VISN 19 Salt Lake City Market Data Discovery & Findings

VISN 19 Salt Lake City Market DataDiscovery & FindingsSubmission to VISN LeadershipOctober 4, 2019

Sec�on Slide Numbers Order

OverviewMarket Geography and DemographicsEs�mated Current and Historic Market Demand – Outpa�entEs�mated Future Market Demand – Outpa�entEs�mated Current and Historic Market Demand – Inpa�entEs�mated Future Market Demand – Inpa�entEs�mated Current Total VA Market SupplyEs�mated Current Total Community Market SupplyCurrent AccessQuality & Sa�sfac�onFacili�esMissionCost

37276884113119133142159176188196

123456789

10111213

VA Market Area Health Systems Op�miza�on

VISN 19: Salt Lake City Market

Table of Contents

2

Overview

3

The Data Discovery & Findings (DD&F) deck is a standardized collec�on of data that will be used across market assessments to understand important aspects of each market. It is similar to the deck that was presented during previous VHA Office of Policy and Planning (OPP) market assessment trainings and will be used to develop key findings and inform the development of opportuni�es to create high-performing networks of care.

Data is pulled from a wide range of VA and commercial sources, and each slide cites the relevant data source.

The DD&F is one piece of the overall market assessment process. The assessments will also be informed by review of local data and site visits to ensure that both qualita�ve and quan�ta�ve data are considered. No single data point will be used as the deciding factor in determining opportuni�es for the market.



Overview Document Purpose

4


VISN 19: Salt Lake City MarketOverview Assump�ons• VA Data & AnalysisüAll VA data was extracted and provided by VA for use in the DD&F.

üWhen there were discrepancies between data obtained from local sources and data obtained from na�onal sources, na�onal sources were used.

üIn various places throughout the deck, there are mappings to translate data between different data types (e.g., HSPC, bed sec�ons, stop codes, specialty, services lines, CPTs, DRGs, etc.). These mappings were provided by the Office of Policy & Planning (OPP) and implemented to aggregate or categorize data for display in the slides. It also allows for a be�er programma�c view of care.

üTrea�ng facili�es that have a parent in a different market are displayed in both the trea�ng facility market and the parent market.

üEnrollee Health Care Projec�on Model (EHCPM) cita�ons include a combina�on of market-based and facility-based projec�ons. These two projec�on model views are different, and the numbers are not intended to match.

üEHCPM data for the year 2017 is pulled from the “Actuals” databases instead of the projected year 2017.

üThe facili�es contained within the DD&F are based on the Facility Hierarchy file provided by OPP. Any data for facili�es not in this file are not included in the DD&F. Addi�onally, the facility market, county, parent, and name are found within this file.

üThe market hierarchy geography used to create the DD&F is from the BY17 EHCPM. All VISN/Market/County mappings are based off of this geography.

üNumeric values of data throughout the DD&F are rounded.

üOffice of Community Care data was obtained using the Program Integrity Tool. This data may have anomalies, gaps, and missing values due to various methods of processing Choice data within the last several years. Any iden�fied gaps were addressed with reasonable logic wherever possible; however, errors may remain.

üFor maps, any site of care deac�vated in VAST a�er July 18, 2019 will not be reflected.

üFor workload trending purposes, slides may contain facili�es that are deac�vated, if they had workload in FY16, FY17 or FY18.

üPlanned sites of care are not included on maps unless specifically requested and jus�fied.

5



• Commercial Market Data & AnalysisüThe commercial market capacity assessment considers only reported physical capacity and does not incorporate: 1) ability to staff pa�ent care services or accept VA pa�ents; 2) length of �me to change facili�es to accommodate Veteran demand; and 3) any nego�a�ons for specific rates for care provided in the community.

üPediatric healthcare was not considered.

üIBM Market Expert FTE es�mated demand is based on a median provider produc�vity level by service line.

üThe 10 year commercial workload es�mates are based on the 10 year IBM/Watson Health Market Expert projec�ons straight-lined through 2028.

üCommunity hospitals within a 60 minute drive �me of the VAMC’s zip code were the primary focus for assessment and used as a comparison to each VAMC.

üDue to differences in hospitals’ cost repor�ng periods, FY18 CMS Cost Report data was used when available and FY17 CMS Cost Report data was used when FY18 data was not available.

• QualityüDifferences in quality metrics between VA and widely accepted commercial benchmarks introduce significant subjec�vity.

• Cost Analysis and Recommenda�onsüThis is a high-level cost analysis. It compares three data points: internal VA cost to provide care to Veterans, poten�al cost to acquire the same care in the market at Medicare rates, and exis�ng experience with purchase of Non-VA care as applicable.

üAdjusted total cost by DRG as well as non-VA purchased care paid by DRG was provided by VA.

Assump�ons, cont.Overview

6

Demographics Market Geography and Demographics

7

Exis�ng VA Market and Facility HierarchyDemographics

Note: Mobile sites are not listedSource: 1. BY17 EHCPM 2. FY18Q4 VAST 1.1.V19.SaltLakeCity



8

Key Market Sta�s�cs

*Core uniques excludes uniques who have only used telephone triage, pharmacy,

and lab.

Total 2017 Enrollee Popula�on: 67,400

Market OverviewDemographics

Source: 1. BY17 EHCPM 2. VSSC Unique Pa�ents Cube 1.2.V19.SaltLakeCity



• Top Coun�es by Enrollee Popula�on: Id

◦ Salt Lake, UT: 20,618◦ Davis, UT: 7,758◦ Weber, UT: 6,654

184185186

• Total Enrollees: 56th of 96 markets

• Es�mated 10-Year Enrollee Change: 4.6%◦ 30th of 96 markets

Total 2017 Eligible Veteran Popula�on: 111,239• -8.5% es�mated 10-Year Eligible Veteran Popula�on Change

Id

◦ (V19) (660) Salt Lake City 1

2018 Core Uniques:* 43,321

VAMC:

Exis�ng VHA System

9

Market Enrollee Demographics

County Sector FY17 FY27 10 Yr. Change FY37 20 Yr. Change DO

Salt Lake, UTSector SubtotalUtah, UTWashington, UTTooele, UTCache, UTElko, NVIron, UTBox Elder, UTSanpete, UTUintah, UTSummit, UTCarbon, UTSevier, UTDuchesne, UTWhite Pine, NVWasatch, UTMorgan, UTKane, UTMillard, UT

19-f-9-A19-f-9-A19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B

20,61820,618

6,4104,3501,7781,4931,4071,2861,035

634685566552532484419356231251248

19,32719,327

6,9874,9072,0371,6981,4261,3441,152

667667619576555487419359298252242

-6.26%-6.26%9.00%

12.82%14.53%13.77%

1.40%4.54%

11.29%5.28%

-2.63%9.43%4.31%4.28%0.72%

-0.11%0.79%

29.10%0.42%

-2.54%

17,64917,649

6,7554,8882,0931,6421,3801,3091,115

628640625565519432393347331254234

-14.40%-14.40%

5.38%12.39%17.68%10.01%-1.89%1.80%7.75%

-0.82%-6.52%10.37%

2.34%-2.45%

-10.78%-6.31%-2.46%43.18%

0.91%-5.64%

123456789

1011121314151617181920

Demographics

Source: BY17 EHCPM VetPop & Enrollment 1.3.V19.SaltLakeCity

Note: Market totals do not exactly match following slides due to rounding by county within EHCPM.



County-Based Enrollee Projec�ons

10

Market Enrollee Demographics, cont.


Juab, UTEmery, UTGarfield, UTBeaver, UTWayne, UTDagge�, UTPiute, UTRich, UTSector SubtotalDavis, UTWeber, UTSector SubtotalBannock, IDBonneville, IDBingham, IDJefferson, IDMadison, IDFremont, IDFranklin, IDCaribou, ID

19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-D19-f-9-D19-f-9-D19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E

221206160145

56534837

23,6427,7586,654

14,4122,7152,5901,101

587352348242185

234198174147

61484634

25,6368,7337,315

16,0492,9612,8761,209

626390364263182

6.07%-3.98%8.91%1.87%8.90%

-9.76%-3.81%-7.29%8.44%

12.57%9.94%

11.36%9.06%

11.04%9.82%6.73%

10.67%4.80%8.59%

-1.90%

225183161143

62524339

25,0588,8987,423

16,3222,8922,7791,162

620363352263173

1.92%-11.40%

0.45%-0.97%9.17%

-2.26%-8.62%6.38%5.99%

14.70%11.57%13.25%

6.53%7.32%5.57%5.71%3.10%1.38%8.78%

-6.67%

2122232425262728293031323334353637383940

Demographics

Source: BY17 EHCPM VetPop & Enrollment 1.3.V19.SaltLakeCity#2





11

Market Enrollee Demographics, cont.


Oneida, IDBear Lake, IDPower, IDTeton, IDClark, IDSector SubtotalMarket Total

19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f

156164138134

168,728

67,400

175170156130

199,520

70,532

12.05%3.71%

13.14%-3.41%16.45%

9.08%4.65%

160157151123

159,212

68,241

2.02%-4.26%9.85%

-8.11%-6.24%5.55%1.25%

41424344454647

Demographics

Source: BY17 EHCPM VetPop & Enrollment 1.3.V19.SaltLakeCity#3





12

Sectors Counties

Market Projected Enrollee 10-Year Change (FY17-27)Demographics




13

Market Enrollee and Eligible Demographics

Geography Measure FY17 FY27 10 Yr. Change FY37 20 Yr. Change DisplayO…

VISNMarketNa�onalVISNMarketNa�onal

EOY EnrolleesEOY EnrolleesEOY Enrollees

Eligible VeteransEligible VeteransEligible Veterans

436,75567,400

8,753,704716,549111,239

14,271,277

469,75170,532

8,896,391675,216101,792

12,265,488

7.6%4.6%1.6%

-5.8%-8.5%

-14.1%

459,59268,241

8,262,997611,823

93,10110,448,365

5.2%1.2%

-5.6%-14.6%-16.3%-26.8%

123456

Market-Based Enrollee and Eligible Projec�ons

Demographics




Es�mated Eligible Veterans by Year

0

100,000

FY 2017 FY 2022 FY 2027

111,239 106,312 101,792

FY 2017 FY 2022 FY 2027

-4.4%5 Year Chg in Eligibles

-8.5%10 Year Chg in Eligibles

Es�mated Eligible Veterans by Year

14

Market Enrollee and Eligible Demographics, cont.Demographics




Sector Measure FY17 FY27 10 Yr. Change FY37 20 Yr. Change Id

19-f-9-A19-f-9-B19-f-9-D19-f-9-E19-f-9-A19-f-9-B19-f-9-D19-f-9-E

EOY EnrolleesEOY EnrolleesEOY EnrolleesEOY EnrolleesEOY EligiblesEOY EligiblesEOY EligiblesEOY Eligibles

20,61823,64214,412

8,72831,87940,42424,74214,194

19,32725,63616,049

9,52025,15139,32224,37312,945

-6.3%8.4%

11.4%9.1%

-21.1%-2.7%-1.5%-8.8%

17,64925,05816,322

9,21220,57537,44123,47611,610

-14.4%6.0%

13.3%5.5%

-35.5%-7.4%-5.1%

-18.2%

831832833834861862863864

Sector-Based Enrollee and Eligible Projec�ons

15

Demographics




2017-2027 Market Enrollee Breakdown by PriorityPriority Enrollees 2017 % Enrollees 2017 Enrollees 2027 % Enrollees 2027 10 Year % Change

12345678

Grand Total

17,0795,7559,2731,686

11,3105,0243,164

14,10967,400

25.3%8.5%

13.8%2.5%

16.8%7.5%4.7%

20.9%100.0%

27,8866,0829,1901,2679,8043,9382,4089,957

70,532

39.5%8.6%

13.0%1.8%

13.9%5.6%3.4%

14.1%100.0%

63.3%5.7%

-0.9%-24.8%-13.3%-21.6%-23.9%-29.4%

4.6%

Market Enrollee Priority Groups

27%

8%

14%2%

20%

6%

4%

19%1

2

3

4

5

6

7

8

31%

10%

16%2%

17%

6%

4%

16%1

2

3

4

5

6

7

8

VISN 19Na�onal

16

2017

26.4%

26.7%

39.0%

7.9%<45

45-64

65-84

85+

24.8%

30.5%

38.9%

<45

45-64

65-84

85+

2017 2027 10 Year % Change

4,453 6,706 50.6%

0

10,000

20,000

30,000

MAL

E

<45 45-64 65-84 85+

-8.1% -13.3%16.3% 0.6%

Female Enrollee Popula�on

2017 Salt Lake City Market Age Breakdown

Market Enrollees and Growth Rates by Age Group




Market Enrollee Popula�on — Age and Gender

2017 VISN 19 Age Breakdown

• • 2027

0

1,000

2,000

3,000

FEM

ALE

<45 45-64 65-84 85+

14.5% 9.5%147.9%64.0%

Demographics

17

Category VA FacilityCare

Na�onal VAFacility Care

VA FacilityVariance fromNa�onal

CommunityCare

Na�onalCommunityCare

CommunityCare Variancefrom Na�onal

TotalReliance

Na�onal TotalReliance

Total RelianceVariance fromNa�onal

DO

OP MED

PATHOLOGY

DIALYSIS

OP SURG

AUDIOLOGY

IP MED

IP SURG

IP MH

OP MH

PROSTHETICS

TOTAL

29.6%

50.2%

13.8%

26.1%

58.0%

24.8%

21.1%

31.5%

85.4%

51.8%

29.1%

27.5%

46.3%

7.4%

23.3%

56.7%

18.5%

13.6%

42.7%

81.1%

47.6%

25.1%

2.1%

3.9%

6.4%

2.8%

1.3%

6.3%

7.5%

-11.2%

4.2%

4.3%

3.9%

7.2%

3.5%

36.2%

5.4%

7.9%

7.0%

8.1%

29.8%

4.7%

0.0%

8.3%

6.1%

2.6%

33.4%

5.1%

2.8%

5.5%

7.8%

9.5%

3.0%

0.0%

6.7%

1.0%

0.9%

2.9%

0.2%

5.1%

1.6%

0.3%

20.2%

1.7%

0.0%

1.6%

36.8%

53.7%

50.1%

31.5%

65.9%

31.8%

29.2%

61.2%

90.1%

51.8%

37.4%

33.7%

48.9%

40.8%

28.4%

59.5%

24.0%

21.4%

52.2%

84.2%

47.6%

31.8%

3.1%

4.8%

9.3%

3.0%

6.4%

7.8%

7.8%

9.0%

5.9%

4.3%

5.5%

1

2

3

4

5

6

7

8

9

10

11Projec�ons from the VA Enrollee Health Care Projec�on Model (EHCPM) account for new enrollment based on demographic changes

• Projec�ons therefore account for a different pool of enrollees in the future as the enrollment popula�on changes• Some Veterans who are currently ineligible and unenrolled may become enrollees in the future

Poten�al use of health care in VA is projected for those Veterans who are assumed to be eligible and enrolled at a given point• The EHCPM projects u�liza�on of health care services rather than projec�ng pa�ent/user counts

○ Some pa�ents may use few services and some pa�ents may use many, so projec�ng by u�liza�on of health services providesa be�er picture of the amount of health care VA will need to provide

• Modeled projec�ons accounts for the amount of care enrollees are expected to receive through VA rather than from their othersources of health care

Source: E&F C22-7217ACBY17 2017 Reliance by Service Category 20181025 1.12.V19.SaltLakeCity



Market RelianceDemographics

18

Market Current Enrollment Rurality – FY18Demographics

Source: Geocoded Enrollee File FY18Q4 1.14.V19.SaltLakeCity#IMG

* Includes Rural and Highly Rural Loca�ons



FY18 Rurality by County

19

County Urban Enrollees Rural Enrollees* % Rural Total Enrollees R

Bannock, ID

Bear Lake, ID

Beaver, UT

Bingham, ID

Bonneville, ID

Box Elder, UT

Cache, UT

Carbon, UT

Caribou, ID

Clark, ID

Dagge�, UT

Davis, UT

Duchesne, UT

Elko, NV

Emery, UT

Franklin, ID

Fremont, ID

Garfield, UT

Iron, UT

Jefferson, ID

2,313

0

0

5

2,466

606

1,377

0

0

0

0

8,048

0

0

0

0

0

0

0

1

376

188

140

1,082

194

457

149

556

146

14

47

0

409

1,432

198

226

331

155

1,307

554

14.0%

100.0%

100.0%

99.5%

7.3%

43.0%

9.8%

100.0%

100.0%

100.0%

100.0%

0.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

99.8%

2,689

188

140

1,087

2,660

1,063

1,526

556

146

14

47

8,048

409

1,432

198

226

331

155

1,307

555

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Market Current Enrollment Rurality — FY18, cont.County

Source: Geocoded Enrollee File FY18Q4 1.13.V19.SaltLakeCity

* Includes Rural and Highly Rural Loca�ons.



DemographicsUrban Enrollees Rural Enrollees* % Rural Total Enrollees

20


Juab, UT

Kane, UT

Madison, ID

Millard, UT

Morgan, UT

Oneida, ID

Piute, UT

Power, ID

Rich, UT

Salt Lake, UT

Sanpete, UT

Sevier, UT

Summit, UT

Teton, ID

Tooele, UT

Uintah, UT

Utah, UT

Wasatch, UT

Washington, UT

Wayne, UT

0

0

0

0

0

0

0

0

0

20,261

0

0

0

0

0

0

6,093

0

3,393

0

222

241

385

236

228

150

50

162

40

9

618

519

535

140

1,830

750

391

434

1,015

55

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

0.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

6.0%

100.0%

23.0%

100.0%

222

241

385

236

228

150

50

162

40

20,270

618

519

535

140

1,830

750

6,484

434

4,408

55

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40


Source: Geocoded Enrollee File FY18Q4 1.13.V19.SaltLakeCity#2





21


Weber, UT

White Pine, NV

Total

6,335

0

50,898

213

386

16,570

3.3%

100.0%

24.6%

6,548

386

67,468

41

42

43


Source: Geocoded Enrollee File FY18Q4 1.13.V19.SaltLakeCity#3





22

Market RuralityDemographics

Source: 1. Geocoded Enrollee File FY18Q4 2. HRSA Data Warehouse 1.15.V19.SaltLakeCity



FQHCs Within Rural Counties (>50% Demographics)

23

Parent Facility Trea�ng Facility Number Trea�ng Facility Name Ini�a�ve Title Approved Funding

(V19) (660) Salt Lake City(V19) (660) Salt Lake City

660660

(V19) (660) Salt Lake City(V19) (660) Salt Lake City

Telemental Health HubTransi�ons Nurse Program

$3,420,615$161,463

Rank: 13 out of 117 Parent Facili�es (ranked by total $ funding)

$0

$2,000,000

$4,000,000

$3,582,078

$1,479,993

Facility Na�onal Average

Medical Center % Na�onal 2019 Total Funding Id

Salt Lake CityNa�onal

2.07%100.00%

$3,582,078$173,159,235

203204

Demographics

Source: VHA Office of Rural Health 1.16.V19.SaltLakeCity.660

Note: The FY19 Funded Project List includes the top ten projects by approved funding.


VISN 19: Salt Lake City Market — Salt Lake City

Office of Rural Health FY19 Funded Project List

Office of Rural Health Project Funding Alloca�on

FY19 Office of Rural Health Funded Project Alloca�on vs. Average Na�onal Alloca�on*

*111 Parent Facili�es received ORH Funding Alloca�on for FY19

24

* Popula�on projec�ons available through 2023; straight line growth rates applied through 2028.

25%

5%

11%

14%

24%

10%

11%

0-14

15-17

18-24

25-34

33-54

55-64

65+

Label 2018 2028* % Change Dis…

Popula�onMaleFemale

3,539,4821,779,2991,760,183

4,014,4342,013,5392,000,895

13.4%13.2%13.7%

123

Demographic Summary – Salt Lake City

Demographics

Source: IBM Market Expert 1.17.V19.SaltLakeCity



Overall Market Popula�on (Veterans and Non-Veterans) — Salt Lake City Market

Popula�on Distribu�on by Age Group

78%

14%

1% 3%White Non-Hispanic

Hispanic

Black Non-Hispanic

Asian & Pacific Is. Non-Hispanic

All Others

8%7%

21%

19%15%

30%<$15K

$15-25K

$25-50K

$50-75K

$75-100K

Over $100K

Popula�on Distribu�on by Race/Ethnicity

Households by Income Group

25

Overall Parent Facility Area Popula�on (Veterans and Non-Veterans) —

* Popula�on projec�ons available through 2023; straight line growth rates applied through 2028. Popula�on based on area

within 60 minute drive from applicable VAMC/HCC.

25%

5%

11%

15%

25%

9%10%

0-14

15-17

18-24

25-34

35-54

55-64

65+

Label 2018 2028* % Change Di…

Popula�onFemaleMale

2,441,6161,214,6301,226,986

2,793,1181,392,4221,400,696

14.4%14.6%14.2%

123

Demographic Summary – Salt Lake City Area

Demographics

Source: IBM Market Expert 1.18.V19.SaltLakeCity.660



Popula�on Distribu�on by Age Group

76%

15%

1% 3%White Non-Hispanic

Hispanic

Black Non-Hispanic

Asian & Pacific Is. Non-Hispanic

All Others

7%6%

19%

19%15%

33%

<$15K

$15-25K

$25-50K

$50-75K

$75-100K

Over $100K

Popula�on Distribu�on by Race/Ethnicity

Households by Income Group

Salt Lake City Area

Validation of the data for this slide is not required 26

Demand Es�mated Current and Historic Market Demand — Outpa�ent

27

Facility FY13 FY14 FY15 FY16 FY17 FY18 6 Year Change

(V19) (660) Salt Lake City(V19) (660BU) Salt Lake City Domiciliary(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) Price

46,032102

5,0965,099

250765

3,2162,9947,678

584N/AN/A

49,019140

5,1745,189

244741

3,0933,0287,028

614N/AN/A

49,818277

5,4175,583

240755

3,5553,5006,388

618N/AN/A

50,379132

5,6655,886

229714

3,5783,8365,828

605N/AN/A

56,825139

5,6625,706

173739

3,4524,0156,526

579548202

58,557127

5,3825,699

N/A739

3,1573,8846,161

6391,314

407

27.2%24.5%

5.6%11.8%

-100.0%-3.4%-1.8%29.7%

-19.8%9.4%N/AN/A

*Core uniques excludes uniques who have only used telephone triage, pharmacy, and lab.

Demand

Source: VSSC Uniques Cube 2.13.V19.SaltLakeCity



Core Uniques Trends by FacilityCore Uniques*

28

Outpa�ent Encounters FY15-18

Facility FY15 FY16 FY17 FY18 FY15 FY16 FY17 FY18 FY15 FY16 FY17 FY18

(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) Price(V19) (660) Salt Lake City Total(V19) Salt Lake City Total

58,5144,4055,423

N/A221

2,8911,0272,114

155N/AN/A

74,75074,750

62,7984,5155,160

N/A195

3,5271,2191,895

184N/AN/A

79,49379,493

63,5974,1144,842

N/A227

3,8501,4271,541

1246972

79,86379,863

77,9363,0844,030

N/A293

3,2661,6781,377

177386252

92,47992,479

32,5219,434

10,1091,1802,0585,2296,794

11,2411,516

N/AN/A

80,08280,082

30,90110,353

9,8641,0991,6195,3346,339

11,8731,208

N/AN/A

78,59078,590

32,42910,822

8,688521

1,2914,8526,118

12,546979430138

78,81478,814

39,3219,5459,604

N/A1,3974,0935,891

11,703855

2,005774

85,18885,188

160,182529778N/A

56334

2,5311,250

195N/AN/A

165,855165,855

156,830641

1,143N/A

46854

3,4421,742

166N/AN/A

164,864164,864

156,904631986N/A121

1,3103,7713,092

1316138

167,045167,045

160,1012,210

704N/A103

1,2394,5512,739

129267156

172,199172,199

Mental Health

Demand

Source: VSSC Outpa�ent Encounters Cube 2.20.V19.SaltLakeCity



Primary Care Specialty CareFacility

29

Primary Care Encounters – FY15-18Demand

Source: 1. VSSC Encounters Cube 2. Geocoded Enrollee File FY18Q4 2.1.V19.SaltLakeCity#IMG



FY15-18 PC Average Encounters by County

30

County FY15-18 AvgEncounters

FY18 Encounters Most Commonly Used Facility % ofEncounters

Bannock,IDBear Lake,IDBeaver,UTBingham,IDBonneville,IDBox Elder,UTCache,UTCarbon,UTCaribou,IDClark,IDDagge�,UTDavis,UTDuchesne,UTElko,NVEmery,UTFranklin,IDFremont,IDGarfield,UTIron,UTJefferson,ID

4,340180

931,4673,0041,0991,124

909235

2084

7,193904

1,996302251379144

1,071701

4,778185

851,5153,3401,1771,242

982232

2181

8,038837

1,838317282407131

1,029773

(660GA) Pocatello(660GA) Pocatello(660GG) St. George(660GA) Pocatello(660GA) Pocatello(660GB) Ogden(660GB) Ogden(660QB) Price(660GA) Pocatello(660QA) Idaho Falls(666GF) Rock Springs(660) Salt Lake City(660GD) Roosevelt(660GK) Elko(660QB) Price(660GA) Pocatello(660GA) Pocatello(660GG) St. George(660GG) St. George(660GA) Pocatello

94.2%69.7%38.8%85.0%46.7%60.0%50.6%59.0%83.6%61.9%49.4%55.8%78.1%43.0%52.1%58.5%45.7%61.1%64.6%51.5%

County

Demand

Source: 1. VSSC Encounters Cube 2. Geocoded Enrollee File FY18Q4 2.1.V19.SaltLakeCity

Note: Yellow cells indicate coun�es going out of Market/VISN for the majority of encounters.



Primary Care Encounters – FY15-18, cont.FY18

EncountersFY15-18 Avg Encounters

Most Commonly Used Facility % of Encounters

31



Juab,UTKane,UTMadison,IDMillard,UTMorgan,UTOneida,IDPiute,UTPower,IDRich,UTSalt Lake,UTSanpete,UTSevier,UTSummit,UTTeton,IDTooele,UTUintah,UTUtah,UTWasatch,UTWashington,UTWayne,UT

240298341209209189

39193

4329,239

541407635

982,264

9215,602

3855,391

47

232271384187232197

48194

3931,679

577416688

912,440

8476,085

4385,541

46

(660GE) Orem(660GG) St. George(660GA) Pocatello(660GE) Orem(660GB) Ogden(660GA) Pocatello(660GG) St. George(660GA) Pocatello(660GB) Ogden(660) Salt Lake City(660) Salt Lake City(660) Salt Lake City(660) Salt Lake City(660GA) Pocatello(660) Salt Lake City(660GD) Roosevelt(660GE) Orem(660) Salt Lake City(660GG) St. George(660) Salt Lake City

62.1%51.3%50.3%40.6%59.9%64.0%50.0%94.8%41.0%71.6%43.8%51.9%84.3%50.5%52.3%81.1%51.2%74.2%76.3%32.6%

County

Demand

Source: 1. VSSC Encounters Cube 2. Geocoded Enrollee File FY18Q4 2.1.V19.SaltLakeCity#2







32



Weber,UTWhite Pine,NVTotal

6,870831

80,488

7,416207

85,545

(660GB) Ogden(660) Salt Lake City

67.4%45.9%

County

Demand








33

Primary Care Drive Times for FY18 EnrolleesDemand

Source: Geocoded Enrollee File FY18Q4 2.3.V19.SaltLakeCity



34

Demand

Source: VSSC Encounters Cube – Public Grouping (Primary Care) 2.4.V19.SaltLakeCity.660

Note: Data limited to workload from pa�ents origina�ng from within the coun�es of Phase Two VISNs in the Market Assessments. * Includes top 3 stop codes, where applicable (some sites reported less than 3).



Facility Stop Code FY15 FY16 FY17 FY18 4 Yr. Ch FY15 FY16 FY17 FY18 4 Yr. Ch FY15 FY16 FY17 FY18 4 Yr. Ch

(V19) (660) Salt Lake City



(V19) (660GA) Pocatello


(V19) (660GB) Ogden

(V19) (660GB) Ogden

(323) PRIMARYCARE/MEDICINE

(322) ComprehensiveWomen's Primary CareClinic

(350) GeriPACT





29,245

2,998

278

9,411

23

9,974

135

26,632

3,449

820

10,266

87

9,715

149

28,494

3,115

820

10,703

119

8,535

153

34,820

3,457

1,044

9,259

286

9,340

264

19.1%

15.3%

275.5%

-1.6%

1143.5%

-6.4%

95.6%

13,389

1,106

225

5,046

23

5,011

119

11,931

1,244

409

5,311

78

5,116

133

11,981

1,204

386

5,267

107

4,713

140

13,241

1,336

484

4,597

229

4,729

223

-1.1%

20.8%

115.1%

-8.9%

895.7%

-5.6%

87.4%

32,321

2,816

491

9,626

29

11,824

261

28,719

3,551

1,493

10,702

127

11,240

308

32,834

4,920

1,505

11,028

207

9,774

265

36,793

5,626

1,780

9,976

441

9,998

456

13.8%

99.8%

262.8%

3.6%

1404.1%

-15.4%

74.9%

CPT Work RVUUnique Pa�entsEncounters

Top Primary Care Stop Code* Trends FY15-FY18 — Salt Lake City

35

Demand

Source: VSSC Encounters Cube – Public Grouping (Primary Care) 2.4.V19.SaltLakeCity.660#2





(V19) (660GC) Ely-Nevada

(V19) (660GD) Roosevelt

(V19) (660GE) Orem

(V19) (660GE) Orem

(V19) (660GG) St. George


(V19) (660GJ) Western SaltLake








1,180

2,058

5,193

36

6,717

77

11,145

1,099

1,619

5,148

186

6,246

93

11,812

521

1,291

4,688

164

6,028

90

12,470

N/A

1,397

3,878

215

5,793

98

11,648

-100.0%

-32.1%

-25.3%

497.2%

-13.8%

27.3%

4.5%

240

730

3,111

34

3,048

71

5,678

229

683

2,929

158

3,099

85

5,192

173

694

2,775

128

3,062

85

5,674

N/A

680

2,336

167

2,674

84

5,348

-100.0%

-6.8%

-24.9%

391.2%

-12.3%

18.3%

-5.8%

1,175

2,618

5,620

39

7,092

155

13,475

1,120

2,512

5,180

113

6,913

191

12,817

558

2,179

5,377

160

7,448

193

14,505

N/A

2,214

5,085

239

5,593

184

13,004

-100.0%

-15.5%

-9.5%

507.0%

-21.1%

18.8%

-3.5%


Top Primary Care Stop Code* Trends FY15-FY18 — Salt Lake City, cont.

36

Demand

Source: VSSC Encounters Cube – Public Grouping (Primary Care) 2.4.V19.SaltLakeCity.660#3





(V19) (660GJ) Western SaltLake

(V19) (660GK) Elko

(V19) (660QA) Idaho Falls

(V19) (660QB) Price





96

1,516

N/A

N/A

61

1,208

N/A

N/A

76

979

430

138

55

855

2,005

774

-42.7%

-43.6%

77

537

N/A

N/A

56

506

N/A

N/A

68

514

353

114

49

533

1,020

369

-36.4%

-0.7%

136

770

N/A

N/A

93

523

N/A

N/A

128

580

337

89

93

525

1,353

452

-31.7%

-31.7%


Top Primary Care Stop Code* Trends FY15-FY18 — Salt Lake City, cont.

37

Home-Based Primary CareDemand

Source: VSSC Encounters Cube 2.14.V19.SaltLakeCity#IMG



FY18 HBPC Encounters by County

38

2_14 Selected Facility FY15 FY16 FY17 FY18 AVGer FY15 FY16 FY17 FY18 AVG

(660) Salt Lake City 290 182 168 167 201 2,665 2,947 3,963 4,024 3,399

FY15-18 HBPC Uniques & Encounter Distribu�on

Demand

Source: VSSC Encounters Cube 2.14.V19.SaltLakeCity


Home-Based Primary Care, cont.

