Greg SteinConstruction Manager

July 15July 15thth, 2004, 2004

CMAA - Washington

An overview presented by:

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CMAA - Washington

About HCAFounded by Dr. Thomas Frist, Sr. in 1968A leader in Investor–Owned hospital companiesA leader in technology integration to benefit patient care

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CMAA - Washington

Our Mission & ValuesAbove all else, we are committed to the care and improvement of human

life. In recognition of this commitment, we strive to deliver high-quality, cost-effective healthcare in the communities we serve.

In pursuit of our mission, we believe the following value statements are essential and timeless.

We recognize and affirm the unique and intrinsic worth of each individual.

We treat all those we serve with compassion and kindness.

We act with absolute honesty, integrity and fairness in the way we conduct our business and the way we live our lives.

We trust our colleagues as valuable members of our healthcare teamand pledge to treat one another with loyalty, respect and dignity.

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CMAA - WashingtonHCA Geographically

Switzerland

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U.K.

184 Hospitals184 Hospitals23 States, U.K. and Switzerland23 States, U.K. and Switzerland

%

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CMAA - Washington

45 Million Square Feet of Acute Care Space

Average 238,000 SF/Hospital

41,251 beds in the system

Average 218 beds per hospital

SIZE OF HCA

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CMAA - WashingtonOperations Team

Eastern Group

Eastern Eastern GroupGroup

Western Group

Western Western GroupGroup

Sam HazenPresident

Sam HazenSam HazenPresidentPresident

Charles EvansPresident

Charles EvansCharles EvansPresidentPresident

Rick ShallcrossCFO

Rick ShallcrossRick ShallcrossCFOCFO

Bill RutherfordCFO

Bill RutherfordBill RutherfordCFOCFO

OrlandoTreasure CoastPalm BeachBrowardDade

Ft. MyersTampa

CharlestonMyrtle Beach

ColumbusAtlanta

Rome

Middle GA

ChattanoogaNashville

Frankfort

Terre Haute

S.W. Virginia

BeckleyCharleston

Parkersburg

N. VirginiaRichmond

PanhandleN. Central Fl.

JacksonvilleAlbanyLos Angeles

Anchorage

San Jose

CaldwellIdaho Falls

Salt LakeCity Denver Wichita

OklahomaCity

Dallas/Ft. Worth

El Paso

San Antonio

McAllenBrownsville Corpus Christi

New Orleans

AustinHouston

Lafayette

Monroe

Alexandria

Gulfport

Olympia

Las VegasKansas

City

HCA Operations

NewHampshire

Multi-Facility MarketsSingle Facility Markets

Domestic Hospitals 184

Florida 22%Texas 20%Georgia 8%Louisiana 8%Tennessee 7%

ASCs 79Domestic Employees 137,000

Augusta

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CMAA - Washington

Baby Baby BoomersBoomers

200520054343--6060

Baby Boomers To Drive Hospital Utilization Rates Up

Source: National Hospital Discharge Survey, Center for DiseaseControl and Prevention, 1998

Baby Baby BoomersBoomers

201020104848--6565

Baby Baby BoomersBoomers

201520155353--7070

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

15-24 yrs

25-34 yrs

35-44 yrs

45-54 yrs

55-64 yrs

65-74 yrs

75-84 yrs

85+ yrs

Hospital Days Hospital Days Per 1,000 Per 1,000 PopulationPopulation

Days of Care

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CMAA - WashingtonHospital Admission Trends RisingWhile Number of U.S. Hospitals Declining

Boomers Begin

Turning 50

Admissions

Hospitals

4,400

4,600

4,800

5,000

5,200

5,400

5,600

5,800

6,000

19751979

19811983

19851987

19891991

19931995

19971999

27,00028,000

29,00030,00031,000

32,00033,00034,00035,000

36,00037,000

Source: American Hospital Association

Number ofHospitals

Admissions(000’s)

HCA Is A Volume Game

We Deal With The Volume by Process

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CMAA - Washington#

of H

ospi

tals

$9.3

$4.6$6.2

$7.7

$5.5$4.5

100

200

300

400

1997 1998 1999 2000 2001 2002$2

$3

$4

$5

$6

$7

$8

$9

$10

Cap Expenditures in billions

Cap

Exp

endi

ture

s

# of Hospitals

Capital Expenditures Per Hospital

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CMAA - WashingtonHCA Capital ExpendituresAccelerating to Meet Service Demands

$0.0

$0.5

$1.0

$1.5

$2.0

2000 2001 2002 Est. 2003 Est.

