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<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>Dear Community
Members,<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>It has been a busy
couple of weeks for <st1:place w:st="on"><st1:PlaceName w:st="on">Gritman</st1:PlaceName>
<st1:PlaceName w:st="on">Medical</st1:PlaceName> <st1:PlaceType w:st="on">Center</st1:PlaceType></st1:place>.
As you may have heard, Latah Health Services recently discontinued its physical
therapy and skilled nursing operations. At the request of Latah Health
Services, our <st1:PlaceType w:st="on">County</st1:PlaceType> <st1:PlaceName
w:st="on">Commissioners</st1:PlaceName>, many community members and in an
effort to maintain an important service to our community, <st1:place w:st="on"><st1:PlaceName
w:st="on">Gritman</st1:PlaceName> <st1:PlaceName w:st="on">Medical</st1:PlaceName>
<st1:PlaceType w:st="on">Center</st1:PlaceType></st1:place> has agreed to
temporarily take on management of the therapy pool, formerly operated by Latah
Health Services. With that comes a large space that Gritman would need to
make positive use of to assure this arrangement does not become a further
financial burden on pool operations or our community.<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>This agreement is
barely days old, as it was formally decided on October 11. With just
weeks to consider the feasibility of this plan Gritman has had very little time
to communicate with our patients and the community regarding the affect this
will have on services. As such, we would like to apologize for any
misunderstandings that may have prompted uncertainty, especially regarding our
Cardiac Rehab program.<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>There have been
rumors that Gritman would move that entire program to Latah Health Services
without taking the proper precautions to ensure our patients' safety.
Please accept our assurance that no programs will be moved to this facility
without all of the proper staff and equipment those programs require to promote
patient safety. If it is not feasible to meet this standard of care for a
particular program, it will not be moved. In short, our patients' safety
and wellbeing are first and foremost in our consideration of how to proceed
with services in the additional space.<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>We would like to
share with you where we are going from here. At this time we are
reviewing our Cardiac Rehab and Wellness Program to determine the feasibility
of potentially moving all or part of those services (again, only if safe and
feasible for all involved) to this new space. We view this as a great
opportunity to improve and increase the services Gritman offers to our
community. Pool programs will continue as is with Gritman taking over
management on November 1, 2006. By that time, we will have a concrete
plan in place for the remainder of the space; one that is a good blend of
programs, community benefit, and of course, is safe for all potential patients
or participants. That adjustment is slated to begin by
mid-November. <o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>We would like to
thank all of our patients, staff, and participants for their understanding and
support in this endeavor. We are very happy to play a role in continuing
what is certainly a valuable resource to our community, the Latah therapy
pool. This would not have been possible without the dedication of our
community and your support in making this a reality. Please don't hesitate
to contact us at (208) 883-6008 should you have any additional questions or
comments. <o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>Thank you,<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>Sincerely,<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><st1:place w:st="on"><st1:PlaceName
w:st="on"><font size=2 color=black face=Arial><span style='font-size:11.0pt;
color:windowtext'>Gritman</span></font></st1:PlaceName><font size=2
color=black><span style='font-size:11.0pt;color:windowtext'> <st1:PlaceName
w:st="on">Medical</st1:PlaceName> <st1:PlaceType w:st="on">Center</st1:PlaceType></span></font></st1:place><font
size=2 color=black><span style='font-size:11.0pt;color:windowtext'><o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>B.J. Swanson
Jeffrey
W. Martin Ryan
McAllister<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>Chairman of the Board President
& CEO Therapy
Solutions Director<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'>-------------------<o:p></o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>-----Original Message-----<br>
From: vision2020-bounces@moscow.com [mailto:vision2020-bounces@moscow.com] On
Behalf Of Tom Hansen<br>
Sent: Friday, October 13, 2006 12:11 PM<br>
To: Vision 2020<br>
Subject: [Vision2020] Termination of the Cardio Rehab Program at Gritman<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Reproduced below is a letter addressed to Jeff Martin,
CEO of Gritman<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Medical Services, from <st1:place w:st="on"><st1:PlaceName
w:st="on">Representative</st1:PlaceName> <st1:PlaceName w:st="on">Tom</st1:PlaceName>
<st1:PlaceName w:st="on">Trail</st1:PlaceName></st1:place>, concerning the
planned<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>transfer of Gritman's Cardio Rehab Unit to the Latah
Therapy Unit.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>A copy of this letter was obtained by my wife while at
her appointment this<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>morning.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>I strongly encourage support of Rep. Trail's concerns
as this move would<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>adversely impact the readiness of an invaluable
program.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>------------------------------------------------------------------<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>October 12, 2006<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Jeff Martin, CEO<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Gritman Medical Services<o:p></o:p></span></font></p>
<p class=MsoPlainText><st1:Street w:st="on"><st1:address w:st="on"><font
size=2 color=black face="Courier New"><span style='font-size:10.0pt'>700 S.