Facility UniquesFY15 FY16 FY17 FY18 AVG FY15 FY16 FY17 FY18 AVG

Encounters


39

Demand

Source: VSSC Encounters Cube 2.36.V19.SaltLakeCity



Home-Based Primary Care by Provider TypeFY18 HBPC Encounters by Provider Type

Provider Type MD RN SW MH RD Other I

EncountersPercentage

48412.0%

1,58639.4%

46011.4%

3288.2%

2736.8%

89322.2%

11

40

Mental Health Encounters – FY15-18Demand




FY15-18 Average Mental Health Encounters by County

41

Mental Health Encounters — FY15-18, cont.Demand




County FY15-18 Avg Encounters FY18 Encounters Most Commonly Used Facility % of Encounters

Bannock,ID

Bear Lake,ID

Bingham,ID

Bonneville,ID

Caribou,ID

Clark,ID

Franklin,ID

Fremont,ID

Jefferson,ID

Madison,ID

Oneida,ID

Power,ID

Teton,ID

Elko,NV

White Pine,NV

Beaver,UT

Box Elder,UT

Cache,UT

2,926

70

856

1,801

172

3

67

159

312

148

75

179

54

946

85

34

826

943

2,725

53

595

1,813

113

73

142

273

116

84

85

39

1,031

93

33

892

837






(V19) (436) Fort Harrison







(V17) (549BY) Fort Worth


(V21) (593) Las Vegas-Nevada




58.6%

35.8%

74.5%

48.6%

90.3%

50.7%

45.8%

40.7%

32.8%

56.0%

81.2%

74.4%

73.3%

38.7%

30.3%

69.4%

54.6%

42






Carbon,UT

Dagge�,UT

Davis,UT

Duchesne,UT

Emery,UT

Garfield,UT

Iron,UT

Juab,UT

Kane,UT

Millard,UT

Morgan,UT

Piute,UT

Rich,UT

Salt Lake,UT

Sanpete,UT

Sevier,UT

Summit,UT

Tooele,UT

830

25

8,132

488

171

28

872

318

179

156

154

23

10

37,470

447

248

432

2,733

772

11

8,455

588

133

31

923

140

206

127

218

9

39,454

571

289

594

3,068








(V19) (660GE) Orem





(V19) (660GB) Ogden






69.6%

63.6%

75.2%

47.6%

48.9%

41.9%

23.8%

67.1%

72.3%

74.0%

39.9%

33.3%

91.2%

57.4%

77.9%

93.4%

89.5%

43






Uintah,UT

Utah,UT

Wasatch,UT

Washington,UT

Wayne,UT

Weber,UT

Total

408

6,343

289

2,382

11

7,179

78,980

570

6,340

297

2,488

18

7,531

81,830





(V08) (573GF) Tallahassee


43.2%

52.0%

78.1%

49.3%

38.9%

65.8%

44

Top Mental Health Stop Code* Trends FY15-FY18 — Salt Lake CityDemand

Source: VSSC Encounters Cube – Public Grouping (Mental Health) 2.7.V19.SaltLakeCity.660

Note: Data limited to workload from pa�ents origina�ng from within the coun�es of Phase Two VISNs in the Market Assessments *Includes top 3 stop codes, where applicable (some sites reported less than 3)



Facility Stop Code FY15 FY16 FY17 FY18 4 Yr Ch. FY15 FY16 FY17 FY18 4 Yr. Ch. FY15 FY16 FY17 FY18 4 Yr. Ch. .







(V19) (660GB) Ogden

(V19) (660GB) Ogden

(V19) (660GB) Ogden




(V19) (660GE) Orem

(V19) (660GE) Orem

(V19) (660GE) Orem




(V19) (660GJ) Western Salt Lake

(V19) (660GJ) Western Salt Lake

(502) MH CLINIC IND

(560) SUB USE DISORDER GROUP

(513) SUB USE DISORDER INDIV

(502) MH CLINIC IND

(562) PTSD-INDIV

(550) MH CLINIC GROUP

(502) MH CLINIC IND

(562) PTSD-INDIV

(534) MH INTGRTD CARE IND

(502) MH CLINIC IND

(562) PTSD-INDIV

(540) PCT-PTSD IND

(502) MH CLINIC IND

(562) PTSD-INDIV


(502) MH CLINIC IND

(562) PTSD-INDIV



(502) MH CLINIC IND

28,776

3,736

4,487

3,412

N/A

333

4,597

N/A

N/A

162

N/A

59

1,910

N/A

N/A

886

N/A

6

2,025

89

32,123

6,566

5,839

3,561

309

272

4,242

457

1

166

10

19

2,711

313

N/A

1,068

75

N/A

1,895

N/A

33,796

5,725

6,166

3,219

584

240

3,984

801

1

192

35

N/A

3,014

637

N/A

1,267

160

N/A

1,541

N/A

45,120

9,067

6,716

2,223

393

252

3,243

517

216

243

50

N/A

2,422

665

118

1,491

131

54

1,377

N/A

56.8%

142.7%

49.7%

-34.8%

0.0%

-24.3%

-29.5%

0.0%

0.0%

50.0%

0.0%

-100.0%

26.8%

0.0%

0.0%

68.3%

0.0%

800.0%

-32.0%

-100.0%

5,563

365

802

906

N/A

36

1,331

N/A

N/A

73

N/A

11

659

N/A

N/A

258

N/A

3

632

37

6,252

411

838

939

79

42

1,313

143

1

58

6

4

662

84

N/A

290

33

N/A

578

N/A

7,073

430

830

920

147

34

1,295

168

1

61

9

N/A

694

99

N/A

353

48

N/A

504

N/A

9,606

473

824

772

134

35

1,109

138

184

72

9

N/A

653

167

58

381

29

33

441

N/A

72.7%

29.6%

2.7%

-14.8%

0.0%

-2.8%

-16.7%

0.0%

0.0%

-1.4%

0.0%

-100.0%

-0.9%

0.0%

0.0%

47.7%

0.0%

1000.0%

-30.2%

-100.0%

62,145

2,213

9,125

6,662

N/A

193

8,719

N/A

N/A

15

N/A

10

3,743

N/A

N/A

1,717

N/A

2

3,626

209

72,334

6,911

12,630

6,848

700

171

8,991

1,281

1

15

0

0

6,627

722

N/A

2,695

181

N/A

3,436

N/A

80,193

8,074

13,915

6,851

1,441

143

9,186

2,200

2

22

6

N/A

6,987

1,875

N/A

3,008

399

N/A

3,820

N/A

115,031

13,784

15,400

5,298

1,061

89

7,142

1,432

511

12

0

N/A

6,068

2,092

323

3,145

289

50

3,483

N/A

85.1%

523.0%

68.8%

-20.5%

0.0%

-53.9%

-18.1%

0.0%

0.0%

-20.9%

0.0%

-99.8%

62.1%

0.0%

0.0%

83.2%

0.0%

2851.8%

-3.9%

-100.0%

660-1

660-2

660-3

660GA-1

660GA-2

660GA-3

660GB-1

660GB-2

660GB-3

660GD-1

660GD-2

660GD-3

660GE-1

660GE-2

660GE-3

660GG-1

660GG-2

660GG-3

660GJ-1

660GJ-2

Encounters Unique Pa�ents CPT Work RVU

45

Top Mental Health Stop Code* Trends FY15-FY18 — Salt Lake City, cont.Demand

Source: VSSC Encounters Cube – Public Grouping (Mental Health) 2.7.V19.SaltLakeCity.660#2

Note: Data limited to workload from pa�ents origina�ng from within the coun�es of Phase Two VISNs in the Market Assessments *Includes top 3 stop codes, where applicable (some sites reported less than 3)



Facility Stop Code FY15 FY16 FY17 FY18 4 Yr Ch. FY15 FY16 FY17 FY18 4 Yr. Ch. FY15 FY16 FY17 FY18 4 Yr. Ch. .

(V19) (660GK) Elko

(V19) (660GK) Elko

(V19) (660GK) Elko




(V19) (660QB) Price

(V19) (660QB) Price

(502) MH CLINIC IND

(562) PTSD-INDIV

(540) PCT-PTSD IND

(502) MH CLINIC IND

(562) PTSD-INDIV


(502) MH CLINIC IND

(562) PTSD-INDIV

106

N/A

49

N/A

N/A

N/A

N/A

N/A

126

30

28

N/A

N/A

N/A

N/A

N/A

70

54

N/A

57

10

2

45

27

131

46

N/A

340

38

8

183

69

23.6%

0.0%

-100.0%

0.0%

0.0%

0.0%

0.0%

0.0%

34

N/A

14

N/A

N/A

N/A

N/A

N/A

53

7

8

N/A

N/A

N/A

N/A

N/A

40

11

N/A

46

6

1

27

7

60

18

N/A

154

17

4

51

12

76.5%

0.0%

-100.0%

0.0%

0.0%

0.0%

0.0%

0.0%

2

N/A

0

N/A

N/A

N/A

N/A

N/A

4

0

0

N/A

N/A

N/A

N/A

N/A

3

3

N/A

24

8

4

3

0

12

0

N/A

256

99

16

18

7

732.0%

0.0%

0.0%

0.0%

0.0%

0.0%

0.0%

0.0%

660GK-1

660GK-2

660GK-3

660QA-1

660QA-2

660QA-3

660QB-1

660QB-2

Encounters Unique Pa�ents CPT Work RVU

46

Specialty Encounters – FY15-18Demand




FY15-18 Average Specialty Encounters by County

47

Specialty Encounters — FY15-18, cont.Demand




County FY15-18 Avg Encounters FY18 Encounters Most Commonly Used Facility % of Encounters Id

Sanpete,UT

Sevier,UT

Summit,UT

Tooele,UT

Uintah,UT

Utah,UT

Wasatch,UT

Washington,UT

Wayne,UT

Weber,UT

Bannock,ID

Bear Lake,ID

Bingham,ID

Bonneville,ID

Caribou,ID

Clark,ID

Franklin,ID

Fremont,ID

1,380

937

1,481

5,005

1,134

13,335

919

6,645

109

14,828

3,618

187

1,368

2,818

255

12

342

452

1,420

979

1,537

5,350

1,140

14,174

871

8,062

109

15,282

4,310

231

1,423

2,928

263

15

373

422



















92.1%

88.7%

96.0%

93.3%

85.7%

91.7%

95.8%

40.9%

78.9%

95.5%

71.7%

74.9%

73.9%

70.9%

70.7%

73.3%

81.8%

72.3%

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

48






Jefferson,ID

Madison,ID

Oneida,ID

Power,ID

Teton,ID

Iron,UT

Juab,UT

Kane,UT

Millard,UT

Morgan,UT

Piute,UT

Rich,UT

Salt Lake,UT

Beaver,UT

Box Elder,UT

Cache,UT

Carbon,UT

Dagge�,UT

713

402

251

203

84

1,482

599

379

534

555

87

89

71,168

207

2,591

2,369

1,462

142

727

494

264

177

81

1,703

580

417

398

601

124

78

70,859

231

2,623

2,369

1,443

122



















71.8%

68.8%

82.6%

45.8%

71.6%

44.2%

90.7%

42.0%

86.7%

96.5%

83.9%

94.9%

95.5%

64.1%

93.7%

91.6%

78.6%

88.5%

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

49






Davis,UT

Duchesne,UT

Emery,UT

Garfield,UT

Elko,NV

White Pine,NV

Total

18,052

1,134

465

250

2,489

769

161,297

18,707

1,188

515

279

2,518

787

166,174







96.3%

89.6%

62.1%

60.6%

75.1%

68.7%

…

…

…

…

…

…

…

50

Specialty Care Stop Code Trends FY15-18

Id

Specialty Title FY15 FY16 FY17 FY18 4 Yr Ch FY15 FY16 FY17 FY18 4 Yr ChA

77797780778177827783778477857786778777887789779077917792779377947795779677977798

(V19) (660) Salt Lake CityAllergy and Immunology

Audiology & Speech PathologyCardiology

Clinical PharmacologyCri�cal Care / Pulmonary Disease

DermatologyEndocrinology

GastroenterologyGeriatric Medicine

Hematology-OncologyInfec�ous DiseaseInternal Medicine

NephrologyNeurological Surgery

NeurologyNutri�on

Obstetrics & GynecologyOphthalmology

Optometry

147,5301,012

21,9437,0491,4211,4697,0302,9222,5841,7453,515

98312,008

1,531968

3,8851,682

59510,346

6,769

144,832928

17,1078,4501,5741,4816,9393,2302,958

2183,777

99511,724

1,6151,1013,9591,961

35910,424

7,875

144,8601,150

17,8559,5661,8401,4627,1943,6503,805

1473,9141,0668,6891,7591,0204,0391,691

37210,192

7,988

147,8291,651

17,9419,7741,3471,5316,9704,4254,008

873,994

9448,2682,0211,4084,2401,716

44710,357

8,310

0.2%63.1%

-18.2%38.7%-5.2%4.2%

-0.9%51.4%55.1%

-95.0%13.6%-4.0%

-31.1%32.0%45.5%

9.1%2.0%

-24.9%0.1%

22.8%

182,165616

13,81711,441

2992,748

12,6913,7424,2422,0214,8201,1888,1192,946

8175,948

7491,096

14,22613,881

196,569626

10,63514,070

2162,766

13,5834,9635,089

1935,1821,2869,7793,1701,0266,7911,454

65812,94122,657

198,257785

10,69516,484

272,894

12,9835,5226,171

645,6391,5345,5483,510

8797,1881,905

73212,71423,640

204,8281,024

10,84517,455

442,880

11,8526,6116,063

786,2571,4525,7993,9851,3077,8272,109

87913,51325,729

12.4%66.2%

-21.5%52.6%

-85.3%4.8%

-6.6%76.7%42.9%

-96.1%29.8%22.3%

-28.6%35.2%60.0%31.6%

181.6%-19.8%

-5.0%85.4%

7799 Orthopaedic Surgery 5,436 5,163 4,865 5,020 -7.7% 6,567 5,628 5,480 5,211 -20.6%

Demand

Source: VSSC Encounters Cube – Public Grouping (Specialty Care) 2.10.V19.SaltLakeCity



CPT Work RVU4 Yr. Ch. 4 Yr. Ch.Encounters*

*Special�es were only included if there were greater than 15 encounters in any of the past four years. Note: Data limited to workload from pa�ents origina�ng from within the coun�es of Phase Two VISNs in the Market Assessments

51

Specialty Care Stop Code Trends FY15-18, cont.

Id


78007801780278037804780578067807780878097810781178127813781478157816781778187819

OtolaryngologyPain Medicine

Physical Medicine & Rehabilita�onPlas�c Surgery

PodiatryPolytrauma

RheumatologySCI

SurgeryThoracic Surgery

UrologyVascular Surgery

(V19) (660GA) PocatelloAudiology & Speech Pathology

Clinical PharmacologyDermatology

GastroenterologyGeriatric MedicineInternal Medicine

Nutri�on

2,9792,974

19,806846

13,016311

2,43179

2,278371

5,7791,767

52814

N/A19

N/A62

274159

3,0243,676

20,713662

12,538254

2,47265

2,077395

5,5821,536

64114

N/A23

N/A53

273278

2,9133,560

20,591728

12,318239

3,61665

1,757324

4,8821,603

62616562344

N/A192295

2,9323,809

23,313718

10,933202

3,22066

1,516369

4,7771,5152,1871,660

896

49N/A

31352

-1.6%28.1%17.7%

-15.1%-16.0%-35.0%32.5%

-16.5%-33.5%

-0.5%-17.3%-14.3%314.2%

11757.1%N/A

-68.4%N/A

-100.0%-88.7%121.4%

6,3155,633

26,020872

10,293490

4,370157

4,072553

9,2282,188

140

N/A0

N/A10

13

6,5767,365

27,789615

11,001445

4,585140

3,726558

9,3201,737

51

N/A1

N/A030

6,7137,654

26,964700

11,985458

5,629130

3,180427

8,3631,662

20000

N/A02

6,2447,511

31,634639

9,810406

5,373122

2,413448

7,8241,4821,304

876210

N/A0

425

-1.1%33.3%21.6%

-26.7%-4.7%

-17.2%22.9%

-22.2%-40.7%-19.0%-15.2%-32.3%

9166.3%N/AN/AN/AN/A

-100.0%-100.0%

14064.7%7820 (V19) (660GB) Ogden 773 1,142 972 687 -11.1% 281 764 469 403 43.4%

Demand

Source: VSSC Encounters Cube – Public Grouping (Specialty Care) 2.10.V19.SaltLakeCity#2





52


Id


78217822782378247825782678277828782978307831783278337834783578367837783878397840

Audiology & Speech PathologyDermatology

EndocrinologyInternal Medicine

Nutri�on(V19) (660GD) Roosevelt

Audiology & Speech PathologyInternal Medicine

(V19) (660GE) OremAudiology & Speech Pathology


Nutri�on(V19) (660GG) St. George

Audiology & Speech PathologyClinical Pharmacology

DermatologyGastroenterologyInternal Medicine

Nutri�on

18763

288100135

513120

329123

478376

2,5212,304

244

N/A55

134

12627

263134592

463412

854121

40217476

3,4332,896

1156

N/A50

366

155N/A188101528118

6850

1,299118

31638512

3,7643,119

3088

61538

1486

9745

391836815

1,225150N/A418657

4,5264,007

73872641

292

-20.9%-90.5%-66.3%-55.0%189.6%

62.7%119.4%-25.0%272.3%

22.0%-100.0%403.6%764.5%

79.5%73.9%

204.2%2075.0%

N/A-25.5%117.9%

01

27307000

18020

161,1531,130

40

N/A8

11

01

1350

629000

495002

4921,9981,493

211

N/A9

475

0N/A

40

465000

380000

3801,8541,250

300

12589

0000

403000

5920

N/A4

5891,7671,644

0001

122

-100.0%-100.0%

-99.9%N/A

5888.6%N/AN/AN/A

3207.8%-100.0%-100.0%

N/A3555.2%

53.2%45.6%

-100.0%-100.0%

N/A-87.1%974.9%

7841 (V19) (660GJ) Western Salt Lake 1,247 1,742 3,092 2,739 119.6% 623 870 1,427 1,216 95.2%

Demand






53


Id


7842784378447845784678477848784978507851785278537854785578567857785878597860

Audiology & Speech PathologyDermatology


Nutri�on(V19) (660GK) Elko

Audiology & Speech PathologyEndocrinology

Internal MedicineNutri�on

(V19) (660QA) Idaho FallsGastroenterologyInternal Medicine

Nutri�on(V19) (660QB) Price

Audiology & Speech PathologyEndocrinology

Internal MedicineNutri�on

N/A81

63356

477188

42794126

N/AN/AN/AN/AN/AN/AN/AN/AN/A

2532

95494

439166

31694422


1,474N/A

1,01765

536127

265438

958

7203138

888

14

1,59870

52544

502124

38452516

2393350

156152

22274954

N/A-13.6%-17.1%-21.4%

5.2%-34.0%

-9.5%-43.0%-39.0%-38.5%


N/A1

5420

8110100


1550

3530

36200000


730N/A

260

67120002000000000

7202

130

48200000000020002

N/A108.9%-97.7%

N/A498.1%-86.7%

N/A-100.0%

N/A-100.0%


Demand






54

Facility FY15 FY16 FY17 FY18 4 Yr ch. FY15 FY16 FY17 FY18 4 Yr ch. Id

(V19) (660) Salt Lake City 13,272 12,541 13,319 13,174 -0.7% 1,435,723 1,350,646 1,398,508 1,340,125 -6.7% 350

Demand

Source: Office of Den�stry 2.35.V19.SaltLakeCity

*Dental Data is derived from the Office of Den�stry’s dataset and represents Visits, RVU Equivalents, and Unique Pa�ents.



Specialty Care Stop Code Trends FY15-18 – Dental

Visits 4 Yr. Ch. RVU Equivalent 4 Yr. Ch.Dental*

55

TelehealthU�liza�on Forma�ed FacilityPerc Na�onalPerc

Telehealth Use (Tele1) Home Telehealth (Tele2) Clinical Video Telehealth (Tele3) Store and Forward Telehealth (Tele4)eConsult (SC10)Video Telehealth to Off Site Pa�ents (Tele9)

31.1%1.3%

13.5%17.1%14.1%

0.5%

13.1%2.3%6.6%5.3%8.3%0.5%

Salt Lake City

Demand

Source: VSSC Telehealth Dashboard - Connected Care 2.15.V19.SaltLakeCity.660

Note: Telehealth u�liza�on is based on percentage of unique pa�ents leveraging telehealth-related tools/technology.



Telehealth — FY18 Telehealth U�liza�on

Telehealth U�liza�on Na�onal

56

Note: Pa�ent site indicates the clinic loca�on by primary stop code where the pa�ent receives the service

Salt Lake City VAMC & Trea�ng Facility Encounters by Provider Site

Demand



2.16.V19.SaltLakeCity.660

Pa�ent Site FY15 FY16 FY17 FY18 4 Yr Avg

(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) PriceTotal

1,5501,6741,191

2741,156

261730641

7,477

1,7492,141

529250

1,404410308611

7,402

1,4621,602

583373

1,230290337526201138

6,742

3,095925937417570

1,161346776

1,059530

9,816

1,9641,585

810328

1,090530430638630334

7,859

Provider Site FY15-18 TotalEncounters

% of TotalEncounters

(V19) (660) Salt Lake City(V19) (660GJ) Western Salt Lake(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660GD) Roosevelt(V19) (660QB) Price

24,3903,0081,8361,214

700127118

191312

77.6%9.6%5.8%3.9%2.2%0.4%0.4%0.1%0.0%0.0%

Telehealth Encounters by Pa�ent and Provider Site* — Salt Lake City

*Includes 4 Types: CVT General (690/692,693,699), CVT Na�onalCenter (644/645), CVT ProviderToHomePa�ent(179), and SF General (694/695,696)

Source: FY15-18 Detailed Telehealth Workload by Pa�ent Site, Provider Site, Stop Codes, and Telehealth Type Report

57

Demand



Telehealth Encounters by Specialty*

58

Emergency Department Uniques (FY15-18)Demand

Source: HRSA Data Warehouse 2.28.V19.SaltLakeCity#IMG

Note: Map shows acute and cri�cal access hospitals with Emergency Departments and does not include freestanding Emergency Departments



Unique Patients by County FY15-18

59

2_28 Data Level Title CPT Code FY15 FY16 FY17 FY18

Encounters

Total EncountersVA Admissions %

% Transfers

9928199282992839928499285TotalTotalTotal

2151,6179,3187,2842,857

21,29116.1%

2.4%

2241,3338,6386,8363,722

20,75315.2%

2.9%

131974

9,0737,1932,807

20,17816.8%

2.9%

190803

7,8148,8422,444

20,09317.5%

3.0%

2_28 Data Level Title CPT Code FY15 FY16 FY17 FY18

Encounters

Total EncountersVA Admissions %

% Transfers

9928199282992839928499285TotalTotalTotal

2151,6179,3187,2842,857

21,29116.1%

2.4%

2241,3338,6386,8363,722

20,75315.2%

2.9%

131974

9,0737,1932,807

20,17816.8%

2.9%

190803

7,8148,8422,444

20,09317.5%

3.0%

88.1% of encounters seen between FY15-FY18 occurred between 8 A.M. and 10 P.M.

Emergency Department Encounters FY15-FY18 — Salt Lake City VAMC

Encounters FY15-18

0

2,000

4,000

6,000

8,000

10,000

Enco

unte

rs

1:00 AM2:00 AM

3:00 AM4:00 AM

5:00 AM6:00 AM

7:00 AM8:00 AM

9:00 AM

10:00 AM

11:00 AMNoon

1:00 PM2:00 PM

3:00 PM4:00 PM

5:00 PM6:00 PM

7:00 PM8:00 PM

9:00 PM

10:00 PM

11:00 PM

Midnight

Average

800

678

672

686

828 1,

416

2,70

5

4,26

2

6,46

8

7,75

0

8,00

1

7,20

0

6,74

6

6,49

3

5,89

7

5,22

6

4,21

8

3,69

9

3,48

5

2,95

6

2,60

4

2,05

8

1,51

8

1,09

7

Demand

Source: 1. VSSC Encounters Cube 2. Emergency Medicine Management Tool 2.28.V19.SaltLakeCity.660



78.3% of encounters seen between FY15-FY18 occurred on weekdays vs. weekends.

60

Emergency Department Opera�onsDemand

Source: Integrated Flow Management Tool (IFMT) 2.31.V19.SaltLakeCity



12_5 Measure FY17 FY18 FY17 Na�onal FY18 Na�onal

Salt Lake City ED Door to Inpa�ent Floor (Min)ED Admit Delay (Min)ED % Boarded > 4 HrsDiversion Total Hours

276105

3.8%N/A

275107

4.5%N/A

312126

15.2%N/A

316129

16.2%262,871

12_5 Measure FY17 FY18 FY17 Na�onal FY18 Na�onal

Salt Lake City ED Door to Inpa�ent Floor (Min)ED Admit Delay (Min)ED % Boarded > 4 HrsDiversion Total Hours

276105

3.8%N/A

275107

4.5%N/A

312126

15.2%N/A

316129

16.2%262,871

61

Sector County Name 2017Enrollees

FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18 ,


Salt Lake, UTSector SubtotalBeaver, UTBox Elder, UTCache, UTCarbon, UTDagge�, UTDuchesne, UTElko, NVEmery, UTGarfield, UTIron, UTJuab, UTKane, UTMillard, UTMorgan, UTPiute, UTRich, UTSanpete, UTSevier, UT

20,61820,618

1441,0351,492

55252

4831,406

206160

1,285220251248231

4736

633531

1919

41118

2N/AN/A

8N/AN/A

2029

11N/A

3N/A

1735

5519

2931252

N/A17

355

N/A1

N/A1414

34341437

10213

17

1010

5126

101916

N/A6

N/A5965

110110N/A

423

3N/AN/A

61

N/A4

N/AN/AN/AN/AN/AN/A

33

140140N/A

523

4N/AN/A

81

N/A17

N/A1

N/AN/AN/AN/A

24

170170N/A

1043

3N/AN/A

41

N/A25

N/AN/A

211

N/AN/A

10

1,0181,018

10469047

355

1471312

1687

411410

56

6150

1,0501,050

779

12741

674

1162616

15310292111

98

5127

1,8711,871

13156290122

9200215

5526

3423773273120

3132

98

436436

11286830

2175015

371122413

12

N/A3237

456456

5385722

1264413

35011

87511

3418

613613

2076

15047

871893710

1791836151511

N/A6945

122122N/A

527917

21070

91

235

1313

311

1221

158158

2394517

31141

3N/A

197575

N/A2

1714

315315

369

11241

225

12919

476

8111510

21

5837

01000000000000000000

19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B

Summit, UTTooele, UTUintah, UTUtah, UTWasatch, UTWashington, UT

5661,778

6846,409

3554,349

225819

N/A1741

11

23

1717

285

176

21N/A

15

184

19N/A

14

211

532

120

147986

30514

285

1985

106301

15396

57161262570

33759

103018

1068

127

114231

1419

134

1562

105212

12347

111819

1221791

153630

1201373

218843

24921

169

000000

Sector/County Name

Demand

Source: VHA Office of Community Care 2.30.V19.SaltLakeCity



Primary Care Mental Health Medicine Surgery Rehab Medicine

Non-VA Community Care (NVCC) FY16-18 – Outpa�ent CPT Authoriza�ons

62

Sector County Name 2017Enrollees

FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18 ,

19-f-9-B19-f-9-B19-f-9-B19-f-9-D19-f-9-D19-f-9-D19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E

Wayne, UTWhite Pine, NVSector SubtotalDavis, UTWeber, UTSector SubtotalBannock, IDBear Lake, IDBingham, IDBonneville, IDCaribou, IDClark, IDFranklin, IDFremont, IDJefferson, IDMadison, IDOneida, IDPower, IDTeton, IDSector Subtotal

56419

23,6287,7586,653

14,4112,714

1641,1002,589

18515

241347586352156137134

8,720

32

17291

1012

54

4710

N/A52696

N/A7

113

2105242

81220

623

49N/AN/A

44

1711

2N/A

11109

4161791

131629281218

15620

N/A17273724

6N/A

20365

N/A4

101153651

913

371

N/A1247112

69

N/A5

11619496812

17

641

N/A127

10N/AN/A

1106

N/A4

1754159

10026

517

1671

N/A48

3217

4N/A

3284

N/A52

1,620301257558294

10108312

165

16307049

71610

943

N/A39

1,772289264553333

19172439

252

254391751617

81,265

670

3,767599578

1,177571

36287995

645

6598

211113

274135

2,548

321

739131104235

951339

19213

419174627

654

480

225

739128125253120

869

15412

28

163727

588

474

436

1,689176184360198

23104376

352

3348

10556101413

1,017

116

62752

146198241

1195

28817

418248035212211

867

310

53785

148233255

15116291

95

17346435121011

874

519

1,237219261480361

22158542

307

3165

12581101728

1,477

00100100000000000001

Market To… Market Total 67,377 314 376 1,219 331 430 729 4,139 4,640 9,363 1,890 1,922 3,679 1,814 1,802 3,509 2

Sector/County Name

Demand

Source: VHA Office of Community Care 2.30.V19.SaltLakeCity#2



Primary Care Mental Health Medicine Surgery Rehab Medicine

Non-VA Community Care (NVCC) FY16-18 – Outpa�ent CPT Authoriza�ons, cont.

63

Primary Care NVCC CPT Authorizations per County Mental Health NVCC CPT Authorizations per County

NVCC Outpa�ent CPT Authoriza�ons (Primary Care and Mental Health)Demand




64

Demand




NVCC Outpa�ent CPT Authoriza�ons (Medicine and Surgery)Medicine NVCC CPT Authorizations per County Surgery NVCC CPT Authorizations per County

65

Demand




NVCC Outpa�ent CPT Authoriza�ons (Physical Medicine)

Physical Medicine NVCC CPT Authorizations per County

66

Top Services Provided by NVCC for Salt Lake City

Category of Care Total Authoriza�ons Total Authoriza�ons Total Authoriza�ons Id

NIC SKILLED NURSINGNIC HOMEMAKER/HOME HEALTH AIDER VISIT/URGENT CARETRANSPORTATIONSLEEP STUDY/POLYSOMNOGRAPHYInpa�entNIC SKILLED HOME CARERADIOLOGY MAMMOGRAMDERMATOLOGY TESTS, PROCEDURES, STUDIESPHYSICAL THERAPYOPTOMETRYLAB AND PATHOLOGYMENTAL HEALTHOPHTHALMOLOGY TESTS, PROCEDURES, STUDIESIV THERAPY/INFUSION, CLINICRADIATION THERAPYRADIOLOGY NOSORTHOPEDIC TESTS, PROCEDURES, STUDIESPRIMARY CARECHIROPRACTIC

2,9383,2581,678

240208

1,358640511544738331922256408312220219

595

42

4,1104,4921,848

321413

1,248901415526470566877353406372185261150129

45

4,0653,6091,8231,4241,3301,261

935840827670550508430412365266240228222201

27552756275727582759276027612762276327642765276627672768276927702771277227732774

CARDIOLOGY TESTS, PROCEDURES, STUDIESAUDIOLOGYORTHOPEDICHEMATOLOGY/ONCOLOGYNEPHROLOGYOtherTotal

62117

8882

1186,165

21,519

85127

93121131

2,56421,209

156151147140135

2,53023,465

2775277627772778277927802781

Demand



FY18FY17FY16

Commercial*

2.26.V19.SaltLakeCity.660Source: VHA Office of Community Care*Commercial includes authoriza�ons from federally qualified health centers and provider agreements

67

Demand Es�mated Future Market Demand — Outpa�ent

68

l 2017 l 2027

0

2,000,000

4,000,000

6,000,000

8,000,000

0.0T%

0.0T%

0.0T%

0.0T%

RVU

s

Rehab Therapies Dental Clinic Medical Special�es Mental Health Programs Primary Care Surgical Special�es

67.2% 85.4%57.6%77.6%62.2% 62.9%

Total2017 Rvu2027 Percent Change 3_1

Demand

Source: BY17 EHCPM U�liza�on Projec�ons 3.1.V19.SaltLakeCity



BY17 Market U�liza�on Projec�ons (Outpa�ent) — Salt Lake City Market

Health Systems Planning Group (HSPGs)

69

Ambulatory Mental Health, Health Systems Planning Categories (HSPCs)

50,000

100,000

0M%

5000M%

10000M%

15000M%

20000M%

Health Systems Planning Categories (HSPCs)

RVU

s

Homeless IntensiveCommunityMental Hlth

Recovery(ICMHR)

Psychiatry Psychology PsychosocialRehabilita�onand Recovery

Centers

MH RRTPOutpa�entEncounters

MH RRTPResiden�alEncounters

Work Therapy Community CareSocial Work

Non Psychiatristand Psychologist

-4.7% 87.3%130.5%-7.6%90.0% 17.0%87.8% 22.6% 12.0%-2.7%

2017 2027 Percent Change

Outpa�ent U�liza�on Projec�ons by Health Systems Planning Category (HSPC) Mental Health RVUs — Salt Lake City Market

Demand




l 2017 l 2027

70

Ambulatory Surgical Special�es, Health Systems Planning Categories (HSPCs)

10,000

20,000

30,000

40,000

Health Systems Planning Categories (HSPCs)

RVU

s

NeurologicalSurgery

Obstetrics &Gynecology

OrthopaedicSurgery

Otolaryngology Plas�c Surgery Podiatry Surgery Thoracic Surgery Urology Vascular Surgery Ophthalmology

122.4% 100.7% 108.5% 79.2% 88.8% 78.6% 79.5% 100.8% 68.1% 61.9% 82.3%

Rvu2017 Rvu2027 Rvu2027 % difference from Rvu2017

Outpatient Utilization Projections by Health Systems Planning Category (HSPC) Surgical Specialties RVUs — Salt Lake City Market

Demand




l 2017 l 2027

71

Ambulatory Medical Specialties, Health Systems Planning Categories (HSPCs)

0

20,000

40,000

60,000

5T%

10T%

15T%

Health Systems Planning Category (HSPCs)

RVU

s

Cardiology

Cri�cal Care/Pulmonary Dise

ase

Emergency Medicine

Gastroenterology

Neurology

Optometry

Physical Medicine & Rehabilita

�on

Allergy and Immunology

Chiropracty

Dermatology

Endocrinology

Hematology-Oncology

Infec�ous Dise

ase

Nephrology

Pain Medicine

Rheumatology

63.1% 71.4%112.7%22.1% 40.8%100.1%82.7% 69.2%68.6% 87.5%63.3% 103.1%62.9% 89.1% 45.9%82.9%


Demand




Outpatient Utilization Projections by Health Systems Planning Category (HSPC) Medical Specialties RVUs —Salt Lake City Market

l 2017 l 2027

72

BY17 Salt Lake City Market In-House LTSS U�liza�on Projec�ons (RVUs).

