.20%78.73%35.44%

PPS5.7%6.9%7.3%5.8%5.86%3.36%0.50%74.13%35.41%

Northwestern Medical CenterNMCNMC2.6%2.5%4.5%7.0%10.5%10.7%5.2%1.8%6.3%2.9%3.9%6.40%-10.00%2.90%57.20%14.20%

Sheet2

CAH

PPS

NMC

Rate Increase

Annual Rate Increases

Sheet3

Carefully Monitoring & Cautiously Predicting the Future:

Budget Adjusted2012 2013 2014 2015 2016 2017 2017

Bad debt 2.30% 2.60% 3.00% 2.10% 1.60% 1.90% 1.60%

Charity 1.20% 1.00% 0.70% 0.60% 0.71% 0.80% 0.70%

Total 3.50% 3.60% 3.70% 2.70% 2.31% 2.70% 2.30%

Bad debt and charity analysisActual as a percentage of gross revenues

19

Sheet1

Bad debt and charity analysis

Actual as a percentage of gross revenues

2012201320142015*2016

Bad debt2.30%2.60%3.00%2.10%1.40%

Charity1.20%1.00%0.70%0.60%0.70%

Total3.50%3.60%3.70%2.70%2.10%

Budget

Budget as a percentage of gross revenues2017

Bad debt3.30%2.70%2.80%3.20%2.80%1.90%

Charity1.00%1.30%1.20%1.00%0.90%0.80%

Total4.30%4.00%4.00%4.20%3.70%2.70%

*Through April

Sheet2

Bad debt and charity analysis

Actual as a percentage of gross revenues

BudgetAdjusted

2012201320142015201620172017

Bad debt2.30%2.60%3.00%2.10%1.60%1.90%1.60%

Charity1.20%1.00%0.70%0.60%0.71%0.80%0.70%

Total3.50%3.60%3.70%2.70%2.31%2.70%2.30%

Budget

Budget as a percentage of gross revenues2017

Bad debt3.30%2.70%2.80%3.20%2.80%1.90%

Charity1.00%1.30%1.20%1.00%0.90%0.80%

Total4.30%4.00%4.00%4.20%3.70%2.70%

Sheet3

Understanding Trends In Our Inpatient Volumes:

Age FY2014 FY2015 FY2016-P

0-17 1.55% 1.05% 2.03%

18-44 29.10% 27.37% 23.25%

45-64 25.41% 25.00% 25.10%

65+ 43.94% 46.58% 49.62%

20

Chart1

2013201320132013

2014201420142014

2015201520152015

2016201620162016

2017201720172017

Admissions

Patient Days

Length of Stay

Births

% Change

Annual IP % Change in Utilization

0.0238410596

0.0091907644

-0.0143091499

-0.0114155251

0.0288917637

-0.0940693025

-0.1195082618

0.0831408776

0.0339480302

-0.0239058477

-0.0559543383

-0.066098081

0.0672882043

0.0450891736

-0.0207994716

-0.1438356164

-0.0011393847

0.0097344069

0.0108861952

0.0933333333

Key Operating Statistics

April YTD 2016 Actual2016 Annualized2016 Budget2017 Budget% Change from Projected% Change from Budget

Admissions (acute)1,5362,6332,2962,630-0.1%14.5%

Patient Days

Acute4,5647,8247,6118,1524.2%7.1%

Observation0.0%0.0%

Swing290497249250-49.7%0.4%

Average Daily Census

Acute21.421.420.822.34.3%7.2%

Observation0.0%0.0%

Average Length of Stay

Acute2.972.973.313.104.3%-6.5%

Medicare3.323.32

Swing16.1116.11

Adjusted Admissions6,50311,14810,43111,100-0.4%6.4%

ED Visits15,52726,61824,41327,3612.8%12.1%

Surgeries (operating rooms)

Inpatient432741712698-5.8%-2.0%

Outpatient1,3232,2682,2152,2700.1%2.5%

Total1,7553,0092,9272,968-1.4%1.4%

Outpatient Surgical Procedures2,6324,5124,4704,499-0.3%0.6%

Births2193754204109.3%-2.4%

Other Stats

Outpatient Lab tests177,676304,587308,564334,6039.9%8.4%

Outpatient DI procedures26,76245,87851,28246,6051.6%-9.1%

Urgent Care visits11,51719,74316,11917,858-9.5%10.8%

Physician Practice visits43,82975,13576,09787,32916.2%14.8%

Case Mix Index

Medicare1.34941.3494

Total1.28391.2839

0

Payor Mix % of gross revenue

Medicare35.5%35.5%36.1%35.0%

Medicaid24.2%24.2%22.4%24.3%

Blue Cross23.6%23.6%22.7%23.9%

Cigna2.9%2.9%3.0%2.9%

All other13.8%13.8%15.7%13.9%

0.0%

Payor Mix (% of net revenue)0.0%

Medicare0.0%

Medicaid0.0%

Blue Cross0.0%

All other0.0%

&C&12NORTHWESTERN MEDICAL CENTERKEY OPERATING STATISTICS2017 BUDGET

Stat History

Average Percent

20122013201420152016201720132014201520162017ChangeLowest IncreaseHighest IncreaseAverage

Admissions2,2652,3192,3862,4672,6332,6302.4%2.9%3.4%6.7%-0.1%3.1%Admissions-0.1%6.7%3.1%

Patient Days8,9229,0048,1577,9628,3218,4020.9%-9.4%-2.4%4.5%1.0%-1.1%Patient Days-9.4%4.5%-1.1%

Length of Stay3.943.883.423.233.163.19-1.4%-12.0%-5.6%-2.1%1.1%-4.0%Length of Stay-12.0%1.1%-4.0%

Births438433469438375410-1.1%8.3%-6.6%-14.4%9.3%-0.9%Births-14.4%9.3%-0.9%

Adjusted Admissions9,5709,2779,71410,77211,14811,100-3.1%4.7%10.9%3.5%-0.4%3.1%Adjusted Admissions-3.1%10.9%3.1%

ED Visits27,99826,99526,01925,93726,61827,361-3.6%-3.6%-0.3%2.6%2.8%-0.4%ED Visits-3.6%2.8%-0.4%

Surgeries & Procedures7,1367,3147,0627,4067,5217,4672.5%-3.4%4.9%1.6%-0.7%1.0%Surgeries & Procedures-3.4%4.9%1.0%