Main St</span></font></st1:address></st1:Street>.<o:p></o:p></p>
<p class=MsoPlainText><st1:place w:st="on"><st1:City w:st="on"><font size=2
color=black face="Courier New"><span style='font-size:10.0pt'>Moscow</span></font></st1:City>,
<st1:State w:st="on">Id.</st1:State> <st1:PostalCode w:st="on">83843</st1:PostalCode></st1:place><o:p></o:p></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Dear Jeff:<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>It came as quite a shock for those of us who
participate in the Gritman<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Cardio Rehab Program that plans are being made to
transfer the Cardio Rehab<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Unit to the Latah Therapy Unit. This sudden
decision without consulting<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>those of us who participate in the Cardio Rehab
Program appears to violate<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>areas of Gritman Medical Centers Vision, <st1:City
w:st="on"><st1:place w:st="on">Mission</st1:place></st1:City> and Values
Statement.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>We view the major problem as safety and access to
immediate life support<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>assistance when crisis situations occur, There
are documented cases that<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>individuals who were participating in the Cardio Rehab
Program at Gritman<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>and collapsed were only saved because of the location
of the program in the<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>hospital. Immediate access to the crash cart,
emergency room, and the<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>doctors and staff were crucial elements to the
survival of those affected.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>The constant monitoring of the cardio rehab
participants and knowledge of<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>the participants by cardio rehab staff has been
crucial in providing timely<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>interventions which in a number of cases has saved
lives. My cardiologist<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>indicates that he views it as essential for me to be
closely monitored when<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>I exercise and be close to life support systems.
This is true of many of<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>the cardio rehab participants including those who had
open heart surgery.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>By moving the Cardio Rehab Program to Latah Therapy it
becomes a major<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>safety issues of those who participate in the
program. As they say, "Time<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>is Life," and without the support system we now
have in place, access to<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>immediate medical attention and increased distance
with the location at<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Latah Therapy, the chances increase that a participant
who suffers a major<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>heart crisis will not survive. This places
Gritman Medical Services at a<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>higher liability risk.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>We would like to request a meeting to meet with you
and the Board to present<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>our very serious concerns.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Sincerely,<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Rep. Tom Trail<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>------------------------------------------------------------------<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Failing any satisfactory response from Mr. Martin, I
would demand that he<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>outline those benefits associated with such a move
that would outweigh the<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>hardship being forced upon Cardio Rehab Program
participants.<o:p></o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'>Tom Hansen<o:p></o:p></span></font></p>
<p class=MsoPlainText><st1:place w:st="on"><st1:City w:st="on"><font size=2
color=black face="Courier New"><span style='font-size:10.0pt'>Moscow</span></font></st1:City>,
<st1:State w:st="on">Idaho</st1:State></st1:place><o:p></o:p></p>
<p class=MsoPlainText><font size=2 color=black face="Courier New"><span
style='font-size:10.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-autospace:none'><font size=2 color=black
face=Arial><span style='font-size:11.0pt;color:windowtext'><o:p> </o:p></span></font></p>
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