FY17 FY22 FY27 10 Year Change 10 Year % Change

VA Adult Day Health CareHome-Based Primary CareSCI&D Home CareCommunity Residen�al CareHome Telehealth

06,057

039

16,431

07,210

548

18,125

08,126

544

18,844

02,069

55

2,413

34.2%

12.8%14.7%

Outpa�ent U�liza�on Projec�ons by Health Systems Planning Category (HSPC) Ambulatory Long Term Support Services —

0

50,000

100,000

150,000

200,000

250,000

50,000%

100,000%

150,000%

200,000%

Community AdultDay Health Care

Home Respite Care Purchased SkilledHome Care

Home HospiceCare

Homemaker/HomeHealth AidePrograms

34.2% 58.0%66.0% 16.2%26.6%

Total2017 U�l2027 U�l2027 % difference from Total2017l 2017 l 2027

Salt Lake City Market

0

5,000

10,000

15,000

20,000

0%

50,000%

100,000%

150,000%

200,000%

VA Adult DayHealth Care

Home-BasedPrimary Care

SCI&D HomeCare

CommunityResiden�al Care

HomeTelehealth

34.2% 14.7%12.8%

Total2017 Rvu2027 Rvu2027 % difference from Total2017l 2017 l 2027

BY17 Salt Lake City Market Community LTSS U�liza�on Projec�ons (Procedures).

FY17 FY22 FY27 10 Year Change 10 Year % Change

Community Adult Day Health CareHome Respite CarePurchased Skilled Home CareHome Hospice CareHomemaker/Home Health Aide Programs

4,4661,362

43,758907

150,921

5,4721,895

52,2781,037

210,202

5,9922,261

55,4161,054

238,449

1,526899

11,658147

87,528

34.2%66.0%26.6%16.2%58.0%

Demand




73

FY18 Primary Care Encounters by County

Demand

Source: 1. VSSC Encounters Cube 2. BY17 EHCPM U�liza�on Projec�ons 3.6.V19.SaltLakeCity#IMG



FY17-FY27 Primary Care RVU Growth Rate by Sector

Primary Care Workload – Historic & Projected

74

FY18 Mental Health Encounters by County

Demand




FY17-FY27 Mental Health RVU Growth Rate by Sector

Mental Health Workload – Historic & Projected

75

FY18 Specialty Care Encounters by County

Demand




FY17-FY27 Specialty Care RVU Growth Rate by Sector

Specialty Care Workload (Med/Surg Special�es Combined) – Historic & Projected

76

0M

2M

4M

6M

8M

Rehab Therapies Dental Clinic

2017 2022 2027 Order

0.0M

0.1M

0.2M

0.3M

0.4M

Primary Care MedicalSpecial�es

SurgicalSpecial�es

Mental HealthPrograms

2017 2022 2027 Order

. In-House Community Total Total Total .. ... o

Primary CareMedical Special�esSurgical Special�esMental Health ProgramsRehab TherapiesDental Clinic

136,342189,383

96,364197,770

2,993,1921,134,776

12,43949,40429,152

8,9451,167,610

237,186

148,781238,787125,516206,715

4,160,8021,371,962

196,676327,396184,299288,861

5,667,7831,931,360

233,547385,675228,973367,699

6,952,8122,224,473

84,766146,888103,457160,984

2,792,010852,511

57.0%61.5%82.4%77.9%67.1%62.1%

123456

Demand

Source: BY17 EHCPM U�liza�on Projec�ons 3.9.V19.SaltLakeCity.660



FY17 FY22 FY27

10 Year

Change in

Total

10 Year %

Change in

Total

32.2%57.0% 61.5% 82.4% 77.9%

37.1% 46.8% 39.7%

BY17 Parent Facility U�liza�on Projec�ons (Outpa�ent) – Salt Lake City VAMCBY17 Salt Lake City VAMC U�liza�on Projec�ons (RVUs)

36.2% 40.8%67.1% 62.1%

77

Ambulatory Mental Health, Health Systems Planning Categories (HSPCs)

20,000

40,000

60,000

80,000

100,000

0.0%

5000000000.0%

10000000000.0%

15000000000.0%

20000000000.0%

Health Systems Planning Category (HSPC)

RVU

s

Homeless IntensiveCommunity MH

Recovery (ICMHR)

Psychiatry Psychology PsychosocialRehabilita�on andRecovery Centers

MH RRTP Outpa�entEncounters

MH RRTP Residen�alEncounters

Work Therapy

-5.1% -7.6%89.2% 17.0%87.2% 22.1% 12.3%-3.5%

ActualRvu2017 ProjectedRvu2027 Percent Change

Demand




Outpa�ent Parent Facility U�liza�on Projec�ons by Health Systems Planning Category (HSPC)

l 2017 l 2027

Mental Health RVUs — Salt Lake City VAMC

78

Ambulatory Surgical Special�es, Health Systems Planning Categories (HSPCs)

10,000

20,000

30,000

40,000

50,000

2000000000.0%

4000000000.0%

6000000000.0%

8000000000.0%

10000000000.0%

12000000000.0%

14000000000.0%

16000000000.0%

18000000000.0%

20000000000.0%

Health Systems Planning Category (HSPC)

RVU

s

Neurological Obstetrics &Gynecology

Orthopaedic Otolaryngology Plas�c Podiatry Surgery Thoracic Urology Vascular Ophthalmology

114.1% 79.2%58.6%76.6% 81.9%104.2% 88.3% 77.2%99.8% 77.3% 66.1%

ActualRvu2017 ProjectedRvu2027 Percent Change 3_11

Demand




Outpa�ent Parent Facility U�liza�on Projec�ons by Health Systems Planning Category (HSPC)

l 2017 l 2027

Surgical Special�es RVUs — Salt Lake City VAMC

79

Ambulatory Medical Special�es, Health Systems Planning Categories (HSPCs)

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

2T%

4T%

6T%

8T%

10T%

12T%

14T%

16T%

18T%

Health Systems Planning Category

RVU

s

Cardiology Cri�cal Care/PulmonaryDisease

Emergency Medicine Gastroenterology Neurology Optometry Physical Medicine &Rehabilita�on

59.8% 80.9%81.5%22.1%62.9% 67.4%61.0%


Demand




Outpa�ent Parent Facility U�liza�on Projec�ons by Health Systems Planning Category (HSPC) Medical Special�es RVUs — Salt Lake City VAMC

l 2017 l 2027

80

0

10,000

0%

500000%

1000000%

TenY

rPer

cDel

taTo

tal

VA Adult Day HealthCare

CommunityResiden�al Care

Home-Based PrimaryCare

Home Telehealth

0.0% 14.4%34.2%10.6%

Actual Projected2027Rvu TenYrPercDeltaTotal

0

100,000

200,000

100000%

200000%

TenY

rPer

cDel

taTo

tal

Community AdultDay Health Care

Home Respite Care Purchased SkilledHome Care

Home HospiceCare

Homemaker/HomeHealth Aide Progr…

34.1% 58.4%66.0% 20.9%26.9%

Actual Projected2027U�liza�on TenYrPercDeltaTotal

* Provided at procedure level given the limited RVU repor�ng for these services

HSPC

FY17 FY22 FY27 10 YearChange

10 Year %Change

Community Adult Day HealthCareHome Respite CarePurchased Skilled Home CareHome Hospice CareHomemaker/Home Health AidePrograms

4,459

1,36044,856

1,082154,560

5,463

1,89253,682

1,286215,598

5,980

2,25856,936

1,308244,824

1,521

89812,080

22690,264

34.1%

66.0%26.9%20.9%58.4%

HSPC

FY17 FY22 FY27 10 YearChange

10 Year %Change

SCI&D Home CareVA Adult Day Health CareCommunity Residen�alCareHome-Based PrimaryCareHome Telehealth

N/A0

39

6,072

16,917

N/AN/A

48

7,229

18,642

N/AN/A

44

8,150

19,361

N/A04

2,077

2,444

N/A0.0%

10.6%

34.2%

14.4%



Outpa�ent Parent Facility U�liza�on Projec�ons by Health Systems Planning Category (HSPC)Ambulatory Long Term Support Services — Salt Lake City VAMC

BY17 Salt Lake City VAMC In-HouseLTSS U�liza�on Projec�ons (RVUs)

BY17 Salt Lake City VAMC CommunityLTSS U�liza�on Projec�ons (Procedures)*

Demand

FY17 FY22 FY27 FY17 FY22 FY27

l 2017 l 2027 l 2017 l 2027


Homemaker/Home

Health Aide Programs

81

Demand

Source: IBM Market Expert 3.14.V19.SaltLakeCity.660



• Overview:

ü Outpa�ent demand es�mates (pa�ent visits)

were also developed to understand current

and future expected commercial outpa�ent

demand

ü Demand es�mates are based on non-Veteran

pa�ent origin within a 60 minute drive �me

from parent VA Medical Center/ Health Care

Center noted

Clinical Service Line 2018 2023 2028 5 Year Chg % Chg 10 Year Chg % Chg

General/Family Prac�ceInternal MedicinePrimary Care TotalAllergy/ImmunologyCardiologyDermatologyEndocrinologyGastroenterologyHematology/OncologyInfec�ous DiseaseNephrologyNeurologyPain ManagementPulmonologyRheumatologyVascularSpecialty Care (Medicine) Sub-TotalCardio/Thoracic SurgeryColorectal SurgeryGeneral Surgery

2,219,1991,118,8553,338,054

81,161283,326358,503

91,289124,782238,635

16,75444,714

113,04354,68870,94571,62317,853

1,567,3158,5468,847

104,019

2,499,3921,298,5873,797,979

91,814346,515412,633105,075145,819291,975

19,57754,679

129,87465,52184,73384,21622,158

1,854,58910,13810,262

120,865

2,848,5761,514,3644,362,940

104,675418,537477,486121,830170,971352,797

22,93466,034

150,07978,102

100,78999,24327,015

2,190,49311,99711,967

140,799

280,194179,732459,925

10,65363,18954,12913,78621,03753,341

2,8239,965

16,83210,83213,78912,594

4,305287,274

1,5921,414

16,846

12.6%16.1%13.8%13.1%22.3%15.1%15.1%16.9%22.4%16.8%22.3%14.9%19.8%19.4%17.6%24.1%18.3%18.6%16.0%16.2%

629,377395,509

1,024,88623,514

135,211118,983

30,54146,189

114,1626,181

21,32137,03623,41429,84527,620

9,162623,178

3,4513,120

36,780

28.4%35.3%30.7%29.0%47.7%33.2%33.5%37.0%47.8%36.9%47.7%32.8%42.8%42.1%38.6%51.3%39.8%40.4%35.3%35.4%

NeurosurgeryOphthalmologyOrthopedic SurgeryOtolaryngologyPlas�c SurgeryUrologySpecialty Care (Surgery) Sub-TotalMedicine/Surgery TotalObstetrics/GynecologyWomen's Health TotalPsychiatryMental Health TotalPhysical Medicine/RehabRehab TotalEmergency/Cri�cal Care

23,434309,254336,400158,229

24,827146,256

1,119,8132,687,128

421,928421,928310,073310,073

78,06578,065

712,286

27,008369,687387,043180,215

28,581173,459

1,307,2583,161,847

466,487466,487343,994343,994

90,70990,709

808,417

31,317439,948447,720206,631

33,087205,348

1,528,8153,719,308

526,053526,053388,418388,418105,833105,833921,177

3,57360,43450,64321,985

3,75427,203

187,445474,719

44,55844,55833,92133,92112,64412,64496,130

15.2%19.5%15.1%13.9%15.1%18.6%16.7%17.7%10.6%10.6%10.9%10.9%16.2%16.2%13.5%

7,883130,694111,321

48,4018,260

59,092409,002

1,032,180104,124104,124

78,34578,34527,76727,767

208,891

33.6%42.3%33.1%30.6%33.3%40.4%36.5%38.4%24.7%24.7%25.3%25.3%35.6%35.6%29.3%

Growth Projec�onsPa�ent Visits

Overall Outpa�ent Commercial Demand – Salt Lake City Area


Demand

Source: IBM Market Expert 3.14.V19.SaltLakeCity.660#2



• Overview:

ü Outpa�ent demand es�mates (pa�ent visits)

were also developed to understand current

and future expected commercial outpa�ent

demand

ü Demand es�mates are based on non-Veteran

pa�ent origin within a 60 minute drive �me

from parent VA Medical Center/ Health Care

Center noted

Clinical Service Line 2018 2023 2028 5 Year Chg % Chg 10 Year Chg % Chg

Emergency Services TotalNurse Prac��onerPhysician AssistantOther Services TotalGrand Total

712,286292,455185,480477,935

8,025,470

808,417336,760216,368553,128

9,222,561

921,177389,788252,813642,601

10,666,330

96,13044,30530,88875,193

1,197,091

13.5%15.1%16.7%15.7%14.9%

208,89197,33467,333

164,6672,640,861

29.3%33.3%36.3%34.5%32.9%

Growth Projec�onsPa�ent Visits

Overall Outpa�ent Commercial Demand – Salt Lake City Area, cont.


Demand Es�mated Current and Historic Market Demand — Inpa�ent

84

Commercial Provider Case Mix Index⁴

Inpa�ent Demand and CMI – Salt Lake City

VAMC Case Mix Index³

Bed Service FY15 FY16 FY17 FY18 Current FY15 FY16 FY17 FY18 FY15-18 Change % DO

MedicalSurgeryTotal Med/SurgMental HealthRRTP*Rehab MedVAMC Total

5030802115

5121

5030803015

5130

5030803015

5130

4731783015

5128

4631773015

5127

31.617.549.119.639.5

3.8112.0

30.113.743.818.112.8

2.877.5

33.612.746.318.513.1

3.781.6

32.711.944.620.413.6

3.482.0

3.5%-32.0%

-9.2%4.1%

-65.6%-10.5%-26.8%

1234567

Facility 2015Unique

2016Unique

2017Unique

2018Unique

2015CMI

2016CMI

2017CMI

2018CMI

MedianCMI*

HighCMI**

Id

(660) Salt Lake City 2,911 2,851 2,739 2,611 1.63 1.59 1.55 1.60 1.76 2.46 …

Demand


*RRTP includes Domiciliary and CWT/TR Bed Services**Market: Within a 60 minute drive �me of the VAMC


VISN 19: Salt Lake City Market – Salt Lake City

Opera�ng Beds from PTF Cube Average Daily Census (ADC)Opera�ng Beds Reported by Field

Source: 1. Beds reported by the field in GFI submission 2. VSSC Beds Using PTF Cube 3. MCAO Discharge Cube 4. CMI (acute inpatient care) based on Medicare only population from 2018 CMS Cost Reports

85

Medical/Surgical Bed Days of Care (BDOC) – FY15-18Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. Geocoded Enrollee File FY18Q4 4.1.V19.SaltLakeCity#IMG



FY15-18 Average Medical/Surgical Bed Days of Care by County

86

Medical/Surgical BDOC — FY15-18, cont.County FY18 BDOC FY18 ADC % ADC FY15-18 AVG BDOC Majority Receiving Facility % BDOC …

Bannock, ID

Bear Lake, ID

Bingham, ID

Bonneville, ID

Caribou, ID

Franklin, ID

Fremont, ID

Jefferson, ID

Madison, ID

Oneida, ID

Power, ID

Teton, ID

Elko, NV

White Pine, NV

Beaver, UT

Box Elder, UT

Cache, UT

Carbon, UT

305

16

74

339

8

5

16

82

42

26

4

6

394

174

24

180

164

79

0.8

0.0

0.2

0.9

0.0

0.0

0.0

0.2

0.1

0.1

0.0

0.0

1.1

0.5

0.1

0.5

0.4

0.2

30.0%

31.4%

18.8%

39.5%

15.7%

5.8%

13.3%

25.9%

23.5%

34.7%

11.1%

27.3%

29.2%

37.8%

34.8%

26.0%

24.3%

16.9%

254

13

98

215

13

22

30

79

45

19

9

6

337

115

17

173

169

117





(V04) (595) Lebanon














84.6%

100.0%

83.8%

71.4%

75.0%

100.0%

75.0%

97.6%

100.0%

88.5%

100.0%

100.0%

71.3%

100.2%

54.2%

97.8%

98.2%

88.6%

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. Geocoded Enrollee File FY18Q4 4.1.V19.SaltLakeCity



87


Dagge�, UT

Davis, UT

Duchesne, UT

Emery, UT

Garfield, UT

Iron, UT

Juab, UT

Kane, UT

Millard, UT

Morgan, UT

Piute, UT

Rich, UT

Salt Lake, UT

Sanpete, UT

Sevier, UT

Summit, UT

Tooele, UT

Uintah, UT

15

1,123

192

28

17

71

63

37

46

34

17

9

7,927

103

141

80

474

157

0.0

3.1

0.5

0.1

0.0

0.2

0.2

0.1

0.1

0.1

0.0

0.0

21.7

0.3

0.4

0.2

1.3

0.4

15.8%

25.5%

29.2%

17.8%

33.3%

17.5%

36.0%

22.4%

32.6%

20.4%

65.4%

34.6%

24.8%

21.3%

34.7%

27.1%

25.8%

30.1%

24

1,100

165

39

13

102

44

41

35

42

7

7

7,991

121

102

74

459

131



















100.0%

95.7%

93.8%

75.0%

82.4%

91.5%

81.0%

75.7%

78.3%

100.0%

100.0%

100.0%

95.1%

100.0%

97.2%

100.0%

90.7%

96.8%

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

…

Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. Geocoded Enrollee File FY18Q4 4.1.V19.SaltLakeCity#2



88


Utah, UT

Wasatch, UT

Washington, UT

Wayne, UT

Wayne, UT

Weber, UT

Total

924

82

175

12

12

793

14,470

2.5

0.2

0.5

0.0

0.0

2.2

39.6

24.5%

25.9%

17.2%

46.2%

46.2%

22.1%

N/A

943

79

255

7

7

897

14,409




(V19) (575) Grand Junc�on-Colorado



98.1%

95.1%

48.0%

50.0%

50.0%

93.8%

N/A

…

…

…

…

…

…

…

Demand




89

Demand

Source: VSSC Trea�ng Specialty Cube 4.2.V19.SaltLakeCity



Top DRGs for Medicine in FY184_4 Facility DRG In Market

BDOCIn Market BDOC

% of TotalIn and Out ofMarket BDOC

In and Out of Market% of Total BDOC

(V19) (660) Salt Lake City O (871) Sep�cemia W/o Mv 96+ Hours W MccO (291) Heart Failure & Shock W MccO (286) Circulatory Disorders Except Ami, W Card Cath W MccO (292) Heart Failure & Shock W CcO (287) Circulatory Disorders Except Ami, W Card Cath W/o MccO (872) Sep�cemia W/o Mv 96+ Hours W/o MccO (189) Pulmonary Edema & Respiratory FailureO (641) Nutri�onal & Misc Metabolic Disorders W/o MccO (65) Intracranial Hemorrhage Or Cerebral Infarc�on W CcO (190) Chronic Obstruc�ve Pulmonary Disease W MccOtherTotal

721393268429285387360193120120

62449520

7.6%4.1%2.8%4.5%3.0%4.1%3.8%2.0%1.3%1.3%

65.6%100.0%

778572502496494421407209184168

706411295

6.9%5.1%4.4%4.4%4.4%3.7%3.6%1.9%1.6%1.5%

62.5%100.0%

4_4 Facility DRG In MarketBDOC

In Market BDOC% of Total

In and Out ofMarket BDOC


(V19) (660) Salt Lake City O (871) Sep�cemia W/o Mv 96+ Hours W MccO (291) Heart Failure & Shock W MccO (286) Circulatory Disorders Except Ami, W Card Cath W MccO (292) Heart Failure & Shock W CcO (287) Circulatory Disorders Except Ami, W Card Cath W/o MccO (872) Sep�cemia W/o Mv 96+ Hours W/o MccO (189) Pulmonary Edema & Respiratory FailureO (641) Nutri�onal & Misc Metabolic Disorders W/o MccO (65) Intracranial Hemorrhage Or Cerebral Infarc�on W CcO (190) Chronic Obstruc�ve Pulmonary Disease W MccOtherTotal

721393268429285387360193120120

62449520

7.6%4.1%2.8%4.5%3.0%4.1%3.8%2.0%1.3%1.3%

65.6%100.0%

778572502496494421407209184168

706411295

6.9%5.1%4.4%4.4%4.4%3.7%3.6%1.9%1.6%1.5%

62.5%100.0%

90

Demand

Sources: 1. VSSC Trea�ng Specialty Cube 2. VHA Office of Community Care 4.13.V19.SaltLakeCity



Top Medicine DRGs in the Community and Outside of the Market. DRG FY18 BDOC % of Total BDOC

VA Care Outside of the Market

Care in the Community

(57) DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC(189) PULMONARY EDEMA & RESPIRATORY FAILURE(556) SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC(291) HEART FAILURE & SHOCK W MCC(292) HEART FAILURE & SHOCK W CC(950) AFTERCARE W/O CC/MCC(445) DISORDERS OF THE BILIARY TRACT W CC(871) SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC(94) BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC(439) DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CCOtherTotal(871) SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC(291) HEART FAILURE & SHOCK W MCC(682) RENAL FAILURE W MCC(834) ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC(208) RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS(189) PULMONARY EDEMA & RESPIRATORY FAILURE(101) SEIZURES W/O MCC(872) SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC

149684942302828272621

326794228

61604544383633

18.8%8.6%6.2%5.3%3.8%3.5%3.5%3.4%3.3%2.6%

41.1%100.0%

16.9%4.5%4.4%3.3%3.3%2.8%2.7%2.4%

(180) RESPIRATORY NEOPLASMS W MCC(287) CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCCOtherTotal

3230

7461,353

2.4%2.2%

55.1%100.0%

. DRG FY18 BDOC % of Total BDOC



(57) DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC(189) PULMONARY EDEMA & RESPIRATORY FAILURE(556) SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC(291) HEART FAILURE & SHOCK W MCC(292) HEART FAILURE & SHOCK W CC(950) AFTERCARE W/O CC/MCC(445) DISORDERS OF THE BILIARY TRACT W CC(871) SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC(94) BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC(439) DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CCOtherTotal(871) SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC(291) HEART FAILURE & SHOCK W MCC(682) RENAL FAILURE W MCC(834) ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC(208) RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS(189) PULMONARY EDEMA & RESPIRATORY FAILURE(101) SEIZURES W/O MCC(872) SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC

149684942302828272621

326794228

61604544383633

18.8%8.6%6.2%5.3%3.8%3.5%3.5%3.4%3.3%2.6%

41.1%100.0%

16.9%4.5%4.4%3.3%3.3%2.8%2.7%2.4%

(180) RESPIRATORY NEOPLASMS W MCC(287) CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCCOtherTotal

3230

7461,353

2.4%2.2%

55.1%100.0%

Note: Enrollees enrolled in a market and received care at a facility outside of their market

91

Top DRGs for Surgery in FY18Demand




Id





………………………………

(V19) (660) Salt Lake City O (470) Major Joint Replacement Or Rea�achment Of Lower Extremity W/o MccO (235) Coronary Bypass W/o Cardiac Cath W MccO (981) Extensive O.r. Procedure Unrelated To Principal Diagnosis W MccO (219) Cardiac Valve & Oth Maj Cardiothoracic Proc W/o Card Cath W MccO (853) Infec�ous & Parasi�c Diseases W O.r. Procedure W MccO (460) Spinal Fusion Except Cervical W/o MccN (264) Other circulatory system O.R. proceduresO (326) Stomach, Esophageal & Duodenal Proc W MccO (252) Other Vascular Procedures W MccO (329) Major Small & Large Bowel Procedures W MccOtherTotal

212171164

85114113

54463285

2,3263,402

6.2%5.0%4.8%2.5%3.4%3.3%1.6%1.4%0.9%2.5%

68.4%100.0%

225220212140128125123107

9494

2,9474,415

5.1%5.0%4.8%3.2%2.9%2.8%2.8%2.4%2.1%2.1%

66.7%100.0%

Id





………………………………

(V19) (660) Salt Lake City O (470) Major Joint Replacement Or Rea�achment Of Lower Extremity W/o MccO (235) Coronary Bypass W/o Cardiac Cath W MccO (981) Extensive O.r. Procedure Unrelated To Principal Diagnosis W MccO (219) Cardiac Valve & Oth Maj Cardiothoracic Proc W/o Card Cath W MccO (853) Infec�ous & Parasi�c Diseases W O.r. Procedure W MccO (460) Spinal Fusion Except Cervical W/o MccN (264) Other circulatory system O.R. proceduresO (326) Stomach, Esophageal & Duodenal Proc W MccO (252) Other Vascular Procedures W MccO (329) Major Small & Large Bowel Procedures W MccOtherTotal

212171164

85114113

54463285

2,3263,402

6.2%5.0%4.8%2.5%3.4%3.3%1.6%1.4%0.9%2.5%

68.4%100.0%

225220212140128125123107

9494

2,9474,415

5.1%5.0%4.8%3.2%2.9%2.8%2.8%2.4%2.1%2.1%

66.7%100.0%

92

Demand

Source: 1. VSSC Treating Specialty Cube 2. VHA Office of Community Care 4.14.V19.SaltLakeCity



Top Surgery DRGs in the Community and Outside of the Market. DRG FY18 BDOC % of Total BDOC



(988) NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC(16) AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC(824) LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC(470) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC(265) AICD LEAD PROCEDURES(418) LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC(854) INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC(621) O.R. PROCEDURES FOR OBESITY W/O CC/MCC(247) PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC(254) OTHER VASCULAR PROCEDURES W/O CC/MCCOtherTotal(25) CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC(3) ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R.(14) ALLOGENEIC BONE MARROW TRANSPLANT(470) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC(853) INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC(326) STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC(928) FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC(709) PENIS PROCEDURES W CC/MCC

27191911101010

876

51178

9292644949363130

15.2%10.7%10.7%

6.2%5.6%5.6%5.6%4.5%3.9%3.4%

28.7%100.0%

7.6%7.6%5.3%4.1%4.1%3.0%2.6%2.5%

(20) INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC(573) SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCCOtherTotal

3028

7071,208

2.5%2.3%

58.5%100.0%




(988) NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC(16) AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC(824) LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC(470) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC(265) AICD LEAD PROCEDURES(418) LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC(854) INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC(621) O.R. PROCEDURES FOR OBESITY W/O CC/MCC(247) PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC(254) OTHER VASCULAR PROCEDURES W/O CC/MCCOtherTotal(25) CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC(3) ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R.(14) ALLOGENEIC BONE MARROW TRANSPLANT(470) MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC(853) INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC(326) STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC(928) FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC(709) PENIS PROCEDURES W CC/MCC

27191911101010

876

51178

9292644949363130

15.2%10.7%10.7%

6.2%5.6%5.6%5.6%4.5%3.9%3.4%

28.7%100.0%

7.6%7.6%5.3%4.1%4.1%3.0%2.6%2.5%

(20) INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC(573) SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCCOtherTotal

3028

7071,208

2.5%2.3%

58.5%100.0%

Note: Enrollees enrolled in a market and received care at a facility outside of their market

93

Mental Health BDOC – FY15-18Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. Geocoded Enrollee File FY18Q4 4.4.V19.SaltLakeCity#IMG



FY15-18 Average Mental Health Days of Care by County

94

Mental Health BDOC – FY15-18, cont.County FY18 BDOC FY15-18 AVG BDOC Majority Receiving Facility % BDOC Id

Bannock, IDBear Lake, IDBingham, IDBonneville, IDCaribou, IDFremont, IDJefferson, IDMadison, IDOneida, IDPower, IDTeton, IDElko, NVWhite Pine, NVBeaver, UTBox Elder, UTCache, UTCarbon, UTDavis, UTDuchesne, UTEmery, UT

12332

259N/AN/A

18391612

N/A69

N/AN/A

738138

4475382

1341

10173

727

2420

34

8250

615533

4342622

(V19) (660) Salt Lake City(V21) (570) Fresno(V20) (531) Boise(V22) (691) West Los Angeles(V19) (660) Salt Lake City(V20) (668) Spokane-Washington(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V08) (573) Gainesville(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V07) (679) Tuscaloosa-Alabama

82.9%100.0%100.0%

61.4%N/AN/A

100.0%87.2%

100.0%100.0%

N/A89.9%

N/AN/A

79.5%93.8%

100.0%88.8%

100.0%100.0%

……………………………………………………

Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. Geocoded Enrollee File FY18Q4 4.4.V19.SaltLakeCity



95

Mental Health BDOC – FY15-18, cont.County FY18 BDOC FY15-18 AVG BDOC Majority Receiving Facility % BDOC Id

Iron, UTJuab, UTKane, UTMillard, UTPiute, UTRich, UTSalt Lake, UTSanpete, UTSevier, UTSummit, UTTooele, UTUintah, UTUtah, UTWasatch, UTWashington, UTWayne, UTWeber, UTTotal

48416340

N/AN/A

4,076174625

2113

33619

101N/A637

6,978

50302333

51

4,0168

3632

1536

41514

1117

4666,502

(V19) (660) Salt Lake City(V05) (540) Clarksburg-West Virginia(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V22) (678) Tucson(V19) (666) Sheridan(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V17) (674) Temple-Texas(V19) (660) Salt Lake City(V08) (573) Gainesville(V19) (660) Salt Lake City

81.3%53.7%

100.0%100.0%

N/AN/A

84.1%100.0%100.0%100.0%

92.9%100.0%

78.9%57.9%88.1%

N/A70.2%

N/A

………………………………………………

Demand




96

Demand




Top DRGs for Mental Health in FY184_8 DRG In Market

BDOCIn Market BDOC

% of TotalIn and Out ofMarket BDOC


(V19) (660) Salt Lake City N (885) PsychosesN (882) Neuroses except depressiveN (881) Depressive neurosesO (884) Organic Disturbances & Mental Retarda�onO (880) Acute Adjustment Reac�on & Psychosocial Dysfunc�onO (883) Disorders Of Personality & Impulse ControlTotal

2232597282153139

373440

64.9%17.4%

8.2%4.4%4.0%1.1%

100.0%

2807760445161139

374349

64.5%17.5%10.2%

3.7%3.2%0.9%

100.0%

4_8 DRG In MarketBDOC




(V19) (660) Salt Lake City N (885) PsychosesN (882) Neuroses except depressiveN (881) Depressive neurosesO (884) Organic Disturbances & Mental Retarda�onO (880) Acute Adjustment Reac�on & Psychosocial Dysfunc�onO (883) Disorders Of Personality & Impulse ControlTotal

2232597282153139

373440

64.9%17.4%

8.2%4.4%4.0%1.1%

100.0%

2807760445161139

374349

64.5%17.5%10.2%

3.7%3.2%0.9%

100.0%

97

Demand

Source: 1. VSSC Treating Specialty Cube 2. VHA Office of Community Care 4.15.V19.SaltLakeCity



Top Mental Health DRGs in the Community and Outside of the Market. DRG FY18 BDOC % of Total BDOC



(885) PSYCHOSES(884) ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY(881) DEPRESSIVE NEUROSES(882) NEUROSES EXCEPT DEPRESSIVE(880) ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION(883) DISORDERS OF PERSONALITY & IMPULSE CONTROL(886) BEHAVIORAL & DEVELOPMENTAL DISORDERSTotal(885) PSYCHOSES(881) DEPRESSIVE NEUROSES(882) NEUROSES EXCEPT DEPRESSIVE(880) ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTIONTotal

599209

9484633220

1,101310

1076

333

54.4%19.0%

8.5%7.6%5.7%2.9%1.8%

100.0%93.1%

3.0%2.1%1.8%

100.0%




(885) PSYCHOSES(884) ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY(881) DEPRESSIVE NEUROSES(882) NEUROSES EXCEPT DEPRESSIVE(880) ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION(883) DISORDERS OF PERSONALITY & IMPULSE CONTROL(886) BEHAVIORAL & DEVELOPMENTAL DISORDERSTotal(885) PSYCHOSES(881) DEPRESSIVE NEUROSES(882) NEUROSES EXCEPT DEPRESSIVE(880) ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTIONTotal

599209

9484633220

1,101310

1076

333

54.4%19.0%

8.5%7.6%5.7%2.9%1.8%

100.0%93.1%

3.0%2.1%1.8%

100.0%

*Enrollees enrolled in a market and received care at a facility outside of their market

98

Demand

Source: 1. Office of Community Care 4.17.V19.SaltLakeCity.660



Community Care (Inpa�ent)FY16-18 Medicine NVCC (ADC) FY16-18 Surgery NVCC (ADC) FY16-18 Psych NVCC (ADC)

Vendor FY16 FY17 FY18

UNIV OF UT HOSP & CLSINTERMOUNTAIN HLTH CARE INC*POCATELLO HOSP LLCEASTERN IDAHO HLTH SVCSDAVIS HOSP & MED*UNIVERSITY OF UTAH HEALTHJORDAN VALLEY MED CTR LPMADISON MEMORIAL HOSPPIONEER VALLEY HOSPITAL ATIMPANOGOS REG HOSPAll Other VendorsCommunity Total (ADC)

2.50.60.10.10.0

N/AN/A0.0

N/AN/A0.13.5

2.60.70.20.10.00.00.0

N/A0.10.00.23.9

2.80.80.10.10.00.00.00.00.00.00.03.9

Vendor FY16 FY17 FY18

INTERMOUNTAIN HLTH CARE INC*UNIV OF UT HOSP & CLSPOCATELLO HOSP LLCEASTERN IDAHO HLTH SVCSCOLUMBIA OGDEN MC*CRMOUNTAIN VIEW HOSP INCDAVIS HOSP & MED*UINTAH BASIN MED CTRCASTLEVIEW HOSP LLCPHC-ELKO INC*All Other VendorsCommunity Total (ADC)

1.11.00.60.10.20.10.00.00.00.11.64.8

1.70.70.40.20.10.00.10.00.00.00.43.7

1.40.90.40.20.10.10.10.00.00.00.23.4

Vendor FY16 FY17 FY18 .