OP Lab290,026283,937294,819309,474304,587334,603-2.1%3.8%5.0%-1.6%9.9%3.0%OP Lab-2.1%9.9%3.0%

OP Diagnostic Imaging52,88953,27050,90447,57145,87846,6050.7%-4.4%-6.5%-3.6%1.6%-2.4%OP Diagnostic Imaging-6.5%1.6%-2.4%

Physician Pratice Visits- 0- 056,77868,82675,13587,3290.0%0.0%21.2%9.2%16.2%15.5%Physician Pratice Visits9.2%21.2%15.5%

Urgent Care Visits8,2078,39811,34815,57819,74317,8582.3%35.1%37.3%26.7%-9.5%18.4%Urgent Care Visits0.0%0.0%18.4%

Stat History

Admissions

Patient Days

Length of Stay

Births

% Change


Adjusted Admissions

ED Visits

Surgeries & Procedures

OP Lab

OP Diagnostic Imaging

Physician Pratice Visits

% Change

Annual OP % Change in Utilization

Understanding Trends in our Outpatient Volumes:

21

Chart1

201320132013201320132013

201420142014201420142014

201520152015201520152015

201620162016201620162016

201720172017201720172017

Adjusted Admissions

ED Visits


OP Lab


Physician Practice Visits

% Change


-0.0306165099

-0.0358239874

0.0249439462

-0.0209946694

0.0072037664

0

0.0471057454

-0.0361548435

-0.0344544709

0.0383254032

-0.0444152431

0

0.1089149681

-0.0031515431

0.0487114132

0.0497084652

-0.0654761905

0.2121948642

0.0349053101

0.0262559278

0.0155279503

-0.0157913104

-0.0355889092

0.0916659402

-0.0043057051

0.027913442

-0.0071798963

0.0985465565

0.0158463752

0.1622945365




Patient Days

Acute4,5647,8247,6118,1524.2%7.1%

Observation0.0%0.0%

Swing290497249250-49.7%0.4%


Acute21.421.420.822.34.3%7.2%

Observation0.0%0.0%


Acute2.972.973.313.104.3%-6.5%

Medicare3.323.32

Swing16.1116.11


ED Visits15,52726,61824,41327,3612.8%12.1%


Inpatient432741712698-5.8%-2.0%

Outpatient1,3232,2682,2152,2700.1%2.5%

Total1,7553,0092,9272,968-1.4%1.4%


Births2193754204109.3%-2.4%

Other Stats





Case Mix Index


Total1.28391.2839

0


Medicare35.5%35.5%36.1%35.0%

Medicaid24.2%24.2%22.4%24.3%

Blue Cross23.6%23.6%22.7%23.9%

Cigna2.9%2.9%3.0%2.9%

All other13.8%13.8%15.7%13.9%

0.0%


Medicare0.0%

Medicaid0.0%

Blue Cross0.0%

All other0.0%


Stat History

Average Percent





Births438433469438375410-1.1%8.3%-6.6%-14.4%9.3%-0.9%Births-14.4%9.3%-0.9%




OP Lab290,026283,937294,819309,474304,587334,603-2.1%3.8%5.0%-1.6%9.9%3.0%OP Lab-2.1%9.9%3.0%


Physician Practice Visits- 0- 056,77868,82675,13587,3290.0%0.0%21.2%9.2%16.2%15.5%Physician Pratice Visits9.2%21.2%15.5%


Stat History

Admissions

Patient Days

Length of Stay

Births

% Change


Other Operating Revenue

Adjusted Admissions

ED Visits


OP Lab


Physician Practice Visits

% Change


Sheet2

ActualBudgetProjectedBudget

2015201620162017

Oth - 0001 - CAFETERIA SALES542,750498,398562,833578,833

Oth - 0002 - INTER DEPT MEALS64,18652,83268,07568,075

Oth - 0003 - CATERED MEALS107,97899,583116,699116,699

Oth - 0004 - VENDING MACHINE REV7,9417,18422,28522,285

Nutrition Services722,854657,996769,893785,893

Oth - 0005 - REBATES197,38090,000206,353206,353

Oth - 0006 - VENDOR DISCOUNTS10,1447,5009,0649,064

Vendor Discounts207,52497,500215,417215,417

Oth - 0007 - HEALTH PROMOTION91,368150,00052,47052,470

Oth - 0016 - COMMUNITY HEALTH TEAM658,078963,295697,042972,042

Oth - 1001 - GRANT REIMB 1430,469165,200120,937120,937

Oth - 1002 - GRANT REIMB 238,210110,20923,60823,608

Oth - 1003 - GRANT REIMB 3- 0- 0- 0- 0

Oth - 1004 - GRANT REIMB 47,07418,35847,99347,993

Oth - 1005 - GRANT REIMB 5- 095,732- 0- 0

Oth - 1006 - GRANT REIMB 6- 060,082- 0- 0

Oth - 1007 - GRANT REIMB 7- 0200,00083,69883,698

Oth - 1008 - GRANT REIMB 820,3222053,62453,624

Grant and Community1,245,5221,762,8971,079,3711,354,371

Oth - 0011 - NOH SRVS124,651105,000157,3901,057,390

Oth - 0021 - REHAB CONTRACTS- 0- 0- 0103,895

Oth - 0019 - LAB REFERRALS1,736,724- 01,633,3561,450,000

Oth - 0017 - 340b DRUG PROGRAM408,474663,419409,185409,185

Clinical Support2,269,849768,4192,199,9313,020,470

EHR Incentives841,826496,553953,3350

Oth - 0099 - NET ASSETS RELEASED83,52950,00061,25061,250

Oth - 0100 - MISCELLANEOUS28,28350,000116,191116,191

Oth - 0012 - LATE INS PMTS INC40,7304,57444,17844,178

Oth - 0013 - HIM COPY FEES8,9214,46411,14911,149

Oth - 0014 - +-- SALE OF ASSETS1,550- 0(850)(850)

Oth - 0015 - SPEC PURPOSE FUNDS14,86014,00011,03511,035

Oth - 0009 - PHYS ANSWERING SRV13,24013,03510,74010,740

Miscellaneous191,113136,073253,695253,695

Total5,478,6863,919,4375,471,6425,629,846

Total Revenue3741962.273919437.17013838286.385629846.38

Sheet2

Budget 2017

Other Operating RevenueBudget 2017

Projected 2016

Other Operating RevenueProjected 2016

Understanding Shifts Within Other Operating Revenue:

22

Chart1

Nutrition Services

Vendor Discounts

Grant and Community

Clinical Support

EHR Incentives

Miscellaneous

Projected 2016


769892.75

215417.08

1079371.21

2199931.32

953335.1

253694.92




Patient Days

Acute4,5647,8247,6118,1524.2%7.1%

Observation0.0%0.0%

Swing290497249250-49.7%0.4%


Acute21.421.420.822.34.3%7.2%

Observation0.0%0.0%


Acute2.972.973.313.104.3%-6.5%

Medicare3.323.32

Swing16.1116.11


ED Visits15,52726,61824,41327,3612.8%12.1%


Inpatient432741712698-5.8%-2.0%

Outpatient1,3232,2682,2152,2700.1%2.5%

Total1,7553,0092,9272,968-1.4%1.4%


Births2193754204109.3%-2.4%

Other Stats





Case Mix Index


Total1.28391.2839

0


Medicare35.5%35.5%36.1%35.0%

Medicaid24.2%24.2%22.4%24.3%

Blue Cross23.6%23.6%22.7%23.9%

Cigna2.9%2.9%3.0%2.9%

All other13.8%13.8%15.7%13.9%

0.0%


Medicare0.0%

Medicaid0.0%

Blue Cross0.0%

All other0.0%


Stat History

Average Percent





Births438433469438375410-1.1%8.3%-6.6%-14.4%9.3%-0.9%Births-14.4%9.3%-0.9%




OP Lab290,026283,937294,819309,474304,587334,603-2.1%3.8%5.0%-1.6%9.9%3.0%OP Lab-2.1%9.9%3.0%




Stat History

Admissions

Patient Days

Length of Stay

Births

% Change



Adjusted Admissions

ED Visits


OP Lab



% Change


Sheet2


2015201620162017






Oth - 0005 - REBATES197,38090,000206,353206,353





Oth - 1001 - GRANT REIMB 1430,469165,200120,937120,937

Oth - 1002 - GRANT REIMB 238,210110,20923,60823,608

Oth - 1003 - GRANT REIMB 3- 0- 0- 0- 0

Oth - 1004 - GRANT REIMB 47,07418,35847,99347,993

Oth - 1005 - GRANT REIMB 5- 095,732- 0- 0

Oth - 1006 - GRANT REIMB 6- 060,082- 0- 0

Oth - 1007 - GRANT REIMB 7- 0200,00083,69883,698

Oth - 1008 - GRANT REIMB 820,3222053,62453,624


Oth - 0011 - NOH SRVS124,651105,000157,3901,057,390


Oth - 0019 - LAB REFERRALS1,736,724- 01,633,3561,450,000


Clinical Support2,269,849768,4192,199,9313,020,470

EHR Incentives841,826496,553953,3350




Oth - 0013 - HIM COPY FEES8,9214,46411,14911,149




Miscellaneous191,113136,073253,695253,695

Total5,478,6863,919,4375,471,6425,629,846

Total Revenue3741962.273919437.17013838286.385629846.38

Sheet2

Budget 2017


Projected 2016


Chart1

Nutrition Services

Vendor Discounts

Grant and Community

Clinical Support

EHR Incentives

Miscellaneous

Budget 2017


785892.75

215417.08

1354371.21

3020470.32

0.1000000001

253694.92




Patient Days

Acute4,5647,8247,6118,1524.2%7.1%

Observation0.0%0.0%

Swing290497249250-49.7%0.4%


Acute21.421.420.822.34.3%7.2%

Observation0.0%0.0%


Acute2.972.973.313.104.3%-6.5%

Medicare3.323.32

Swing16.1116.11


ED Visits15,52726,61824,41327,3612.8%12.1%


Inpatient432741712698-5.8%-2.0%

Outpatient1,3232,2682,2152,2700.1%2.5%

Total1,7553,0092,9272,968-1.4%1.4%


Births2193754204109.3%-2.4%

Other Stats





Case Mix Index


Total1.28391.2839

0


Medicare35.5%35.5%36.1%35.0%

Medicaid24.2%24.2%22.4%24.3%

Blue Cross23.6%23.6%22.7%23.9%

Cigna2.9%2.9%3.0%2.9%

All other13.8%13.8%15.7%13.9%

0.0%


Medicare0.0%

Medicaid0.0%

Blue Cross0.0%

All other0.0%


Stat History

Average Percent





Births438433469438375410-1.1%8.3%-6.6%-14.4%9.3%-0.9%Births-14.4%9.3%-0.9%




OP Lab290,026283,937294,819309,474304,587334,603-2.1%3.8%5.0%-1.6%9.9%3.0%OP Lab-2.1%9.9%3.0%




Stat History

Admissions

Patient Days

Length of Stay

Births

% Change



Adjusted Admissions

ED Visits


OP Lab



% Change



2015201620162017






Oth - 0005 - REBATES197,38090,000206,353206,353





Oth - 1001 - GRANT REIMB 1430,469165,200120,937120,937

Oth - 1002 - GRANT REIMB 238,210110,20923,60823,608

Oth - 1003 - GRANT REIMB 3- 0- 0- 0- 0

Oth - 1004 - GRANT REIMB 47,07418,35847,99347,993

Oth - 1005 - GRANT REIMB 5- 095,732- 0- 0

Oth - 1006 - GRANT REIMB 6- 060,082- 0- 0

Oth - 1007 - GRANT REIMB 7- 0200,00083,69883,698

Oth - 1008 - GRANT REIMB 820,3222053,62453,624


Oth - 0011 - NOH SRVS124,651105,000157,3901,057,390


Oth - 0019 - LAB REFERRALS- 0- 0- 01,450,000


Clinical Support533,125768,419566,5753,020,470

EHR Incentives841,826496,553953,3350




Oth - 0013 - HIM COPY FEES8,9214,46411,14911,149




Miscellaneous191,113136,073253,695253,695

Total3,741,9623,919,4373,838,2865,629,846

Total Revenue3741962.273919437.17013838286.385629846.38

Budget 2017


Projected 2016


Understanding Our 2017 Capital Budget:

23

Chart1

Information TechnologyInformation TechnologyInformation TechnologyInformation Technology

ClinicalClinicalClinicalClinical

FacilitiesFacilitiesFacilitiesFacilities

Buidings and RenovationBuidings and RenovationBuidings and RenovationBuidings and Renovation

Physician ServicesPhysician ServicesPhysician ServicesPhysician Services

Other / ContingencyOther / ContingencyOther / ContingencyOther / Contingency

MFP Clinical EnhancementMFP Clinical EnhancementMFP Clinical EnhancementMFP Clinical Enhancement

2017 Capital Investments

1385810

1710730.11

1386845

3551500

1154628

797500

21434000

Summary

Northwestern Medical Center

Fiscal Year 2017 Capital Budget Summary

As of 6/1/2016

Capital PoolsAmount

Clinical Services386,000

Physician Services135,628

Facilities194,000

Community Relations/Development47,500

Information Systems294,440

Leadership Team/Contingency250,000

Strategic500,000

Total Capital Pools1,807,568

Individual Items4,844,445

Total Routine Capital Budget6,652,013

Emergency Department Renovation340,000

Georgia Property Development2,995,000

Master Facility Plan21,434,000

Total Capital Budget31,421,013

Individual Item Detail


Fiscal Year 2017 Capital Budget Item Detail

As of 6/1/2016

Recommended:Amount

01.7300 - Clinical System - Meditech 6.1 Upgrade 2016-15591583,000

01.6100 - Instruments Surgical - Upgrade scopes and cameras-15334625,863

01.7420 - Chiller - OR Chiller ReplacementUpgrade-16562942,845

01.7420 - Renovation General - Renovate Enosburg Pediatrics-22043300,000

01.7420 - Renovation General - Pain Clinic Offices-22050189,000

01.6100 - Table OR - Jackson Table Fracture Kit-2206857,135

01.6010 - Telemetry - Telemetry - Mind Ray-22072200,000

01.6430 - System Imaging Ultrasound - Additional Ultrasound Unit-2200581,732

01.7300 - Computer - Wireless Infrastructure Refresh-16489125,000

01.7420 - Construction General - Ophthalmology-22096530,000

01.7300 - Computer - Computer Device Refresh Program-21321130,000

01.7300 - Software General - Meditech Critical Care Module-22073118,370

01.7300 - Software General - e-Signature-2209473,000

01.7300 - Hardware General - Nurse Communication Device-2207762,000

01.7420 - HVAC - Air-conditioner - HeatEx Unit Replacement(Lab)-16565250,000

01.7420 - Renovation General - Lab Department Renovation 2018-17629141,500

01.7425 - Renovation General - Donor Stewardship Recognition TBD-1925675,000

01.6400 - Imaging - X-ray Digital - Digital X-Ray 2017-18126360,000

Total Recommended4,844,445

Not Recommended:Amount

01.7420 - Infrastructure - FBC Infant Abduction System-22061112,000

01.6750 - Clinical System - Automated Biometry and Keratometry Unit-2209149,785

01.7300 - Computer - Server OS upgrade MS Datacenter 2012-1753250,000

01.7300 - Hardware General - Security Camera DVR Replacement-1755667,000

01.7420 - Facilities General - Chilled Water System Tie-In-16492149,373

01.7300 - System RF - RFID Asset Tracking and Clinical Communication-17183100,000

01.7420 - Facilities General - House Acquisition-17497250,000

01.6400 - Imaging - X-ray Digital - Digital Portable X-ray unit-22067150,000

01.6500 - Construction General - Pool-17430964,654

01.7420 - Construction General - Urology-2209799,000

01.7420 - Renovation General - FBCMB Window Replacements - Phase 2-17370241,154

01.6149 - Sterilizer Gas - VB-Pro Sterilizer-16452108,322

01.7420 - Controller Building - FBC HVAC Controls-1730370,000

01.7420 - Renovation General - FBC Nurses Station Renovation-2205675,000

01.7420 - HVAC - Air-conditioner-furnace - ED Garage HVAC Modifications-17304150,000

01.6100 - Defib Biphasic - Physio Control Lifepak15 with Pacing-1748760,243

01.7100 - Software General - Strata Continuous Cost Improvement Framework-2209575,000

01.7420 - Infrastructure - Domestic Hot and Cold Water Piping-2206090,000

01.7420 - Renovation General - Ventilation Units Boiler Room-17216120,000

01.7420 - Infrastructure - De-Aerator System-22058225,000

01.7420 - Renovation General - Conference Center Cosmetic Upgrades-22045200,000

01.7420 - Sitework - Recreation PathSidewalks-2206495,000

01.7300 - Hardware General - RFID badge enabled door locks-1755881,000

01.7420 - Renovation General - 172 Fairfield Renovations-17522300,000

01.7300 - Software General - End User Licenses-22040115,000

01.7300 - Hardware General - Core Network Switch-1619970,000

01.7300 - Hardware General - Audio Visual Systems-1718965,000

01.6020 - Renovation General - Renovations to FBC andor DI to accomodate changing needs of Womens Health Services 2017-1759750,000

01.7420 - Light Exterior - Exterior Lighting Upgrade-1734450,000

01.7300 - Server - Datacenter Server and Appliance Refresh 2016-1616948,000

Total Not Recommended4,280,530

Analysis

Scenario 10Scenario 11IncludedNon DiscApprovedRequested 2017Total RequestedWeighted Avg RatingCapital StatusGlobal TypeDepartment PriorityDepartment

1Approved Non DiscretionaryApproved Non Discretionary01.7300 - Clinical System - Meditech 6.1 Upgrade 2016-15591$583,000$583,000.0076.4Existing Capital UpgradeClinical System101.7300 - NMC INFORMATION TECH

2Approved Non DiscretionaryApproved Non Discretionary01.6100 - Instruments Surgical - Upgrade scopes and cameras-15334$625,863$625,863.0072.4ReplacementInstruments Surgical201.6100 - NMC OPERATING ROOM

3Approved Non DiscretionaryApproved Non Discretionary01.7420 - Chiller - OR Chiller ReplacementUpgrade-16562$942,845$942,845.0068.6ReplacementChiller101.7420 - NMC PLANT AND PROPERTY

