1. Inova Health System Management Team Update September 2007

2. Quality and Safety 2007 SafetyGOAL IAHIFHIFOHILHIMVHICCCICGCCIVNAHH Year to Date Event Rate0.07 0.1630.0490.1440.190.1590.0380.0440 Clinical Effectiveness Percent of Core Measures at 100%75% 68%44%75%50%63%60%70% Percent of 100K Lives Indicators at Target100% 75% 34%100%na Regulatory Readiness Percent of Monthly Mock Surveys Passed67% 57%86%100% 63%34%67%71% At or better than 2007 goal At 50% of goal or better Less than 50% of the goal

3. Patient Safety Year over year statistics: Safety events 2006: 44Safety events 2006: 44 Safety events 2007: 32Safety events 2007: 32 Event related mortality 2006: 29%Event related mortality 2006: 29% Event related mortality 2007: 16%Event related mortality 2007: 16% Event Classification 2006 vs. 2007

4. Clinical Effectiveness Measures

5. 200620072006 CMS Benchmarks IHS Avg. TopVANational AMI 10thAvg Aspirin at Arrival96%100% 95%93% Aspirin Prescribed at Discharge94%93%100%92%90% ACEI for LVSD88%100% 86%83% Adult Smoking Cessation Advice Counseling99%96%100%88%89% Beta Blocker Prescribed at Discharge95%100% 94%90% Beta Blocker at Arrival94%100% 91%87% PCI Received Within 120 Minutes of Hosp Arrival 75%88%60%55% CHF Discharge Instructions50%70%93%68%62% LVF Assessment91%98%99%87%84% ACEI for LVSD88%100% 84%82% Adult Smoking Cessation Advice/Counseling64%67%100%88%83% PNEUMONIA Oxygenation Assessment100% 99% Pneumococcal Vaccination52%83%94%72%71% Adult Smoking Cessation Advise/Counseling57%80%100%84%81% Initial Antibiotic Received Within 4 Hrs of Hosp Arrival80%93% 77%80% SIP Prophylactic antibiotics given within one hour of incision76%78%94%79%78% 2006: % Green (Top 10%)= 7% % Blue (Average) = 40% % Red (Below Avg)= 53% 2007: % Green (Top 10%)= 44% % Blue (Average) = 50% % Red (Below Avg)= 6%

6. Inova Health System Implementation of "Safety Essentials" - Progress Report August 2007 IAHIFH IFHC IFH IFOHILHIMVH ICCCICGCC IVNA AmbulSystem* Safety Essentials CoreIHVI Women's HH Safety Oversight Team4444444433439 of 12 Safety Rounds4444444423439 of 12 Safety Coaches3334444423225 of 12 Safety Huddles44444444244310 of 12 RN staffing at 50th percentile24343443na 4 5 of 9 Charge RN out of staffing33333443na 433 of 10 Charge RN standard reportWIPYes WIP YesWIP Medical Staff Transparency23333333na2 30 of 10 Key Have not started 1 Planning/initial implementation 2 Partially implemented 3 Fully implemented/operational 4 WIP: Work in progress % of shifts with Charge RN out of staffing: (July 07) IAH: 79% IFH: 61% IFOH: 90% ILH: 96% IMVH: 38%

7. People Metric 2007 Q2 Goal2007 Q2 Results  Net New RN’s (FTEs)98131.5  Retention of priority clinical staff with less than 2 years experience 80%71.8%  Reduce Employee Related Injuries by 33% 313452  Great Places to Work Satisfaction Score 70% v 90 Day Action Plans v Employee Pulse Check May 67.6%

8. Growth Metric Q2 2007 YTD Goal Q2 2007 YTD Results  Equivalent Admissions83,95085,168  Outpatient Surgeries27,13527,952  Home Care Visits57,12040,848  Resident Days79,18377,508 Inova Employee Assistance Program EAP achieved a 13.5% increase in overall gross revenue as of 8/1/2007. Sales efforts resulted in 46 new contracts

