Vail Health Request for Proposal: Breckenridge Resort Medical Service Provider

BRECKENRIDGE RESORT

MEDICAL SERVICE PROVIDER

One of Vail Health’s original physicians, Dr. Jack Eck, was also the first physician to serve on the Vail Ski Patrol. He provided medical guidance, patroller training and support for many years.

In the background is Caroline Whalen, a former Vail Ski Patroller who is now a PA-C at Colorado Mountain Medical.

WHO WE ARE

LETTER FROM CEO WILL COOK

Enhancing Summit County ski resort collaboration and skier services.

Vail Health is the expert in mountain medicine . We understand the challenges that come with living in a mountain community and have developed solutions to meet the needs of our residents and guests . Our origins date back to the founding of Vail Mountain in 1962, and our partnership with Vail Resorts later expanded to Beaver Creek in 1992 with the opening of the Beaver Creek Medical Center .

We are ingrained in the Summit County community, having offered multiple services in the area for more than 30 years, including physical and occupational therapy, workers’ compensation, mammography, cancer care, and trusted orthopaedic surgery options with our partners . Vail Health stepped up in critical moments with support during COVID-19 and a measles, mumps and rubella outbreak at Keystone Resort in 2020 . Most recently, we have worked with the Summit County government to expand behavioral health care

As an independent, nonprofit health care system, we make decisions right here in the mountains and can adjust quickly to changing dynamics. We are locals who live here, play at your resorts and care about our neighbors .

In recent years, we have evolved our health system by moving from sick care to health care with a focus on prevention, population health, and behavioral health . We believe strongly in keeping health care local, including for our sick and injured guests, so that they can enjoy their vacation time in the mountains .

Recognizing a need for additional local options for high-quality, health care services in Summit County, we recently opened the new Dillon Health Center, which is comprised of a joint-venture ambulatory surgery center that enables The Steadman Clinic, Vail-Summit Orthopaedics & Neurosurgery, and Vail Health to continue to provide world-renowned care for skier injuries and the patients of the Summit County community . This conveniently located medical facility also offers expanded services in Summit County, including: breast imaging and cancer care from Shaw Cancer Center, urgent and primary care from Colorado Mountain Medical, physical and occupational therapy through Howard Head Sports Medicine, occupational health, behavioral health and more

Given the experience Vail Health and our partners have with providing skier contract services at Vail and Beaver Creek, we have the unique ability to add value by improving the guest experience and reducing costs for Vail Resorts in Summit County . Our goal is to grow and further develop our outstanding relationship with Vail Resorts by offering best-in-class care for injured guests, and keeping care local whenever clinically possible This relationship would also provide increased access and discounted employee health and wellness services at the base of Breckenridge Resort and throughout Summit County

We sincerely appreciate your partnership and collaboration to date, and we are excited to further explore this new chapter of our relationship .

In gratitude,

Will Cook President & CEO

Vail

Health

PO Box 40,000 | Vail, CO 81658 (970) 477-3099 | VailHealth org

YOUR KEY STAKEHOLDERS

Will Cook President & CEO of Vail Health

Dan Drawbaugh Chief Executive Officer of The Steadman Clinic and Steadman Philippon Research Institute

Jennifer Law Vice President of Vail Health Human Resources

Amanda Veit Chief Operating Officer of Vail Health

Chris Greenman Chief Executive Officer of Vail-Summit Orthopaedics and Neurosurgery

Mary Ellen Broersma Senior Vice President of Vail Health Surgical Services & Howard Head Sports Medicine

Chris Lindley Executive Director of Vail Health Behavioral Health

Nico Brown Chief Strategy Officer of Vail Health

Sarah Drew, NP Senior Director of Vail Health Emergency & Trauma Services

COMPANY OVERVIEW

Vail Health is a nonprofit community health care system serving patients and guests from around the world. Locally operated and governed by a volunteer board of directors, Vail Health includes a 56-bed hospital, accredited by the Joint Commission . Our 24/7 Emergency Department in Vail is a Level III Trauma Center with an onsite helipad for necessary medical transports .

