Leadership Development Institute IX February 15 and 16, 2007

Wins  Maury Regional Cardiac Surgery Agreement  Nashville Surgery Center  Home Health Named “Elite”  Susan Cooper Named Commissioner of Health  VICC Invited to Join Elite National Cancer Center Network  Congress Votes $131M for State Safety Net  VUMC Annual Report and Vanderbilt Medicine Win Top Awards  DNA Databank Ready to Launch

Meet me at the State of the Medical Center Monday, March 5 at 4:00 PM NEW LOCATION – STUDENT LIFE CENTER

People

People

People Satisfaction Survey - Meta-Analysis Surveys Included: –Community Survey– Fortune 100 Best –Physician Survey Places to Work –NDNQI Nursing Survey Key Themes: –Cooperation among work teams is a source of friction –Communication between different levels is problematic –Staffing and necessary tools are low rated by MD’s and RN’s –Residents and faculty report little influence over decisions –Adequacy of pay and sharing financial success remain low but improved –Vanderbilt still ranks among the highest in Fortune 100 survey for commitment of staff to mission and purpose

People Fortune 100 Best Places to Work Projecting the Trend Forward

People Arnold Strauss, M.D. Jennifer Pietenpol, Ph.D.Kevin Churchwell, M.D. Jim ShmerlingRay DuBois Jr., M.D., Ph.D.

People David Posch Executive Director VMG Chief Executive Officer Vanderbilt Clinic Strategic direction Business development and growth Marilyn Dubree, M.S.N., R.N. Chief Nursing Officer Vanderbilt Medical Center Oversees all nursing operations – VUH– PHV – VCH– TVC Strategic Direction Practice Innovation Nursing Ecology

Survey% Excellent National Percentile Goal Adult IP63.5% th Percentile VCH IP72.6% th Percentile Adult ED57.7% th Percentile VCH ED64.6% th Percentile OP Surgery74.8% th Percentile OP Technical72.0% th Percentile Clinic Visit68.9% th Percentile Service Quality of Care July 2005 to December 2006

Service Likelihood to Recommend Vanderbilt July 2005 to December 2006 Survey% Excellent National PercentileGoal Adult IP67.2% th Percentile VCH IP77.8% th Percentile Adult ED60.5% th Percentile VCH ED69.4% th Percentile OP Surgery77.0% th Percentile OP Technical74.4% th Percentile Clinic Visit72.1%65.680% Excellent

Quality Quality VUMC Mortality Estimated Dec/Jan O/E

Quality Quality Monthly Mortality Rates * December 2006 = 2.23%

Quality Quality December Mortality Rates December of Monthly Mortality Annual Mortality %2.87% %2.57% %2.53% %2.55% %2.33% %2.27%

Quality Quality Publicly Reported Measures JCAHO and CMS

Growth VUSN Renovates Nursing Annex $2.1 M renovation of classroom space Construction began - 1/1/07 Anticipated completion – 7/31/07 Classes relocated to off-site location (Carell Building) for Spring Semester

Growth VUH Critical Care Tower Phase II CON approved September 2006 $169.0 million project Project mobilization underway: –Construction crane in place –Medical Center Drive Restructuring mid-March –Removal of old heliport complete New elevator construction underway in VUH Anticipated completion Fall 2009

Growth Medical Research Building IV Langford Addition Light Hall Addition Occupied 2005 MRV IV 385,000 GSF 221,900 NSF 13th Floor Framing (Top Research Floor)

Growth Vanderbilt Eye Institute Construction underway Occupancy January ,778 GSF renovation of two floors Program includes: –The Tennessee Lion’s Pediatric Eye Clinic –Comprehensive eye care and low vision rehabilitation –A refractive laser suite and diagnostics area –An optical retail shop –Departmental, Faculty and Business offices –40 subspecialty exam/treatment rooms –Treatment rooms for minor surgery and Argon and YAG laser surgery –New Pierce Ave. and South Garage entrances View from Pierce and 23 rd Ave.

Growth VUH East Garage Expansion Project completes Fall 2007 Adds 800 parking Spaces New Entry on 21 st Ave. New Garage Construction Looking South 21 st AVE.