9. Community 2007 Q2 Goal2007 Q2 Result Philanthropy – Gifts$10,000,000$8,300,000 Disaster Preparedness  Caring is Preparing booklet and dvd sent to all employees  Pandemic Flu staff prophylaxis plan in place Employee +3 to be treated in event of a disaster or flu Nex Genesis tracking system in place with training planned for September  Table top drill planned for 4th quarter

10. Cost Metric Q2 2007 YTD Goal Q2 2007 YTD Result  System-wide EBIDA Margin 14.5%15.6%  System-wide Operating Expenses (excluding interest and bad debt) per Equivalent Admission $9,606$9,267

12. Inpatient Trends

14. Patient Satisfaction Excellent Percentile Ranking Quarter 3 (as of September 17, 2007) Inpatient GoalActual Inova Health System 6372 Inova Alexandria Hospital 4425 Inova Fairfax Hospital 6677 Inova Fairfax Hospital for Children 6285 Inova Fair Oaks Hospital 8186 Inova Loudoun Hospital 6782 Inova Mount Vernon Hospital6115

15. (10525402) Overall, would you rate the quality of care provided as: Rankings for All Service Lines by Sample Group in Jul-Sep 07*

17. Emergency Department Trends

18. Patient Satisfaction Excellent Percentile Ranking Quarter 3 (as of September 17, 2007) Emergency DepartmentsGoalActual Inova Health System7353 Inova Alexandria Hospital5611 IECC Fairfax9651 IECC Loudoun8186 IECC Reston8761 Inova Fairfax Hospital6318 Inova Fairfax Hospital for Children7490 Inova Fair Oaks Hospital7361 Inova HealthPlex7361 Inova Loudoun Hospital6151 Inova Loudoun Hospital – peds6190 Inova Mount Vernon Hospital428

19. (30525402) Overall, would you rate the quality of care provided as: Rankings for All Service Lines by Sample Group in Jul-Sep 07*

20. Outpatient Surgery Trends

21. Patient Satisfaction Excellent Percentile Ranking Quarter 3 (as of September 17, 2007) Outpatient SurgeryGoalActual Inova Health System8674 Inova Alexandria Hospital8255 Inova Fairfax Hospital - ASC7966 Inova Fairfax Hospital – Women’s OR 9484 Inova Fairfax Hospital - Woodburn8640 Inova Fair Oaks Hospital9355 Inova HealthPlex9198 Inova Loudoun Hospital7114 Inova Loudoun Amb Surgery Center87100 Inova Mount Vernon Hospital98

22. (50525402) Overall, would you rate the quality of care provided as: Rankings for All Service Lines by Sample Group in Jul-Sep 07*

23. Outpatient Radiology Trends

24. Patient Satisfaction Excellent Percentile Ranking Quarter 3 (as of September 17, 2007) Outpatient RadiologyGoalActual Inova Health System5079 Inova Alexandria Hospital6492 Inova Fairfax Hospital – CT500 Inova Fairfax Hospital - Diagnostic5024 Inova Fairfax Hospital – MRI OP5095 Inova Fair Oaks Hospital7074 Inova HealthPlex5992 Inova Loudoun Hospital5987 Inova Mount Vernon Hospital6995

25. (20525402) Overall, would you rate the quality of care provided as: Rankings for All Service Lines by Sample Group in Jul-Sep 07*

27. Overall Progress Almost one half (38 of 83) of our departments are meeting or exceeding the systemwide goal for their respective area.

28. Units above 90 th percentile – Q3 td 2007 IHVI – Cardiac Step Down LASC – OP surgery ILH – Medical IFHC – NICU IFH Cardiac cath HealthPlex – OP radiology HealthPlex – OP surgery IFH – OP MRI ILH Leesburg – OP radiology IMVH – OP radiology IMVH – OP surgery IFOH – Medical IHVI – PCCU ILH – Obstetrics IAH – Medical 2122 IAH – OP radiology IAH – Neurovascular IMVH – Rehab 5B IFHC – ED ILH – peds ED