INTERMOUNTAIN HLTH CARE INC*UNIV OF UT HOSP & CLSSALT LAKE REGL MED CTR*SALT LAKE REGL MED PSYCH*COLUMBIA OGDEN MC*CRPOCATELLO HOSP LLCLAKEVIEW HOSP PSYCHMOUNTAIN VIEW HOSP INCPIONEER VALLEY HOSPITAL AEASTERN IDAHO HLTH SVCSAll Other VendorsCommunity Total (ADC)

N/AN/A0.1

N/AN/AN/A0.10.0

N/A0.01.31.4

0.1N/A0.1

N/AN/A0.0

N/A0.10.00.00.40.7

0.30.30.20.00.00.00.00.00.00.00.00.9

123456789101112

99

NVCC FY16-18 – Inpa�ent BDOCDemand




Medicine Mental HealthSurgerySector/ County Name

Sector County Name 2017 Enrollees FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18


Salt Lake, UTSector SubtotalBeaver, UTBox Elder, UTCache, UTCarbon, UTDuchesne, UTElko, NVEmery, UTGarfield, UTIron, UTJuab, UTKane, UTMillard, UTMorgan, UTPiute, UTRich, UTSanpete, UTSevier, UTSummit, UT

20,61820,618

1441,0351,492

552483

1,406206160

1,285220251248231

4736

633531566

406406N/A

823132314

N/AN/A

284422

N/AN/A

2975

280280

42

46161327

N/AN/A

263

128

N/A2

N/A53

N/A

301301

13

30331025

N/AN/A

48N/A

346

N/A34

19N/A

379379

3N/A

213

518501216

3N/AN/A

7N/AN/A

917

2

403403N/A

1914

8N/A

242

N/A28

N/AN/AN/AN/AN/AN/A

618

9

353353

215305846

517

N/A18

N/AN/AN/A

2N/AN/A

132320

429429

7N/AN/A

4N/AN/AN/AN/AN/AN/AN/A

1N/AN/AN/A

17N/AN/A

144144N/AN/A

2N/AN/AN/AN/AN/A


12N/A

141141N/AN/A

22N/AN/AN/AN/AN/A

14N/AN/AN/AN/AN/AN/AN/AN/AN/A

19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B19-f-9-B

Tooele, UTUintah, UTUtah, UTWasatch, UTWashington, UTWayne, UT

1,778684

6,409355

4,34956

22N/A199N/A124N/A

610

1177

250N/A

198

99N/A214N/A

74

82N/A

93N/A

3118510

1843

54

1106

70N/A

5N/A

583

N/A

6N/A

11N/A

13N/A

N/AN/A

70N/A

24N/A

100

NVCC FY16-18 – Inpa�ent BDOC, cont.Demand

Source: VHA Office of Community Care 4.12.V19.SaltLakeCity#2



Medicine Mental HealthSurgerySector/ County Name

Sector County Name 2017 Enrollees FY16 FY17 FY18 FY16 FY17 FY18 FY16 FY17 FY18

19-f-9-B19-f-9-B19-f-9-D19-f-9-D19-f-9-D19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-E19-f-9-EMarket Total

White Pine, NVSector SubtotalDavis, UTWeber, UTSector SubtotalBannock, IDBear Lake, IDBingham, IDBonneville, IDCaribou, IDFranklin, IDFremont, IDJefferson, IDMadison, IDOneida, IDPower, IDTeton, IDSector SubtotalMarket Total

41923,576

7,7586,653

14,4112,714

1641,1002,589

185241347586352156137134

8,70567,310

12519121258379176N/A

215811

N/A24

N/A76

N/A285

1,589

4561

78190268

825

2097

N/A738442

N/A232

1,341

6535

51209260124N/A

1498

N/A2

N/A93

N/A25

2571,353

N/A343

4775

12240

N/AN/A

332

N/A679

N/A4

N/A101945

N/A424

7068

13894

52030

N/A18

N/A32

82

N/A200

1,165

6450

99145244

4616

344

27

N/A26

N/AN/A

17N/A161

1,208

N/A50261642


2N/A

8N/A

15536

N/A46

04949

N/AN/AN/A

8N/AN/AN/AN/AN/AN/AN/AN/A

8247

N/A130

04343

N/AN/AN/A

14N/AN/A

5N/AN/AN/AN/AN/A

19333

101

Demand




NVCC FY16-18 – Inpa�ent U�liza�on Pa�ernsFY16-18 Med/Surg Bed Days of Care FY16-18 Mental Health Bed Days of Care

102

Nursing Home BDOC Distribu�onDemand

4.7.V19.SaltLakeCity#IMG

Note: Data is only for fee basis and does not encompass all Community Care



Source: 1. VSSC Trea�ng Specialty Cube 2. VSSC NVCC Cube 3. Defini�ve HC

FY15-18 Average BDOC by County

103

County FY18 Non-VA Community Care* FY18 VA FY18 Total BDOC Id

Bannock, IDBear Lake, IDBingham, IDBonneville, IDCaribou, IDClark, IDFranklin, IDFremont, IDJefferson, IDMadison, IDOneida, IDPower, IDTeton, IDElko, NVWhite Pine, NVBeaver, UTBox Elder, UTCache, UTCarbon, UTDagge�, UT

139

2

24

29509

1,50527

99

983

39432

159

23802

98300000

240

29903

320

1,50542

90

23442345234623472348234923502351235223532354235523562357235823592360236123622363

Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. VSSC NVCC Cube 3. Defini�ve HC 4.7.V19.SaltLakeCity

*Data is only for fee basis and does not encompass all Community Care



Nursing Home BDOC Distribu�on, cont.

104


Davis, UTDuchesne, UTEmery, UTGarfield, UTIron, UTJuab, UTKane, UTMillard, UTMorgan, UTPiute, UTRich, UTSalt Lake, UTSanpete, UTSevier, UTSummit, UTTooele, UTUintah, UTUtah, UTWasatch, UTWashington, UT

1,561104

13278

2941255

20,589106112

859424

2,16112

320

9

264

38

1,561104

0132

78294

2155

000

20,853106112

859424

2,16112

358

23642365236623672368236923702371237223732374237523762377237823792380238123822383

Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. VSSC NVCC Cube 3. Defini�ve HC 4.7.V19.SaltLakeCity#2





105


Wayne, UTWeber, UTTotal

1,94829,922

23984

01,971

30,906

238423852386

Demand

Source: 1. VSSC Trea�ng Specialty Cube 2. VSSC NVCC Cube 3. Defini�ve HC 4.7.V19.SaltLakeCity#3





106

FY10-18 Long Stay BDOC vs. Short Stay BDOC

0

200

400

600

800

Bed

Days

of C

are

FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18

24993

607

0

286

160

0

386

0

599891924

186

285 298

490541

384

Long Short

FY10-18 Long Stay BDOC vs. Short Stay BDOC

Stay Age FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 % Change s

Long < 40 0 0 76 0 0 0 0 0 0 0.0%55-64 64 0 0 160 0 77 0 0 16 -75.0%65-79 185 242 237 0 0 0 0 0 0 -100.0%80+ 0 365 0 0 0 209 0 0 0 0.0%

Total Long 249 607 386 160 0 286 0 0 93 -62.7%Short < 40 0 5 0 0 0 0 0 0 0 0.0%

40-54 22 93 82 70 102 0 0 96 17 -22.7%55-64 441 55 126 253 20 11 2 273 495 12.2%65-79 133 388 157 29 136 150 149 518 268 101.5%80+ 3 0 30 32 27 124 35 37 90 2900.0%

Total Short 599 541 490 384 285 298 186 924 891 48.7%

11112333334

Demand




In-House LTSS Short Stays vs. Long Stays BDOC

107

Facility Opera�ng Beds Reported in the PTF Cube Opera�ng Beds Reported by the Field FY18 ADC NVCC, FY18 ADC**

(V19) (660) Salt Lake CityTotal

N/AN/A

N/AN/A

N/AN/A

86.486.4

Demand

Source: 1. VSSC Beds Using PTF Cube 2. VSSC NVCC Cube 3. Defini�ve Healthcare 4.9.V19.SaltLakeCity



Community Nursing Home vs. In-House BDOC

Facility Opera�ng Beds FY18 ADC Occupancy Poten�al Available Beds* Id

(V19) (660) Salt Lake City 14,689 10,779.0 73.6% 3,176 …

*Poten�al Available Beds is defined as Opera�ng Beds less ADC based on a 95% occupancy

**Data is only for fee basis and does not encompass all Community Care

***SNFs within a 30 minute drive �me of facility. Does not include SNFs in which the ADC overly exceeded opera�ng beds (>30%) as it indicates a coding issue

VA (In-House)

Community Sta�s�cs***

108

Residen�al Rehab BDOCDemand




FY15-18 Average Residen�al Rehabilita�on Days by County

Source: VSSC Trea�ng Specialty Cube; Substance Abuse and Mental Health Services Administra�on (SAMHSA) (2018)

109

Top 10 Market Coun�es FY15 BDOC FY16 BDOC FY17 BDOC FY18 BDOC

Salt Lake, UTDavis, UTWeber, UTBonneville, IDUintah, UTBannock, IDTooele, UTWashington, UTUtah, UTElko, NV

9,7311,3081,292

17057

414218274

1,098133

3,592540729145

0231174381260254

3,382298765469

57462

83272522

65

3,535621440381284256255225222194

Care Received in a VAMC/VA Facility(not limited to VA Facili�es in the market)

Demand

Source: VSSC Trea�ng Specialty Cube; Substance Abuse and Mental Health Services Administra�on (SAMHSA) (2018) 4.10.V19.SaltLakeCity



Residen�al Rehab BDOC, cont.

110

Demand

Source: VSSC OR Produc�vity Cube 4.11.V19.SaltLakeCity.660



Facility Se�ng Specialty FY15 FY16 FY17 FY18 FY15-18 % Chg

(V19) (660) Salt Lake City Inpa�ent

Outpa�ent

ANESTHESIOLOGYCARDIAC SURGERYEAR, NOSE, THROAT (ENT)GENERAL SURGERYNEUROSURGERYOB/GYNOPHTHALMOLOGYORAL SURGERYORTHOPEDICSPERIPHERAL VASCULARPLASTIC SURGERYPODIATRYTHORACIC SURGERYUROLOGYInpa�ent TotalANESTHESIOLOGYCARDIAC SURGERYEAR, NOSE, THROAT (ENT)GENERAL SURGERYNEUROSURGERY

16259

19688

811

374109

304722

2301,228

14

203343

35

27826

12181

371

313110

153616

106915

512

184331

58

N/A49178976

N/A33

210130

15341884

72816

9222354

31

N/A6114

11654

N/AN/A

3214144

17372477

7613120

223346

52

-100.0%-1.6%

-76.3%-40.8%-38.6%

-100.0%-100.0%200.0%-42.8%32.1%

-43.3%-21.3%

9.1%-66.5%-38.0%

3000.0%400.0%

9.9%0.9%

48.6%OB/GYNOPHTHALMOLOGY

15947

11775

10666

7795

-53.3%-16.1%


(V19) (660) Salt Lake City Inpa�ent

Outpa�ent

ANESTHESIOLOGYCARDIAC SURGERYEAR, NOSE, THROAT (ENT)GENERAL SURGERYNEUROSURGERYOB/GYNOPHTHALMOLOGYORAL SURGERYORTHOPEDICSPERIPHERAL VASCULARPLASTIC SURGERYPODIATRYTHORACIC SURGERYUROLOGYInpa�ent TotalANESTHESIOLOGYCARDIAC SURGERYEAR, NOSE, THROAT (ENT)GENERAL SURGERYNEUROSURGERY

16259

19688

811

374109

304722

2301,228

14

203343

35

27826

12181

371

313110

153616

106915

512

184331

58

N/A49178976

N/A33

210130

15341884

72816

9222354

31

N/A6114

11654

N/AN/A

3214144

17372477

7613120

223346

52

-100.0%-1.6%

-76.3%-40.8%-38.6%

-100.0%-100.0%200.0%-42.8%32.1%

-43.3%-21.3%

9.1%-66.5%-38.0%

3000.0%400.0%

9.9%0.9%

48.6%OB/GYNOPHTHALMOLOGY

15947

11775

10666

7795

-53.3%-16.1%

Surgical Cases FY15-18 – Salt Lake City

111

Demand

Source: VSSC OR Produc�vity Cube 4.11.V19.SaltLakeCity.660#2




(V19) (660) Salt Lake City Outpa�ent ORAL SURGERYORTHOPEDICSPERIPHERAL VASCULARPLASTIC SURGERYPODIATRYTHORACIC SURGERYUROLOGYOutpa�ent Total

2361

96165143

3350

2,6683,896

1367171114157

10386

2,5823,497

2386

93136102

6353

2,3863,114

1409160125137

19562

2,8873,648

-50.0%13.3%66.7%

-24.2%-4.2%

533.3%60.6%

8.2%-6.4%



Facility Total

Outpa�ent ORAL SURGERYORTHOPEDICSPERIPHERAL VASCULARPLASTIC SURGERYPODIATRYTHORACIC SURGERYUROLOGYOutpa�ent Total

2361

96165143

3350

2,6683,896

1367171114157

10386

2,5823,497

2386

93136102

6353

2,3863,114

1409160125137

19562

2,8873,648

-50.0%13.3%66.7%

-24.2%-4.2%

533.3%60.6%

8.2%-6.4%

Surgical Cases FY15-18 – Salt Lake City, cont.

112

Demand Es�mated Future Market Demand — Inpa�ent

113

FY22 FY27

Citc Vw_ph2_5_1_1 Total Bed FY17 Vw_ph2_5_1_1 Total Bed FY22 Vw_ph2_5_1_1 Total Bed FY27

Total Bed Need* 114 120 115

Citc Vw_ph2_5_1_1 Total ADC FY17 Vw_ph2_5_1_1 Total ADC FY22 Vw_ph2_5_1_1 Total ADC FY27

Total ADC 97.0 102.3 97.4

0

5,000

10,000

15,000

20,000

Tota

l BDO

C (In

-Hou

se +

Com

mun

ity)

Med Surg Psych

2017 2022 2027

BY17 Market U�liza�on Projec�ons (Acute Inpa�ent) — Salt Lake City Market

Citc

Med Surg Psych Med Surg Psych Med Surg Psych

In-House BDOCCommunity BDOC

Total BDOCADC By HSPG

11,8113,037

14,84841.0

5,2802,0967,376

20.2

6,6826,498

13,18036.0

12,5863,257

15,84343.0

5,7102,3258,035

22.0

6,7886,661

13,45037.0

12,3033,195

15,49842.0

5,4442,2077,651

21.0

6,1906,218

12,40834.0

Demand




8.9%

Note: Percent changes are for 5 and 10 years

3.7% -5.9%2.0%6.7% 4.4%

BY17 VISN 19 Salt Lake City Market U�liza�on Projec�ons BDOC

FY17

*Total Bed Need is based on a 85% occupancy rate

114

0

10,000

20,000

30,000

40,000

50,000

Tota

l BDO

C (In

-Hou

se +

Com

mun

ity)

Blind Rehab LTSS Res. Rehab SCI

2017 2022 2027

*Total Bed Need is based on a 95% occupancy for LTSS and 85% occupancy for blind rehab, residen�al rehab, and SCI

BY17 Market U�liza�on Projec�ons (Other Inpa�ent) — Salt Lake City MarketDemand




FY17 FY22 FY27


18.8% 30.1%

Citc Total Bed FY17 Total Bed FY22 Total Bed FY27


Citc Vw_ph2_5_2_1 Total ADC FY17 Vw_ph2_5_2_1 Total ADC FY22 Vw_ph2_5_2_1 Total ADC FY27

Total ADC 103.0 135.5 156.7

Citc

BlindRehab

LTSS ResRehab

SCI BlindRehab

LTSS ResRehab

SCI BlindRehab

LTSS ResRehab

SCI

ADC By HSPGTotal BDOC

Community BDOCIn-House BDOC

1.3479

0479

81.129,61628,860

756

19.37,035

07,035

1.3482

0482

1.6569

0569

110.440,28839,697

591

22.28,108

08,108

1.3484

0484

1.7623

0623

133.048,52747,932

595

20.77,573

07,573

1.3457

0457

36.0% 15.3% 0.4% -5.2%7.6%63.9%

BY17 VISN 19 Salt Lake City Market U�liza�on Projec�ons BDOC

115

Demand




BY17 Parent Facility U�liza�on Projec�ons (Acute Inpa�ent) — Salt Lake City VAMC

116

0

10,000

20,000

30,000

40,000

50,000

Tota

l BDO

C (In

-Hou

se +

Com

mun

ity)

Blind Rehab LTSS Res. Rehab SCI

2017 2022 2027

*Total bed need is based on a 95% occupancy for LTSS and 85% occupancy for Blind rehab, residen�al rehab, and SCI

BY17 Parent Facility U�liza�on Projec�ons (Other Inpa�ent) — Salt Lake City VAMCDemand





Measure Vw_ph2_5_4_1 Total Beds Needed FY17 Vw_ph2_5_4_1 Total Bed Needed FY22 Vw_ph2_5_4_1 Total Beds Needed FY27


Measure Vw_ph2_5_4_1 Total ADC FY17 Vw_ph2_5_4_1 Total ADC FY22 Vw_ph2_5_4_1 Total ADC FY27

Total ADC 91.1 120.9 142.2

Measure BlindRehab

LTSS ResRehab

SCI BlindRehab

LTSS ResRehab

SCI BlindRehab

LTSS ResRehab

SCI .

In-House BDOCCommunity BDOC

Total BDOCADC By HSPG

N/AN/AN/AN/A

N/A28,45928,459

78.0

4,792N/A

4,79213.1

N/AN/AN/AN/A

N/AN/AN/AN/A

N/A39,23039,230

107.5

4,884N/A

4,88413.4

N/AN/AN/AN/A

N/AN/AN/AN/A

N/A47,35947,359

129.7

4,551N/A

4,55112.5

N/AN/AN/AN/A

1234

37.8% 1.9% -5.0%66.4%

BY17 Salt Lake City VAMC U�liza�on Projec�ons BDOC

FY17 FY22 FY27

117

Growth Projec�ons (#,%)Total Inpa�ent Bed Days of Care (BDOC)

• Overview:

ü Commercial market inpa�ent demand

es�mates were developed to understand

current and future expected inpa�ent

demand trends for non-Veteran

popula�ons

ü Demand es�mates are based on non-

Veteran pa�ent origin within a 60

minute drive �me from parent VA

Medical Center/ Health Care Center

noted

Clinical Service Line 2018 2023 2028 5 Year Chg 5 Year % Chg 10 Year Chg 10 Year % Chg DisplayOrder

General MedicineNephrologyRheumatologyNeurologyGastroenterologyOncology MedicalPulmonaryDermatologyHematologyCardiologyHIVEndocrineMedicine Sub-TotalOrthopedicsNeurosurgeryOpen HeartVascular SurgeryGeneral SurgeryOphthalmologyThoracic Surgery

58,29214,022

1,39534,86627,58811,00436,769

4,1423,300

33,3972

9,132233,909

64,1168,660

10,7783,192

57,640410

15,500

72,76916,149

1,43239,34828,84311,49037,001

4,2423,296

33,2721

8,246256,089

62,8759,060

11,2983,247

60,995400

15,699

88,26218,346

1,43844,15931,06012,15137,028

4,5533,305

32,8851

8,196281,384

60,2609,509

11,9973,327

66,769398

15,987

14,4772,127

374,4821,255

486232100

-4-125

-1-886

22,180-1,241

400520

553,355

-10199

24.8%15.2%

2.7%12.9%

4.5%4.4%0.6%2.4%

-0.1%-0.4%

-50.0%-9.7%9.5%

-1.9%4.6%4.8%1.7%5.8%

-2.4%1.3%

29,9704,324

439,2933,4721,147

259411

5-512

-1-936

47,475-3,856

8491,219

1359,129

-12487

51.4%30.8%

3.1%26.7%12.6%10.4%

0.7%9.9%0.2%

-1.5%-50.0%-10.2%20.3%-6.0%9.8%

11.3%4.2%

15.8%-2.9%3.1%

123456789

1011121314151617181920

TraumaDen�stryUrologyOtolaryngologySurgery Sub-TotalMedicine/Surgery TotalOB/DeliveryOther OBGynecologyWomen's Health TotalPsych/Drug AbuseMental Health TotalAcute RehabRehab TotalOther TotalGrand Total

5,982433

4,7332,459

173,903407,812

71,6973,1022,817

77,61653,18953,189

1,7091,709

340540,666

6,004408

4,4802,111

176,577432,666

69,6872,8771,982

74,54661,11761,117

1,2441,244

374569,947

6,024379

4,6561,872

181,178462,562

69,7612,8061,637

74,20469,72669,726

933933407

607,832

22-25

-253-348

2,67424,854-2,010

-225-835

-3,0707,9287,928-465-465

3429,281

0.4%-5.8%-5.3%

-14.2%1.5%6.1%

-2.8%-7.3%

-29.6%-4.0%14.9%14.9%

-27.2%-27.2%10.0%

5.4%

42-54-77

-5877,275

54,750-1,936

-296-1,180-3,41216,53716,537

-776-776

6767,166

0.7%-12.5%

-1.6%-23.9%

4.2%13.4%-2.7%-9.5%

-41.9%-4.4%31.1%31.1%

-45.4%-45.4%19.7%12.4%

21222324252627282930313233343536

Demand



5.5.V19.SaltLakeCity.660Source: IBM Market Expert

Overall Inpa�ent Commercial Demand – Salt Lake City Area


Supply Es�mated Current Total VA Market Supply

119

0

20

40

60

80

100

120

140

160

Tota

l Pro

ject

ed In

-hou

se a

nd C

ITC

Bed

Nee

d

Med/Surg Sub-Total Mental Health Nursing Home Residen�al Rehab

61

36

81

19

63

34

133

21

83

15

0

30

Veteran Inpa�ent Projected Demand and VA Supply

Supply

• 2017

Source: 1. BY17 EHCPM U�liza�on Projec�ons 2. VSSC Beds Using PTF Cube 6.1.V19.SaltLakeCity



Comparing Total Market Veteran Demand vs. VA Medical Center Supply — Inpa�ent Services

2027 — FY18 VAMC Beds•

120

Ambulatory Medical (HSPCs)

0K

20K

40K

60K

80K

RVU

s

Allergy & Immunology*

Cardiology

Chiropracty*

Cri�cal Care/Pulmonary Dise

ase

Dermatology

Emergency Medicine

Endocrinology

Gastroenterology

Hematology-Oncology

Infec�ous Dise

ase

Nephrology

Neurology

Optometry

Pain Medicine

Physical Medicine & Rehabilita

�on

Rheumatology

2017 2027 2017 RVU Capacity (FTE x Produc�vity Target)

Supply

6.2.V19.SaltLakeCity

* Reflects service is not provided in-house or there is no VA set produc�vity target



Comparing Total Market Veteran Demand vs. VA Medical Center Supply — Outpa�ent Services — Ambulatory Medical Special�es (HSPCs)

Source: 1. BY17 EHCPM U�liza�on Projec�ons 2. OPES Physician Capacity Reports 3. VSSC Physician Produc�vity Cube 4. VSSC MPCR3 Cube

121

Ambulatory Surgical (HSPCs)

0K

10K

20K

30K

40K

50K

RVU

s

NeurologicalSurgery

Obstetrics &Gynecology

Ophthalmology OrthopaedicSurgery

Otolaryngology Plas�c Surgery Podiatry Surgery Thoracic Surgery Urology Vascular Surgery


Supply





Comparing Total Market Veteran Demand vs. VA Medical Center Supply — Outpa�ent Services — Ambulatory Surgical Special�es (HSPCs)

Source: 1. BY17 EHCPM U�liza�on Projec�ons 2. OPES Physician Capacity Reports 3. VSSC Physician Produc�vity Cube 4. VSSC MPCR3 Cube

122

Ambulatory Rehab (HSPCs)

0.0M

0.5M

1.0M

1.5M

2.0M

2.5M

3.0M

3.5M

RVU

s

Audiology Blind Rehabilita�on Kinesiotherapy Occupa�onal Therapy Physical Therapy Recrea�on Therapy Speech LanguagePathology


Supply





Comparing Total Market Veteran Demand vs. VA Medical Center Supply — Outpa�ent Services — Ambulatory Rehab Special�es (HSPCs)

Source: 1. BY17 EHCPM U�liza�on Projec�ons 2. OPES Physician Capacity Reports 3. VSSC Rehab Produc�vity Cube 4. VSSC MPCR3 Cube

123

Physician Efficiency — Salt Lake City VAMCSupply

Source: 1. VSSC SPARQ Report 2. VSSC Physician Produc�vity Cube 3. VSSC MPCR3 Cube 6.5.V19.SaltLakeCity.660



Id

Specialty SPARQ Quadrant2016

SPARQ Quadrant2017

SPARQ Quadrant2018

2016 MDFTEs

2017 MDFTEs

2018 MDFTEs

2016 APPFTEs

2017 APPFTEs

2018 APPFTEs

37543755375637573758375937603761376237633764376537663767376837693770377137723773

Allergy and ImmunologyAnesthesiaAnesthesiologyCardiologyChiropractyCri�cal Care / Pulmonary DiseaseDermatologyEmergency MedicineEndocrinologyGastroenterologyGeriatric MedicineHematology-OncologyInfec�ous DiseaseInternal MedicineMedical Gene�csNephrologyNeurological SurgeryNeurologyObstetrics & GynecologyOphthalmology

2 - Under ResourcedN/AN/A

4 - Over ResourcedN/A

3 - InefficientN/AN/A

3 - Inefficient4 - Over Resourced

N/A4 - Over Resourced4 - Over Resourced

1 - Op�mized Prac�ceN/A

3 - Inefficient3 - Inefficient3 - Inefficient

4 - Over Resourced3 - Inefficient

N/AN/AN/A


3 - Inefficient2 - Under Resourced

N/A2 - Under Resourced


4 - Over Resourced4 - Over Resourced

N/AN/A

3 - Inefficient3 - Inefficient3 - Inefficient


3 - InefficientN/AN/A


3 - Inefficient2 - Under Resourced

N/A1 - Op�mized Prac�ce



N/AN/A


3 - Inefficient4 - Over Resourced

3 - Inefficient

0.1N/A9.46.11.83.11.1

N/A1.73.71.82.41.9

18.8N/A1.90.92.21.02.7

0.2N/A10.7

5.22.32.11.2

N/A1.33.20.91.81.5

23.80.11.80.82.40.33.1

0.2N/A11.5

5.02.03.31.3

N/A1.42.80.92.21.5

23.10.81.61.32.30.42.9

0.2N/A18.615.7N/A6.11.76.92.74.9

16.05.00.1

84.7N/A3.25.10.70.10.2

0.0N/A19.913.4N/A8.82.48.33.65.7

17.95.40.0

80.1N/A2.92.70.1

N/A0.3

N/A0.0

21.013.3N/A8.75.07.84.44.9

15.52.80.0

76.1N/A2.93.41.30.00.1

124

Physician Efficiency — Salt Lake City VAMC, cont.Supply

Source: 1. VSSC SPARQ Report 2. VSSC Physician Produc�vity Cube 3. VSSC MPCR3 Cube 6.5.V19.SaltLakeCity.660#2



Id

Specialty SPARQ Quadrant2016

SPARQ Quadrant2017

SPARQ Quadrant2018

2016 MDFTEs

2017 MDFTEs

2018 MDFTEs

2016 APPFTEs

2017 APPFTEs

2018 APPFTEs

3774377537763777377837793780378137823783378437853786378737883789379037913792

OptometryOrthopaedic SurgeryOtolaryngologyPain MedicinePathologyPhysical Medicine & Rehabilita�onPlas�c SurgeryPodiatryPrimary CarePsychiatryPsychiatry/PsychologyPsychologyRadiologyRheumatologySurgeryThoracic SurgeryUrologyVascular SurgeryTotal

2 - Under Resourced2 - Under Resourced


N/AN/A

4 - Over Resourced1 - Op�mized Prac�ce


N/A3 - Inefficient

N/A1 - Op�mized Prac�ce

N/AN/A

1 - Op�mized Prac�ce4 - Over Resourced

N/A


1 - Op�mized Prac�ce3 - Inefficient

N/A3 - Inefficient3 - Inefficient

1 - Op�mized Prac�ce3 - Inefficient3 - Inefficient

N/A3 - Inefficient


4 - Over ResourcedN/AN/A




N/A4 - Over Resourced4 - Over Resourced

1 - Op�mized Prac�ce3 - Inefficient3 - Inefficient


N/A3 - Inefficient


2 - Under Resourced4 - Over Resourced

N/A

6.23.21.41.51.93.20.92.9

N/A19.0N/A28.2

1.01.53.0

N/A2.91.5

138.8

6.24.11.30.62.83.61.03.1

N/A18.9N/A31.2

0.71.23.4

N/A2.41.5

144.6

6.33.91.50.52.74.01.12.3

N/A21.4N/A31.8

1.11.83.0

N/A2.61.4

149.9

0.68.62.66.80.10.10.00.2

N/AN/A58.7

1.00.60.43.10.04.01.9

260.4

1.18.22.25.00.10.10.20.0

N/AN/A46.0

0.00.50.34.10.04.51.7

245.5

0.26.32.53.90.10.10.00.0

N/AN/A61.5

0.10.30.31.70.03.90.4

248.5

125

Poten�al Physician Addi�onal Capacity — Salt Lake City VAMCSupply

Source: OPES Physician Capacity Reports 6.6.V19.SaltLakeCity.660

Poten�al Addi�onal RVU Capacity = (Produc�vity Standard – Produc�vity), N/A = Data Not Available



Physician Specialty Poten�al Addi�onal RVU Capacity Id

Allergy and ImmunologyCardiologyChiropractyCri�cal Care / Pulmonary DiseaseDermatologyEndocrinologyGastroenterologyGeriatric MedicineHematology-OncologyInfec�ous DiseaseInternal MedicineNephrologyNeurological SurgeryNeurologyObstetrics & GynecologyOphthalmologyOptometryOrthopaedic SurgeryOtolaryngologyPain Medicine

-3,254

-4,553

--

4,099-

2,791762

-2,6152,8501,344

1034,9993,9113,117

5901,862

36813682368336843685368636873688368936903691369236933694369536963697369836993700

126

Poten�al Physician Addi�onal Capacity — Salt Lake City VAMC, cont.Supply

Source: OPES Physician Capacity Reports 6.6.V19.SaltLakeCity.660#2

Poten�al Addi�onal RVU Capacity = (Produc�vity Standard – Produc�vity), N/A = Data Not Available



Physician Specialty Poten�al Addi�onal RVU Capacity Id

PathologyPhysical Medicine & Rehabilita�onPlas�c SurgeryPodiatryPsychiatryPsychologyRadiologyRheumatologySurgeryThoracic SurgeryUrologyVascular Surgery

5,816371

2,052-

6,306--

344140

---

370137023703370437053706370737083709371037113712

127

VA Facility Primary Care* Specialty Care Emergency Care Mental Health Total

(V19) (660) Salt Lake City(V19) (660BU) Salt Lake City Domiciliary(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls

16.10.01.72.40.81.51.40.1

N/A

68.80.00.00.00.00.00.10.00.0

0.00.00.00.00.00.00.00.00.0

48.4N/A0.51.21.01.10.80.00.0

133.3N/A2.33.61.82.62.30.1

N/A

FY18 Salt Lake City VAMC & CBOC Physicians by Outpa�ent Clinical Category

Physicians by Outpa�ent Clinical CategorySupply

Source: VSSC Physician Produc�vity Cube 6.7.V19.SaltLakeCity.660

*Primary Care includes Internal Medicine and Geriatric Medicine; Note: Contract clinics do not have FTEs represented.



