1. Marshall City Council January 15, 2013 Mary Maertens, President & CEO

2. Background One of six regional Avera facilities 25-bed critical access hospital 76-bed long-term care facility Emergency care center – level 3 trauma designation Behavioral Health Center opened in July 2007 Outpatient services center Avera Medical Group clinics Management agreement with Avera in 2004 and renamed Avera Marshall Regional Medical Center Became an Avera sponsored facility in Nov. 2009

3. Mission Avera Marshall is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

4. Vision Avera Marshall will be the leading provider of high quality health care services for the region. Ministry: Avera Marshall participates in the healing ministry of Jesus. People: Avera Marshall will be the partner of choice for employees, physicians and communities. Service: Avera Marshall will exceed the expectations of our customers. Quality: Avera Marshall will lead the industry in clinical performance and innovative care delivery redesign. Financial Stewardship: Avera Marshall will achieve growth in our markets and maintain financial security.

5. Ministry Chaplain hired Mission leadership development Mission for staff Ethics committee Esther’s Kitchen Sponsor families at Christmas through Human Services

6. Ministry Community Health Needs Assessment Recommendations Partner to meet additional mental health needs Enhance cancer services Continue recruitment of medical professionals Consider additional services for aging population Collaborate to address transportation gaps Collaborate to address unmet basic needs

7. People Studer Group improvement initiatives Employee Engagement efforts Community leader – involvement in community activities and initiatives Support of new BSN program at Southwest Minnesota State University

8. People First Avera Medical Group Scholarship N. Ben Weiner Scholarship for employees Tough Enough to Wear Pink campaign Growth in employee giving to Avera Marshall Foundation

9. 22,500 square feet of new construction 5,220 square feet of remodeled space within the existing clinic structure 40 exam rooms, including 4 procedure rooms Service HCAHPS (patient satisfaction survey) 100% of short-stay rehab residents would recommend Avera Morningside Heights to others (September 2012) Race Against Breast Cancer

10. Service New services: stereotactic breast biopsy, family medicine, podiatry, Lasik vision correction, palliative medicine, medical weight management Growth of Avera Medical Group One provider in 2005 25 providers today in 12 specialties

11. Service New medical providers since January 2012 Family Medicine Hospital Medicine PodiatryGeneral SurgeryPsychiatry Amy Nicolas, CNPMelissa Scotting, CNPTheresa Bly, CNPJane Hartman, DO Justin Hartman, DOAlissa Redding, DPMTraci Kruse, MDRochelle Stark, MDWilliam Del Monte, MD

13. 2013 Priorities Orthopedics Internal Medicine Pediatrics Family Medicine Psychiatry Hospital Medicine Emergency Medicine Physician Recruitment

14. Quality

15. Clinical Pharmacy Services – anti-coagulation therapy, medication therapy management Blue Ribbon in Minnesota Department of Health FluSafe – 100% of staff immunized against influenza Focus on clinical performance

16. Financial Stewardship

17. Financial Stewardship Footprint Growth 2007 2013

18. Future Avera Cancer Institute Marshall Quality cancer treatment nearby home Radiation therapy – in addition to chemotherapy, surgery, on-site CT and MRI, dietitian consultation, home medical equipment Estimated cost $12.5-13.5 million – Portion of needed funds coming from sale of medical center to Avera in 2009

20. Comprehensive Cancer Care in Our Region TreatmentCurrent in MarshallProposed ChemotherapyProvided Included with opportunity to grow with expanded space Radiation TherapyNoYes Breast CancerNoYes Lung CancerNoYes Prostate CancerNoYes Rectal CancerNoYes Other cancers which may receive radiation oncology here: NoYes Skin cancers Lymphomas (Hodgkin's and Non-Hodgkin's) Sarcomas Cervical & Uterine Head & Neck cancers Palliative Radiation TherapyNoYes Other Services Patient NavigatorNoYes Research Coordinator Access in Sioux Falls On Site Multidisciplinary Treatment Planning Via phone or by going to Sioux Falls On Site

21. Identified Target Market