Vail Health provides a wide array of services and access points, including Colorado Mountain Medical; Beaver Creek Medical Center; urgent care clinics in Vail, Dillon, Avon and Eagle; Edwards Medical Campus; Eagle Healthcare Center and a multispecialty clinic in Frisco . Howard Head Sports Medicine offers physical therapy services at 10 locations in Eagle and Summit counties and works closely with our internationally renowned orthopaedic partners at The Steadman Clinic and Vail-Summit Orthopaedics & Neurosurgery .

In addition, Vail Health’s Shaw Cancer Center and Sonnenalp Breast Center are the region’s only fully accredited cancer treatment center and comprehensive breast center Vail Health is leading the way in serving our communities’ behavioral health needs with outpatient behavioral health services at the Edwards Community Health Campus and the Precourt Healing Center, a 28-bed in-patient behavioral health facility, opening in 2025

The Vail Clinic, which was founded in 1965, officially became “Vail Valley Medical Center” in 1980, its first year as a full-service hospital. At that time, we had one primary location and 25 physicians . Today, Vail Health includes the hospital in Vail as well as affiliated service locations throughout Eagle and Summit counties, over 1,800 employees, 460 credentialed physicians, and around 90 volunteers .

MISSION, VISION & VALUES

MISSION

Elevating health across our mountain communities .

Our mission is at the intersection of what we do best and the people we serve . It represents our evolution from sick care to a focus on whole person health that optimizes healing, promotes wellness and guides people to stay healthy .

VISION

The leading mountain health care system attracting the best talent to advance quality health for everyone in our communities.

Vail Health’s vision represents what we aspire to be and the positive impact we want to have in our mountain communities .

VALUES

ALIGNMENT & SHARED GOALS

Vail Resorts’ mission is simple—to create the Experience of a Lifetime for employees, so they can, in turn, provide exceptional experiences for guests .

Vail Resorts’ seven core values are Serve Others, Do Right, Drive Value, Do Good, Be Safe, Have Fun and Be Inclusive .

The common goal of our organizations is to create the best experiences possible, and just like you, we hold ourselves accountable to our mission, vision and values every day, in everything we do .

WHY CHOOSE VAIL HEALTH

OUR COMMITMENT TO YOU

Vail Health has more than 30 years of experience serving the Summit County community . We have consistently stepped up to support community needs when the local health care system did not . Examples include Vail Health’s support during COVID-19 and a measles, mumps and rubella outbreak at Keystone in 2020 . We are also building a behavioral health system in the long absence of this much-needed service .

At Vail Health, we are confident in our ability to deliver high-quality, reliable medical services tailored to the unique needs of your resort. Vail Health will play a crucial role in maintaining the safety and health of all who enjoy Breckenridge Resort . We share Vail Resorts’ commitment to exceptional guest care, regulatory compliance, and a strong presence in the hospitality and resort industry .

PROJECT EXPERIENCE & APPROACH

We are experts in mountain medicine.

Vail Health has been Vail Resorts’ partner since Vail Mountain was founded in 1962

From our early days treating injuries off Vail mountain to providing sophisticated emergency services at the base of Beaver Creek, we understand the challenges of resort operations, and we can handle Breckenridge Resort’s medical care so you can focus on creating epic experiences for your customers .

We brought our services to the Summit County community when you needed us most, providing mammography and cancer care, orthopaedic surgery, and most recently, behavioral health .

Beaver Creek Medical Center, a service of Vail Health Hospital, opened in 1992. Providing slopeside emergency services and staffed by board-certified physicians and emergency trained nurses, the medical center includes a 12-bed treatment area, two of which are critical care, as well as on-site X-ray and teleradiology capabilities; on-site lab services, such as urinalysis, strep, influenza, COVID, pregnancy, mono and glucose; wound, orthopaedic and respiratory care; and physical therapy provided by Howard Head Sports Medicine .

Experts in emergency care.

