MURRIETA FIRE DEPARTMENT Fire Station 5 January 2010

Station 5 May 1, 2007 – Fire District Board of Directors approves agreement for Biological Engineering services for Station 5 site July 1, 2007 – Temporary Fire Station 5 Capital Improvement Project approved by City Council - $650,000, including design, grading, site preparation, utilities installation April 25, 2008 – Fire Station 4 Opens, vacating manufactured home and metal Butler Building intended for use in Temporary Fire Station 5 August 19, 2008 – Site Engineering contract approved by City Council Spetember 15, 2009 – Site design completed by Engineer Grading began January 11 th 2010 Completion Mid March 2010

Station Response Area

Station 5 Structures

Station 5 Site Plan

Staffing and Equipment Staffed with one engine crew, 3 firefighters one of which is a Paramedic One Type 1 engine Cross staff one Brush engine Reduces response times from 10 minutes to under 6 minutes

Hospitals Update January 19, 2010

Recent History Inland and Rancho Springs Hospitals have been placed on 6 month probation (beginning July thru December) by the Federal Center for Medicare and Medicaid Services CMS, for various undisclosed violations. Universal Health Care the parent agency of Southwest Health Care estimates they will loose 50 percent of their revenues resulting from Medicare Medicaid disqualification and possible insolvency if the violations are not resolved Site surveys were underway conducted by the California Department of Public Health (CDPH) in conjunction with the CMS as late as last Friday. CDPH is acting as the inspection arm for the CMS. In addition a Federal Quality Control specialist has been on the two sites since the probation started..

The group of inspectors (15) are a new group of inspectors from Orange County and they witnessed patient backlog In the ER room Tuesday night at Rancho Springs for the first time and issued an IJ (Immediate Jeopardy) violation notice, which required the hospitals to come up with a patient care mitigation plan ASAP. The CDPH team shut down both facilities until the plan was presented. At 0230 last Wednesday morning the inspectors allowed the facilities to resume normal operations. No mention was made to date of what the mitigation plan was that allowed reopening. A statement was made by Bruce Barton RVC EMS Director, that the CDPH assured him the facilities would not be shut down instantly if the final findings indicated that outcome. Bruce stated that the County EMS and Community will have ample notice in which to formulate a plan to bypass patients to Fallbrook, Palomar and other Riverside County area Hospitals. Comment: This solution is obviously not a desirable one for our community

The closure of these hospitals would necessitate the transport of our patient to next nearest receiving centers. Average patient input to these two hospitals is 45 patients a day or 1350 a month; this does not count walk-ins and inter facility transports. Approx 232 patients a month transported Riverside Community, Riverside County Regional, Fallbrook and Palomar hospitals have been contacted by RVC EMS to make arrangements if needed for possible utilization by our communities. Average drive times to Riverside County, Riverside Community and Palomar hospitals are 45 minutes travel time. AMR has formulated and implemented plans to provide our area with additional ambulances to insure that we will not experience excessive on scene ambulance wait times created by “wall times” ( the time that it takes to process the patient into the ER) To date AMR has done a good job in insuring adequate resources. Mercy Air 3 an ALS helicopter, is going to be move from Banning to Hemet Ryan in anticipation of possible increased need.

Hospitals Update Last week the Riv. Co. EMS Agency received news from Southwest Healthcare Administration that they have been noticed by the CDPH site review team to prepare the new expansion at Rancho Springs Medical Center for final licensing inspection. CDPH has authority over facilities and inspections. Fed. CMS has authority over Medicaid and Medicare qualifications.