me: Sent: Cc: Subject: Ambulatory 19 Update MEMORANDUM Anne Arundel FROM: PeterW Odcnwald chief Operating Officer, Luminis Health Clinical Enterprise Ambulatory Update Dear Colleagues, We flrid ourselyes in unprecedented llmes With a global pandemic causing global economic impact recently read that 90% oithe world's schoolsaged children are out of School Unlmaginable 6 weeks ago! What will the implications ofthat phenomena be in 10 years? Of all Needless to say, we are in uncharted waters and as suth we find ourselves lorced to make that would have never been contemplated weeks ago. Our guiding principles furthese remain our priority and locus on the safety ofour staff and our to meet the needs of the community Based on our latest models With the most recent data, we anticipate a surge of patients in our region starting in approximately two weeks and peaking in mid-to-late June We are currently planning lor a surge of500+ comp-19 patients needing hospitalizatlon. This, oi Course, remains subiect to change as we gel updated data and respond to this evolving situation Throughout this pandemic, there is one thing oi which we are sure. We respond as we have ror more than 100 years by taking oaro oreach other and this community To do this in a waythat your health and safety, it is essential that we prioritize and provision pee tor those working in the hospital, With these considerations in mind, we are taking the unprecedented step of closrng our ambulatory locations to patients With few exceptions. This allows us to reallocate resources where they Will be needed most, We will contact many of you about working in the hospital to help with the lower acuity patients. WC Will not put any of you in an unsafe situation With regard to working Dulslde of your clinical competence Bear With us as we work through and roll out the full plan, To be orioctiye, the plan requires us to take ortion today. We have a short window where we can train staff on inpatient Epic and prowde basic orientation to the hospital and procedures To that end, effective Monday, April 6, 2020, we will close our ambulatory practices to physical visits. All providers are expected to maximize telemedicine and continue with video visits. Staff that will not have work are going to be referred to the redeployment center (RDC). The offices will be available for staff and providers to work, while following social distancing practices. WE ARE AVAILABLE to provide care to our patients virtually and in person, if necessary. In person care?will be limited to the following locations with minimal support staff to adhere to social distancing practices: Odenton Office . Orthopedics . Physical Therapy . Primary Care 0 . Cardiology and all other medicine services, as necessary Pasadena . Annapolis office due to in person volumes, will be evaluated weekly Annapolis Belcher - Breast Center (including minimal imaging), Surgical practices, Cardiology and all other medicine services, as necessary 0 Donner OPIV . Truman Pkwy - Infusion and Medical Oncology will provide services in the Sajak pavilion Easton . Chesapeake Women?s Health office . . Primary Care . Cardiology and all other medicine services MFM . Will operate as usual seeing urgent patients given the critical nature of the patients they treat Bay Area Midwifery . Will operate as usual seeing urgent patients due to the safety net services they provide Conexus . Will maintain operations only at the locations identi?ed above I know you will have questions. Please contact the appropriate directors and they will answer your questions. If they cannot answer your questions, the directors will escalate, and answers will be provided ASAP. These are challenging times and we appreciate your professionalism, cooperation, and leadership in helping guide Luminis Health. Warm Regards, -Peter Over the past few weeks and in the coming months, Luminis Health has been forced to redirect its clinical resources to respond to the COVID-19 pandemic. Some of these changes are due to government action, such as Maryland Govemor?s Executive Order prohibiting elective procedures, and other changes are necessary to accommodate the impending surge of 1 9 patients needing inpatient care at Anne Arundcl Medical Center. Regardless of the reason for the change, we recognize that these changes have impacted your ability to see patients in the same manner as you did in the beginning of March. With the decrease in patient volume, we understand there is a direct impact on your income. Therefore, we have created a voluntary Compensation Stabilization Program (the ?Program?) that you may elect to participate in by signing this letter. The goal of the Program is to ensure you maintain an expected level of compensation regardless of your production with the idea that any money advanced above expected production would be repaid over a longer time period. The terms of the Program are as follows (see attached example for further clarity): l. A participating physician will receive 70% of their FY2019 compensation for those days the physician is available and willing to work as required by the physician?s employment agreement and this letter (?Program Compensation?). 2. The physician will be paid Program Compensation in a bi-weekly paycheck with appropriate payroll deductions. For those physicians where expenses are directly attributed to the physicians net collection compensation), AAPG will not assess those expenses while participating in the Program. 3. At the conclusion of the Program, a reconciliation will be performed to identify any compensation paid that exceeded actual production (?Advanced Compensation?). The total amount of Advanced Compensation will be repayable in equal installments as follows: a. If the Advanced Compensation equals $10,000 or less, the Advanced Compensation shall be paid back to AAPG in four (4) equal installments over the subsequent four (4) performance period quarters. b. If the Advanced Compensation is greater than $10,000, the Advanced Compensation shall be paid back to AAPG in eight (8) equal installments over the subsequent eight (8) performance period quarters. 4. A participating physician must participate in the redeployment pool. 1f the physician is redeployed for inpatient care, the physician will receive a compensation credit of $2,000 for a redeployment day shift and $2,500 for a redeployment night shi?. The redeployment compensation will not count as Advanced Compensation at the time of the reconciliation process. 5. In the event notice has been given by either AAPG or physician to terminate the physician?s employment, the physician will not be eligible to participate in the Compensation Stabilization Program. If the physician?s employment terminates with an outstanding balance owed due to participation in the Program, the amount outstanding must be paid in full within thirty (30) days of the physician?s last day of employment. 6. To be eligible to participate, a Physician must be currently employed as a 0.5 FTE or more. The Compensation Stabilization Program is intended to provide you with ?nancial stability during this time of uncertainty. However, given how rapid things are changing in our current environment, we need to consistently reevaluate all of our compensation programs. This particular program will be reevaluated during the week of May 18, 2020 but is subject to change, amendment and/or cancclation at any time at the sole discretion of Luminis Health. If you agree to participate in the Program as outlined in this letter, please sign the letter and return it to me. Upon execution of this letter, you will participate in the program beginning with the next eligible payroll. Sincerely, Mitchell Schwartz, MD. President, Luminis Health Clinical Enterprise Agreed to by: Sign here: Date: Print Name: Compensation Stabilization Program Example 0 Dr. Mary received $300,000 in total FY19 Compensation. 0 70% of Dr. Mary?s FY19 Compensation is $210,000 or $8,076.92 payable bi-weekly (26 pay periods). 0 Dr. Mary elects to participate in the program beginning April 13"1 and the program remains in effect to August Therefore, Dr. Mary received 8 bi-weekly payments of $8,076.92. 0 The majority of Dr. Mary?s work was performed in her normal clinical setting. Dr. Mary did provide ten day redeployment shifts during the period of April 13th to August 3rd. Therefore, Dr. Mary earned $20,000 (10 shifts $2,000/shi? $10,000) in compensation credit during her participation in the Program. 0 At the conclusion of the program, the reconciliation showed that Dr. Mary produced at a level that would have entitled her to $5,000 per pay period during the Program. Therefore, Dr. Mary was advanced $3,076.92 each pay period above her production for a total amount of $24,615.36. However, Dr. Mary earned $20,000 in compensation credit so her total outstanding repayment obligation is $4,615.36. 0 The $4,615.36 in Advanced Compensation would be repaid in four equal installments at the end of each performance quarter in the amount of 1 53.84. Essentially, a repayment over 12 months. If Dr. Mary decided to take a week?s paid vacation during her participation in the Program, she would still receive the Program Compensation but her lack of production during that week would likely increase her repayment obligations.