4Approved Non DiscretionaryApproved Non Discretionary01.7420 - Renovation General - Renovate Enosburg Pediatrics-22043$300,000$300,000.0068.1NewRenovation General401.7420 - NMC PLANT AND PROPERTY

5Approved Non DiscretionaryApproved Non Discretionary01.7420 - Renovation General - Pain Clinic Offices-22050$189,000$189,000.0065.7Existing Capital UpgradeRenovation General401.7420 - NMC PLANT AND PROPERTY

6Not IncludedNot Included01.7420 - Renovation General - ED Renovations Floors-17307$1,875,000$1,875,000.0065.4Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

7Approved Non DiscretionaryApproved Non Discretionary01.6100 - Table OR - Jackson Table Fracture Kit-22068$57,135$57,135.1163.7NewTable OR201.6100 - NMC OPERATING ROOM

8Approved Non DiscretionaryApproved Non Discretionary01.6010 - Telemetry - Telemetry - Mind Ray-22072$200,000$200,000.0062.7NewTelemetry101.6010 - NMC ICU

9Not ApprovedApproved Non Discretionary01.6430 - System Imaging Ultrasound - Additional Ultrasound Unit-22005$81,732$81,732.0061.5NewSystem Imaging Ultrasound201.6430 - NMC ULTRASOUND

10Approved Non DiscretionaryApproved Non Discretionary01.7300 - Computer - Wireless Infrastructure Refresh-16489$125,000$125,000.0061.2ReplacementComputer101.7300 - NMC INFORMATION TECH

11Approved Non DiscretionaryApproved Non Discretionary01.7420 - Construction General - Ophthalmology-22096$530,000$530,000.0061.0NewConstruction General301.7420 - NMC PLANT AND PROPERTY

12Approved Non DiscretionaryApproved Non Discretionary01.7300 - Computer - Computer Device Refresh Program-21321$130,000$130,000.0059.9ReplacementComputer201.7300 - NMC INFORMATION TECH

13Approved Non DiscretionaryApproved Non Discretionary01.7300 - Software General - Meditech Critical Care Module-22073$118,370$118,370.0058.5NewSoftware General101.7300 - NMC INFORMATION TECH

14Not IncludedNot Included01.6400 - Imaging - X-ray Digital - Digital X-Ray 2017-18126$360,000$360,000.0058.3NewImaging - X-ray Digital201.6400 - NMC RADIOLOGY

15Approved Non DiscretionaryApproved Non Discretionary01.7300 - Software General - e-Signature-22094$73,000$73,000.0058.3NewSoftware General201.7300 - NMC INFORMATION TECH

16Not IncludedNot Included01.7420 - Infrastructure - FBC Infant Abduction System-22061$112,000$112,000.0055.4ReplacementInfrastructure101.7420 - NMC PLANT AND PROPERTY

17Approved Non DiscretionaryApproved Non Discretionary01.7300 - Hardware General - Nurse Communication Device-22077$62,000$62,000.0055.2NewHardware General301.7300 - NMC INFORMATION TECH

18Approved Non DiscretionaryApproved Non Discretionary01.7420 - HVAC - Air-conditioner - HeatEx Unit Replacement(Lab)-16565$250,000$250,000.0054.4ReplacementHVAC - Air-conditioner101.7420 - NMC PLANT AND PROPERTY

19Approved Non DiscretionaryNot Included01.6750 - Clinical System - Automated Biometry and Keratometry Unit-22091$49,785$49,785.0054.3NewClinical System201.6750 - NMC OPHTHALMOLOGY

20ApprovedNot Approved01.7300 - Computer - Server OS upgrade MS Datacenter 2012-17532$50,000$50,000.0053.9NewComputer301.7300 - NMC INFORMATION TECH

21Not IncludedNot Included01.7300 - Hardware General - Security Camera DVR Replacement-17556$67,000$67,000.0053.2ReplacementHardware General201.7300 - NMC INFORMATION TECH

22Not IncludedNot Included01.7420 - Facilities General - Chilled Water System Tie-In-16492$149,373$149,373.0052.6NewFacilities General101.7420 - NMC PLANT AND PROPERTY

23Not IncludedNot Included01.7300 - System RF - RFID Asset Tracking and Clinical Communication-17183$100,000$100,000.0051.9NewSystem RF301.7300 - NMC INFORMATION TECH

24Not ApprovedNot Approved01.7420 - Facilities General - House Acquisition-17497$250,000$250,000.0051.1NewFacilities General301.7420 - NMC PLANT AND PROPERTY

25Not IncludedNot Included01.6400 - Imaging - X-ray Digital - Digital Portable X-ray unit-22067$150,000$150,000.0049.8ReplacementImaging - X-ray Digital201.6400 - NMC RADIOLOGY

26Approved Non DiscretionaryApproved Non Discretionary01.7420 - Renovation General - Lab Department Renovation 2018-17629$141,500$141,500.0049.3Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

27Not ApprovedNot Approved01.6500 - Construction General - Pool-17430$964,654$964,654.0048.7NewConstruction General201.6500 - NMC REHAB COBBLESTONE

28Not ApprovedNot Approved01.7420 - Construction General - Urology-22097$99,000$99,000.0045.8NewConstruction General301.7420 - NMC PLANT AND PROPERTY

29Not ApprovedNot Approved01.7420 - Renovation General - FBCMB Window Replacements - Phase 2-17370$241,154$241,154.0045.6ReplacementRenovation General201.7420 - NMC PLANT AND PROPERTY

30Not IncludedNot Included01.6149 - Sterilizer Gas - VB-Pro Sterilizer-16452$108,322$108,321.9644.9ReplacementSterilizer Gas201.6149 - NMC CENTRAL STERILE

31Not ApprovedNot Approved01.7420 - Controller Building - FBC HVAC Controls-17303$70,000$70,000.0044.2Existing Capital UpgradeController Building301.7420 - NMC PLANT AND PROPERTY

32Not ApprovedNot Approved01.7420 - Renovation General - FBC Nurses Station Renovation-22056$75,000$75,000.0041.0Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

33Not ApprovedNot Approved01.7420 - HVAC - Air-conditioner-furnace - ED Garage HVAC Modifications-17304$150,000$150,000.0036.4ReplacementHVAC - Air-conditioner-furnace201.7420 - NMC PLANT AND PROPERTY

