Wellmont Health System - Virginia Department of Health

RESPONSE #6 TO QUESTIONS SUBMITTED DECEMBER 22, 2016

BY VIRGINIA DEPARTMENT OF HEALTH

IN CONNECTION WITH APPLICATION FOR LETTER AUTHORIZING COOPERATIVE AGREEMENT

Pursuant to Virginia Code ? 15.2-5384.1 and the regulations promulgated thereunder at 12VAC5-221-10 et seq.

Submitted by: Date:

Mountain States Health Alliance Wellmont Health System

January 27, 2017

Cooperative Agreement Application Response #6 dated January 27, 2017 For Request Dated December 22, 2016

III. Definitions

All defined terms of Virginia's Rules and Regulations Governing Cooperative Agreements, 12 VAC 5-221, apply.

"Appendices" shall mean: the 3,791 page document labeled Application for a Letter Authorizing Cooperative Agreement ? Exhibits. "Applicants" or "Parties" means MSHA and WHS. "Application" means the Application for Letter Authorizing Cooperative Agreement submitted by MSHA and WHS to the Authority on February 16, 2016. "Authority" means the Southwest Virginia Health Authority. "Authority Report" means the Southwest Virginia Health Authority's "A Review of The Commonwealth of Virginia Application for a Letter Authorizing a Cooperative Agreement Filed by Mountain States Health Alliance and Wellmont Health System" dated December 22, 2016. "Authority Responses" means the Responses submitted by the Parties on July 13 and 25, 2016 to the Authority's Questions dated May 26, 2016. "Ballad Health" or "New Health System" means the entity to be formed under the cooperative agreement contemplated by the Application. "Ballad Health Alignment Overview" means the document attached as Exhibit T-32A. "Cooperative Agreement Statute" means Virginia Code ? 15.2-5384.1 et seq. entitled "Review of cooperative agreements."

"Cooperative Agreement Regulations" means "Virginia's Rules and Regulations Governing Cooperative Agreements" at 12VAC5-221-10 et seq.

"DOH Request #1" means the Commissioner's Request for Supplemental Information dated December 22, 2016.

"DOH Request #2" means the Commissioner's Request for Supplemental Data dated January 9, 2017.

"Facility" shall mean "Hospital" as defined in 12 VAC 5-221-20 of Virginia's Rules and Regulations Governing Cooperative Agreements.

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Cooperative Agreement Application Response #6 dated January 27, 2017 For Request Dated December 22, 2016

"Five (5) year forecast period" shall mean FY 2016-2017, FY 2017-2018, FY 2018-2019, FY 2019-2020, FY 2020-2021.1 "Five (5) year historical baseline period" shall mean FY 2010-2011, FY 2011-2012, FY 2012-2013, FY 2013-2014, FY 2014-2015.2 "FY" shall mean the parties' fiscal year. "MSHA" or "Mountain States" shall mean Mountain States Health Alliance. "NHS" shall mean the proposed New Health System ("Ballad Health"). "Quantitative measures" means a set of measures used to objectively track the progress of a Cooperative Agreement over time to assess whether its benefits outweigh the disadvantages attributable to a reduction in competition resulting from the Cooperative Agreement.

"PSR" or "Pre-Submission Report" means the Pre-Submission Report submitted by the Parties to the Authority on January 7, 2016. "Two (2) year historical baseline period" shall mean FY 2013-2014 and FY 2014-2015.3 "Virginia facilities" shall mean any facility location in Virginia and operated by MSHA, WHS, or a corporation related to MSHA or WHS. "WHS" or "Wellmont" shall mean Wellmont Health System.

"YTD" shall mean year to date.

1 Standard exhibits for two (2) and five (5) year historical period, YTD, and five (5) year forecast should list: 1) Service definitions, 2) Utilization statistics, 3) FTE by job class, 4) Revenues and Expense classifications consistent with Medicare cost report department definitions. 2 Standard exhibits for two (2) and five (5) year historical period, YTD, and five (5) year forecast should list: 1) Service definitions, 2) Utilization statistics, 3) FTE by job class, 4) Revenues and Expense classifications consistent with Medicare cost report department definitions. 3 Standard exhibits for two (2) and five (5) year historical period, YTD, and five (5) year forecast should list: 1) Service definitions, 2) Utilization statistics, 3) FTE by job class, and 4) Revenues and Expense classifications consistent with Medicare cost report department definitions.

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