$1.2 $1.4 $1.6 $1.8

RoutineCapital

Facility ExpansionProjects

New &Replacement Facilities

Shared Services/Technology

Billions

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CMAA - Washington

Land & Improvements

14%/$565M

Surgery/Special Units

22%/$870M

Beds14%/$550M

New Facilities10%/$395M

New & Expanded Services

18%/$740M

Replacement Facilities3%/$98M

ER & Outpatient Services19%/$720

Distribution of Capital DollarsDistribution of Capital Dollars20022002--2005 and beyond2005 and beyond

1,565 New Beds

54 Facilities with Surgery and/or ICU/CCU

expansions

Four New Facilities378 Beds

37 ERExpansions Imaging,

Open Heart, CardiologyOncology, etc.

How Do We Do All That We Do

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CMAA - Washington

Project DevelopmentStrategic PlanningFacility Planning/Space PlanningMedical/Equipment PlanningDesignConstructionCommissioning

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CMAA - WashingtonTom GormleyVice President

Planning & Architecture

Claudia Stengel AVP (7)

Design & Construction

ADA/ Bulk Purchasing

Jon Faill Director (4)

Financial Admin., & Diversity

Juliann Cataldi

Director (3)

Corporate Facility MgmtBrian Weldy

Director (12)

EngineeringMike

McIlwainDirector (10)

Equipment Planning

Robert BirdAVP

West/ASDDrew White

AVP(6)

East/IntlSteve

Brecker AVP(5)

West/ASDHarry Batten

Sr. Eqpt Mgr. (7)

EastMike

Wessel Sr. Eqpt Mgr. (4)

Design, Construction, Equipment, Corp Facility Mgmt., Engineering,

ADA & Diversity

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CMAA - Washington

Project OversightConstruction Managers(6)

EngineerContractorArchitect

ConsultantsTesting Agency

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CMAA - Washington

Southern Hills, Las Vegas, Nevada

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CMAA - WashingtonStonecrest, Nashville, Tennessee

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CMAA - WashingtonDenton Regional, Denton, Texas

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CMAA - WashingtonCapital Regional, Tallahassee, Florida

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CMAA - Washington

HCA PARTNERS WITH THEIR

ARCHITECTS/CONTRACTORS/ENGINEERS

HCA PARTNERS WITH THEIRHCA PARTNERS WITH THEIR

ARCHITECTS/CONTRACTORS/ARCHITECTS/CONTRACTORS/ENGINEERSENGINEERS

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CMAA - Washington

Project Delivery Methods

Construction management @ Risk utilizing a Cost Plus Fee FormatDesign Build utilizing both Stipulated Sum and Cost Plus FeeGeneral Construction utilizing a Stipulated Sum

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CMAA - WashingtonCommissioning:

A Buzzword ?Is it Designed Properly?Is it Installed Properly?Is it Optimized for Peak Efficiency?Is it interfaced properly?Is it Really Commissioning or Is It just Doing it Right? Should Doing It Right Cost More?

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CMAA - Washington

Top 6 CM ChallengesToo Many Project Developments

Too Many Vendor Direct Reports

Too Many Voice Mails

Too Many Emails

Too Much Travel

Not Enough Greg To Go Around!

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CMAA - Washington

Top 4 CM Challenges (seriously)

Training Our Vendors To “Our Way”

Rising Cost of Labor and Materials

Poor Contract Administration

Not Enough Greg To Go Around!

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CMAA - Washington

Keys To SuccessEliminate “Earn As You Learn” Mentality

Eliminate Costly Mistakes through Process

Hire Vendors You Trust and Trust The Vendors You Hire

Inspect What is Expected

Enforce the Fundamentals “Blocking & Tackling”