Vail Health’s Emergency Department achieved the Emergency Nursing Association Lantern Award in 2023 for exceptional and innovative performance in leadership, practice, education and advocacy Less than 1% of Emergency Departments achieve this award and we are one of only two in Colorado to earn this award in 2023 The Emergency Department also achieved the Press Ganey Guardians of Excellence Award for being in the top 5% of Emergency Departments for providing a positive patient experience for 36 consecutive months . Vail Health’s Emergency Department nurses have an average of 13 years experience (compared to the national average of 3-5 years) . 52% of our Emergency Department nursing staff hold advanced certifications in emergency specialties (Certified Emergency Nurse, Certified Pediatric Emergency Nurse, Trauma Certified Nurse, Critical Care Nurse). 86% of our ED nurses have bachelor’s or higher degrees . Emergency Department registered nurses are all certified in ACLS (advanced cardiac life support), PALS (pediatric advanced life support), TNCC (Trauma nurse Core Course), Minimal & Moderate Sedation, and NIHSS (National Institute of Health Stroke Scale) .

We know orthopaedics.

With multiple ambulatory surgery centers and partnerships with The Steadman Clinic and Vail-Summit Orthopaedics & Neurosurgery, we perform approximately 15,000 surgeries/year and 3,600 pain treatments/year

At a minimum, Vail Health would operate Breckenridge Medical Clinic in its current capacity Plus we can offer an array of additional value Our goal would be to make a transition as seamless as possible while enhancing services and the patient and employee experience

• Critical patient stabilization and arrange transfer to higher level of care as needed

• On-site X-ray and teleradiology

• On-site lab services

• Pain management

• Fracture care – reductions of dislocations, stabilization of fractures, etc.

• Wound care and laceration repairs

• Medical treatment for minor medical conditions

• On-site physical therapy

• Occupational health services

• Head injury evaluation and management

• Additional services to be discussed

WHAT MAKES US DIFFERENT

St . Anthony Summit is our major competitor in this market . They are also the health care system we would collaborate with when a higher level of care is needed than can be provided at Breckenridge Medical Clinic .

Our primary differentiators are as follows:

• Vail Health is an independent, local nonprofit health system whose mission is to elevate health in our mountain communities With local decision-making authority, we do not have to seek out-of-state approval on any decision, small or large

• Vail Health has tackled difficult issues where others have not. Two examples are our COVID-19 response and our investment in the area of behavioral health

• With a consistent Net Promoter Score of over 80 (the industry average for health care is 58+), our patients are extremely satisfied with the care they receive in our facilities and would recommend us to others . We are focused on culture and doing right by our patients and guests .

Net Promoter Score (NPS) for FY’24:

• Vail Health has partnered with Vail Resorts at your flagship resorts, Vail and at Beaver Creek, for decades . Through this partnership we have created and evolved the model for resort services with proven outcomes for patients, guests and workplace wellbeing .

• Vail Health measures talent factors such as turnover and vacancy, which are well below industry averages . We also measure cultural aspects such as employee engagement, which is the top quartile for health care providers, as well as the number of promotions per year to ensure employees feel valued and have opportunity for growth

• We are a destination for health care . This map shows all of the patients we have provided care for across the U .S . in the last 12 months .

• Vail Health is committed to local affordability as evidenced by 3rd party, public data from the Center for Improving Value in Healthcare (CIVHC), where amounts paid for services at St Anthony Summit were roughly double that of Vail Health This not only impacts Vail Resorts’ guests, but also Vail Resorts’ employees and the community at large More at civhc org

Health Care System

Vail Health - Patient’s Residence County Counties with patient messages between Dec 1, 2002 and Nov 30, 2023

OUR RESPONSES

SKIER TRANSPORT

Vail Health will staff and supply skier transport vehicles from Breckenridge Resorts multiple base areas to the medical facility . This is a complimentary service we provide to patients .

We are the only provider nationwide that utilizes the state-of-the-art skier transport system with dual Stryker powerLOADs.

We can transport two non-ambulatory patients and four other patients or guests at a time, securely, safely and comfortably

Stryker powerLOAD systems support 100% of the weight of the patient and the stretcher The entire system is pneumatic and can be operated with a push of the finger. This allows for a smooth and secure ride for our patients and prevents potential injuries for our employees Our skier transport staff are often recognized in comments on our patient surveys for the superior customer service they provide to our mutual patients

Vail Health and Colorado Mountain Medical donated an EvacKart to Vail Mountain Ski Patrol to allow for easier and faster transport of an injured person from rough terrain areas during summer operations.