Growth Vanderbilt Institute of Imaging Science Occupied October ,000 GSF 6 Magnets Vivarium Construction Above

Growth Centralized Vivarium and Gross Anatomy Lab at VUIIS Five Floor Addition of 42,500 GSF Gross Anatomy Lab 10 th Floor Three Vivarium floors One Shelled floor View from 21st Avenue

Growth Vanderbilt Ingram Cancer Center Clinic Entrance Clinic Waiting & Reception Multi-phased project Construction starts March 2007 Completion December 2008

Growth Hospital and Clinic Key Volume Measures Forecast Volume FY 2007 December YTD FY 2007 Forecast FY 2007 Target % Forecast To Target Discharges LOS CMI Patient Days Ambulatory Visits ED Visits Surgical Operations 25, , ,370 45,911 19,988 50, ,612 1,094,900 94,500 40,350 49, ,101 1,085,143 94,540 40, % -5.6% 0.0% -1.3% +0.9% 0.0% -1.4%

Financial Vanderbilt University Hospitals and Clinics Financial Performance Results Fiscal Year (in thousands) FY 2007 December YTD FY 2007 Forecast FY 2007 Target % Forecast to Target Net Revenue$584,018$1,193,818$1,183, % Operating Expenses$569,512$1,155,749$1,141, % Available for Capital Improvements$14,506$38,069$42, %

Financial Vanderbilt Children’s Hospital & Clinic Key Volume Measures - Fiscal Year 2006 – 2007 FY 2007 December YTD FY 2007 Forecast FY 2007 Target % Forecast to Target Volume Discharges6,63613,10012, % LOS % Patient Days38,38775,84475, % Ambulatory Visits75,968155,000147, % ED Visits20,25642,00041, % Surgical Operations6,31812,92013, %

Financial Vanderbilt Children’s Hospital & Clinic Financial Performance Results Fiscal Year (in thousands) FY 2007 December YTD FY 2007 Forecast FY 2007 Target % Forecast to Target Net Revenue$134,017$270,833$270, % Operating Expenses$124,841$253,548$256, % Available for Capital Improvements$9,176$17,285$ 14, %

Financial VUH Performance Results Fiscal Year 2006 – 2007 (in millions) FY 2007 December YTD FY 2007 Forecast FY 2007 Target % Forecast to Target Net Revenue$584.0$1,193.8$1, % Expenses$569.5$1,155.7 $1, % Available for Capital Improvements$14.5$38.1 $ % Source: VUMC Department of Finance

Financial Uncompensated Care Amount and Rate Year-to-Date December, 2006 (in thousands) FY 2007 Actual FY 2007 Target % Actual To Target FY 2006 Actual % Year to Year Uncompensated Care Amount $119,860$116, %$97, % Uncompensated Care Rate 7.6%7.5% +1.3%7.1%+7.0% Source: VUMC Department of Finance

Financial Uncompensated Care As of December 31, 2006 Self Pay Patients up 30% over Fiscal 2006 and 168% over fiscal 2005 Uncompensated Care Rate up to 7.6% compared to 4.6% in Fiscal 2005 $30 million in lost TennCare reimbursement compared to pre-disenrollment. Self Pay Patients are up in all major services since 2005 with the most significant increase in Trauma.

Solutions –Increased payment rates for Adults and Children –New Funding for Level I Trauma Centers –Federal Approval of $131Million Disproportionate Share Pool for Tennessee that needs to grow to $400 million by 2010 Financial TennCare

Financial Shape the Future Campaign as of January 31, 2007 $1.25B $1.31B $1.75B $625M $571M $888M dollars in billions

Financial Philanthropy PrioritiesGoalRaised to Date % towards goal Facilities$301.3M$135.3M45% Endowed Support$190.9M$96.2M50% Scholarship Support$78.2M$25.1M32% Programs & Research$301.8M$262.4M86% Unrestricted$15.8M$34.1M215% Designation Pending$17.8M TOTAL$888M$571M64%

Financial Philanthropy VICC$50MEye Institute$5M VCH$40MCELA$2M Dry Lab Building$21MNursing Annex$2M Kennedy Center$20MAnatomy Lab$2M Critical Care Tower $15M Selected Facilities and Program Priorities thru 2010