34Not ApprovedNot Approved01.6100 - Defib Biphasic - Physio Control Lifepak15 with Pacing-17487$60,243$60,243.0034.4ReplacementDefib Biphasic201.6100 - NMC OPERATING ROOM

35Not ApprovedNot Approved01.7100 - Software General - Strata Continuous Cost Improvement Framework-22095$75,000$75,000.0033.5NewSoftware General201.7100 - NMC FISCAL SERVICES

36Not ApprovedNot Approved01.7420 - Infrastructure - Domestic Hot and Cold Water Piping-22060$90,000$90,000.0032.9ReplacementInfrastructure301.7420 - NMC PLANT AND PROPERTY

37Not ApprovedNot Approved01.7420 - Renovation General - Ventilation Units Boiler Room-17216$120,000$120,000.0030.8Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

38Approved Non DiscretionaryApproved Non Discretionary01.7425 - Renovation General - Donor Stewardship Recognition TBD-19256$75,000$75,000.0028.9Existing Capital UpgradeRenovation General301.7425 - NMC DEVELOPMENT

39Not ApprovedNot Approved01.7420 - Infrastructure - De-Aerator System-22058$225,000$225,000.0028.2ReplacementInfrastructure101.7420 - NMC PLANT AND PROPERTY

40Not ApprovedNot Approved01.7420 - Renovation General - Conference Center Cosmetic Upgrades-22045$200,000$199,999.5028.0Existing Capital UpgradeRenovation General301.7420 - NMC PLANT AND PROPERTY

41Not ApprovedNot Approved01.7420 - Sitework - Recreation PathSidewalks-22064$95,000$95,000.009.2NewSitework401.7420 - NMC PLANT AND PROPERTY

42Not ApprovedNot Approved01.7300 - Hardware General - RFID badge enabled door locks-17558$81,000$81,000.001.4NewHardware General401.7300 - NMC INFORMATION TECH

43Not ApprovedNot Approved01.7420 - Renovation General - 172 Fairfield Renovations-17522$300,000$300,000.000.0Existing Capital UpgradeRenovation General301.7420 - NMC PLANT AND PROPERTY

44Not ApprovedNot Approved01.7300 - Software General - End User Licenses-22040$115,000$115,000.000.0Existing Capital UpgradeSoftware General201.7300 - NMC INFORMATION TECH

45Not ApprovedNot Approved01.7300 - Hardware General - Core Network Switch-16199$70,000$70,000.000.0ReplacementHardware General101.7300 - NMC INFORMATION TECH

46Not ApprovedNot Approved01.7300 - Hardware General - Audio Visual Systems-17189$65,000$65,000.000.0NewHardware General301.7300 - NMC INFORMATION TECH

47Not ApprovedNot Approved01.6020 - Renovation General - Renovations to FBC andor DI to accomodate changing needs of Womens Health Services 2017-17597$50,000$50,000.000.0Existing Capital UpgradeRenovation General201.6020 - NMC OBSTETRICS

48Not ApprovedNot Approved01.7420 - Light Exterior - Exterior Lighting Upgrade-17344$50,000$50,000.000.0Existing Capital UpgradeLight Exterior301.7420 - NMC PLANT AND PROPERTY

49Not ApprovedNot Approved01.7300 - Server - Datacenter Server and Appliance Refresh 2016-16169$48,000$48,000.000.0ReplacementServer201.7300 - NMC INFORMATION TECH

50Not ApprovedNot Approved01.7420 - Renovation General - Roof Replacement-17211$0$.000.0ReplacementRenovation General201.7420 - NMC PLANT AND PROPERTY

Sources and Uses


2017 Budgeted Sources and Uses

Sources:

Depreciation and Amortization4,676,645

Gain from Operations3,340,878

Non-Operating Income2,741,192

MFP Accumulated Cash9,193,000

MFP Investment Bonds and Accumulated Cash12,241,000

Cash Generated by Operations32,192,715

Uses:

Principal Debt Payments771,702

Growth in Days Cash on Hand- 0

Strategic Investment Pool500,000

Divisional Capital Pools1,057,568

Contingency250,000

Committee Allocation4,844,445

Emergency Department340,000

Georgia Health Center2,995,000

MFP21,434,000

Cash Used for Capital and Principal32,192,715

Presentation Data



As of 6/1/2016

Recommended:AmountCommitteeDivisionStrategicTotal

01.7300 - Clinical System - Meditech 6.1 Upgrade 2016-15591583,000ITInformation Technology1,091,370294,4401,385,810

01.6100 - Instruments Surgical - Upgrade scopes and cameras-15334625,863ClinicalClinical1,324,730386,0001,710,730

01.7420 - Chiller - OR Chiller ReplacementUpgrade-16562942,845FacilitiesFacilities1,192,845194,0001,386,845

01.7420 - Renovation General - Renovate Enosburg Pediatrics-22043300,000Physician ServicesBuidings and Renovation216,5003,335,0003,551,500

01.7420 - Renovation General - Pain Clinic Offices-22050189,000Physician ServicesPhysician Services1,019,000135,6281,154,628

01.6100 - Table OR - Jackson Table Fracture Kit-2206857,135ClinicalOther / Contingency0797,500797,500

01.6010 - Telemetry - Telemetry - Mind Ray-22072200,000ClinicalMFP Clinical Enhancement21,434,00021,434,000

01.6430 - System Imaging Ultrasound - Additional Ultrasound Unit-2200581,732Clinical4,844,4451,807,56824,769,00031,421,013

01.7300 - Computer - Wireless Infrastructure Refresh-16489125,000IT

01.7420 - Construction General - Ophthalmology-22096530,000Physician Services

01.7300 - Computer - Computer Device Refresh Program-21321130,000IT

01.7300 - Software General - Meditech Critical Care Module-22073118,370IT

01.7300 - Software General - e-Signature-2209473,000IT

01.7300 - Hardware General - Nurse Communication Device-2207762,000IT

01.7420 - HVAC - Air-conditioner - HeatEx Unit Replacement(Lab)-16565250,000Facilities

01.7420 - Renovation General - Lab Department Renovation 2018-17629141,500Buidings and Renovation

01.7425 - Renovation General - Donor Stewardship Recognition TBD-1925675,000Buidings and Renovation

01.6400 - Imaging - X-ray Digital - Digital X-Ray 2017-18126360,000Clinical


































Presentation Data

2017 Capital Investments

2017 Capital Excluding MFP

Chart1

Information TechnologyInformation TechnologyInformation TechnologyInformation Technology

