1. Regional Review
Central Region
Robert L. Smith
Senior Vice President

2. Key Messages
• Attractive markets
• Physician employment
• Expanding the outpatient footprint
• Increasing case mix intensity or patient severity

3. Missouri and Tennessee
Hospitals
St. Louis
Des Peres, 2
St. Louis University
Total Beds 523
Hospitals
Memphis
St. Francis, 2
St. Francis-Bartlett
Total Beds 619
• Certificate of Need Regulations

4. Texas
Hospitals
El Paso
Providence, Sierra, Eastside 3
Dallas
Centennial, Doctors 3
at White Rock, Lake Pointe
Houston
Cypress Fairbanks, 3
Houston Northwest,
Park Plaza
East Texas
1
Nacogdoches
Total Beds 2,644
• Dallas-Fort Worth currently adding more residents than any other metro area nationwide
and projected to be 3rd largest in the country by 2030
• Houston 4th largest city in the nation
• El Paso’s Ft. Bliss BRAC (base realignment and closure) is in the process of adding
65,000 soldiers and their families through 2013

5. High Population Growth Service Areas
2000 - 2007 2007 - 2012
Dallas MSA 16.4% 9.7%
Centennial 85.9% 30.6%
Lake Pointe 37.2% 17.9%
Houston MSA 16.4% 8.7%
Cypress Fairbanks 39.9% 17.0%
Houston Northwest 17.8% 9.0%
El Paso MSA 8.2% 5.3%
Sierra Providence East 17.8% 9.0%
Source: Thomson Medstat – 2007 Claritas Data

6. Central Region TGI Actions
• Physician employment in primary care specialties
• Expansion of the outpatient footprint
• Growth of service intensity

7. Central Region Markets
HealthGrades 2007 statistics
• 3.7 million searches for a physician
• 780,000 physician reports opened
• Consumers clicked on “appointment request”
button over 208,000 times
• HealthGrades results show consumers are 33%
more likely to contact the physician when they have
more information about the practice

8. Cypress Fairbanks Regional Health Network
Houston, Texas

9. Physician Employment
PROJ PROJ
2006 2007 2008 2009
Markets 1 6 9 9
Clinics 3 12 19 23
Physicians 5 19 27 40

10. Primary Care Physician Productivity
Annual admissions per productive physician average
• Family Practice 70
• Internal Medicine 120
• OB/GYN 185
• Pediatrics 65
Source: Tenet – McKinsey analysis

11. Lake Pointe Regional Network
Outpatient Footprint

12. Lake Pointe Regional Network
Outpatient Footprint

13. Outpatient Footprint
• New Offsite Clinics Include
– 5 Imaging Centers
– 2 Sleep Labs
– 2 Urgent Care Centers
– Wound Care Center
– Physical Therapy Clinic
• 6 - 7 mile average distance from hospital campus

14. Lake Pointe Regional Network
Outpatient Footprint

15. Lake Pointe Regional Network
Outpatient Footprint

16. Ease of Access a Priority
• Ease of access to results for physician
– PACS
– Physician Portal
• Ease of access in scheduling for physicians and patients
– Evening and Saturday appointments
– Centralized scheduling
– Online scheduling and precertification
• Ease of access in registration for patients
– Online
– Kiosk
– SmartCard

17. Patient Kiosk

18. Growing Intensity
Acute Case Mix Index
Total Medicare
2006 1.326 1.519
2007 1.330 1.520
2008 YTD 1.369 1.539
• 8 of 13 hospitals increased both Medicare and total CMI from
2006 to 2007
• 12 hospitals have increased in total CMI and 5 have increased in
Medicare CMI from 2007 into 2008

19. Service Lines Growing Intensity
• Neonatal ICUs
• Vascular Programs
• Neurosciences/Stroke
• Spine & Orthopedic Surgery
• Oncology Programs
• Cardiac Programs
• ER Trauma Designations

20. Growing Intensity
2006 2007
Medicare LOS 6.13 6.02
Medicare CMI 1.519 1.520
• Every .01 increase in CMI change across the Region
creates an estimated $5.6 million in net revenue

21. Central Region Summary
• Attractive growing markets
• Continued TGI focus from 2005
• Physician employment
• Expanding outpatient access points
• Growing intensity