‘November 17, 2014 Cree a Ce a By Email and Hand Delivery — Return Receipt Requested Pa cae Sherman Lohnes, Esq. Director, Division of Health Care Quality Department of Public Health Division of Health Care quality 99 Chauncy Street Boston, MA 02111 ‘Thomas O’Brien, Fsq General Counsel Department of Public Health 250 Washington Street Boston, MA 02108 Re: r;_ Amendment to Notice of Closure of Essential Services Dear Mr. Lohnes and Mr. O'Brien: We write on bebalf of Quincy Medical Center, A Steward Family Hospital, Inc., (the “Hospital”) regarding the Hospital’s notice of November 6, 2014, and the subsequent discussions that have ‘occurred with representatives of the Department of Public Health (“DPH”). In recognition of such discussions, and in accordance with 105 CMR 130.122(C), the Hospital hereby amends its essential service filing by notifying DPH that the Hospital is extending the notice timeline to reflect the ninety day (90) day period, from December 31, 2014, to no later than February 4, 2015. The Hospital will continue to work closely with DPH and other agencies to ensure that throughout the closure process, patient safety is maintained and access to services ensured. Furthermore, in accordance with 105 CMR 130.122(C), and the Hospital's notice filed on November 6, 2014, it is our understanding that DPH has scheduled a public hearing regarding said notice, to be held on December 2, 2014. Please be assured that the Hospital will be present at said hearing and participate accordingly. As stated in the Hospital’s filing, demand for such services has dramatically declined over the past years, rendering the Hospital non-essential in the Quincy health care delivery system. Furthermore, as DPH is aware, since announcing its intent to close, the hospital has continued to experience a steady and substantial decline in patient volume. As services that are no longer in demand or use are identified, the Hospital will phase out such services and work with DPH to ensure patient safety and access to care. As the Hospital continues to experience a drop in census, it is our expectation that by mid to late December, patient demand for any of the Hospital’s services will be gone. In addition, by this point in time the free standing, physician Donoghue Barrett & Singat ‘One Beacon Steet, Suite 1320, Boston, MA 02108-3106 1 617.898.6700 F 4177220276 397286.1 sw. ceslavrirm.comSherman Lohnes, Bsq, Perens ‘Thomas O’Brien , Esq. eas November 17, 2014 Page 2 based urgent care centers, that we have discussed with DPH, will be fully operational and readily available to the people of Quincy. The importance of this timeline is to help facilitate the re- employment of employees. This has been explicitly requested by our union employees. Notwithstanding our notification of closure by February 4, 2015, if the aforementioned situation arises we will coordinate with DPH to facilitate closure before said time. We look forward to working with DPH throughout the closure process. If you have any questions or comments, please do not hesitate to call me at 617-598-6700. Thank you. Sincerely, 1G; Andrew 8, Levine cc: J. Maher, Esq. K. Whalen D. Allwes J. Youmans 937286.4