ClinicalClinicalClinicalClinical

FacilitiesFacilitiesFacilitiesFacilities

Buidings and RenovationBuidings and RenovationBuidings and RenovationBuidings and Renovation

Physician ServicesPhysician ServicesPhysician ServicesPhysician Services

Other / ContingencyOther / ContingencyOther / ContingencyOther / Contingency

2017 Capital Excluding MFP

1385810

1710730.11

1386845

3551500

1154628

797500

Summary


Fiscal Year 2017 Capital Budget Summary

As of 6/1/2016

Capital PoolsAmount

Clinical Services386,000

Physician Services135,628

Facilities194,000

Community Relations/Development47,500

Information Systems294,440

Leadership Team/Contingency250,000

Strategic500,000

Total Capital Pools1,807,568

Individual Items4,844,445

Total Routine Capital Budget6,652,013

Emergency Department Renovation340,000

Georgia Property Development2,995,000

Master Facility Plan21,434,000

Total Capital Budget31,421,013

Individual Item Detail



As of 6/1/2016

Recommended:Amount

01.7300 - Clinical System - Meditech 6.1 Upgrade 2016-15591583,000

01.6100 - Instruments Surgical - Upgrade scopes and cameras-15334625,863

01.7420 - Chiller - OR Chiller ReplacementUpgrade-16562942,845

01.7420 - Renovation General - Renovate Enosburg Pediatrics-22043300,000

01.7420 - Renovation General - Pain Clinic Offices-22050189,000

01.6100 - Table OR - Jackson Table Fracture Kit-2206857,135

01.6010 - Telemetry - Telemetry - Mind Ray-22072200,000

01.6430 - System Imaging Ultrasound - Additional Ultrasound Unit-2200581,732

01.7300 - Computer - Wireless Infrastructure Refresh-16489125,000

01.7420 - Construction General - Ophthalmology-22096530,000

01.7300 - Computer - Computer Device Refresh Program-21321130,000

01.7300 - Software General - Meditech Critical Care Module-22073118,370

01.7300 - Software General - e-Signature-2209473,000

01.7300 - Hardware General - Nurse Communication Device-2207762,000

01.7420 - HVAC - Air-conditioner - HeatEx Unit Replacement(Lab)-16565250,000

01.7420 - Renovation General - Lab Department Renovation 2018-17629141,500

01.7425 - Renovation General - Donor Stewardship Recognition TBD-1925675,000

01.6400 - Imaging - X-ray Digital - Digital X-Ray 2017-18126360,000


































Analysis

Scenario 10Scenario 11IncludedNon DiscApprovedRequested 2017Total RequestedWeighted Avg RatingCapital StatusGlobal TypeDepartment PriorityDepartment

1Approved Non DiscretionaryApproved Non Discretionary01.7300 - Clinical System - Meditech 6.1 Upgrade 2016-15591$583,000$583,000.0076.4Existing Capital UpgradeClinical System101.7300 - NMC INFORMATION TECH

2Approved Non DiscretionaryApproved Non Discretionary01.6100 - Instruments Surgical - Upgrade scopes and cameras-15334$625,863$625,863.0072.4ReplacementInstruments Surgical201.6100 - NMC OPERATING ROOM

3Approved Non DiscretionaryApproved Non Discretionary01.7420 - Chiller - OR Chiller ReplacementUpgrade-16562$942,845$942,845.0068.6ReplacementChiller101.7420 - NMC PLANT AND PROPERTY

4Approved Non DiscretionaryApproved Non Discretionary01.7420 - Renovation General - Renovate Enosburg Pediatrics-22043$300,000$300,000.0068.1NewRenovation General401.7420 - NMC PLANT AND PROPERTY

5Approved Non DiscretionaryApproved Non Discretionary01.7420 - Renovation General - Pain Clinic Offices-22050$189,000$189,000.0065.7Existing Capital UpgradeRenovation General401.7420 - NMC PLANT AND PROPERTY

6Not IncludedNot Included01.7420 - Renovation General - ED Renovations Floors-17307$1,875,000$1,875,000.0065.4Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

7Approved Non DiscretionaryApproved Non Discretionary01.6100 - Table OR - Jackson Table Fracture Kit-22068$57,135$57,135.1163.7NewTable OR201.6100 - NMC OPERATING ROOM

8Approved Non DiscretionaryApproved Non Discretionary01.6010 - Telemetry - Telemetry - Mind Ray-22072$200,000$200,000.0062.7NewTelemetry101.6010 - NMC ICU

9Not ApprovedApproved Non Discretionary01.6430 - System Imaging Ultrasound - Additional Ultrasound Unit-22005$81,732$81,732.0061.5NewSystem Imaging Ultrasound201.6430 - NMC ULTRASOUND

10Approved Non DiscretionaryApproved Non Discretionary01.7300 - Computer - Wireless Infrastructure Refresh-16489$125,000$125,000.0061.2ReplacementComputer101.7300 - NMC INFORMATION TECH

11Approved Non DiscretionaryApproved Non Discretionary01.7420 - Construction General - Ophthalmology-22096$530,000$530,000.0061.0NewConstruction General301.7420 - NMC PLANT AND PROPERTY

12Approved Non DiscretionaryApproved Non Discretionary01.7300 - Computer - Computer Device Refresh Program-21321$130,000$130,000.0059.9ReplacementComputer201.7300 - NMC INFORMATION TECH

13Approved Non DiscretionaryApproved Non Discretionary01.7300 - Software General - Meditech Critical Care Module-22073$118,370$118,370.0058.5NewSoftware General101.7300 - NMC INFORMATION TECH

14Not IncludedNot Included01.6400 - Imaging - X-ray Digital - Digital X-Ray 2017-18126$360,000$360,000.0058.3NewImaging - X-ray Digital201.6400 - NMC RADIOLOGY

15Approved Non DiscretionaryApproved Non Discretionary01.7300 - Software General - e-Signature-22094$73,000$73,000.0058.3NewSoftware General201.7300 - NMC INFORMATION TECH

16Not IncludedNot Included01.7420 - Infrastructure - FBC Infant Abduction System-22061$112,000$112,000.0055.4ReplacementInfrastructure101.7420 - NMC PLANT AND PROPERTY