As an additional courtesy to patients, Vail Health will provide a local courtesy shuttle to or from the Breckenridge Medical Clinic .

RESORT & PROVIDER EMERGENCY RESPONSE PLAN (ERP)

Vail Health has a robust Emergency Response Plan and Disaster Recovery Plan

We tailor our emergency response plans to the environments we are providing care for, and we audit our plans annually to ensure they are up-to-date and compliant . We will engage in a collaborative approach with Vail Summit Resorts, Inc . to develop an Emergency Response Plan that provides guidance on unforeseen circumstances and leverages our knowledge of mountain medicine .

Vail Health participates in routine training with our local community partners We also maintain relationships with regional partners (Northwest Regional Healthcare Coalition, as an example) and collaborate as needed to coordinate responses to emergency situations. Our public information officer was a Vail Resorts employee and understands the landscape and tactical needs of public relations in an emergency .

With active and personal working relationships with Eagle County safety officials, Vail Health has been developing relationships with Summit County police, fire and county-level officials, including:

Kim McDonald, Fire Marshal (Summit Fire & EMS)

Adam Nance, Police Sergeant (Dillon Police Department)

Brian Bovaird, Director of Emergency Management (Summit County)

Scott Wagner, Operations Division Commander (Summit County Sheriff’s Office)

CASE STUDY

Emergency Response Plan: COVID-19

Vail Health took the lessons we learned from our Eagle County COVID-19 initial response and implemented COVID-19 testing protocols in Summit County when resources were not being adequately provided there.

• Testing was first provided in Frisco and then shifted to Breckenridge to meet the testing demands of residents and visitors .

• Participated in Eagle County and the state incident command

• Provided COVID-19 testing facilities across Eagle County – 1st site in the country to start mobile testing We provided more tests per capita than anywhere in the U S

• Developed logistics pipelines to ensure adequate personal protective equipment (PPE) for staff.

• Was one of the first locations in the country to receive and distribute COVID-19 vaccines .

• First county in the U S to open back up in-person schooling

• Had several staff members recognized for Unit Citation Awards by the Eagle County emergency management division

• Recognized as the model of operations by the Governor .

• Modified building operations to safely treat patients while minimizing staff exposure risks .

• Had the lowest death rate in the state due to COVID-19

OCCUPATIONAL HEALTH SERVICES

Vail Health’s Occupational Health team consists of certified occupational health providers.

• Occupational Health providers specialize in Occupational Health

• All Occupational Health Advanced Practice Providers (Physician Assistants and Nurse Practitioners) are level I work comp certified.

• Vail Health Occupational Health also employs two board-certified Occupational Health level II work comp certified physicians.

Division of Workers’ Compensation

Vail Health will provide the following Comprehensive Occupational Health services:

• Workplace injury treatment

• Case coordination and management of injury treatment

• Drug and alcohol screening (Department of Transportation DOT and non-DOT)

• Vaccine administration

• Pre-employment physicals

• Department of Transportation (DOT) physicals

• Annual employment physicals

• Hazardous materials exams

• Work-related impairment ratings

• Firefighter and police examinations

• OSHA compliance programs (hearing conservation and respirator fit programs, and blood borne pathogens)

• Pulmonary function screening

• Audiometric (hearing) screening

Employee drug and alcohol testing:

• Drug and alcohol screening will be made available during operational hours for both winter and summer seasons

• All staff administering drug and alcohol testing, including breathalyzer testing, undergo training and are proficient in the operation of the breathalyzer and in the drug and alcohol testing procedures of DISA Labs and Vail Summit Resorts, Inc Breckenridge Resort

Vaccine administration:

• Vail Health Occupational Health has a long history of partnering with Vail Resorts to administer vaccines to its employees .

• Vail Health will provide vaccinations to Vail Resorts’ employee base as needed and subject to employer’s policies at the same rates as parent hospital

• Hep B is commonly administered to employees who have potential exposure to bloodborne pathogens (ex housekeeping staff or Ski Patrol)

• Vail Health will also administer MMR (measles, mumps, rubella) vaccines or other vaccines that are deemed necessary such as in the presence of a community outbreak .