128

Occupa�on FY18 FY19* DisplayOrd…

0028Environmental Protec�on Specialist0060 Chaplain0083 Police0086 Security Clerical and Assistance0089Emergency Management0101 Social Science0102 Social Science Aid and Technician0180 Psychology0185 Social Work0201 Human Resources Management0203 Human Resources Assistance0301 Miscellaneous Administra�on and Program0303 Miscellaneous Clerk and Assistant0305 Mail and File0318 Secretary0326Office Automa�on Clerical And Assistance0340 Program Management & 0344 Management and …0341 Administra�ve Officer0343 Management and Program Analysis0346Logis�cs Management

N/A0.01.01.0

N/A2.00.35.0

24.717.8

1.09.0

30.52.03.0

N/A1.01.08.0

N/A

1.0N/A6.01.01.04.01.58.0

20.713.0

2.024.520.5

2.01.01.01.01.07.01.0

123456789

1011121314151617181920

0382Telephone Opera�ng0503 Financial Clerical and Assistance0525 Accoun�ng Technician0530Cash Processing0601 General Health Science

N/AN/A1.0

N/A16.5

1.01.01.01.0

19.6

2122232425

Vacant Posi�onsSupply

Source: VHA Office of Workforce Management 6.8.V19.SaltLakeCity.660

*FY19 vacant posi�ons as of March 2019



Salt Lake City VAMC Open FTE Posi�ons

129


0602 Medical Officer0603 Physician's Assistant0610 Nurse0620 Prac�cal Nurse0621 Nursing Assistant0622 Medical Supply Aide and Technician0630 Die��an and Nutri�onist0631 Occupa�onal Therapist0633 Physical Therapist0640 Health Aid and Technician0644 Medical Technologist0645 Medical Technician0647 Diagnos�c Radiologic Technologist0649 Medical Instrument Technician0660 Pharmacist0661 Pharmacy Technician0665 Speech Pathology and Audiology0667 Ortho�st and Prosthe�st0668 Podiatrist0669Medical Records Administra�on

23.84.0

62.015.513.8

5.03.00.92.06.07.03.59.06.05.09.0

N/A2.00.3

N/A

23.52.0

72.816.415.0

5.0N/AN/A1.69.4

11.06.58.06.07.25.30.6

N/A0.02.0

2627282930313233343536373839404142434445

0671 Health System Specialist0672 Prosthe�c Representa�ve0675 Medical Records Technician0679 Medical Support Assistance0680 Dental Officer

1.02.0

13.091.3

1.0

N/A1.0

11.060.5N/A

4647484950

Vacant Posi�ons, cont.Supply

Source: VHA Office of Workforce Management 6.8.V19.SaltLakeCity.660#2





130


0681 Dental Assistant0690Industrial Hygiene0801 General Engineering0858 Biomedical Engineering1035Public Affairs1101General Business And Industry1105 Purchasing1412Technical Informa�on Services1601 General Facili�es and Equipment1702Educa�on And Training Technician1715 Voca�onal Rehabilita�on1720Educa�on Program2003 Supply Program Management2005 Supply Clerical and Technician2010 Inventory Management2102Transporta�on Clerk And Assistant2805 Electrician3566 Custodial Worker4102Pain�ng4607Carpentry

2.0N/A3.01.0

N/AN/A2.0

N/AN/AN/A2.0

N/A1.09.09.0

N/AN/A16.0N/AN/A

4.01.03.0

N/A1.02.0

N/A1.01.01.01.01.0

N/A6.01.03.01.0

27.61.01.0

5152535455565758596061626364656667686970

5048Animal Caretaking5306 Air Condi�oning Equipment Mechanic5703 Motor Vehicle Operator5705Tractor Opera�ng6907 Materials Handler

N/A2.01.0

N/AN/A

1.01.02.01.02.0

7172737475







131


7304 Laundry Working7404 Cook7408 Food Service WorkerGrand Total

1.01.02.4

463.2

N/A1.01.5

471.8

76777879







132

Supply Es�mated Current Total Community Market Supply

133

Supply




Exis�ng Federal Facili�es

Source: 1. FQHC – HRSA Data Warehouse 2. IHS – ESRI Meta Data 3. DoD – Federal Prac��oner, 2019 Directory

Federal Facilities

134

Exis�ng Federal Facili�es, cont.Sector Type* Partner Facility Name** Distance From VA POC (x miles, POC Name)

19-f-9-A

19-f-9-A19-f-9-B

19-f-9-B

19-f-9-D19-f-9-D

19-f-9-E

19-f-9-E

FQHC (10)

IHS (1)FQHC (26)

IHS (13)

DOD (1)FQHC (8)

FQHC (12)

IHS (3)

●Copperview Comm Health Center●Vounteers Of America, Utah Women And Childrens Facility●Stephen Ratcliffe Community Hlth Ctr●Indian Walk In Center●Jackpot Community Health Center●Wayne Community Health Center, Inc.●Wendover Community Health Center●Ely Health Sta�on●Newe Medical Clinic●Goshute Health Sta�on●AF-C-75th MEDGRP-HILL●Midtown Chc Davis County Medical Clinic●Midtown Chc - Davis County Dental Clinic●Midtown Community Health Center..●Aberdeen Clinic●Downey Clinic●Upper Valley Community Health Service●Shoshone-Bannock Tribal Health Department●Not-Tsoo Gah-Nee Indian Health Center●NW Band of Shoshone Health & Human Services Administra�on

●17, (V19) (660GJ) Western Salt Lake, UT●11, (V19) (660GJ) Western Salt Lake, UT●10, (V19) (660GJ) Western Salt Lake, UT●4, (V19) (660) Salt Lake City, UT●119, (V19) (660GK) Elko, NV●112, (V19) (660QB) Price, UT●109, (V19) (660GK) Elko, NV●181, (V19) (660GK) Elko, NV●181, (V19) (660GK) Elko, NV●167, (V19) (660GK) Elko, NV●8, (V19) (660QC) Weber County, UT●13, (V19) (660QC) Weber County, UT●9, (V19) (660QC) Weber County, UT●5, (V19) (660GB) Ogden, UT●42, (V19) (660GA) Pocatello, ID●39, (V19) (660GA) Pocatello, ID●38, (V19) (660QA) Idaho Falls, ID●13, (V19) (660GA) Pocatello, ID●12, (V19) (660GA) Pocatello, ID●1, (V19) (660GA) Pocatello, ID

Supply




*FQHC quan�ty in parentheses reflects total number of FQHCs within a sector.

**The three FQHCs listed reflect the three most distant FQHCs from a VA POC.

Source: 1. FQHC – HRSA Data Warehouse 2. IHS – ESRI Meta Data 3. DoD – Federal Prac��oner - 2019 Directory

135

Supply

Source: 1. Defini�ve Healthcare 2. Geocoded Enrollee File FY18Q4 7.2.V19.SaltLakeCity#IMG



Market Community Hospital Overview

Note: Map provides context of community hospital density as map scale prevents illustra�on of all hospitals. A Dartmouth Atlas Hospital Service Area (HSA) is a ZIP code-defined geography encompassing the community where the ZIP code’s Medicare residents predominantly receive their hospital care.

Community Hospitals and FY18 Enrollees

136

VAMC Area Hospitals* Total Staffed Beds Total Occupancy**

(660) Salt Lake CityTotal Hospitals in the Market

2963

3,3505,958

50.3%50.0%

Note: The VAMC area is defined as the area within a 60 minute drive �me of VAMC.

*Includes short term acute, cri�cal access, psychiatric, and rehabilita�on hospitals with a CMS Cost Report in FY17 or FY18 (does not include pediatric or DOD hospitals) and can include mul�-campus hospitals repor�ng under a single provider number.

**Occupancy is based on total staffed beds.

Supply

Source: 1. Defini�ve Healthcare 2. Geocoded Enrollee File FY18Q4 7.2.V19.SaltLakeCity



Market Community Hospital Overview, cont.Community Hospital Overview


TopHospitals Beds³ Occupancy⁴ Beds³ Occupancy⁴ Beds³ Occupancy⁴ CMI .

University Hospital, Huntsman Cancer Ins�tute, UU Health Care - UniversityOrthopaedic CenterIntermountain Medical CenterUtah State HospitalUtah Valley HospitalJordan Valley Medical Center, Jordan Valley Medical Center - West ValleyCampusMcKay-Dee HospitalSt Marks HospitalLDS HospitalDavis Hospital and Medical CenterOgden Regional Medical CenterUU Health Care - University Neuropsychiatric Ins�tuteSalt Lake Behavioral HealthTimpanogos Regional HospitalSalt Lake Regional Medical CenterAmerican Fork HospitalOther Hospitals in Area (14)Total

516

484N/A315278

249233204170170N/AN/A117107

91416

3,350

77.0%

62.2%N/A

61.6%27.7%

54.1%55.5%43.3%25.7%45.9%

N/AN/A

34.8%20.8%43.1%33.9%50.3%

24

N/A329

2726

43163925

N/A159118N/A

20N/A167993

61.8%

N/A89.0%73.2%64.1%

87.0%73.8%83.5%49.3%

N/A79.6%52.1%

N/A63.8%

N/A64.4%75.2%

38

24N/A

1710

2014

N/A10

N/AN/AN/AN/A

16N/A124273

88.5%

79.4%N/A

70.8%54.3%

48.5%80.0%

N/A14.2%

N/AN/AN/AN/A

21.6%N/A

34.9%51.0%

2.43

2.26N/A2.061.76

2.061.901.871.681.73N/AN/A1.942.151.581.661.83

1

2345

6789

1011121314151617

Top Hospitals¹᾽²

Supply

Source: 1. CMS Cost Reports 2. IBM Market Expert 7.3.V19.SaltLakeCity.660



Community Hospital Current and Future Inpa�ent Demand & Supply

Med/Surg/Acute

1. Top hospitals based on number of staffed beds. 2. All beds within acute psychiatric and rehab commercial hospitals were assumed to be psychiatric or rehab beds. 3. Indicates staffed beds 4. Occupancy rate = total Bed Days of Care (BDOC)

divided by staffed opera�ng beds. 5. Applied growth rate and assumes actual beds remains the same. 6. BDOC and Projec�on Rate from IBM Market Expert

* Includes acute rehabilita�on

Mental Health Rehab CMI


OccupancyType ADC BDOC Actual Beds 2018 ActualOccupancy

75%OccupancyBed Need


Projec�onRate

ADC BDOC Actual Beds 2028Projected

Occupancy



.

Medicine/Surgical*Medicine/Surgical* Conceptual Excess

Mental HealthMental Health Conceptual Excess

1,826

747

666,318

272,553

3,623

993

50.4%

75.2%

2,4341,189

996-3

2,2821,341

93360

13.4%

31.1%

1,989

979

725,901

357,292

3,623

993

54.9%

98.6%

2,652971

1,305-312

2,4861,1371,224-231

1234

1. Top hospitals based on number of staffed beds. 2. All beds within acute psychiatric and rehab commercial hospitals were assumed to be psychiatric or rehab beds. 3. Indicates staffed beds 4. Occupancy rate = total Bed Days of Care (BDOC)

divided by staffed opera ng beds. 5. Applied growth rate and assumes actual beds remains the same. 6. BDOC and Projec on Rate from IBM Market Expert

* Includes acute rehabilita on

2018

Supply

Source: 1. CMS Cost Reports 2. IBM Market Expert 7.4.V19.SaltLakeCity.660



Community Hospital Current and Future Inpa�ent Demand & Supply, cont.

Es�mated 2028Surplus of beds

Shortage of beds

Future Supply and Demand


Specialty 2018 FTE Supply 2018 FTE Demand Shortage/Surplus

1. Primary CareGeneral/Family Prac�ceInternal Medicine

2. Specialty Care (Medical)Allergy/ImmunologyCardiologyDermatologyEndocrinologyGastroenterologyHematology/OncologyInfec�ous DiseaseNephrologyNeurologyPulmonologyRheumatology

3. Specialty Care (Surgical)Cardio/Thoracic SurgeryColorectal SurgeryGeneral SurgeryNeurosurgeryOphthalmologyOrthopedic SurgeryOtolaryngologyPlas�c SurgeryUrologyVascular

4. Women's HealthObstetrics/Gynecology

5. Mental HealthPsychiatry

6. RehabPhysical Medicine/Rehab

7. Emergency ServicesEmergency/Cri�cal Care

8. Other ServicesPain Management

767437

25148106

3391843743

1276826

2515

16145

708466

39145

943084

1182343594924

287

12120

59-30

-153

1136

-3415

06818

2

-38

4026

153238

89785920

317

246

96

369

19

89157

61434915

265

320

52

407

17

6380283510

5

53

-74

43

-38

2

2018 FTE Supply and 2018 FTE Demand by Specialty

0

500

FTE

General/Family …

Internal Medicine

Emergency/Cri�cal Care

Obstetric

s/Gynecology

Psychiatry

Orthopedic Surgery

General Surgery

Ophthalmology

Cardiology

Neurology

Dermatology

Physical Medicine/Rehab

Gastroenterology

Otolaryngology

Hematology/Oncology

Plas�c Surgery

PulmonologyUrology

Neurosurgery

Nephrology

Infec�ous Dise

ase

Endocrinology

Rheumatology

Cardio/Thoracic Surgery

Allergy/Immunology

Vascular

Pain Management

Colorectal Surgery

2018 FTE Supply 2018 FTE Demand

Supply

Source: IBM Watson Market ExpertNote: FTE demand based on median produc�vity by specialty



Community Physician Current Supply & Demand

Provider Surplus/Shortage vs. 2018 FTE Demand*

0%

100%

Surp

lus/

Shor

tage

Neurosurgery

Colorectal Surgery

Neurology

Physical Medicine/Rehab

Plas�c Surgery

Ophthalmology

Infec�ous Dise

ase

Orthopedic Surgery

Otolaryngology

Pulmonology

General Surgery

Vascular

Urology

Obstetric

s/Gynecology

Psychiatry

Hematology/Oncology

Allergy/Immunology

130%

119%

116%

84%

81%

71%

65%

51%

46%

37%

34%

31%

20%

20%

-23%

-29%

-38%


*FTE net percentage of supply for special�es between -15% and 15% are not included given the FTE supply for those special�es are comparable to FTE demand


Supply




Known Major Changes in Community Hospitals – Salt Lake City Area

Source: Definitive Healthcare, The Spectrum

141

Access Current Access

142


(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) PriceFacility TotalMarket Total

1,725330142N/A

169730

1344

N/AN/A

2,4782,478

1,955291141N/A

7981870

7N/AN/A

2,5872,587

2,591228188N/A

13134

3369

347

3,2703,270

3,682140169N/A

9115

4364

81330

4,2734,273

5,6931,182

8831,036

162710715566

17N/AN/A

10,96410,964

1,3871,258

854835197735620587

8N/AN/A

6,4816,481

1,8211,808

627319125618913701

83615

6,9916,991

1,7761,597

846N/A142457663610

11196104

6,4026,402

13,3382523

N/A4

16375

9213

N/AN/A

13,88613,886

12,1564020

N/A4

43437

842

N/AN/A

12,78612,786

11,4081813

N/A2

281,125

348343

12,95212,952

10,661166

12N/A

722

534504

110

311,92011,920

Same Day Appointment Totals

Access

Source: VSSC Completed Appointments Cube 8.1.V19.SaltLakeCity

N/A: Not Available



Same Day Appointments (FY15-18)

Mental Health Primary Care Specialty Care

143


(4V19) (660) Salt Lake City, UT (George E. Wahlen)(4V19) (660GA) Pocatello, ID(4V19) (660GB) Ogden, UT(4V19) (660GC) Ely, NV(4V19) (660GD) Roosevelt, UT(4V19) (660GE) Orem, UT(4V19) (660GG) St. George, UT(4V19) (660GJ) Western Salt Lake, UT(4V19) (660GK) Elko, NV(4V19) (660QA) Idaho Falls, ID(4V19) (660QB) Price, UTNa�onal Average

2.61.63.4

N/A0.94.71.43.20.2

N/AN/A2.9

2.72.45.2

N/A2.93.53.72.23.2

N/AN/A2.7

3.23.46.7

N/A3.02.23.81.44.51.62.02.6

3.45.56.4

N/A7.91.55.23.36.46.34.93.3

7.13.84.10.00.55.52.27.5

11.3N/AN/A4.0

6.42.94.00.02.33.90.52.94.6

N/AN/A4.4

7.23.24.50.00.35.52.33.73.31.58.24.1

7.43.84.1

N/A0.84.45.25.64.11.0

13.74.3

6.39.59.9

N/A3.66.68.34.43.1

N/AN/A4.5

8.59.68.2

N/A4.16.05.14.6

10.4N/AN/A5.3

8.14.97.5

N/A8.85.73.13.65.13.14.55.4

9.211.1

6.5N/A12.4

4.98.93.57.14.8

13.26.3

Established Pa�ent Appointments (FY15-18)Access


N/A: Not Available



Specialty CarePrimary CareMental Health

Average Established Pa�ent Wait (Days) from Preferred Date (PD)

144

Established Pa�ent Percent of Appointments Completed within 30 Days of Clinically Indicated/Pa�ent Preference

Established Pa�ent Appointments (FY15-18), cont.

Facility FY15 FY16 FY17 FY18 FY15 FY16 FY17 FY18 FY15 FY16 FY17 FY18 Id

(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) PriceNa�onal Average

98.6%99.1%96.1%

N/A100.0%

94.5%99.2%97.5%

100.0%N/AN/A

97.7%

98.1%98.1%93.0%

N/A96.3%95.8%98.0%99.5%95.4%

N/AN/A

98.2%

97.5%96.5%92.4%

N/A97.0%98.5%97.5%

100.0%93.9%98.3%

100.0%98.5%

98.0%95.4%93.0%

N/A92.6%98.8%96.4%98.9%93.6%92.3%94.4%97.6%

92.5%97.5%97.2%

100.0%99.5%96.7%98.7%93.4%90.6%

N/AN/A

96.8%

94.8%98.7%98.5%99.9%97.5%97.8%99.9%99.7%99.5%

N/AN/A

96.8%

94.7%98.2%98.2%

100.0%99.9%96.0%98.9%99.2%99.8%99.3%86.9%97.4%

94.7%99.5%97.9%

N/A99.2%97.9%97.7%97.9%98.9%99.4%82.8%97.2%

94.4%92.0%90.1%

N/A96.2%95.3%87.7%96.7%96.6%

N/AN/A

96.1%

90.8%87.8%92.6%

N/A95.4%94.4%93.1%96.1%91.2%

N/AN/A

95.3%

92.0%95.0%91.3%

N/A88.5%94.8%98.2%97.7%96.1%95.8%96.9%95.5%

91.8%91.1%95.4%

N/A88.8%95.8%96.7%97.9%93.5%92.4%84.0%94.5%

950951952953954955956957958959960961

Access





N/A: Not Available

145

Average New Pa�ent Average Wait (Days) from Create Date (CD)

New Pa�ent Appointments (FY15-18)


(4V19) (660) Salt Lake City, UT (George E. Wahlen)(4V19) (660GA) Pocatello, ID(4V19) (660GB) Ogden, UT(4V19) (660GC) Ely, NV(4V19) (660GD) Roosevelt, UT(4V19) (660GE) Orem, UT(4V19) (660GG) St. George, UT(4V19) (660GJ) Western Salt Lake, UT(4V19) (660GK) Elko, NV(4V19) (660QA) Idaho Falls, ID(4V19) (660QB) Price, UTNa�onal Average

12.28.6

27.5N/A11.915.110.012.7

9.9N/AN/A12.4

13.28.6

37.2N/AN/A16.314.811.718.4N/AN/A12.0

12.810.728.1N/A27.618.916.812.027.815.029.011.3

11.115.420.1N/A14.421.522.2

9.626.717.1

4.311.3

24.752.130.9

0.019.920.317.215.928.8N/AN/A21.2

24.112.825.8

0.024.117.516.4

9.128.4N/AN/A22.7

26.026.147.7

0.027.631.038.211.318.417.033.022.6

24.614.833.3N/A33.214.2

112.510.521.1

6.121.921.2

20.011.022.6N/A29.322.436.213.617.0N/AN/A21.5

20.35.9

18.5N/A0.0

11.726.714.618.4N/AN/A21.2

18.516.225.3N/A28.412.121.417.113.8

8.531.321.0

20.625.011.0N/A47.027.138.211.425.711.0N/A22.5

939940941942943944945946947948949950

Access




Specialty CarePrimary Care

N/A: Not Available

Mental Health

146

New Pa�ent Appointments (FY15-18), cont.


(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) PriceNa�onal Average

96.6%97.9%54.9%

N/A87.5%93.9%90.1%88.5%

100.0%N/AN/A

90.1%

93.4%97.8%25.1%

N/AN/A

89.8%93.6%90.0%80.8%

N/AN/A

90.8%

92.3%96.9%58.0%

N/A66.7%87.5%86.8%94.7%53.9%

100.0%50.0%91.2%

91.9%85.0%78.4%

N/A87.5%81.9%81.0%93.8%60.0%85.7%

100.0%N/A

65.9%39.6%61.8%

100.0%73.8%79.9%91.1%83.6%55.4%

N/AN/A

76.4%

71.4%97.0%71.6%

100.0%76.5%86.2%95.1%97.1%70.0%

N/AN/A

73.2%

63.3%62.6%41.9%

100.0%53.6%43.1%46.8%97.0%88.2%

100.0%42.9%73.8%

69.2%94.9%47.7%

N/A48.9%80.0%52.6%97.9%86.5%

100.0%63.2%

N/A

79.2%84.6%68.8%

N/A33.3%77.8%38.2%83.5%77.1%

N/AN/A

75.2%

76.6%93.1%82.6%

N/A100.0%

90.2%65.2%89.6%89.5%

N/AN/A

76.2%

81.8%76.9%61.4%

N/A60.0%92.6%72.1%80.2%95.2%75.0%33.3%76.3%

76.1%60.3%92.9%

N/A25.0%53.5%43.5%91.4%65.4%89.3%

N/AN/A

9…9…9…9…9…9…9…9…9…9…9…9…

Access


N/A: Not Available




Percent of New Pa�ent Appointments Completed within 30 Days

147

Rece ReceivingFacility FY18 Consults Avg

S

(349) SLEEP MEDICINE(408) OPTOMETRY(303) CARDIOLOGY(502) MH CLINIC IND(205) PHYSICAL THERAPY(407) OPHTHALMOLOGY(180) DENTAL(718) DIABETIC RETINAL SCREENING(697) CHART CONSULT(107) EKG

(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City

6,1867,5279,555

10,60914,858

8,2837,070

12,75523,08817,087

62.638.632.031.830.421.015.8

2.72.62.0

…………………………

Average Wait Time for Top 10 Consults – Salt Lake CityReceiving Service Stop Code

(Top 10 by FY18 Consults)

Access

Source: VSSC Consults Cube V2 8.6.V19.SaltLakeCity.660



Receiving Facility FY18 ConsultsAverage Days to

Completed Consult

148

ReceivingServiceStopCode Facility FY18 Consults AvergeDaysToCompletedConsult 8_8 Sort

(345) EPILEPSY CENTER OF EXCELLENCE(436) CHIROPRACTIC CARE(159) COMPLEMENTARY AND INTEGRATIVE HEALTH TREATMENT(308) HEMATOLOGY(302) ALLERGY IMMUNOLOGY(109) NUCLEAR MEDICINE(143) SLEEP STUDY(151) MAGNETIC RESONANCE IMAGING/MRI(150) COMPUTERIZED TOMOGRAPHY (CT)(350) GeriPACT

(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City

241,1603,699

39327

421,768

310211150

138.5120.0112.7105.7101.2

97.287.384.482.580.6

138.5455120.0179112.7366105.7241101.2277

97.287.341684.409582.459680.6452

Access

Source: VSSC Consults Cube V2 8.7.V19.SaltLakeCity.660



Longest Wait Time – Top 10 ConsultsAverage Days to

Completed Consult (Top 10 Stop Codes)

FY18 ConsultsReceiving FacilityReceiving Service Stop Code

149

VA Facility

Total Uniq Total Enc Prim Enc Prim Unq Cnt Of Prm Tms Ovr Tms Un Pcp Cap Cap Le� PanelFul

Third

(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) Price

59,8845,4155,894

7473,2874,0256,161

6541,728

424

827,39626,31236,372

2,82521,22724,81327,736

3,6316,8432,185

39,3219,5459,6041,3974,0935,891

11,703855

2,005774

14,4024,7244,859

6802,4202,7235,374

5331,020

369

19251248

N/A1

N/A

4020012

N/A0

N/A

14221235

N/A1

N/A

7,8611,9102,356

126900

2,3863,566

N/A808N/A

559-8

-11054

5439505N/A

13N/A

93.0%100.0%105.0%

57.0%99.0%82.0%86.0%

N/A98.0%

N/A

30.74.35.54.36.66.26.7

14.925.522.1

Primary Care PACT Teams

Es�mated Capacity for Outpa�ent WorkloadAccess

Source: 1.VSSC Encounters Cube 2. VSSC PACT Compass Cube 8.8.V19.SaltLakeCity.660



VA Facility

FY18 Actual Primary Care (PC) EncountersFY18

Total Uniques UniquesPrimary Care

Encounters

Countof Primary

CarePACT Teams

Number of

Teams at or

over

Capacity

Number of

Teams at or

under

Capacity

Team PCP

Capacity

Total

CapacityLe�

PanelFullness

3rd Next Available

Appt.

FY18 Total

Encounters

150

*Other includes Post Deployment and Homeless Teams

Es�mated Capacity for Outpa�ent Workload, cont.Access

Source: VSSC PACT Compass Cube 8.15.V19.SaltLakeCity



151

Es�mated 30 Minute Drive Time ZonesAccess

Source: Geocoded Enrollee File FY18Q4 8.9.V19.SaltLakeCity#IMG



152


(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) Price(V19) (660QC) Weber County

84.0%78.0%92.0%

-92.0%82.0%72.0%86.0%88.0%

---

64.0%75.0%87.0%

-69.0%55.0%69.0%75.0%78.0%

---

63.0%74.0%83.0%

-71.0%50.0%79.0%62.0%69.0%78.0%51.0%

-

48.0%49.0%35.0%

-65.0%44.0%44.0%23.0%53.0%78.0%50.0%32.0%

68.0%69.0%59.0%

100.0%76.0%86.0%55.0%61.0%56.0%

---

66.0%65.0%48.0%

100.0%73.0%76.0%48.0%60.0%58.0%

---

58.0%61.0%38.0%

100.0%69.0%82.0%54.0%58.0%53.0%49.0%99.0%

-

59.0%57.0%38.0%

-71.0%59.0%51.0%54.0%58.0%49.0%98.0%

-

80.0%55.0%54.0%

100.0%74.0%50.0%74.0%57.0%59.0%

---

75.0%66.0%62.0%

100.0%66.0%49.0%83.0%56.0%64.0%

---

75.0%72.0%66.0%

100.0%81.0%58.0%81.0%50.0%62.0%83.0%65.0%

-

75.0%83.0%61.0%

-85.0%74.0%85.0%60.0%80.0%84.0%62.0%

-

874875876877878879880881882883884885

Clinic U�liza�on — Percent Slots Used of Total SlotsAccess

Source: VSSC Clinic U�liza�on Cube 8.10.V19.SaltLakeCity




153

Cancelled by Clinic Report


(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660QA) Idaho Falls(V19) (660QB) PriceTotal

3,625282481N/A

30408110243

24N/AN/A

5,203

3,217245376N/A

14362275134

32N/AN/A

4,655

3,864318675N/A

47397297143

322425

5,822

3,443345925N/A

45261221134

399228

5,533

2,073482

1,0859

37489447

1,12274

N/AN/A

5,818

2,048450852

744

464389742

50N/AN/A

5,046

2,523722

1,098N/A100473676

1,122313733

6,815

1,892798

1,787N/A

88275663880

24129

626,598

12,66039

111N/A

870

1938332

N/AN/A

13,196

11,5345578

N/A6

116186131

22N/AN/A

12,128

11,2506085

N/A8

105326242

131611

12,116

9,776138

62N/A

879

163133

187

1510,399

945946947948949950951952953954955956

Access

Source: VSSC No Show and Cancella�on Cube 8.11.V19.SaltLakeCity

Note: Appointments cancelled within 45 days




154

Market/Parent Facility Exis�ng VA Drive Times AssessmentAccess

Source: 1. Dartmouth Atlas 2. Geocoded Enrollee File FY18Q4 8.12.V19.SaltLakeCity#IMG



VA & Commercial Drive Time Measures

Note: A Dartmouth Atlas Hospital Service Area (HSA) is a ZIP code-defined geography encompassing the community where the ZIP code's Medicare residents predominantly receive their hospital care. HSA total enrollees are displayed on map. A Dartmouth Atlas Hospital Referral Region (HRR) is a

ZIP code-defined geography encompassing the community where the ZIP code's Medicare residents predominantly receive their cardiovascular and neurosurgery hospital care.

