Mercy Medical Center- Sioux City Announces Strengthened Relationship with Siouxland Surgery Center

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1 JOINT NEWS RELEASE July 16, 2014 For more information, contact: Dianne Krier, Mercy Marketing and Communications Coordinator, Deb Lemmon, Director of Marketing and Planning, Ashley Mozak, PhyCare Management Services, Greg Miner, Siouxland Surgery Center Chief Executive Officer, Mercy Medical Center- Sioux City Announces Strengthened Relationship with Siouxland Surgery Center SIOUX CITY, IA - As part of its commitment to continually improve healthcare services in Siouxland and beyond, Mercy Medical Center - Sioux City (MMC- SC) announced today it has aligned with United Surgical Partners International (USPI) to jointly acquire majority ownership of the Siouxland Surgery Center (SSC) of Dakota Dunes, S.D. "In line with Mercy Health Network's (MHN) central mission, this move allows us to deliver an even higher- quality patient experience, and in ways unprecedented in this market," says James FitzPatrick, Interim CEO of MMC- SC. "For staff, for physicians, and for patients who entrust their care to us, it's about growing our organization in the right place for the right reasons at the right time." MMC- SC has been an established partner of SSC for many years. The expansion of the relationship to allow MMC- SC and USPI to hold the majority of SSC will help assure continued strength and stability of SSC and to improve medical services to the Siouxland community into the future. With more than 215 facilities in the United States, USPI has extensive experience in developing and managing successful partnerships focused on the highest quality patient care. According to FitzPatrick, this new partnership will lead to the investment of more than $100 million in improvements to surrounding facilities, innovation and technology, and for population health and community health programs.

2 "We are pleased to partner with organizations that are so clearly aligned with our own mission of providing the quality of care we would expect for our own families. We look forward to being part of the Siouxland Community," adds Brett Brodnax, USPI President and Chief Development Officer. "This is a historic day for Siouxland," says Milt Avery, Board Chair of MMC- SC and MHN. "It's a testament to our founding Sisters of Mercy, our 125 years of service to those in need, and our continued focus on the future of health care." "Expanding the partnership with MMC- SC and USPI demonstrates a very clear commitment of the physicians of SSC to the health care of the Siouxland Community," says SSC President, Dr. Ralph Reeder. "In working with MMC- SC, SSC will have a strong regional and national health care network and USPI brings a solid reputation for working with hospitals, physicians, and communities to work on the transition from hospital to ambulatory care. By all three of us working together, we will secure the much needed capital commitment for the health care of our community and the development of a true clinically integrated network." "By integrating our institutions," says Greg Miner, SSC CEO, "we can focus even more on the exceptional, individualized care our patients deserve." A member of CHE Trinity Health, the country's second- largest Catholic healthcare system, MMC- SC currently serves 33 counties in Iowa, Nebraska and South Dakota. As part of MHN, Mercy also owns or manages four rural hospitals, and operates 17 family- practice and nine specialty clinics in Iowa and Nebraska. It has earned more national recognition for quality patient outcomes than any other hospital in the region, as well as multiple honors for its leadership and excellence in many areas - including critical care, cardiac, stroke and cancer care. SSC is a 40- bed facility supported by over 130 physicians and providers who perform a variety of same- day and extended- stay general and specialized surgical procedures. Its reputation for patient satisfaction and procedural success aligns with the MHN tradition of compassionate and comprehensive service in the healthcare industry.