• Vaccinations will be performed at the occupational health clinic or on-site in an outreach clinic model .

Savings for work comp costs:

• Vail Health is open to discussions on a discount off Colorado Workers’ Compensation rates up to an aggregate of 50% reduction, including incentives on mutually agreed upon value or performance parameters

• We are also willing to participate in programs to reduce the incidence of work comp injuries as well as facilitate a safe rapid return to duties for those who have been injured

Physical therapy & SafeFit employee wellness:

SafeFit is an employee wellness program provided by Vail Health’s Howard Head Sports Medicine and developed in collaboration with Vail Resorts . The program is designed to provide a valuable employee benefit, improve employees’ physical health, mitigate workers’ compensation risk and reduce overall health care costs .

Howard Head Sports Medicine has provided this program for Keystone and Breckenridge Resorts since 2013 . On-site injury prevention education is led by physical therapists, and outpatient physical therapy services include manual therapy, neuromuscular re-education, bracing and taping . Howard Head also provides snow-specific return to sport assessments.

Since its inception, SafeFit has provided more than 5,000 treatment sessions to Vail Resorts employees in Summit and Eagle counties . The program has saved $2.5M in medical costs over the last 10 years.

Section 1 - Professional/Medical Services - RATE CARD- For discussion purposes only

Note: We currently have a number for Alcohol and Drug testing options depending on employers preferences. For VR we offer a significant discount for their reasonable suspicion testing by bundling Drug and Alcohol Screen services together into one price.

Note: Physicals/ Preemployment physicals exam level is determined by the complexity of what is being requested by the employer. VR does not currently request these through VH OccHealth, but we can work together to create a products and solutions as needed

Note: Fee or rate would depend upon severity of injury, body part injured, age, co-morbidities, etc. Regardless of these factors, fee would be Colorado Workers Compensation Fee Schedule less 20%

OPPORTUNITIES FOR GROWTH

Vail Health agrees to grow our Occupational Health offerings to meet the demands of your resort employee base The Dillon Health Center Occupational Health clinic currently offers a comprehensive array of occupational health services, all of which are scalable, depending on your needs In addition, Vail Health is committed to the behavioral and physical health of your employees, as outlined below

Continuing Education Opportunities

• Host emergency management training for Ski Patrol .

• Physical therapists to teach ergonomics, proper lifting techniques, etc.

• Behavioral health team to educate Vail Resorts on how to support employees after trauma

• Other areas of training available as needed .

Behavioral

Health Service Offerings

• Vail Health Behavioral Health’s clinic in Frisco employs three full-time therapists, with the ability to add up to four additional providers

• Our behavioral health clinic in Edwards has 17 full-time providers who serve Summit County residents and many Vail Resorts staff and family members . We offer:

• Child, family and adult therapy and medication management for depression, anxiety and other diagnoses .

• Substance use treatment and pain management

• Psychological assessments for learning disabilities .

• Transmagnetic stimulation (TMS) for treatment-resistant depression .

• All of our behavioral health providers live within Eagle and Summit counties, including four psychiatrists, three of which are the only adolescent psychiatrists on the Western Slope .

• Eagle Valley Behavioral Health serves as Summit County’s Community Mental Health Center (CMHC) .

• Depending on Vail Resorts goals and objectives, Vail Health can offer the following enhancements:

• Mountain Strong Employee Assistance Program (EAP): Mountain Strong provides access to comprehensive behavioral health services for employees The program also allows employee teams to access group-based services; for example, avalanche trauma specialist seminars for Ski Patrol or engagement fatigue seminars for customerfacing personnel Within Mountain Strong, we have over 200 providers that cover everything from medication management to talk therapy

• Critical Incident Response: Vail Health is able to provide specific behavioral health support for on-mountain or off-mountain incidents that result in trauma for Vail Resorts employees This includes on-mountain accidents, employee deaths, or acute critical incident issues (threats to Vail Resorts)

• Substance Use & Recovery Support Services: Vail Health Behavioral Health provides comprehensive Substance Use Addiction and Recovery Support Services This includes withdrawal management and support, as well as tapering services Addiction rates are higher in rural resort regions and are the highest amongst hospitality workers It is critical that our resort community proactively engages in resources to address addiction services

Howard Head Sports Medicine

• SafeHealth employee wellness training

• Group, in-person and virtual live and on-demand opportunities

• Biometric strength and power assessments, pre- and post-season

• Snow sport readiness

• As the Official Medical Provider for the US Ski & Snowboard teams, the same physical therapists that care for the country’s best are also here for your employees and guests .

