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John Muir Health Building Program Update
April 2005

The Surface Parking Lot at John Muir Medical Center, Walnut Creek Campus has been completed and the hospital staff began utilizing the lot December 2004. We continue to work with the cities of Concord and Walnut Creek:

• John Muir Medical Center, Walnut Creek Campus - We anticipate gaining City Council approval of the Hospital's Amended Master Plan for the Plan Development Ordinance (original master plan was approved in 1998) from the City of Walnut Creek by April 2005
• John Muir Medical Center, Concord Campus - We're working with the staff of City of Concord in finalizing our Formal Application Package for the Hospital Project and anticipate City approval for our application by the end of next summer.

We have been moving through the phases of the design process for both hospital projects, starting with Master Planning through Schematic Design and through Design Development phase which is much more detailed and specific. We anticipate completing the last phase of design, Construction Documents, for submission to the Office of Statewide Health Planning and Development (OSHPD) for permit by the later part of this year. As we go through the different phases of design we are gaining a clearer picture of the overall project cost to build a hospital facility under OSHPD and California's imposed Seismic Safety Act (SB 1953).

Along with other hospitals in California and across the country we're having a difficult time predicting an unpredictable market and sky rocketing escalation and their effect on construction cost. Duane Dauner, President and CEO of the California Healthcare Association recently said, "The cost of hospital construction in California is exploding, due to the demands placed on hospitals by the seismic requirements adopted after the Northridge earthquake."

We're finding that hospital construction cost is being affected by the escalating cost of steel, concrete and other raw materials all of which have been increasing building cost dramatically over the past year or so. Add to these market driven forces such as the supply of competent and experienced hospital architects, engineers and contractors are making it very difficult to design hospital projects with-in what were traditionally thought to be solid estimates or opinion of cost. It seems that every time we hear about a hospital project in California the cost of construction is exceeding the budgets and cost estimates because of these factors.

The project teams are constantly struggling to maintain the key drivers of the projects; seismic requirements, single patient rooms, parking, operating room, emergency room and in-patient capacity. We continue to manage the controllable factors, such as program and scope, but are having difficulty controlling the uncontrollable factors such as, market forces and escalation.

The project teams at both Hospitals remain committed to bring the projects in on budget, on time, maintain the quality and key drivers.

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John Muir Medical Center, Concord Campus
Seismic Replacement & Remodel Project

John Muir Medical Center, Concord Campus - New Patient Tower

Garden level - 25,735 SF	New Entrance & Lobby 4 Cath. Labs and Preoperative beds
1st Floor - 3,000 SF 37,498 SF	34 Treatment Bed Emergency Dept. with 3 Imaging rooms
2nd Floor - 25,734 SF	12 bed CV ICU & 17 bed telemetry
3rd Floor - 25,734 SF	32 bed Telemetry unit
4th Floor - 25,734 SF	16 bed ICU & 8 bed future build out
5th Floor - 25,734 SF	Future patient room build out

Building Program - Timelines

We anticipate the following completion dates for the various phases of our building projects:

John Muir Medical Center, Concord Campus

• 2007 - Surface parking
• 2007 - In-patient unit renovation
• 2009 - Patient care tower

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John Muir Medical Center, Walnut Creek Campus Expansion & Remodel Project

New Patient Tower

Basement level- 66,340 SF	PBX, IT Service Offices & Pharmacy (future expansion for Materials Management, Nutritional Care Kitchen & Educations Auditorium)
1st Floor - 68,960 SF	Imaging, Cardiology, Nuclear Medicine, Pulmonary, Lab. Patient Service Center, new Entrance / Lobby & part of the ER (future expansion for retail space)
2nd Floor - 68,500 SF	PACU, 3 new OR"s, 24 bed ICU & 3 Cath Labs
3rd Floor - 54,810 SF	34 ICNN bassinets, 34 bed Postpartum unit & 16 bed Pedi unit
4th Floor - 42,730 SF	32 bed Medical / Surgical & 32 bed Rehabilitation unit
5th Floor - 42,730 SF	Two 32 bed Medical / Surgical unit
6th Floor/Roof - 3,900 SF	Helistop with a dedicated Trauma Elevator

Building Program - Timelines

We anticipate the following completion dates for the various phases of our building projects:

John Muir Medical Center, Walnut Creek Campus

• 2004 - Surface Parking Lot Completed
• 2005 - Start the relocation of the Helipad & Temporary Loading
• 2006 - Relocation of Emergency Dept.
• 2006 - Parking Structure completion
• 2009 - Phase 4 / Patient Care Tower completion Central Plant completion

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