155

FY 2018 # of TotalEnrollees

# of enrolleeswithin 30

minutes drive�me

% of enrolleeswithin 30minutes

# of enrolleesoutside 30

minutes drive�me

% of enrolleesoutside 30

minutes

# of enrolleeswithin 60

minutes drive�me

% of enrolleeswithin 60minutes

# of enrolleesoutside 60

minutes drive�me

% of enrolleesoutside 60

minutes

Id

(V19) Salt Lake City 70,893 51,879 73.2% 19,014 26.8% 45,488 64.2% 25,405 35.8% 1

Access




Drive Time Summary

Secondary CarePrimary Care

Source: 1. FY2018 Q4 Enrollment 2. FY2018 Q4 VA Site Tracking (VAST) data; VHA OPP Planning Systems Support Group

156

Poten�al Service GapsAccess

Source: 1. Dartmouth Atlas 2. Geocoded Enrollee File FY18Q4 8.14.V19.SaltLakeCity#IMG


VISN 19: Salt Lake City Market Potential service gaps are areas identified by the Dartmouth Atlas in a Hospital Service Area (HSA). The medical community in these areas provide as

opportunities to consider different tactics to extend the VA network of care. Strategies for expansion might include telehealth, FQHC partnership,

unique rural outreach, contracted provider(s) or a new VA asset. The following page shows the number of Enrollees that reside within a particular HSA.

Planning best practice suggests that 4,800 enrollees are required to justify establishing a new site of care.

Potential Service Gaps

157

Poten�al Service Gaps, cont.Access

Source: 1. Dartmouth Atlas 2. Geocoded Enrollee File FY18Q4 8.14.V19.SaltLakeCity


VISN 19: Salt Lake City Market Potential service gaps are areas identified by the Dartmouth Atlas in a Hospital Service Area (HSA). The medical community in these areas provides

opportunities to consider different tactics to extend the VA network of care. Strategies for expansion might include telehealth, FQHC partnership,

unique rural outreach, contracted provider(s) or a new VA asset. The table below shows the number of Enrollees that reside within a particular HSA.

Planning best practices suggests that 4,800 enrollees are required to justify establishing a new site of care.

158

Quality & Sa�sfac�on

159

Category Sub-Category Na�onal . ..

Insurance (Reliance) Have Private Insurance PlanPlanned Use of VA as Primary Source of CareUninsured

Sa�sfac�on (Best CareAnywhere)

Appointments are Always/Nearly Always Easy to Get with VAVery Sa�sfied with Respect Given by Health Care ProfessionalsVery Sa�sfied with the Ability to Get Referrals

Access (Choose VA) Believes Care in the Community is Easier to Get to than VA(Answered Yes)Believes Care in the Community Quality is Be�er than VA (AnsweredYes)

Internet Use(Telehealth Poten�al)

Internet Use to Look at Health Informa�on (Answered Yes)Used Internet to Make Medical Appointments (Answered Yes)

27.6 %40.5 %19.2 %45.3 %72.3 %32.4 %66.0 %

43.0 %

76.1 %36.5 %

36.3 %36.0 %17.5 %39.3 %74.5 %44.9 %74.2 %

45.4 %

75.7 %36.9 %

1112223

3

44

1. Sa�sfac�on denominator = enrolled Veterans who said they had used VA since January 1, 20162. Access denominator = enrolled Veterans who said they had used a provider other than VA for some or all of their care since January 1, 20163. The denominator for Internet Use = enrolled Veterans who said they used the internet at least occasionally


Source: 2018 Survey of Enrollees Market Profiles 9.1.V19.SaltLakeCity



VA Pa�ent Feedback: Survey of Enrollees – Salt Lake City MarketSalt Lake City Market

160

Facility SurveyDate

CareCoord.

Cleanlinessof Hospital

Envt.

CommaboutMeds

Commw/

Doctors

Commw/

Nurses

PainMgmt.

CommaboutPain

QuietnessOf

HospitalEnvt.

Hosp.Staff

Respon-siveness

Recom-mend

Hospital

CareTransi�on

Hosp.Ra�ng

DischargeInfo

SharedDecisionMaking

(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake CityVISN 19 AverageVISN 19 AverageVISN 19 AverageVISN 19 AverageNa�onal AverageNa�onal AverageNa�onal AverageNa�onal Average

201520162017201820152016201720182015201620172018

58.457.255.761.252.254.751.954.752.053.253.254.2

75.475.676.075.270.572.271.371.669.970.069.670.4

65.168.068.356.463.264.562.461.061.261.962.663.4

73.375.573.674.271.374.171.472.273.874.775.175.7

74.175.573.674.672.574.673.474.772.173.173.574.6

63.065.361.6N/A59.161.360.1N/A60.160.159.5N/A

N/AN/AN/A60.7N/AN/AN/A57.9N/AN/AN/A57.9

48.851.452.950.847.850.649.749.049.349.850.151.4

62.164.459.363.063.665.064.264.958.859.759.761.0

70.871.871.471.063.366.062.663.165.565.866.766.9

53.152.354.854.749.651.150.650.849.750.852.051.9

69.669.668.365.961.465.061.061.664.365.265.466.2

88.386.688.887.784.986.186.986.884.785.385.686.2

78.080.780.078.373.077.275.675.574.075.375.475.5

VA Pa�ent Sa�sfac�on – Inpa�ent% Reported as Always % Definitely Yes


Source: VSSC Pa�ent Experiences Survey Reports 9.2.V19.SaltLakeCity

Note: Green cells indicate a score at or above na�onal average. Red cells indicate a score below na�onal average.



% Strongly Agree % 9 or 10 % Yes

161


Source: SAIL Scorecards 9.3.V19.SaltLakeCity.660



VA Market Facility Trends – Access/Quality/Pa�ent Sa�sfac�on

162




VA Market Facility Trends – Access/Quality/Pa�ent Sa�sfac�on, cont.

Note: Performance Measures cited above represent composite measures. Some measures havechanged, but appear to be rela�vely close to current measures and therefore are reported forperiods shown (PCMH Timely Appointments, Days Waited for Urgent Appointment).

9.13.V19.SaltLakeCity.660Source: SAIL Scorecards

163

VA Pa�ent Sa�sfac�on – Outpa�ent (PCMH)

Facility Survey Date Access Care Coordina�on Communica�on Office Staff Overall Ra�ng ofProvider

OverallSa�sfac�on

CK

(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GA) Pocatello(V19) (660GA) Pocatello(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GB) Ogden(V19) (660GB) Ogden(V19) (660GB) Ogden(V19) (660GC) Ely-Nevada(V19) (660GC) Ely-Nevada(V19) (660GC) Ely-Nevada(V19) (660GD) Roosevelt(V19) (660GD) Roosevelt(V19) (660GD) Roosevelt(V19) (660GD) Roosevelt(V19) (660GE) Orem

20152016201720182015201620172018201520162017201820152016201720152016201720182015

36.950.449.149.934.048.849.352.733.944.846.052.041.263.548.844.660.863.653.436.1

N/A61.961.066.3N/A68.666.571.5N/A59.760.360.1N/A55.956.3N/A68.465.366.9N/A

75.680.080.384.968.183.984.982.570.677.677.179.157.162.973.476.985.487.186.261.6

65.672.670.876.274.480.080.173.268.864.668.968.264.464.578.081.986.388.777.069.1

67.273.673.081.765.176.173.175.966.371.471.975.648.056.758.170.775.481.782.251.6

N/AN/AN/A81.2N/AN/AN/A81.7N/AN/AN/A84.6N/AN/AN/AN/AN/AN/A85.6N/A

……………………………………………………

% Always






% 9 or 10

164

VA Pa�ent Sa�sfac�on – Outpa�ent (PCMH), cont.



CK

(V19) (660GE) Orem(V19) (660GE) Orem(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GG) St. George(V19) (660GG) St. George(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GJ) Western Salt Lake(V19) (660GJ) Western Salt Lake(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660GK) Elko(V19) (660GK) Elko(V19) (660GK) ElkoVISN 19 AverageVISN 19 AverageVISN 19 AverageVISN 19 AverageNa�onal Average

20162017201820152016201720182015201620172018201520162017201820152016201720182015

50.646.051.832.549.343.242.433.952.857.249.741.841.950.646.532.144.044.046.837.4

57.756.956.5N/A62.159.150.6N/A62.368.161.8N/A54.962.462.2N/A55.555.257.5N/A

74.774.477.474.479.378.074.772.481.384.181.663.769.880.282.765.672.771.774.770.9

76.475.872.668.369.872.765.072.573.476.171.180.671.882.286.163.567.367.770.966.2

62.259.272.063.473.469.165.066.974.079.375.754.155.573.269.359.664.063.465.665.2

N/AN/A80.2N/AN/AN/A76.4N/AN/AN/A85.6N/AN/AN/A87.8N/AN/AN/A75.8N/A

……………………………………………………

% Always


Source: VSSC Pa�ent Experiences Survey Reports 9.4.V19.SaltLakeCity#2




% 9 or 10

165

VA Pa�ent Sa�sfac�on – Outpa�ent (PCMH), cont.



CK

Na�onal AverageNa�onal AverageNa�onal Average

201620172018

49.249.851.3

58.458.760.1

75.675.877.1

69.170.071.0

68.168.969.7

N/AN/A80.3

………

% Always






% 9 or 10

166

VA Pa�ent Sa�sfac�on – Outpa�ent (Specialty Care)



CK

(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660GA) Pocatello(V19) (660GA) Pocatello(V19) (660GA) Pocatello(V19) (660GB) Ogden(V19) (660GB) Ogden(V19) (660GB) Ogden(V19) (660GD) Roosevelt(V19) (660GD) Roosevelt(V19) (660GD) Roosevelt(V19) (660GE) Orem(V19) (660GE) Orem(V19) (660GE) Orem(V19) (660GG) St. George(V19) (660GG) St. George(V19) (660GG) St. George(V19) (660GJ) Western Salt Lake(V19) (660GJ) Western Salt Lake

20162017201820162017201820162017201820162017201820162017201820162017201820162017

42.0%46.9%50.9%42.2%23.6%39.5%70.6%83.2%37.4%

100.0%100.0%

N/A40.0%83.6%24.1%58.0%41.7%50.2%72.4%22.3%

50.5%49.8%56.2%27.3%51.8%52.6%51.7%67.6%54.8%

100.0%100.0%

50.0%59.7%45.6%59.1%60.4%46.3%57.7%62.3%34.0%

70.6%71.1%75.4%69.1%56.7%54.1%65.2%89.0%61.0%

100.0%100.0%100.0%

83.6%94.9%90.0%82.0%82.7%66.2%92.7%45.4%

69.4%64.4%68.2%75.6%68.3%53.0%52.0%83.7%76.2%

100.0%100.0%100.0%

83.6%57.7%94.8%86.7%68.5%61.0%92.7%42.6%

62.6%61.9%66.7%54.7%59.6%47.3%50.6%91.1%65.2%

100.0%100.0%100.0%

61.9%66.5%84.4%65.1%56.5%54.6%

100.0%29.2%

N/AN/A

83.2%N/AN/A

62.2%N/AN/A

77.7%N/AN/A

100.0%N/AN/A

92.7%N/AN/A

67.1%N/AN/A

19…19…19…19…19…19…19…19…19…19…19…19…19…19…19…19…19…19…19…19…

% Always






% 9 or 10

167

VA Pa�ent Sa�sfac�on – Outpa�ent (Specialty Care), cont.



CK

(V19) (660GJ) Western Salt Lake(V19) (660GK) Elko(V19) (660GK) Elko(V19) (660GK) ElkoVISN 19 AverageVISN 19 AverageVISN 19 AverageNa�onal AverageNa�onal AverageNa�onal Average

2018201620172018201620172018201620172018

56.5%N/AN/AN/A

41.7%43.3%44.6%47.3%48.7%49.7%

72.2%N/A

100.0%N/A

51.7%51.6%53.1%55.1%56.2%57.1%

88.5%N/A

100.0%N/A

71.5%71.0%73.4%73.2%74.2%75.3%

91.5%N/A

100.0%N/A

67.6%68.2%69.1%69.1%70.4%71.7%

90.1%N/A

100.0%N/A

62.4%62.4%65.0%65.4%66.8%68.4%

87.2%N/AN/AN/AN/AN/A

76.2%N/AN/A

81.0%

19…19…19…19…19…19…19…19…19…19…

% Always






% 9 or 10

168

Facility SurveyDate

ProviderRa�ng

CommunityCare

Received

Commu-nica�on

ProviderAwareHistory

ProviderInformed

VAProviderInformed

Next StepClear

TestFollow-

up

TestResult to

VA

First Appt.Soon asNeeded

First Appt.Easy to Get


(V19) (660) Salt Lake City(V19) (660) Salt Lake City(V19) (660) Salt Lake CityVISN 19 AverageVISN 19 AverageVISN 19 AverageNational AverageNational AverageNational Average

201620172018201620172018201620172018

56.064.366.458.461.465.658.862.164.5

46.552.952.447.850.353.250.454.255.3

63.366.975.063.564.569.563.766.468.0

38.144.054.646.245.953.847.049.251.0

34.147.948.542.544.045.142.244.545.7

30.644.450.139.644.542.841.043.744.8

39.042.549.340.543.346.642.745.247.0

45.762.560.452.754.055.551.653.454.9

60.267.152.761.059.959.059.660.662.5

63.460.760.657.459.561.059.962.166.0

53.255.857.655.957.460.559.862.266.1

78.371.568.770.370.073.071.774.076.9

VA Pa�ent Sa�sfac�on – Community Care

% Always






% 9 or 10 % Strongly Agree

% Very Sa�sfied

or Sa�sfied

169

Quality of Community Hospitals – Salt Lake City AreaQuality & Sa�sfac�on

Source: 1. Best Care Report 2. Definitive Healthcare 9.6.V19.SaltLakeCity.660

Note: Data is reported by provider number and may includes mul�-campus hospitals repor�ng under a single provider number, N/A = Not Applicable





Source: 1. US News and World Report Flagship Hospital Rankings 2. Hospital website 9.7.V19.SaltLakeCity.660



Awards and Recogni�on of Top Five Largest Community Hospitals* – Salt Lake City Area

*As measured by total staffed beds. Excludes rehabilita�on, psychiatric, and long term care facili�es.Note: N/A for High Performing Ranked Special�es/Programs and High Performing Procedures/Condi�ons indicates the hospital did not meet criteria or volume thresholds set by US News and World Report to be eligible for a ra�ng/ranking.N/A in for Notable Awards indicate the hospital did not list any care or service delivery awards website. Reflects informa�on that was available as of July 29th, 2019.



Source: CMS.gov 9.8.V19.SaltLakeCity



Quality of Top Community Hospital Outpa�ent ServicesHospital Outpa�ent Quality Repor�ng Program Overview

• The Hospital Outpa�ent Quality Repor�ng Program (Hospital OQR) is a pay for quality data repor�ng program implemented by the Centers for Medicare & Medicaid Services (CMS) for outpa�ent hospital servicesü Mandated by the Tax Relief and Health Care Act of 2006 by the Centers for Medicare & Medicaid Services

to promote higher quality and more efficient health care for Medicare beneficiaries through measurement

• Subsec�on (d) hospitals that meet Hospital OQR Program requirements during a given calendar year receive a full OPPS payment update, also called the Outpa�ent Department (OPD) fee schedule increase factor, for the upcoming calendar year

• Eligible hospitals that do not par�cipate or par�cipate but fail to meet program requirements receive a two percentage point reduc�on of their annual payment update (APU) for the applicable payment year

• Hospitals must submit data for 26 quality measures:ü 5 Cardiac Care Measuresü 3 ED-Throughput Measuresü 1 Pain Management Measuresü 6 Imaging Efficiency Measuresü 1 Stroke Measuresü 9 Submi�ed Via a Web-Based Tool Measuresü 1 Outcome Claims-Based Measuresü Commercial Market Data & Analysis

For more informa�on, including measure specifica�ons and minimum case count requirements, see CMS.gov

172

This analysis is subjec�ve in nature and is only meant to provide a direc�onal opinion as to the current state of VA and non-VA providers in the market.

*ED volume (EDV) is not a Hospital OQR measure, but OP-18 and OP-22 na�onal data are based on ED volumes.

**The first repor�ng period for OP-35 and -36 began January 1, 2018 and goes through December 31, 2018, for the CY 2020 payment determina�on. Data for these 2 measures have not made available by CMS and are not included in this analysis.

Validation of the data for this slide is not required

Acute Myocardial Infarc�on /

Chest Pain Measure Score


Source: CMS.gov 9.9.V19.SaltLakeCity



Quality of Top Community Hospital Outpa�ent Services, cont.•In order to be�er compare outpa�ent quality between hospitals, the 21 outpa�ent quality measure were grouped into broader categories

•Na�onal outpa�ent data was also grouped following the same methodology and used as a benchmark comparison

• OP-2: Fibrinoly�c Therapy Received Within 30 Minutes of ED arrival (%)

• OP-3: Median Time to Transfer to Another Facility for Acute Coronary Interven�on (mins)

• OP-5: Median Time to ECG (mins

Structural

(Submi�ed Via a

Web-based Tool)

• OP-12: The Ability for Providers with HIT to Receive Laboratory Data Electronically

Directly into their ONC-Cer�fied EHR System as Discrete Searchable Data (Y/N)

• OP-17: Tracking Clinical Results between Visits (Y/N)

• OP-29: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Pa�ents

(%)

• OP-30: Colonoscopy Interval for Pa�ents with a History of Adenomatous Polyps –

Avoidance of Inappropriate Use (%)

• OP-31: Cataracts – Improvement in Pa�ent’s Visual Func�on within 90 days Following

Cataract Surgery (survey)

•OP-33 Facility 7-Day Risk-Standardized Hospital Visit Rate a�er Outpa�ent Colonoscopy

• OP-8: MRI Lumbar Spine for Low Back Pain (%)

• OP-9: Mammography Follow-up Rates (%)

• OP-10: Abdomen CT-Use of Contrast Material (%)

• OP-11: Thorax CT-Use of Contrast Material (%)

• OP-13: Cardiac Imaging for Preopera�ve Risk Assessment for Non-Cardiac Low Risk Surgery (%)

• OP-14: Simultaneous Use of Brain Computed Tomography (CT) and Sinus Computed

Tomography (CT) (%)

• OP-32 Facility 7-Day Risk-Standardized Hospital Visit Rate a�er Outpa�ent Colonoscopy

• OP-35: Admissions and Emergency Department (ED) Visits for Pa�ents Receiving Outpa�ent

Chemotherapy**

• OP-36: Hospital Visits a�er Hospital Outpa�ent Surgery**

ED - Throughput • OP-18: Median Time from ED Arrival to ED Departure for Discharged ED Pa�ents (mins)

• OP-22: Le� Without Being Seen (%)

• EDV - Emergency Department Volume

• OP-23: Head CT or MRI Scan Results for Acute Ischemic Stroke or Hemorrhagic Stroke Pa�ents

who Received Head CT or MRI Scan Interpreta�on Within 45 minutes of ED Arrival (%)

Hospital Outpa�ent Quality Repor�ng Groupings

ED - Volume*

Imaging Efficiency

StrokeOutcome Claims-Based

173

Id

Outpa�entQuality Category

Measure Name Preferred Direc�on Hospital1 Hospital2 Hospital3 Hospital4 Hospital5 Na�onalRate

1072

1073107410751076

10771078

1079

1080

10811082

108310841085

1086

1087108810891090

1091

Outpa�entQuality CategoryAMI / Chest Pain

Structural(Submi�ed Via aWeb-Based Tool)

Outcome Claims-BasedED – Throughput

ED – Volume

ImagingEfficiency

Measure Name

OP-2: Fibrinoly�c Therapy Received Within 30 Minutes of ED arrival (%)OP-3: Median Time to Transfer to Another Facility for Acute Coronary Interven�on (mins)OP-5: Median Time to ECG (mins)OP-12: Receive Laboratory Data Electronically Directly as Discrete Searchable Data (Y/N)

OP-17: Tracking Clinical Results between Visits (Y/N)OP-29: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Pa�ents(%)OP-30: Colonoscopy Interval for Pa�ents with a History of Adenomatous Polyps ?Avoidance of Inappropriate Use (%)OP-31: Cataracts ? Improvement in Pa�ent?s Visual Func�on within 90 days FollowingCataract Surgery (survey)OP-33: External Beam Radiotherapy for Bone Metastases (%)OP-32: Facility 7-Day Risk-Standardized Hospital Visit Rate a�er Outpa�ent Colonoscopy

OP-18: Median Time from ED Arrival to ED Departure for Discharged ED Pa�ents (mins)OP-22: Le� Without Being Seen (%)EDV: Emergency Department Volume

OP-8: MRI Lumbar Spine for Low Back Pain (%)

OP-9: Mammography Follow-up Rates (%)OP-10: Abdomen CT-Use of Contrast Material (%)OP-11: Thorax CT-Use of Contrast Material (%)OP-13: Cardiac Imaging for Preopera�ve Risk Assessment for Non Cardiac Low RiskSurgery (%)OP-14: Simultaneous Use of Brain Computed Tomography (CT) and Sinus ComputedTomography (CT) (%)

Preferred Direc�on

HighLowLowYes

YesHigh

High

High

HighLow

LowLowN/A

Low

LowLowLowLow

Low

University Hospital

N/AN/AN/AYes

Yes93.0%

98.0%

N/A

90.0%15.1%

2382.0%High (40,000-59,999pa�ents annually)40.3%

4.8%4.5%0.1%6.6%

2.0%

IntermountainMedical CenterN/AN/AN/AYes

Yes95.0%

100.0%

N/A

30.0%15.3%

1841.0%Very High (60,000+pa�ents annually)50.0%

8.7%2.2%0.3%5.7%

1.9%

Utah Valley Hospital

N/AN/AN/AYes

Yes99.0%

98.0%

N/A

N/A13.7%


5.8%3.8%0.4%2.3%

1.2%

Jordan ValleyMedical CenterN/AN/A7Yes

Yes79.0%

74.0%

N/A

N/A14.0%


9.7%3.9%1.7%3.2%

1.2%

McKay-DeeHospitalN/AN/AN/AYes

Yes95.0%

97.0%

N/A

88.0%14.0%


6.3%1.5%0.5%4.2%

1.0%

Na�onal Rate

59.0%628N/A

N/A88.0%

90.0%

95

86.0%14.8%

1372.0%N/A

39.3%

8.9%7.8%1.5%4.6%

1.1%

1092 OP-23: Head CT or MRI Scan Results Within 45 minutes of ED Arrival (%) High N/A 53.0% N/A 63.0% 44.0% 73.0%

Id

Outpa�entQuality Category

Measure Name Preferred Direc�on Hospital1 Hospital2 Hospital3 Hospital4 Hospital5 Na�onalRate

1072

1073107410751076

10771078

1079

1080

10811082

108310841085

1086

1087108810891090

1091

Outpa�entQuality CategoryAMI / Chest Pain

Structural(Submi�ed Via aWeb-Based Tool)

Outcome Claims-BasedED – Throughput

ED – Volume

ImagingEfficiency

Measure Name

OP-2: Fibrinoly�c Therapy Received Within 30 Minutes of ED arrival (%)OP-3: Median Time to Transfer to Another Facility for Acute Coronary Interven�on (mins)OP-5: Median Time to ECG (mins)OP-12: Receive Laboratory Data Electronically Directly as Discrete Searchable Data (Y/N)

OP-17: Tracking Clinical Results between Visits (Y/N)OP-29: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Pa�ents(%)OP-30: Colonoscopy Interval for Pa�ents with a History of Adenomatous Polyps ?Avoidance of Inappropriate Use (%)OP-31: Cataracts ? Improvement in Pa�ent?s Visual Func�on within 90 days FollowingCataract Surgery (survey)OP-33: External Beam Radiotherapy for Bone Metastases (%)OP-32: Facility 7-Day Risk-Standardized Hospital Visit Rate a�er Outpa�ent Colonoscopy

OP-18: Median Time from ED Arrival to ED Departure for Discharged ED Pa�ents (mins)OP-22: Le� Without Being Seen (%)EDV: Emergency Department Volume

OP-8: MRI Lumbar Spine for Low Back Pain (%)

OP-9: Mammography Follow-up Rates (%)OP-10: Abdomen CT-Use of Contrast Material (%)OP-11: Thorax CT-Use of Contrast Material (%)OP-13: Cardiac Imaging for Preopera�ve Risk Assessment for Non Cardiac Low RiskSurgery (%)OP-14: Simultaneous Use of Brain Computed Tomography (CT) and Sinus ComputedTomography (CT) (%)

Preferred Direc�on

HighLowLowYes

YesHigh

High

High

HighLow

LowLowN/A

Low

LowLowLowLow

Low

University Hospital

N/AN/AN/AYes

Yes93.0%

98.0%

N/A

90.0%15.1%


4.8%4.5%0.1%6.6%

2.0%

IntermountainMedical CenterN/AN/AN/AYes

Yes95.0%

100.0%

N/A

30.0%15.3%


8.7%2.2%0.3%5.7%

1.9%


N/AN/AN/AYes

Yes99.0%

98.0%

N/A

N/A13.7%


5.8%3.8%0.4%2.3%

1.2%

Jordan ValleyMedical CenterN/AN/A7Yes

Yes79.0%

74.0%

N/A

N/A14.0%


9.7%3.9%1.7%3.2%

1.2%

McKay-DeeHospitalN/AN/AN/AYes

Yes95.0%

97.0%

N/A

88.0%14.0%


6.3%1.5%0.5%4.2%

1.0%

Na�onal Rate

59.0%628N/A

N/A88.0%

90.0%

95

86.0%14.8%

1372.0%N/A

39.3%

8.9%7.8%1.5%4.6%

1.1%

1092 OP-23: Head CT or MRI Scan Results Within 45 minutes of ED Arrival (%) High N/A 53.0% N/A 63.0% 44.0% 73.0%




*As measured by total staffed beds **A rate of 8% - 14% is typically ideal for mammography follow-up rates N/A = Not available/reported Green: at/above Na�onal Rate

Source: 2017 CMS.gov

Quality & Sa�sfac�on Key Quality Metrics of Top Five Largest Community Hospitals* – Salt Lake City Area

174

Id

9… 9_12_1A Output ProcedureType Hospital1 Hospital2 Hospital3 Hospital4 Hospital5

441

442443444445

446447448449450451

1

2345

6789

1011

Outpatient Quality Category

OP Surgical ProcedureVolume

Procedure Type

GastrointestinalEye

Nervous SystemMusculoskeletal

SkinGenitourinaryCardiovascular

RespiratoryOtherTotal

University Hospital

11,6603,982

4741,670

30,8453,3102,2576,097

60360,898

Intermountain MedicalCenter5,3851,809

259784

3,438949

1,896141317

14,978


6,642490217

1,513

938071389022

10,012

Jordan Valley MedicalCenter4,239

125206

1,369

5,662594120380

12,353

McKay-Dee Hospital

7,60214

270461

1856708314

1129,411

Id

9… 9_12_1A Output ProcedureType Hospital1 Hospital2 Hospital3 Hospital4 Hospital5

441

442443444445

446447448449450451

1

2345

6789

1011

Outpatient Quality Category

OP Surgical ProcedureVolume

Procedure Type

GastrointestinalEye

Nervous SystemMusculoskeletal

SkinGenitourinaryCardiovascular

RespiratoryOtherTotal

University Hospital

11,6603,982

4741,670

30,8453,3102,2576,097

60360,898

Intermountain MedicalCenter5,3851,809

259784

3,438949

1,896141317

14,978


6,642490217

1,513

938071389022

10,012

Jordan Valley MedicalCenter4,239

125206

1,369

5,662594120380

12,353

McKay-Dee Hospital

7,60214

270461

1856708314

1129,411

Hospitals* – Salt Lake City AreaOutpa�ent Procedure Volumes of Top Five Largest CommunityQuality & Sa�sfac�on

Source: 2017 CMS.gov 9.11.V19.SaltLakeCity.660



N/A = Not available/reported

*As measured by total staffed beds

• Most hospital outpa�ent procedures (99%) fall into one of eight categories: Cardiovascular, Eye, Gastrointes�nal, Genitourinary, Musculoskeletal, Nervous System, Skin, and Other

(CMS.gov; green: at/above Na�onal Rate)

• Research has suggested higher procedure volumes are associated with lower costs and be�er quality (Advisory Board).


Facili�es

176

1 2

Acres availableMain Pa�ent Care Facility Construc�on DateMost Recent Renova�on Date (Main Hospital Building)BGSF (campus total)DGSF (direct pa�ent care)Property SizeAnnual Opera�ons and Maintenance CostTotal 10-Year Capital Investment*Facili�es Condi�ons Assessment DeficienciesSeismic RiskOpera�onal Leases

0194919881,104,191 sq. �406,512 sq. � 37.0% of BGSF81 acres 0 acres available**$13,393,837$153,526,350$160,668,026 $2,698/UniqueHigh13 Leases $4,569,825 total annual cost 132,942 total NUSF

1 2 3

Facility Complexity Level (2017): High-1A 1

1 2 3

Facility Complexity Level (2017):FY18 Core Facility Uniques (VAMC only):

High-1A59,561

12

REAL PROPERTY OVERVIEW




Facili�es

Facility Name: Salt Lake City

Inpa�ent Campus Snapshot

Source: CAI Buildings and FCA Condi�on Gaps Reports 9-7-2019, and CAPRES CEOSH Report 1-29-2019

* Sum of Major and Minor Con. and NRM spending** Provides an indica�on of any excess or surplus land, not currently in use and with no plans for future expansion needs that could be used for future development.

177

1. Includes Acute Psych, Medicine, and Surgical Beds




Facili�es

Source: CAI Buildings, Floor, Leases, and FCA Red Green Reports 9-7-2019; VSSC Core Uniques Cube; CAPRES CEOSH Report 1-29-2019; Locally Provided GFI

Inpa�ent Campus and Outpa�ent Care Loca�ons

2. Includes Spinal Cord, Blind Rehab, CLC, DRRTP, and Intermediate Beds3. Only reflects SF related to VA owned and leased fixed facili�es

178

Major Construc�on Funding

$0

$50,000,000

$100,000,000

FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18

VHA Average Major VISN Average Major Facility Major

Measure Facility VISN Average VHA Average Id

FCA Backlog/SF**Current FCA BacklogInvestment/SF**Total 10-Year Capital Investment*Owned SF

$146$160,668,026

$139$153,526,350

1,104,191

$147$94,123,341

$399$289,616,572

725,580

$139$123,886,618

$155$137,521,745

886,486

2625252525

Investment – Salt Lake City


*Sum of Major and Minor Con. and NRM spending **Total 10-Year Capital Investment and Current FCA Backlog Divided by Owned SF



Facili�esMinor Construc�on Funding

$0

$20,000,000


VHA Average Minor VISN Average Minor Facility Minor

NRM Funding

$0

$10,000,000


VHA Average NRM VISN Average NRM Facility NRM

Total Construc�on Funding

$0

$50,000,000

$100,000,000


VHA Average Total VISN Average Total Facility Total

Source: CAI Buildings and FCA Red Green Reports 9-7-2019; FMS 830 837, Accounts 110, 111, and 162 (Cost Center 8542, BOC 32XX, (less BOC 3222 and BOC 3224))

179

Site Plan

Source: Locally Provided GFI 10.4.V19.SaltLakeCity.660



Facili�esSalt Lake City

180

Building Inventory (Owned)

Func�on Title Current Use YearBuilt

BuildingGross Sq.

Ft.

Outpa�entSq. Ft.

