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4

INDEPENDENT REVIEW ORGANIZATION

healthcare to the residents of Broward County and the surrounding areas. The Group employs

more than 70 physicians and has offices located throughout Broward County.

NBHD formed Broward Health ACO Services, Inc., an Accountable Care Organization

("ACO"). The ACO has at least two contracts, one with Cigna and one with Florida Blue. The

aim of the ACO is to improve patient access to care, enhance care coordination and achieve the

goal of improved health, affordability and patient experience. The ACO is collaborating with

south Florida physicians to improve the quality of patient care.

NBHD has an extensive array of community health services. NBHD provides healthcare

at health centers located throughout the community making the following services available

through its network of community health center sites: bereavement, home health aide, home

IV/infusion nursing, hospice services, palliative care, skilled nursing care, rehabilitative services,

and wound care as well as healthcare services for adult patients with HIV/AIDS in its

community health center sites. These services are furnished under and managed by the

Community Health Services ("CHS") Department of NBHD.

B.

OVERVIEW OF INTERNAL REVIEW ORGANIZATION FINDINGS

As a result of what can only be described as a "cultural civil war" within NBHD, the

system is now confronted with serious problems, including:

Operational mismanagement, emphasized by severe downgrades by Moody's and

S&P,

Senior management transition, turnover, retention and replacement issues,

Employee morale,

Lack of commitment to an effectively implemented compliance program,

Failure to perform mandatory internal audit functions,

Apparent inappropriate interference by members of the

former

Board of

Commissioners into operational matters; and

Heightened federal and state government scrutiny.

Amongst the senior management team, there has been more than a lack of

communication, there has been a pervasive pattern of personal destruction in which former and

some current members of the senior management team use public meetings, the media, self-

serving reports disguised as work product, and frivolous "anonymous" complaints through the

disclosure program as a means to falsely attack the character of, pressure, or aid in the

termination of NBHD's Board of Commissioners, senior management, and others. In other

situations, it appears the methods are used to enhance the influence of senior management's