3 About MERCY MEDICAL CENTER 801 Fifth Street, Sioux City Iowa Living the traditions, visions and values of the Sisters of Mercy, Mercy Medical Center - Sioux City (MMC- SC) today is a part of CHE Trinity Health of Livonia, Mich., the second- largest Catholic healthcare system in the United States. MMC- SC is part of Mercy Health Network, an integrated system of member hospitals and other health and patient care facilities united into one operating organization to improve the delivery of healthcare services to the people of Iowa and surrounding communities. MMC- SC is a 238- bed regional center that provides residents in a 33- county tri- state region an entire continuum of preventive, primary, acute and tertiary healthcare services. MMC- SC also owns Baum Harmon Mercy Hospital in Primghar, Iowa, and Oakland Mercy Hospital in Oakland, Nebraska. MHN also manages Hawarden Community Hospital in Hawarden, Iowa, and Pender Community Hospital in Pender Nebraska. MMC- SC is home to the only Level II trauma center in western Iowa - one of only four trauma care facilities in the State to receive verification from the American College of Surgeons - and Mercy Air Care, the region's only helicopter ambulance service. Healthgrades, the nation s leading independent hospital ratings agency, in 2014 named MMC- SC as one of America s 100 Best Hospitals in coronary intervention and stroke care. In addition, Mercy received the Healthgrades Critical Care Excellence Award, placing it among the top 10 percent in the nation. About SIOUXLAND SURGERY CENTER 600 Sioux Point Rd., Dakota Dunes, S.D., Siouxland Surgery Center was organized in 1994 as an ambulatory surgery center in South Dakota, then licensed in 1998 as a licensed specialty hospital providing a wide range of major and minor surgical procedures on an ambulatory basis. Currently operating in Dakota Dunes, S.D., the 66,000- square foot facility features 14 surgical suites, licensed for 40 beds featuring 20 private rooms, numerous pre- op and recovery rooms, a consultation room, a pharmacy and a cafeteria.

4 Surgical specialties include gastroenterology; general surgery; gynecology; orthopedics; neurosurgery; otolaryngology; pain management; pediatric dentistry; plastic, cosmetic and reconstructive surgery; podiatry; urology; anesthesiology; pathology; and radiology. SSC is staffed by 130 physicians in addition to registered nurses, certified registered nurse anesthetists, anesthesiologists, certified surgical technicians, pharmacists, a registered dietician, a licensed nutritionist, a radiology technologist, and certified nursing assistants. SSC is the recipient of numerous nationwide accolades to by Press Ganey, Accreditation Association for Ambulatory Health Care (AAAHC), and most recently, Becker's Hospital Review. SSC is included on the list of "82 Physician- Owned Hospitals to Know " which highlights some of the highest performing hospitals that are partly or fully owned by physicians. About UNITED SURGICAL PARTNERS INTERNATIONAL Dallas Pkwy Suite 1600, Dallas, TX United Surgical Partners International is an experienced and trusted partner in some of the nation s most successful surgical networks. With over 215 facilities in the United States, USPI has extensive experience in developing and managing successful partnerships focused on high quality patient care. USPI maintains strategic joint- venture partnerships and over 60 percent of their facilities are owned with local not- for- profit health systems along with their physician partners. The company s strategy enables its partners and other aligned constituents to benefit from the high- quality, efficient and convenient settings in their facilities that provide superior satisfaction rates and critical access points under financial structures that work for them. About CHE TRINITY HEALTH Victor Parkway, Livonia, MI CHE Trinity Health is one of the largest multi- institutional Catholic health care delivery systems in the nation. It serves people and communities in 20 states from coast to coast with 84 hospitals, 109 continuing care facilities and home health and hospice programs that provide nearly 2.8 million visits annually. The organization was formed in May 2013, when Trinity Health and Catholic Health

5 East closed their consolidation to strengthen their shared mission, increase excellence in care and advance transformative efforts with their unified voice. With annual operating revenues of about $13.3 billion and assets of about $19.3 billion, the new organization returns almost $1 billion to its communities annually in the form of charity care and other community benefit programs. CHE Trinity Health employs more than 87,000 people, including 3,200 employed physicians. Committed to those who are poor and underserved in its communities, CHE Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not- for- profit provider of home health care services ranked by number of visits in the nation, as well as the nation s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit either health.org, or ###