Inpa�ent Non-Clinical

Other Vacant Cost of FCADeficiencies*

FullReplacement

Cost

Historical Status SeismicRisk

TotalPa�ent Complex (1)Main Hospital (14)Research/Admin. (2)Psychiatry/Dom (3)Research/Laundry/Warehouse (7)Out Pa�ent Mental Health (16)Recrea�on/Canteen (8)HR/Financial/Admin. (4)Nutri�on & Food (5)Engineering/Boiler Plant/Shops (6)Fisher House (32)Na�onal Media Development (9)Concourse (Red-B.1 to B.3) (C1)Prosthe�cs Temp Lab (47)Misc. (T1)Engineering (38)Concourse (Blue-B.4 to B.2) (C2)Child Care (13)Concourse (Green-B.1 to B.8) (C3)

HospitalHospital

LaboratoriesHospital

LaboratoriesHospital

Ins�tu�onalOffice

ServiceServiceHousing

Ins�tu�onalAll Other

Outpa�ent F…ServiceService

All OtherIns�tu�onal

All Other

1949198119491949194920111949194919491949201119491949199319921987194919491949

1,104,191366,082217,935128,772

75,23050,10039,99335,65335,00030,59022,30014,63113,50011,350

6,4006,3695,8005,6445,6005,507

330,722139,794102,020

8,74026,125

034,923

7,100585

1,10000

2,4200

6,4001,515

0000

75,79051,210

00

24,580000000000000000

314,20228,76731,45495,230

2,84248,975

013,77827,12028,005

4,6300

9,12000

3,0045,000

000

363,233131,827

78,70124,80221,683

1,1255,070

14,7757,2951,485

17,67014,631

1,96011,350

01,850

8005,6445,6005,507

20,24414,484

5,76000000000000000000

$130,325,392$36,234,909$21,512,261$24,817,035$12,569,494

$9,153,901$933,682

$6,150,542$3,837,848$2,964,490$4,076,722

$35,909$1,065,956

$128,143$61,600

$110,637$134,237

$88,420$388,082

$51,787

$761,822,304$258,737,767$151,469,198

$93,328,821$49,148,336$35,468,941$26,374,357$23,108,953$22,192,905$21,994,629$14,129,001

$8,890,564$8,625,172$7,191,218$4,315,808$4,069,796$3,674,808$3,575,968$3,548,090$3,489,166

Not HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot Historic

ExemptExemptExemptExemptExempt

Not ListedExemptExemptExemptExempt

Not ListedExempt

Non-Exe…Not Listed

ExemptExempt

Non-Exe…Exempt

Non-Exe…

Salt Lake City

Source: CAI Buildings & FCA Condi�on Gaps Report 9-7-2019 10.5.V19.SaltLakeCity.660

*Project Costs to remediate FCAs vary significantly, from below assessed value to more than 3 �mes the value **“Non-Contribu�ng” is a non-contribu�ng element of a landmark or listed district



Facili�es

181

Building Inventory (Owned), cont.


BuildingGross Sq.

Ft.

Outpa�entSq. Ft.


Other Vacant Cost of FCADeficiencies*

FullReplacement

Cost

Historical Status SeismicRisk

Credit Union (CU)Emergency Prepardness (18)Research (45)Chiller Plant (27)Research ARF (37)P & H (25)Generator Structure (44)Safety/QA (T2)Research ARF (35)Engineering Trailers (6A-B)Research (30)Engineering (PH)Research (29)Safety (T4)

ServiceAll Other

LaboratoriesService

LaboratoriesWarehouses

All OtherService

LaboratoriesService

LaboratoriesService

LaboratoriesService

19772010198919641986198220101991198219871982198819491992

5,0005,0004,3703,5812,3661,4881,4001,3601,177

700696300177120

00000000000000

00000000000000

05,0004,370

02,3661,288

01,360

0600696300177120

5,00000

3,5810

2001,400

01,177

1000000

00000000000000

$51,500$183,581$341,677

$4,596,445$365,163

$56,506$1,000

$39,514$145,905$132,895

$62,473$19,653$13,425

$0

$3,167,938$3,167,938$3,295,002$2,268,877$1,783,976

$942,778$887,023$861,679$745,732$443,511$524,787$190,076$133,459

$76,031

Not HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot HistoricNot Historic

Non-Exe…Not Listed

ExemptExempt

High RiskExempt

Not ListedExemptExemptExemptExemptExempt

Non-Exe…Exempt

Salt Lake City

Source: CAI Buildings & FCA Condi�on Gaps Report 9-7-2019 10.5.V19.SaltLakeCity.660#2

*Project Costs to remediate FCAs vary significantly, from below assessed value to more than 3 �mes the value **“Non-Contribu�ng” is a non-contribu�ng element of a landmark or listed district



Facili�es

182


BuildingGrossSq. Ft.

Outpa�entSq. Ft.


Other Vacant Lease Termina�on (Hard) Year ofAc�va�on

Annual Rent

TotalSalt Lake Dental, Audilology, PFSWest Salt Lake Valley CBOCPocatello ClinicOgden CBOCBusiness Office Support ServicesSt. George CBOCOrem CBOCIdaho Falls OutreachGenomic Medicine SLCMental Health Tele-HubWeber County Clinic - LicenseElko CBOCPrice Telehealth Clinic

OtherCBOCCBOCCBOCOfficeCBOCCBOCCBOCIndependent OPCMental HealthMental HealthCBOCOutreach Clinic

2006200220061999197719962003200020002001

20162016

132,94245,17517,98015,235

9,1097,2437,1746,3746,1806,1364,7963,0502,6401,850

85,23219,15015,90015,235

9,1090

7,1746,3744,750

00

3,0502,6401,850

00000000000000

25,49911,020

1,10000

7,243000

6,1360000

6,2271000000

1,4300

4,796000

00000000000000

Wednesday, June 20, 2029Wednesday, September 30, 2020Saturday, May 23, 2037Tuesday, October 1, 2024Sunday, January 9, 2028Monday, January 1, 2024Wednesday, September 30, 2020Tuesday, October 31, 2028Thursday, September 30, 2027Friday, June 30, 2023Wednesday, September 30, 2020Thursday, April 29, 2021Tuesday, March 30, 2021

2018200920172014201820142009201820182019201820112011

$4,569,825$1,571,202

$535,804$697,420$358,895$331,717$226,461$213,004$100,958$199,334$120,539

$76,982$94,929$42,580

Source: CAI Leases Report 9-7-2019 10.6.V19.SaltLakeCity.660



Facili�esSalt Lake City

Building Inventory (Leased)

183

Summary of Architectural and Engineering Challenges – Salt Lake City

Source: Locally Provided GFI 10.7.V19.SaltLakeCity.660



Facili�es

184

Note: All ac�ve projects have received all levels of approvals and are assumed to be proceeding.




Facili�es Ac�ve and Planned Projects — Salt Lake City

10_8 Program Project SF/ Count Status Es�matedCost

.

Ac�ve Minor Construc�on¹

Ac�ve NRMs¹

Construct Rehab/Prosthe�cs & Ortho/Neuro/Holis�c Medicine Addi�on (B.01) (660-302)Gait & Prosthe�cs Lab Addi�on (660-337)Genomic Medicine Addi�on (660-801)Parking Garage Expansion, Phase 2 (660-336)Urgent Care and Support Expansion (660-332)AMU Renova�on (660-18-254)B.08 Gait Lab Addi�on (660-CSI-105)B.2 Upgrades / Asbestos Abatement (660-17-228)B.7, B.35, B.37 Research Renova�on (660-17-104)B.9 (HBPC) Home Based Primay Care (660-19-03S)Campus Chilled Water Study (660-18-235)Campus wide Rekey (660-15-35S)Chilled Water and HVAC Upgrade, B.14 (660-15-108)Combined Heat and Power Plant (660-14-130)Consolidate Intensive Care Units (ICUs) (660-18-237)Construct Emergency Water Storage (660-15-112)CT Site Prep (660-CSI-112)Damper/Penetra�on Project (660-18-03S)Demolish Building 1 G Zone (660-18-232)Domes�c Water Study (660-18-241)

23,5008,000

16,84983,00035,130

4,5673,000

2,366

14,600

1,250

Construc�on Awarded 09/28/16Design Awarded 09/04/14

PlannedConstruc�on Awarded 09/28/16Construc�on Awarded 09/28/16Construc�on Awarded 12/28/18Construc�on Awarded 07/17/14

Design Awarded 07/31/18Design Awarded 09/24/18

PlannedDesign Awarded 09/21/18



PlannedConstruc�on Awarded 06/24/19Construc�on Awarded 06/01/18Construc�on Awarded 07/11/19

Design Awarded 09/19/18

$9,964,000$5,500,000

$15,900,000$9,900,000$9,850,000

$962,500$2,108,105

$853,000$2,825,000

$60,000$534,433

$2,515,000$3,300,000$8,927,137$5,830,000$2,700,000

$825,000$92,500

$800,000$300,000

11111111111111111111

Electrical Study (660-18-236) Design Awarded 09/19/18 $240,000 1


.

Ac�ve Minor Construc�on¹

Ac�ve NRMs¹

Construct Rehab/Prosthe�cs & Ortho/Neuro/Holis�c Medicine Addi�on (B.01) (660-302)Gait & Prosthe�cs Lab Addi�on (660-337)Genomic Medicine Addi�on (660-801)Parking Garage Expansion, Phase 2 (660-336)Urgent Care and Support Expansion (660-332)AMU Renova�on (660-18-254)B.08 Gait Lab Addi�on (660-CSI-105)B.2 Upgrades / Asbestos Abatement (660-17-228)B.7, B.35, B.37 Research Renova�on (660-17-104)B.9 (HBPC) Home Based Primay Care (660-19-03S)Campus Chilled Water Study (660-18-235)Campus wide Rekey (660-15-35S)Chilled Water and HVAC Upgrade, B.14 (660-15-108)Combined Heat and Power Plant (660-14-130)Consolidate Intensive Care Units (ICUs) (660-18-237)Construct Emergency Water Storage (660-15-112)CT Site Prep (660-CSI-112)Damper/Penetra�on Project (660-18-03S)Demolish Building 1 G Zone (660-18-232)Domes�c Water Study (660-18-241)

23,5008,000

16,84983,00035,130

4,5673,000

2,366

14,600

1,250


PlannedConstruc�on Awarded 09/28/16Construc�on Awarded 09/28/16Construc�on Awarded 12/28/18Construc�on Awarded 07/17/14

Design Awarded 07/31/18Design Awarded 09/24/18




PlannedConstruc�on Awarded 06/24/19Construc�on Awarded 06/01/18Construc�on Awarded 07/11/19


$9,964,000$5,500,000

$15,900,000$9,900,000$9,850,000

$962,500$2,108,105

$853,000$2,825,000

$60,000$534,433

$2,515,000$3,300,000$8,927,137$5,830,000$2,700,000

$825,000$92,500

$800,000$300,000

11111111111111111111

Electrical Study (660-18-236) Design Awarded 09/19/18 $240,000 1

Source: 1. Capital Assets database (PTR as of 9-4-19) 2. Strategic Capital Investment Plan (FY2020 submission) 3. CFM Major Construc�on Monthly Report, ORP Project Repor�ng, CAI Proposed (New) Leases (9-7-19)

185




10.8.V19.SaltLakeCity.660#2

Facili�es Ac�ve and Planned Projects — Salt Lake City, cont.


.

Ac�ve NRMs¹ Energy Efficiency Building Improvements B.2,4,5,6,9 (660-15-121)Energy Efficiency, Commissioning Correc�ons (660-16-102)Expand Linen Distribu�on Center (660-18-243)Facility Roof Replacements (660-18-239)FY19 Under 25K (660-19-MISC19)Install Mental Health Door Alarms (660-19-105)Interven�onal Radiology Site Prep (660-CSI-111)Legionella - Mixing Valves, Schema�cs, Controls (660-15-111)MRI Site Prep (660-CSI-110)PET Scanner Site Prep (660-CSI-108)Pharmacy - USP 800 (660-19-104)Renovate Inpa�ent Substance Abuse (660-18-100)Replace Boiler #1 (660-17-100)Replace Cri�cal Power UPS and PDUs (660-18-242)Replace DA Tank and Expand Propane Storage (660-17-234)Solar PV Parking Garage (660-16-101)SPEC CT Imaging Site Prep (660-CSI-109)Specialty Clinic Renova�on (660-19-18S)Upgrade Elevators (660-18-231)Upgrade Fire Alarms (660-17-101)

10,000

8,571

700700

9,2001,000

4502,000

Construc�on Awarded 09/18/17Design Awarded 08/28/16Design Awarded 12/31/18

Construc�on Awarded 01/07/19Construc�on Awarded 10/25/18

PlannedDesign Awarded 07/03/18Design Awarded 05/03/18Design Awarded 09/19/18Design Awarded 08/06/18

PlannedConstruc�on Awarded 08/01/19

Design Awarded 08/08/18Construc�on Awarded 06/12/19Construc�on Awarded 05/29/19




$988,000$1,376,500$2,280,000$3,000,000

$200,000$200,000

$3,850,000$2,500,000

$209,000$280,000

$1,700,000$3,734,972$3,875,000

$880,000$1,430,000$4,180,000

$130,000$185,000

$3,200,000$1,679,700

11111111111111111111

Upgrade Public Address Mass No�fica�on System (PAMNS) (660-16-122) Design Awarded 12/20/17 $4,800,000 1


.

Ac�ve NRMs¹ Energy Efficiency Building Improvements B.2,4,5,6,9 (660-15-121)Energy Efficiency, Commissioning Correc�ons (660-16-102)Expand Linen Distribu�on Center (660-18-243)Facility Roof Replacements (660-18-239)FY19 Under 25K (660-19-MISC19)Install Mental Health Door Alarms (660-19-105)Interven�onal Radiology Site Prep (660-CSI-111)Legionella - Mixing Valves, Schema�cs, Controls (660-15-111)MRI Site Prep (660-CSI-110)PET Scanner Site Prep (660-CSI-108)Pharmacy - USP 800 (660-19-104)Renovate Inpa�ent Substance Abuse (660-18-100)Replace Boiler #1 (660-17-100)Replace Cri�cal Power UPS and PDUs (660-18-242)Replace DA Tank and Expand Propane Storage (660-17-234)Solar PV Parking Garage (660-16-101)SPEC CT Imaging Site Prep (660-CSI-109)Specialty Clinic Renova�on (660-19-18S)Upgrade Elevators (660-18-231)Upgrade Fire Alarms (660-17-101)

10,000

8,571

700700

9,2001,000

4502,000

Construc�on Awarded 09/18/17Design Awarded 08/28/16Design Awarded 12/31/18


PlannedDesign Awarded 07/03/18Design Awarded 05/03/18Design Awarded 09/19/18Design Awarded 08/06/18

PlannedConstruc�on Awarded 08/01/19

Design Awarded 08/08/18Construc�on Awarded 06/12/19Construc�on Awarded 05/29/19




$988,000$1,376,500$2,280,000$3,000,000

$200,000$200,000

$3,850,000$2,500,000

$209,000$280,000

$1,700,000$3,734,972$3,875,000

$880,000$1,430,000$4,180,000

$130,000$185,000

$3,200,000$1,679,700

11111111111111111111

Upgrade Public Address Mass No�fica�on System (PAMNS) (660-16-122) Design Awarded 12/20/17 $4,800,000 1


186




10.8.V19.SaltLakeCity.660#3

Facili�es Ac�ve and Planned Projects — Salt Lake City, cont.


.

Ac�ve NRMs¹

Ac�ve Projects Total Es�mated Cost (Major, Minor, NRM)¹Minor Leases in Procurement

SCIP FY2020 Submi�ed Projects (10-Year-Plan)

USP 800/797 Upgrade (Terminal HEPA) (660-19-110)Whole Health (660-18-252)Ac�ve Projects Total Es�mated Cost (Major, Minor, NRM)Replacement Lease of Ogden CBOC (Proposed New)Replacement Lease Orem CBOC (Proposed New)Minor Construc�onMinor LeasesNRM-Infrastructure Moderniza�onNRM-SustainmentTotal Es�mated Cost SCIP Projects

2,100

23,2586,578

4392

18


Proposed New (CAI)Proposed New (CAI)

$119,000$618,000

$125,401,847$794,883$405,894

$44,230,000$11,981,000$36,710,000

$9,285,000$102,206,000

1111111111


.

Ac�ve NRMs¹

Ac�ve Projects Total Es�mated Cost (Major, Minor, NRM)¹Minor Leases in Procurement

SCIP FY2020 Submi�ed Projects (10-Year-Plan)

USP 800/797 Upgrade (Terminal HEPA) (660-19-110)Whole Health (660-18-252)Ac�ve Projects Total Es�mated Cost (Major, Minor, NRM)Replacement Lease of Ogden CBOC (Proposed New)Replacement Lease Orem CBOC (Proposed New)Minor Construc�onMinor LeasesNRM-Infrastructure Moderniza�onNRM-SustainmentTotal Es�mated Cost SCIP Projects

2,100

23,2586,578

4392

18


Proposed New (CAI)Proposed New (CAI)

$119,000$618,000

$125,401,847$794,883$405,894

$44,230,000$11,981,000$36,710,000

$9,285,000$102,206,000

1111111111


187

Mission

188

Mission

Source: Facility Summary Report provided by Office of Academic Affiliation 11.1.V19.SaltLakeCity.660

*Base Posi�ons = Training Posi�ons, GME = Graduate Medical Educa�on, VACAA = Addi�onal GME Slots aligned to The Veterans Access, Choice, and Accountability Act of 2014 (VACAA).



Medical Educa�on/Training – Salt Lake City11_1 Sponsoring Facility Program Type Specialty D

O

Salt Lake City VAMCUniversity of Utah Medical Center

DentalGMEGMEGMEGMEVACAAGMEGMEGMEVACAAGMEGMEGMEGMEGMEVACAAGMEGMEGME

Den�stry - General Prac�ce Residency 12 MonthsAddic�on MedicineAddic�on psychiatryAnesthesiologyCardiovascular diseaseCardiovascular diseaseChief Resident (IM - Quality and Pa�ent Safety)Chief Resident (IM)DermatologyDermatologyEmergency medicineEndocrinology, diabetes, and metabolismFamily medicineGastroenterologyGeriatric medicineGeriatric medicineHematology and OncologyHospice and pallia�ve medicine (mul�disciplinary)Infec�ous Disease

4.00.01.02.06.01.02.03.03.01.02.01.51.04.02.00.32.00.22.0

123456789

10111213141516171819

Sponsoring Facility Program Type Specialty AY 2019 Training Positions (FTEs)*

DO

Salt Lake City VAMCUniversity of Utah Medical Center

DentalGMEGMEGMEGMEVACAAGMEGMEGMEVACAAGMEGMEGMEGMEGMEVACAAGMEGMEGME

Den�stry - General Prac�ce Residency 12 MonthsAddic�on MedicineAddic�on psychiatryAnesthesiologyCardiovascular diseaseCardiovascular diseaseChief Resident (IM - Quality and Pa�ent Safety)Chief Resident (IM)DermatologyDermatologyEmergency medicineEndocrinology, diabetes, and metabolismFamily medicineGastroenterologyGeriatric medicineGeriatric medicineHematology and OncologyHospice and pallia�ve medicine (mul�disciplinary)Infec�ous Disease

4.00.01.02.06.01.02.03.03.01.02.01.51.04.02.00.32.00.22.0

123456789

10111213141516171819

189

Mission

Source: Facility Summary Report provided by Office of Academic Affiliation 11.1.V19.SaltLakeCity.660#2




Medical Educa�on/Training – Salt Lake City, cont.11_1 Sponsoring Facility Program Type Specialty D

O

University of Utah Medical Center GMEVACAAGMEGMEGMEGMEVACAAGMEGMEVACAAGMEGMEGMEGMEGMEGMEVACAAGMEVACAA

Internal medicineInternal medicineInterven�onal cardiologyNephrologyNeurological surgeryNeurologyNeurologyObstetrics and gynecologyOphthalmologyOphthalmologyOrthopaedic surgeryOtherOtolaryngologyPain MedicinePathology-Anatomic and ClinicalPhysical medicine and rehabilita�onPhysical medicine and rehabilita�onPlas�c surgeryPlas�c surgery - integrated

46.49.11.02.01.06.01.00.33.01.05.01.02.00.70.05.02.01.01.0

20212223242526272829303132333435363738


DO

University of Utah Medical Center GMEVACAAGMEGMEGMEGMEVACAAGMEGMEVACAAGMEGMEGMEGMEGMEGMEVACAAGMEVACAA

Internal medicineInternal medicineInterven�onal cardiologyNephrologyNeurological surgeryNeurologyNeurologyObstetrics and gynecologyOphthalmologyOphthalmologyOrthopaedic surgeryOtherOtolaryngologyPain MedicinePathology-Anatomic and ClinicalPhysical medicine and rehabilita�onPhysical medicine and rehabilita�onPlas�c surgeryPlas�c surgery - integrated

46.49.11.02.01.06.01.00.33.01.05.01.02.00.70.05.02.01.01.0

20212223242526272829303132333435363738

190

Mission






O

University of Utah Medical Center

Other Training Programs

GMEGMEGMEGMEGMEGMEGMEGMEGMEVACAAGMEAdvanced FellowsAdvanced FellowsAssociated HealthAdvanced FellowsAdvanced FellowsNursingNursingNursing

Preven�ve medicinePsychiatryPulmonary disease and cri�cal care medicineRadiology-diagnos�cRheumatologySleep MedicineSurgery-generalThoracic surgeryUrologyUrologyVascular surgeryAdvanced Geriatrics (GRECC)Advanced Psychology (MIRECC)Audiology Doctoral Extern (4th Year)Medical Informa�cs (MD)Medical Informa�cs (PhD)Nursing - Clinical Nurse SpecialistNursing - Nurse Prac��onerNursing - Nurse Prac��oner (NP)

2.010.2

3.09.02.50.35.30.53.01.01.02.51.01.02.04.20.0

25.06.0

39404142434445464748495051525354555657


DO

University of Utah Medical Center

Other Training Programs

GMEGMEGMEGMEGMEGMEGMEGMEGMEVACAAGMEAdvanced FellowsAdvanced FellowsAssociated HealthAdvanced FellowsAdvanced FellowsNursingNursingNursing

Preven�ve medicinePsychiatryPulmonary disease and cri�cal care medicineRadiology-diagnos�cRheumatologySleep MedicineSurgery-generalThoracic surgeryUrologyUrologyVascular surgeryAdvanced Geriatrics (GRECC)Advanced Psychology (MIRECC)Audiology Doctoral Extern (4th Year)Medical Informa�cs (MD)Medical Informa�cs (PhD)Nursing - Clinical Nurse SpecialistNursing - Nurse Prac��onerNursing - Nurse Prac��oner (NP)

2.010.2

3.09.02.50.35.30.53.01.01.02.51.01.02.04.20.0

25.06.0

39404142434445464748495051525354555657

191

Mission






O

Other Training Programs NursingAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated Health

Nursing - ResidencyNutri�on/Diete�cs InternOccupa�onal TherapyOptometry ResidentPharmacy ResidentPhysical TherapyPhysician Assistant (Masters)Podiatry ResidentPsychologySocial WorkSpeech Pathology Fellow

10.05.07.02.07.0

21.012.0

8.013.015.0

1.0

5859606162636465666768


DO

Other Training Programs NursingAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated HealthAssociated Health

Nursing - ResidencyNutri�on/Diete�cs InternOccupa�onal TherapyOptometry ResidentPharmacy ResidentPhysical TherapyPhysician Assistant (Masters)Podiatry ResidentPsychologySocial WorkSpeech Pathology Fellow

10.05.07.02.07.0

21.012.0

8.013.015.0

1.0

5859606162636465666768

192

Mission


*Base Positions = Training Positions



Medical Educa�on/Training – Salt Lake City, cont.

193

talligood001

Stamp

Funding Group Number ofProjects

Reported CostFY17

.

Department of Veterans Affairs (VACO)Other U.S. Federal AgencyPrivate Proprietary CompanyNa�onal Ins�tutes of Health (NIH)Academic Ins�tu�on, Donor, or GovernmentVoluntary Agency or Founda�on

811824171510

$12,329,581$3,547,168$2,442,186$2,061,782

$884,998$353,588

12329581354716824421862061782

884998353588

TOTAL 165 $21,619,303 21619303

Research dollars for the Quality Enhancement Research Ini�a�ve (QUERI) are included in the formula for alloca�ng research support dollars.

Medical Center % Na�onal 2019VERA Alloca�on

Total Research VERAAlloca�on

DisplayOrder

(V19) (660) Salt Lake CityNa�onal Total

2.0%100.0%

$21,619,303$1,067,382,760

12

Source: FY2019 VERA Research Back Up Data and Allocation on file 11.3.V19.SaltLakeCity.660



Mission

VERA Alloca�on

Total VAMC Supported Research Projects

2019 VERA Alloca�on vs Average Na�onal Alloca�on*

$0

$5,000,000

$10,000,000

$15,000,000

$20,000,000

$25,000,000$21,619,303

$11,411,136

VAMC Na�onal Average

*96 VAMCs received VERA Alloca�on for FY19

Rank: 20 out of 96 research sites (ranked by total funding)

2019 VERA Alloca�on vs Average Na�onal Alloca�on*

Research – Salt Lake City

194

Project Name FY17 Actual Funding¹ .

Veterans Informa�cs and Compu�ng Infrastructure (VINCI): Opera�onal ProtocolDevelopment of highly Func�onal, Neurally Controlled, Skeletally A�ached, andIntelligent Prosthe�c DevicesEpidemiology, Treatment prac�ces and outcomes of malignancies in VHA: Prac�ces,Resource U�liza�on, treatment Effec�veness across CLL Illness trajectory in actualprac�ce Se�ngs in the modern Era with focus on Relapsed/Refractory disease(PRECISE-Salt Lake Informa�cs, Decision-Enhancement and Analy�c Sciences Center (IDEAS2.0) / Center of Innova�on (COIN)Enable NHSN Enrollment of All VA Medical Centers and Report An�microbial Useand Resistance Data.

$1,390,450$874,517

$820,996

$748,200

$517,177

1390450874517

820996

748200

517177

Project Title FY17 Actual Funding¹ .

Veterans Informa�cs and Compu�ng Infrastructure (VINCI): Opera�onal ProtocolSalt Lake Informa�cs, Decision-Enhancement and Analy�c Sciences Center (IDEAS2.0) / Center of Innova�on (COIN)Immune responses in trauma�c RGC deathCollec�ng duct renin regula�on of blood pressure in health and hypertensionVascular Func�on in Health and Disease: Rehabilita�on for Hypertension andAlzheimer's Disease; Excercise and Skeletal Muscle Afferent Feedback; Passive limbmovement: A tool to assess vascular health and guide rehabilita�on.

$1,390,450$748,200

$466,355$418,269$319,946

1390450748200

466355418269319946

Research – Salt Lake City, cont.

Top 5 VACO-Funded Projects by $

Source: FY17 Research Submissions by VISN and Facility 11.4.V19.SaltLakeCity.6601. The project’s actual (non-discounted) grant dollars.



MissionTop 5 Projects by Funding $

195

Cost

196




Cost Conceptual Cost Analysis for Inpa�ent Services – Methodology Overview

Source: 1. MCAO Discharge Na onal Data Extract, adjusted by ne ng out Fixed Indirect overhead as calculated by MCAO 2. 2018 CMS Medicare Standard AnalyticalFiles (SAF) from Definitive Healthcare limited by a 50 mile radius from the parent facility 3. Based on JAMA study ‘Administrative Costs Associated With Physician Billing and Insurance-Related Ac vi es at an Academic Health Care System,’ February 20, 2018 4. Office of Community Care


Conceptual Cost Analysis for Inpa�ent Services – Salt Lake City




Cost


VISN 19 Salt Lake City Market Data Discovery & Findings Informational Addendum – Enrollment Proximity Analysis

199

VA Market Area Health Systems Optimization


Access Enrollment Proximity to VA Site (HSA and HRR Alignment)

2

200



Access Enrollment Proximity to VA Site (30- and 60-minute Drive Times)*

3

* VA sites include VAMCs, HCCs, MS CBOCs, CBOCs, and OOS; drive times are not comparable to Primary and Secondary Care Enrollment Access measures as defined by PSSG.

201



Access Enrollment Proximity to VA Site* by Facility

4

Facility NameFacility

Classification

Total (Overlapping)** Non-Overlapping***30 min 60 min 30 min 60 min

Enrollees Users Enrollees Users Enrollees Users Enrollees Users(V19) (660) Salt Lake City VAMC 20,132 12,956 43,235 26,002 6,813 4,352 7,123 4,538(V19) (660GA) Pocatello CBOC 3,296 2,355 6,685 4,722 3,296 2,355 3,816 2,746(V19) (660GB) Ogden CBOC 14,770 8,374 38,046 23,166 8,655 5,026 10,560 6,143(V19) (660GD) Roosevelt OOS 509 399 1,121 818 509 399 1,121 818(V19) (660GE) Orem CBOC 10,510 5,986 31,968 19,624 7,600 4,169 8,391 4,662(V19) (660GG) St. George CBOC 4,200 2,834 6,663 4,384 4,200 2,834 6,663 4,384(V19) (660GJ) Western Salt Lake MS-CBOC 24,265 15,447 43,480 26,134 15,343 9,894 15,635 10,080(V19) (660GK) Elko OOS 1,207 728 1,268 770 1,207 728 1,268 770(V19) (660QA) Idaho Falls OOS 3,462 2,399 7,292 5,096 3,462 2,399 4,112 2,829(V19) (660QB) Price OOS 622 433 710 496 622 433 710 496(V19) (660QC) Weber County OOS 14,770 8,374 38,808 23,663 4,708 2,498 4,734 2,514

FY18Q4 Enrollment by ZIP Code. Enrollee population within each Point of Care’s (POC) drive time (30 and 60 minutes) was calculated by intersecting the drive-time area and the ZIP Code Centroid, then aggregating the ZIP code population to the POC.

* VA sites include VAMCs, HCCs, MS CBOCs, CBOCs, and OOS; drive times are not comparable to Primary and Secondary Care Enrollment Access measures as defined by PSSG. ** Drive time polygons overlap and may include ZIP code population assigned to two or more POC.*** Drive time polygons are adjusted to closest facility to eliminate overlap and duplication of ZIP code population assignment to a POC.

202



Access Enrollment Proximity to VA Site* by County

5

CountyName

TotalEnrollees

Enrollees Outside of 30-Minute Drive Time


Bannock, ID 2,719 121 0

Bear Lake, ID 160 160 59Beaver, UT 140 140 140Bingham, ID 1,084 93 0Bonneville, ID 2,624 38 0Box Elder, UT 1,053 973 33Cache, UT 1,526 1,526 688Carbon, UT 556 0 0Caribou, ID 177 177 145Clark, ID 14 14 0Daggett, UT 47 47 47Davis, UT 7,868 0 0Duchesne, UT 486 56 38Elko, NV 1,431 224 163Emery, UT 197 131 9Franklin, ID 226 226 226Fremont, ID 343 343 124Garfield, UT 157 157 157Iron, UT 1,303 1,303 178Jefferson, ID 610 27 0Juab, UT 216 216 0Kane, UT 241 241 241Madison, ID 352 352 0Millard, UT 236 236 236Morgan, UT 228 4 0

FY18Q4 Enrollment by ZIP Code. Enrollee population within each Point of Care’s (POC) drive time (30 and 60 minutes) was calculated by intersecting the drive-time area and the ZIP Code Centroid, then aggregating the ZIP code population to the POC.

* VA sites include VAMCs, HCCs, MS CBOCs, CBOCs, and OOS; drive times are not comparable to Primary and Secondary Care Enrollment Access measures as defined by PSSG.

CountyName

TotalEnrollees



Oneida, ID 151 151 5

Piute, UT 47 47 47Power, ID 133 133 0Rich, UT 39 33 21Salt Lake, UT 19,093 1 1Sanpete, UT 621 621 515Sevier, UT 519 519 519Summit, UT 583 333 0Teton, ID 140 140 140Tooele, UT 1,835 457 110Uintah, UT 673 594 0Utah, UT 6,388 47 0Wasatch, UT 379 367 0Washington, UT 4,412 212 0Wayne, UT 55 55 55Weber, UT 6,725 127 0White Pine, NV 391 391 391

203

VISN 19 Data Discovery & Findings Informational Addendum – DOD Data

204

VISN 19-f Salt Lake City

22

205



Market OverviewDemographics

Source: 1. BY17 EHCPM 2. VSSC Unique Patients Cube 3. DoD M2 Data System

Existing VHA-DOD Construct

23

Key Market Statistics

Total 2017 VA Enrollee Population: 67,400

• Top Counties by Enrollee Population:

o Salt Lake, UT: 20,618

o Davis, UT: 7,758

o Weber, UT: 6,654

• Total Enrollees: 56thof 96 markets

2018 Core Uniques*: 43,321

VAMC:

• (V19) (660) Salt Lake City

DOD Clinic:

• (119) AF-C-75th MED GRP-HILL

*Core uniques excludes uniques who have only usedtelephone triage, pharmacy, and lab.

206

Click to edit Master title style

Post-DD&F Data Addendum

Data Compendium - General Information


PurposeThe Data Discovery and Findings (DD&F) data books prepared for each market presented a standardized collection of data used across markets to understand important aspects of each market. Because of the passage of time since the original market assessment phases were conducted, VA has developed an appendix to the DD&F to capture more recent data for key data points. Because the COVID-19 pandemic impacted 2020 and 2021 data, 2019 was the latest fiscal year incorporated for most data elements.