17Approved Non DiscretionaryApproved Non Discretionary01.7300 - Hardware General - Nurse Communication Device-22077$62,000$62,000.0055.2NewHardware General301.7300 - NMC INFORMATION TECH

18Approved Non DiscretionaryApproved Non Discretionary01.7420 - HVAC - Air-conditioner - HeatEx Unit Replacement(Lab)-16565$250,000$250,000.0054.4ReplacementHVAC - Air-conditioner101.7420 - NMC PLANT AND PROPERTY

19Approved Non DiscretionaryNot Included01.6750 - Clinical System - Automated Biometry and Keratometry Unit-22091$49,785$49,785.0054.3NewClinical System201.6750 - NMC OPHTHALMOLOGY

20ApprovedNot Approved01.7300 - Computer - Server OS upgrade MS Datacenter 2012-17532$50,000$50,000.0053.9NewComputer301.7300 - NMC INFORMATION TECH

21Not IncludedNot Included01.7300 - Hardware General - Security Camera DVR Replacement-17556$67,000$67,000.0053.2ReplacementHardware General201.7300 - NMC INFORMATION TECH

22Not IncludedNot Included01.7420 - Facilities General - Chilled Water System Tie-In-16492$149,373$149,373.0052.6NewFacilities General101.7420 - NMC PLANT AND PROPERTY

23Not IncludedNot Included01.7300 - System RF - RFID Asset Tracking and Clinical Communication-17183$100,000$100,000.0051.9NewSystem RF301.7300 - NMC INFORMATION TECH

24Not ApprovedNot Approved01.7420 - Facilities General - House Acquisition-17497$250,000$250,000.0051.1NewFacilities General301.7420 - NMC PLANT AND PROPERTY

25Not IncludedNot Included01.6400 - Imaging - X-ray Digital - Digital Portable X-ray unit-22067$150,000$150,000.0049.8ReplacementImaging - X-ray Digital201.6400 - NMC RADIOLOGY

26Approved Non DiscretionaryApproved Non Discretionary01.7420 - Renovation General - Lab Department Renovation 2018-17629$141,500$141,500.0049.3Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

27Not ApprovedNot Approved01.6500 - Construction General - Pool-17430$964,654$964,654.0048.7NewConstruction General201.6500 - NMC REHAB COBBLESTONE

28Not ApprovedNot Approved01.7420 - Construction General - Urology-22097$99,000$99,000.0045.8NewConstruction General301.7420 - NMC PLANT AND PROPERTY

29Not ApprovedNot Approved01.7420 - Renovation General - FBCMB Window Replacements - Phase 2-17370$241,154$241,154.0045.6ReplacementRenovation General201.7420 - NMC PLANT AND PROPERTY

30Not IncludedNot Included01.6149 - Sterilizer Gas - VB-Pro Sterilizer-16452$108,322$108,321.9644.9ReplacementSterilizer Gas201.6149 - NMC CENTRAL STERILE

31Not ApprovedNot Approved01.7420 - Controller Building - FBC HVAC Controls-17303$70,000$70,000.0044.2Existing Capital UpgradeController Building301.7420 - NMC PLANT AND PROPERTY

32Not ApprovedNot Approved01.7420 - Renovation General - FBC Nurses Station Renovation-22056$75,000$75,000.0041.0Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

33Not ApprovedNot Approved01.7420 - HVAC - Air-conditioner-furnace - ED Garage HVAC Modifications-17304$150,000$150,000.0036.4ReplacementHVAC - Air-conditioner-furnace201.7420 - NMC PLANT AND PROPERTY

34Not ApprovedNot Approved01.6100 - Defib Biphasic - Physio Control Lifepak15 with Pacing-17487$60,243$60,243.0034.4ReplacementDefib Biphasic201.6100 - NMC OPERATING ROOM

35Not ApprovedNot Approved01.7100 - Software General - Strata Continuous Cost Improvement Framework-22095$75,000$75,000.0033.5NewSoftware General201.7100 - NMC FISCAL SERVICES

36Not ApprovedNot Approved01.7420 - Infrastructure - Domestic Hot and Cold Water Piping-22060$90,000$90,000.0032.9ReplacementInfrastructure301.7420 - NMC PLANT AND PROPERTY

37Not ApprovedNot Approved01.7420 - Renovation General - Ventilation Units Boiler Room-17216$120,000$120,000.0030.8Existing Capital UpgradeRenovation General201.7420 - NMC PLANT AND PROPERTY

38Approved Non DiscretionaryApproved Non Discretionary01.7425 - Renovation General - Donor Stewardship Recognition TBD-19256$75,000$75,000.0028.9Existing Capital UpgradeRenovation General301.7425 - NMC DEVELOPMENT

39Not ApprovedNot Approved01.7420 - Infrastructure - De-Aerator System-22058$225,000$225,000.0028.2ReplacementInfrastructure101.7420 - NMC PLANT AND PROPERTY

40Not ApprovedNot Approved01.7420 - Renovation General - Conference Center Cosmetic Upgrades-22045$200,000$199,999.5028.0Existing Capital UpgradeRenovation General301.7420 - NMC PLANT AND PROPERTY

41Not ApprovedNot Approved01.7420 - Sitework - Recreation PathSidewalks-22064$95,000$95,000.009.2NewSitework401.7420 - NMC PLANT AND PROPERTY

42Not ApprovedNot Approved01.7300 - Hardware General - RFID badge enabled door locks-17558$81,000$81,000.001.4NewHardware General401.7300 - NMC INFORMATION TECH

43Not ApprovedNot Approved01.7420 - Renovation General - 172 Fairfield Renovations-17522$300,000$300,000.000.0Existing Capital UpgradeRenovation General301.7420 - NMC PLANT AND PROPERTY

44Not ApprovedNot Approved01.7300 - Software General - End User Licenses-22040$115,000$115,000.000.0Existing Capital UpgradeSoftware General201.7300 - NMC INFORMATION TECH

45Not ApprovedNot Approved01.7300 - Hardware General - Core Network Switch-16199$70,000$70,000.000.0ReplacementHardware General101.7300 - NMC INFORMATION TECH

46Not ApprovedNot Approved01.7300 - Hardware General - Audio Visual Systems-17189$65,000$65,000.000.0NewHardware General301.7300 - NMC INFORMATION TECH

47Not Approved

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