• The Academy of Orthopedic Physical Therapy recruited our leading experts to teach the management of snow sport athletes to physical therapists across the country and around the world .

STAFFING

The on-mountain Emergency Department shall be appropriately staffed in accordance with applicable law and standards of care, to provide treatment to ill or injured persons (with emphasis on traumatic care), including those transported to the Emergency Department by the Resort . Nurses are utilized to staff the Emergency Department and 100% of them are Advanced Life Support certified. We have dedicated Spanish-speaking staff and access to interpretation for hundreds of other languages to support guests from around the world

Our employees LOVE where they work:

• 87 Employee Engagement Score (top quartile for all health care industry)

• 18% turnover rate (5% below national health care industry)

• Our culture is guided by our leadership competencies:

• Inclusion

• Development

• Emotional Intelligence

• Accountability

• Strategic Thinking

• 11% vacancy (10% below national health care industry)

• Our values:

• Safety

• Stewardship

• Excellence

• Integrity

• Teamwork

• Compassion

ADDITIONAL STAFFING REQUIREMENTS

• Staffing of licensed advanced practice provider/physician and medical assistant.

• Dedicated triage nurse (allowing for quicker patroller turnaround).

• Nurses who are 100% trained in Advanced Cardiovascular Life Support (ACLS) or higher certification.

• Year-round employee in-network care .

TECHNOLOGY

• Full array of technologies to report information to patients and medical staff locally and nationwide, including CDPHE, CIIS, local paramedics, and regional and national health information exchanges .

• Real-time laboratory results present to patient through the electronic medical record patient portal . Online scheduling promotes easy scheduling .

• PowerShare™ provides access to diagnostic imaging exams (MRI, CT Scans, X-rays, Ultrasounds, Mammograms, PET scans) through a secure URL

• Extensive HIPAA regulation

• Data governance tooling and program established .

• Extensive integration capabilities - Report, Flat File, API via (AWS, Azure, etc .), real-time or batch processing .

• Retrieval can be accomplished by SFTP, API, or file exchange via VPN

Vail Health partners with the PowerShare™ Network to provide patients with free and secure access to diagnostic imaging exams, including:

• MRIs

• CT Scans

• X-Rays

• Ultrasounds

• Mammograms

• PET scans

• Nuclear medicine

To access your imaging exams, visit VailHealth.org/Imaging and register with PowerShare

ADDED VALUE

In addition to the comprehensive and enhanced health care services described in this proposal, Vail Health is proposing additional incentives in the form of discounts on Vail Health services at all of our locations for all Vail Resorts employees . With a better understanding of your goals and objectives, Vail Health would also look to expand our current wellness and behavioral health services for Vail Resorts employees .

Please also refer to page 31 for a more detailed breakdown of rates .

Value of Proposal - Additional Incentives

Wayfinding

Our Signage & Wayfinding team is focused on getting patients and guests to their destination easily and efficiently.

Community Outreach

Vail Health’s outreach team hosts and attends a variety of community events in Summit County, making genuine connections with locals and visitors

MOUNTAIN GOAT KIDS’ TRAIL RUNNING SERIES

Community Education on Available Services

Vail Health promotes its locations to ensure guests are aware of the services provided on-mountain

EMERGENCY CARE IN BEAVER CREEK

We love our resort partners!

To show our appreciation for our Ski Patrollers and enhance the relationships between resort employees and our providers, we host gatherings with food, drink and camaraderie .

BEAVER CREEK ORIENTATION

SUSHI PARTY FOR SKI PATROL

GOLDEN SKI AWARD 2020