ContentsProjected PopulationRuralityOutpatient DemandOutpatient EncountersSpecialty Care EncountersSurgical CasesInpatient Demand (Facility Level)Market DemandEnrollment ProximityFacilityBuilding FCAAcademic MissionResearch MissionFootnotesSources

Additional InformationThe Footnotes page provides additional details about tables and individual data elements when required. The Sources page provides the relevant data cube or program office sourcing information for each of the data elements.

Projected Veteran Enrollee and Eligible Population (Market)


Market Group FY19 FY29 10 Year % Growth

(V19) Salt Lake City Eligible Veterans 108,897 98,553 -9.5%

Enrollees 68,864 69,576 1.0%

Market Population Rank (out of 95 markets)


Market Total Enrollee Rank FY19

Total Enrollee Rank FY29

% Change Rank

(V19) Salt Lake City 54 50 28

County-Based Enrollee Projections


Market Sector County FY19 Enrollees FY29 Enrollees 10 Year % Change

(V19) Salt Lake City 19-f-9-A (49035) Salt Lake, UT 20,232 18,666 -7.7%

19-f-9-B (32007) Elko, NV 1,433 1,371 -4.3%

(32033) White Pine, NV 389 368 -5.6%

(49001) Beaver, UT 146 146 0.0%

(49003) Box Elder, UT 1,066 1,114 4.5%

(49005) Cache, UT 1,557 1,647 5.8%

(49007) Carbon, UT 568 527 -7.3%

(49009) Daggett, UT 50 41 -17.8%

(49013) Duchesne, UT 488 457 -6.2%

(49015) Emery, UT 211 187 -11.3%

(49017) Garfield, UT 157 151 -3.5%

(49021) Iron, UT 1,387 1,368 -1.4%

(49023) Juab, UT 218 201 -7.9%

(49025) Kane, UT 257 248 -3.5%

(49027) Millard, UT 254 237 -6.9%

(49029) Morgan, UT 243 302 24.5%

(49031) Piute, UT 49 48 -0.1%

(49033) Rich, UT 41 41 -0.7%

(49039) Sanpete, UT 647 636 -1.6%

(49041) Sevier, UT 540 527 -2.4%

(49043) Summit, UT 580 584 0.7%

(49045) Tooele, UT 1,868 1,960 5.0%

(49047) Uintah, UT 678 632 -6.8%

(49049) Utah, UT 6,589 6,781 2.9%

(49051) Wasatch, UT 395 391 -1.3%

(49053) Washington, UT 4,658 4,960 6.5%

(49055) Wayne, UT 61 52 -14.6%

19-f-9-D (49011) Davis, UT 8,053 9,014 11.9%

(49057) Weber, UT 7,052 7,786 10.4%

19-f-9-E (16005) Bannock, ID 2,767 2,803 1.3%

(16007) Bear Lake, ID 174 164 -5.9%

(16011) Bingham, ID 1,111 1,124 1.1%

County-Based Enrollee Projections


Market Sector County FY19 Enrollees FY29 Enrollees 10 Year % Change

(V19) Salt Lake City 19-f-9-E (16019) Bonneville, ID 2,748 2,835 3.2%

(16029) Caribou, ID 178 167 -6.2%

(16033) Clark, ID 12 14 21.2%

(16041) Franklin, ID 237 249 5.1%

(16043) Fremont, ID 342 332 -2.8%

(16051) Jefferson, ID 642 651 1.5%

(16065) Madison, ID 374 375 0.2%

(16071) Oneida, ID 146 151 2.8%

(16077) Power, ID 140 146 3.9%

(16081) Teton, ID 127 122 -3.8%

Projected Veteran Enrollee and Eligible Population (Demographics)


Market Group Measure Description

Measure Categories

FY19 FY29 10 Year % Change

(V19) Salt Lake City Eligible Veterans Age <45 31,598 28,266 -10.5%

45-64 27,292 29,834 9.3%

65+ (Combination)

50,007 40,453 -19.1%

65-84 40,111 32,982 -17.8%

85-89 6,180 4,495 -27.3%

90+ 3,716 2,976 -19.9%

Gender Female 8,809 10,967 24.5%

Male 100,088 87,586 -12.5%

Priority Priority 1-6 83,891 79,259 -5.5%

Priority 7-8 25,006 19,294 -22.8%

Enrollees Age <45 18,652 16,517 -11.4%

45-64 18,083 23,189 28.2%

65+ (Combination)

32,129 29,870 -7.0%

65-84 26,780 25,232 -5.8%

85-89 3,393 2,875 -15.3%

90+ 1,956 1,763 -9.9%

Gender Female 4,986 7,311 46.6%

Male 63,878 62,265 -2.5%

Priority Priority 1-6 52,129 58,471 12.2%

Priority 7-8 16,735 11,105 -33.6%

Market Enrollment Rurality (FY19)


Market Rural Enrollees Total Enrollees % Rurality

(V19) Salt Lake City 16,629 67,055 24.8%

County Enrollment Rurality


Market County Rural Enrollee Total Enrollees % Rurality

(V19) Salt Lake City Bannock, ID 357 2,677 13.3%

Bear Lake, ID 171 171 100.0%

Beaver, UT 134 134 100.0%

Bingham, ID 1,064 1,069 99.5%

Bonneville, ID 205 2,715 7.6%

Box Elder, UT 458 1,043 43.9%

Cache, UT 148 1,513 9.8%

Carbon, UT 548 548 100.0%

Caribou, ID 167 167 100.0%

Clark, ID 13 13 100.0%

Daggett, UT 49 49 100.0%

Davis, UT 0 8,094 0.0%

Duchesne, UT 439 439 100.0%

Elko, NV 1,432 1,432 100.0%

Emery, UT 200 200 100.0%

Franklin, ID 231 231 100.0%

Fremont, ID 325 325 100.0%

Garfield, UT 154 154 100.0%

Iron, UT 1,387 1,387 100.0%

Jefferson, ID 580 580 100.0%

Juab, UT 245 245 100.0%

Kane, UT 251 251 100.0%

Madison, ID 375 375 100.0%

Millard, UT 234 234 100.0%

Morgan, UT 228 228 100.0%

Oneida, ID 139 139 100.0%

Piute, UT 50 50 100.0%

Power, ID 168 168 100.0%

Rich, UT 41 41 100.0%

Salt Lake, UT 10 19,622 0.1%

Sanpete, UT 624 624 100.0%

Sevier, UT 519 519 100.0%

County Enrollment Rurality


Market County Rural Enrollee Total Enrollees % Rurality

(V19) Salt Lake City Summit, UT 571 571 100.0%

Teton, ID 134 134 100.0%

Tooele, UT 1,816 1,816 100.0%

Uintah, UT 680 680 100.0%

Utah, UT 405 6,422 6.3%

Wasatch, UT 413 413 100.0%

Washington, UT 1,021 4,493 22.7%

Wayne, UT 59 59 100.0%

Weber, UT 214 6,660 3.2%

White Pine, NV 370 370 100.0%

FY19 Market Core Uniques


Market Name Core Uniques

(V19) Salt Lake City 44,182

Core Uniques


Market Facility FY15 FY16 FY17 FY18 FY19 5 Year % Change

(V19) Salt Lake City (V19) (660) George E. Wahlen Department of Veterans Affairs Medical Center

49,818 50,379 56,825 58,557 58,978 18.4%

(V19) (660BU) Salt Lake City Domiciliary 277 132 139 127 119 -57.0%

(V19) (660GB) Ogden VA Clinic 5,583 5,886 5,706 5,699 5,556 -0.5%

(V19) (660GD) Roosevelt VA Clinic 755 714 739 739 744 -1.5%

(V19) (660GE) Orem VA Clinic 3,555 3,578 3,452 3,157 3,278 -7.8%

(V19) (660GG) St. George VA Clinic 3,500 3,836 4,015 3,884 4,447 27.1%

(V19) (660GJ) South Jordan VA Clinic 6,388 5,828 6,526 6,161 6,155 -3.6%

(V19) (660GK) Elko VA Clinic 618 605 579 639 667 7.9%

(V19) (660QA) Idaho Falls VA Clinic 548 1,314 2,270

(V19) (660QB) Price VA Clinic 202 407 487

Emergency Department (ED) Encounters


Market Facility Measure FY17 FY18 FY19 3 Year % Change

(V19) Salt Lake City (V19) (660) Salt Lake City 99281 131 190 249 90.1%

99282 974 803 1,259 29.3%

99283 9,073 7,814 7,228 -20.3%

99284 7,193 8,842 7,444 3.5%

99285 2,807 2,444 3,150 12.2%

Total Encounters 20,178 20,093 19,330 -4.2%

ED % Transfers & Admissions


Market Description Facility Measure FY17 FY18 FY19

(V19) Salt Lake City (V19) (660) Salt Lake City % Transfers 2.9% 3.0% 2.2%

VA Admission % 16.8% 17.5% 17.7%

Outpatient Encounters (FY17-19)


Market Facility Clinic Grouping FY17 FY18 FY19 3 Year % Change

(V19) Salt Lake City (V19) (660) Salt Lake City Mental Health 115,086 133,646 134,626 17.0%

Primary Care 61,275 68,717 75,540 23.3%

Specialty Care 448,825 460,331 461,998 2.9%

(V19) (660GA) Pocatello Mental Health 5,322 4,477 4,611 -13.4%

Primary Care 15,309 14,266 13,655 -10.8%

Specialty Care 7,027 6,526 9,710 38.2%

(V19) (660GB) Ogden Mental Health 8,273 7,432 3,717 -55.1%

Primary Care 18,027 17,659 17,554 -2.6%

Specialty Care 10,337 11,123 11,015 6.6%

(V19) (660GD) Roosevelt Mental Health 224 293 357 59.4%

Primary Care 2,201 2,182 2,707 23.0%

Specialty Care 277 313 413 49.1%

(V19) (660GE) Orem Mental Health 4,510 3,803 3,768 -16.5%

Primary Care 10,205 9,211 9,480 -7.1%

Specialty Care 7,703 7,840 8,108 5.3%

(V19) (660GG) St. George Mental Health 1,746 2,430 2,824 61.7%

Primary Care 10,118 10,472 11,943 18.0%

Specialty Care 10,873 10,985 11,642 7.1%

(V19) (660GJ) Western Salt Lake Mental Health 1,954 1,912 1,930 -1.2%

Primary Care 21,229 20,293 20,236 -4.7%

Specialty Care 4,508 4,054 3,354 -25.6%

(V19) (660GK) Elko Mental Health 122 177 348 185.2%

Primary Care 1,215 2,119 2,352 93.6%

Specialty Care 820 1,293 1,140 39.0%

(V19) (660QA) Idaho Falls Mental Health 69 387 820 1088.4%

Primary Care 646 3,053 5,792 796.6%

Specialty Care 795 3,351 3,617 355.0%

(V19) (660QB) Price Mental Health 72 252 218 202.8%

Primary Care 226 1,049 1,293 472.1%

Specialty Care 236 863 851 260.6%

Specialty Care Encounters (FY17-19)


Market Facility Specialty FY17 FY18 FY19 3 Year % Change


Allergy and Immunology

1,145 1,648 1,515 32.3%

Anesthesiology 6,272 7,689 9,375 49.5%

Audiology / Speech Pathology

17,714 17,848 17,549 -0.9%

Blind Rehabilitation 80 85 139 73.8%

Cardiology 25,508 25,313 26,881 5.4%

Critical Care / Pulmonary Disease

12,152 18,477 20,389 67.8%

Dermatology 7,150 6,941 7,195 0.6%

Emergency Medicine 20,483 20,483 19,460 -5.0%

Endocrinology 3,621 4,400 4,677 29.2%

Gastroenterology 7,242 7,293 7,914 9.3%

Geriatric Medicine 9,732 9,773 10,485 7.7%

Hematology-Oncology 5,919 6,179 6,073 2.6%

Infectious Disease 1,054 936 1,019 -3.3%

Nephrology 5,834 6,687 4,167 -28.6%

Neurological Surgery 1,010 1,394 2,146 112.5%

Neurology 5,157 5,493 5,323 3.2%

Nutrition 1,797 1,871 1,964 9.3%

Obstetrics & Gynecology

369 443 489 32.5%

Occupational Health 1,195 858 995 -16.7%

Ophthalmology 10,137 10,306 10,080 -0.6%

Optometry 20,254 19,110 17,942 -11.4%

Orthopaedic Surgery 6,251 6,500 6,182 -1.1%

Otolaryngology 2,894 2,920 2,806 -3.0%

Pain Medicine 3,547 3,796 5,711 61.0%

Pathology 146,794 145,613 142,353 -3.0%

Pharmacy 10,791 15,877 14,839 37.5%

Physical Medicine & Rehabilitation

24,083 26,900 26,466 9.9%

Plastic Surgery 722 716 815 12.9%





Podiatry 12,214 10,890 11,601 -5.0%

Prosthetics/Orthotics 4,359 2,664 3,691 -15.3%

Radiology 44,837 43,952 44,790 -0.1%

Rheumatology 3,579 3,189 2,876 -19.6%

Sleep Medicine 0 0 175

Surgery 15,401 14,862 14,412 -6.4%

Thoracic Surgery 322 369 438 36.0%

Urology 5,561 5,491 5,823 4.7%

Vascular Surgery 3,645 3,365 3,243 -11.0%

(V19) (660GA) Pocatello VA Clinic Audiology / Speech Pathology

16 1,653 3,848 23950.0%

Cardiology 445 363 333 -25.2%

Dermatology 23 6 5 -78.3%

Gastroenterology 44 48 56 27.3%

Nephrology 0 0 9

Nutrition 292 352 802 174.7%

Optometry 314 244 269 -14.3%

Pathology 5,002 2,854 2,709 -45.8%

Pharmacy 592 678 538 -9.1%


299 328 1,141 281.6%

(V19) (660GB) Ogden VA Clinic Audiology / Speech Pathology

155 145 144 -7.1%

Cardiology 228 268 221 -3.1%

Endocrinology 188 97 0 -100.0%

Nutrition 570 493 479 -16.0%

Optometry 89 55 22 -75.3%

Pain Medicine 0 0 80

Pathology 7,039 7,422 7,467 6.1%

Pharmacy 833 932 1,086 30.4%


1,235 1,711 1,516 22.8%

Podiatry 0 0 0




(V19) Salt Lake City (V19) (660GD) Roosevelt VA Clinic Audiology / Speech Pathology

67 68 64 -4.5%

Cardiology 10 17 16 60.0%

Pathology 200 228 333 66.5%

(V19) (660GE) Orem VA Clinic Audiology / Speech Pathology

117 148 125 6.8%

Cardiology 96 160 138 43.8%


Nutrition 851 664 631 -25.9%

Optometry 83 65 52 -37.3%

Pathology 5,046 4,584 4,521 -10.4%

Pharmacy 608 488 717 17.9%


871 1,731 1,924 120.9%

(V19) (660GG) St. George VA Clinic Audiology / Speech Pathology

3,052 3,960 4,103 34.4%

Cardiology 512 288 370 -27.7%

Critical Care / Pulmonary Disease

13 15 8 -38.5%

Dermatology 8 85 70 775.0%


Nutrition 529 290 169 -68.1%

Optometry 106 148 93 -12.3%

Orthopaedic Surgery 76 65 75 -1.3%

Pathology 4,865 4,750 4,890 0.5%

Pharmacy 715 540 790 10.5%


989 818 1,059 7.1%

(V19) (660GJ) South Jordan VA Clinic Audiology / Speech Pathology

1,468 1,593 1,556 6.0%

Cardiology 284 255 339 19.4%

Dermatology 0 70 0

Endocrinology 1,008 518 0 -100.0%

Nutrition 533 501 523 -1.9%

Optometry 140 144 9 -93.6%




(V19) Salt Lake City (V19) (660GJ) South Jordan VA Clinic Pathology 0 0 0

Pharmacy 398 390 331 -16.8%


677 583 596 -12.0%

(V19) (660GK) Elko VA Clinic Audiology / Speech Pathology

26 38 30 15.4%

Cardiology 19 28 13 -31.6%


Nutrition 9 16 18 100.0%

Optometry 23 94 43 87.0%

Pathology 689 1,072 1,036 50.4%

(V19) (660QA) Idaho Falls VA Clinic Cardiology 31 119 213 587.1%


Nutrition 30 156 138 360.0%

Optometry 32 159 164 412.5%

Pathology 657 2,602 2,742 317.4%

Pharmacy 6 28 26 333.3%


32 254 300 837.5%

(V19) (660QB) Price VA Clinic Audiology / Speech Pathology

8 22 33 312.5%

Cardiology 4 14 18 350.0%


Nutrition 14 54 46 228.6%

Optometry 12 20 7 -41.7%

Pathology 185 681 687 271.4%

Pharmacy 0 2 38


5 43 22 340.0%

Surgical Cases (FY15-19)


Market Facility Setting FY15 FY16 FY17 FY18 FY19 5 Year % Change


IP Cases 1,046 918 961 957 915 -12.5%

OP Cases 2,715 2,475 2,112 2,642 2,519 -7.2%

Historical VAMC ADC


Market Facility Bed Service FY15 FY16 FY17 FY18 FY19 5 Year % Change


Medical 31.6 30.1 33.6 32.7 32.9 4.1%

Mental Health 19.6 18.1 18.5 20.4 24 22.4%

Rehab Med 3.8 2.8 3.7 3.4 2.6 -31.6%

RRTP* 39.5 12.8 13.1 13.6 13 -67.1%

Surgery 17.5 13.7 12.7 11.9 12 -31.4%

Total Med/Surg

49.1 43.8 46.3 44.6 44.9 -8.6%

VAMC Total 112 77.5 81.6 82 84.5 -24.6%

FY19 RRTP Beds and ADC


Market Facility RRTP Service FY19 ADC Operational Beds

(V19) Salt Lake City Salt Lake City DOM SA 12.9 15

FY19 Community Capacity


Market Facility Bed Section Beds Beds Available % Occupancy

(V19) Salt Lake City Salt Lake City Acute 3,658 712 61.2%

Nursing Home 2,789 527 71.7%

Psych 305 8 77.8%

Rehab 115 3 80.7%

BY19 Projected Parent Facility ADC (EHCPM)


Market Parent Facility Bed Service Funding Source FY19 Actual

FY29 Projected

10 Year % Change

(V19) Salt Lake City Salt Lake City, UT HCS Acute Inpatient Med/Surg Community 15.9 19.8 24.3%

In-House 48.2 38.9 -19.4%

Acute Inpatient Medicine Community 10.9 14.7 34.5%

In-House 30.9 27.4 -11.3%

Acute Inpatient Mental Health Community 13.0 16.1 23.5%

In-House 23.9 23.2 -3.3%

Acute Inpatient Surgery Community 5.0 5.1 2.0%

In-House 17.3 11.5 -33.8%

Inpatient LTSS Community 86.4 125.1 44.8%

Inpatient Residential Rehab In-House 12.9 12.1 -6.1%

BY19 Projected Market ADC (EHCPM)


Market Planning Category Group Funding Source FY19 ADC Actual

FY29 ADC Projected

10 Year % Change

(V19) Salt Lake City Acute Inpatient Med/Surg Community 17.9 22.9 27.6%

In-House 42.3 33.8 -20.0%

Acute Inpatient Medicine Community 12.2 16.3 33.2%

In-House 27.8 24.3 -12.8%

Acute Inpatient Mental Health

Community 14.0 17.6 25.1%

In-House 21.8 21.0 -3.4%

Acute Inpatient Surgery Community 5.7 6.6 15.7%

In-House 14.5 9.6 -33.9%

Inpatient Blind Rehab Community 0.0 0.0

In-House 1.0 1.1 18.0%

Inpatient LTSS Community 85.7 124.0 44.7%

In-House 2.0 2.1 2.5%

Inpatient Residential Rehab Community 0.0 0.0

In-House 22.5 22.6 0.7%

Inpatient Spinal Cord Injury Community 0.0 0.0

In-House 2.4 1.8 -24.2%

BY18 RRTP Projected Market ADC (3D Model)


Market Market (BY18) RRTP Bed Section FY28 ADC FY28 Bed Need

(V19) Salt Lake City 19-f All Bed Sections 44.2 52

Dom Homeless 11.0 13

Gen Dom 14.9 17

PTSD 4.7 6

Substance Abuse 13.6 16

BY19 Projected Market RVUs (EHCPM)


Market Planning Category Group Funding Source FY19 RVUs Actual

FY29 RVUs Projected

10 Year % Change

(V19) Salt Lake City Amb LTSS Home and Community Based In-House 22,748 25,738 13.1%

Amb Medical Specialties Community 89,892 176,284 96.1%

In-House 196,437 300,403 52.9%

Amb Mental Health Programs Community 29,055 52,973 82.3%

In-House 235,013 401,110 70.7%

Amb Pathology Community 1,572 3,982 153.3%

In-House 12,807 19,364 51.2%

Amb Primary Care Community 16,347 46,937 187.1%

In-House 144,414 218,201 51.1%

Amb Radiology Community 24,073 38,022 57.9%

In-House 41,742 65,278 56.4%

Amb Rehab Therapies Community 46,736 83,770 79.2%

In-House 56,827 86,669 52.5%

Amb Surgical Specialties Community 36,226 76,938 112.4%

In-House 94,909 157,183 65.6%

Specialty Care (Amb Med/Surg/Rehab) Community 172,854 336,992 95.0%

In-House 348,174 544,256 56.3%

BY19 Projected Market Dental Procedures (EHCPM)


Market Funding Source FY19 Procedures

Actual

FY29 Procedures Projected

Projected % Change

(V19) Salt Lake City Community 6,470 9,315 44.0%

In-House 38,720 59,167 52.8%

Enrollment Proximity to Current VA Sites by Market


Market Market (FY18) Total Enrollees

Primary Care # of Enrollees

within 30 Min Drive Time

Primary Care % of Enrollees

within 30 Min Drive Time

Secondary Care # of Enrollees within 60 Min

Drive Time

Secondary Care % of Enrollees within 60 Min

Drive Time(V19) Salt Lake City 19-f 71,718 55,920 78.0% 45,584 63.6%

Real Property Overview


Market Facility Acres Available

Property Size

Main Patient Care Facility Construction

Date

Most Recent Renovation Date (Main

Hospital Building)

Estimated Annual

Operations and Maintenance

Cost

FCA Cost Seismic Risk

(V19) Salt Lake City Salt Lake City 0.0 81 1949 1988 $13,393,837 $225,881,300 High

Building FCA


Market Station Building No Function Title FCA Correction Cost

(V19) Salt Lake City Salt Lake City 1 Main Hospital $52,820,377

13 ChildCare $259,489

14 Main Hospital $38,364,080

16 Out Patient Mental Health $858,987

18 Emergency Prepardness $168,894

2 Research/Admin/Vacant $23,497,357

25 P & H Storage $74,060

27 Chiller Plant $5,366,177

29 Research $14,352

3 Mental Health Hospital $14,136,222

30 Research $35,421

32 Fisher House $17,555

35 Research ARF $60,491

37 Research ARF $261,631

38 Engineering $160,921

4 Vacant $3,164,484

40 Emergency Generator/Primary Switchgear $331,845

41 Emergency Generator/Switchgear $420,994

42 Brine Storage/Emergency Generator $56,001

44 Generator Structure $920

45 Research $685,107

47 Prosthetics Temp Lab $56,672

48 Parking Structure $4,600

5 Nutrition & Food $3,513,881

6 Boiler Plant/Shops $9,733,154

6A-B Engineering Trailers $128,117

7 Laundry/Warehouse/ARF/Engineering $8,291,853

8 RECREATION/CANTEEN $2,598,485

9 National Media Development $1,331,407

C1 Concourse (Red-B.1 to B.3) $136,805

C2 Concourse (Blue-B.4 to B.2) $174,709

C3 Concourse (Green-B.1 to B.8) $142,049

Building FCA


Market Station Building No Function Title FCA Correction Cost

(V19) Salt Lake City Salt Lake City CU CREDIT UNION $47,380

PH Engineering $19,872

Site Site Utilities $58,803,803

T1 Miscellaneous $78,949

T2 Safety/QA $64,198

T4 Safety Office $0

FY20 Allocated Training Positions


Market Facility Training Category Program Name Paid WOC Total HPTs

(V19) Salt Lake City Salt Lake City Advanced Fellow Advanced Geriatrics (GRECC) 4 0 4

Advanced Psychology (MIRECC) 1 0 1

Medical Informatics (MD) 1 0 1

Medical Informatics (PhD) 6 0 6

Anesthesiology/Surgery Anesthesiology 0 11 11

Anesthesiology-Pain Medicine 0 6 6

Neurological Surgery 0 4 4

Obstetrics & Gynecology 0 7 7

Ophthalmology 0 12 12

Orthopaedic Surgery 0 19 19

Orthopaedic-Hand Surgery 0 4 4

Otolaryngology-Head and Neck Surgery 0 6 6

Plastic Surgery 0 4 4

Plastic Surgery-integrated 0 5 5

Surgery 0 25 25

Surgery-Thoracic Surgery 0 1 1

Surgery-Vascular 0 3 3

Surgical Critical Care 0 2 2

Urology 0 10 10

Associated Health Audiologist Extern 2 0 2

Audiologist Student 0 5 5

Chiropractor Student 0 4 4

Dental Hygienist 0 81 81

Nutritionist/dietitian Intern/Fellow 4 0 4

Occupational Therapist Student/Intern 3 1 4

Optometrist Resident/Fellow 3 8 11

Optometrist Student/Extern 0 20 20

Pharmacist Resident/Fellow 7 0 7

Pharmacist Student/Extern 0 39 39

Physical Therapist Assistant 0 20 20

Physical Therapist Resident 2 0 2

Physical Therapist Student/Intern 36 0 36




(V19) Salt Lake City Salt Lake City Associated Health Physician Assistant Student 0 18 18

Podiatrist Resident/Fellow 8 0 8

Podiatrist Student/Extern 0 39 39

Psychologist Intern 7 0 7

Psychologist Resident 3 0 3

Psychologist Student 0 10 10

Social Worker Student/Intern 14 1 15

Speech-Language Pathologist Fellow 1 7 8

Combined Physicians Internal Medicine/Pediatrics 0 7 7

Dental Dentist, General Practice 4 0 4

Medical Dermatology 0 11 11

Emergency Medicine 0 25 25

Family Medicine 0 16 16

Family Medicine-Hospice and Palliative Medicine

0 2 2

Internal Medicine 0 124 124

Internal Medicine-Advanced Heart Failure and Transplant Cardiology

0 3 3

Internal Medicine-Cardiovascular Disease

0 16 16

Internal Medicine-Chief Resident 0 3 3

Internal Medicine-Clinical Cardiac Electrophysiology

0 2 2

Internal Medicine-Endocrinology, Diabetes & Metabolism

0 9 9

Internal Medicine-Gastroenterology 0 9 9

Internal Medicine-Geriatric Medicine 0 3 3

Internal Medicine-Hematology & Medical Oncology

0 9 9

Internal Medicine-Infectious Disease 0 7 7

Internal Medicine-Interventional Cardiology

0 2 2

Internal Medicine-Nephrology 0 4 4

Internal Medicine-Pulmonary Disease and Critical Care Medicine

0 10 10

Internal Medicine-Rheumatology 0 6 6

Internal Medicine-Sleep Medicine 0 2 2

Medical Student 0 124 124




(V19) Salt Lake City Salt Lake City Medical Physical Medicine & Rehabilitation-Spinal Cord Injury Medicine

0 1 1

Preventive Medicine 0 3 3

Nurse APN-NP Resident 7 7 14

APN-NP Student 2 10 12

Licensed Psychiatric Technician 0 2 2

Registered Nurse Resident 11 0 11

Registered Nurse Student 0 86 86

Psychiatry/Neurology Neurology 0 18 18

Psychiatry 0 33 33

Psychiatry-Addiction Medicine 0 4 4

Psychiatry-Addiction Psychiatry 0 1 1

Psychiatry-Child & Adolescent Psychiatry

0 4 4

Radiology/Pathology Radiology-Diagnostic Radiology 0 29 29

Radiology-Neuroradiology 0 7 7

Radiology-Vascular & Interventional Radiology

0 1 1

Academic Ranking (by Total HPTs)


Market Facility Total HPTs National Ranking (out of

154 sites)(V19) Salt Lake City Salt Lake City 1,098 46

FY21 Research Funding


Market Medical Center Total Funding (VA and Non-VA)

Rank

(V19) Salt Lake City Salt Lake City $41,965,144 5

Footnotes


Market Population Rank (out of 95 markets)Note: The VISN 02 Finger Lakes and Southern Tier markets merged in 2019 during the market assessments, changing the count of markets assessed from 96 to 95.

County-Based Enrollee ProjectionsNote: Market totals do not exactly match the values in the Rurality tables due to a difference in data sources. Note: Counties with fewer than 10 enrollees were reduced to 0 based on privacy guidelines.

RuralityNote: FY19 enrollees in this data differ from the values shown in the EHCPM (Projected Population). This data is sourced from the Geocoded Enrollee file.Note: Rural enrollees include enrollees residing in rural and highly rural locations.Note: Counties with fewer than 10 enrollees were reduced to 0 based on privacy guidelines.

Core UniquesNote: Core uniques excludes uniques who have only used telephone triage, pharmacy, and lab.

Historical VAMC ADCNote: *RRTP includes Domiciliary and Compensated Work Therapy/Transitional Residence (CWT/TR) bed services.

FY19 Community CapacityNote: Although similar data was incorporated in the DD&F, community capacity in this compendium displays the supply of total community beds, occupancy, and beds available among community providers within 60 minutes of each VAMC or HCC. Each community hospital or nursing home which is not currently included in the Veterans Community Care Program or does not meet the minimum quality criteria established in the Section 203 Criteria analysis is excluded. Additionally, providers at or above target occupancy (80% for short-term acute care hospitals, 90% for nursing homes) are assumed to have no bed availability.

BY19 Projected Market RVUs (EHCPM)Note: Specialty Care includes Medical Specialties, Surgical Specialties, and Rehab Therapies.

OP Encounters & SC EncountersNote: The stop code mapping used in the data compendium is based on a custom stop code mapping created by VA for the market assessments. The Data Discovery and Findings (DD&F) documents used the Public Data Clinic Group stop code mapping.

Enrollment Proximity to Current VA Sites by MarketNote: Primary care sites include VAMCs, HCCs, MS CBOCs, and CBOCs. Secondary care sites include VA facilities providing ambulatory surgery or acute inpatient services.

Real Property OverviewNote: Acres available provides an indication of any excess or surplus land, not currently in use and has no plans for future expansion needs that could be used for future development.

Building FCANote: Project Costs to remediate FCAs vary significantly, from below assessed value to more than 3 times the value.

FY20 Allocated Training PositionsNote: This data displays the number of paid, unpaid (WOC), and total Health Profession Trainees (HPTs) at each facility by training program. This data was acquired from the Office of Academic Affiliations.

Sources


Facility HierarchyFY21 Q4 VA Site Tracking (VAST)

Enrollee ProjectionsBY19 EHCPM

RuralityGeocoded Enrollee FY19 Q4

Core UniquesVSSC Uniques Cube

ED/UCC EncountersVSSC Encounters Cube

ED Transfers & AdmissionsEmergency Medicine Management Tool

Surgical CasesNational Surgery Office

Outpatient EncountersVSSC Encounters Cube

Historical VAMC ADCMCAO Discharge Cube

Projected DemandBY19 EHCPM

Projected RRTP DemandRRTP 3D Model

FY19 RRTP Beds and ADCRRTP Program Office

FY19 Quality Community Capacity2019 CMS Cost Reports

Enrollment Proximity to Current VA Sites by MarketFY19 Q4 Enrollment; FY19 Q4 VAST data; VHA OPP Planning Systems Support Group

Real Property OverviewCAI Buildings and FCA Condition Gaps Report (November 2021)

Building FCACAI Buildings and FCA Condition Gaps Report (November 2021)

Emergency Preparedness Primary Receiving CentersOffice of Emergency Management

Academic Mission - Allocated Training PositionsOffice of Academic Affiliations

Research Mission - Research FundingOffice of Research and Development

VISN 19 Salt Lake City Market Data Discovery & Findings

Documents

Transcript of VISN 19 Salt Lake City Market Data Discovery & Findings