Risk Identification

We have assembled a partial list of potential risks facing the company for you to rank. You may select a risk from the dropbox or add any other business risks that you believe to be significant by selecting the "OTHER" option in the drop down listing, allowing you to type in free form text response, rather than using one of the potential risks. We request that you respond to the following question: What are the top three risks (business, operational, accounting, etc. in priority order) your Hospital system or the company faces over the next two years that could have a significant adverse effect on in achieving strategic and/or financial objectives? Below are the list of potential risks: Changing Business Model Competition Recruitment and Retainment Inappropriate Utilzation Information Systems Reimbursement Safety/Quality Transparency Charges Communication Regulatory Audits Meaningful Use ICD-10 Access to Capital

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Please indicate your #1 risk, by selecting it from the drop down list OR if your #1 risk is not provided in the drop down list, please select "OTHER" and in the space provided, please type the risk.

For Risk #1: if you know of things being done either at your Hospital or at Corporate to help manage/mitigate the risk, please describe below:

Please indicate your #2 risk, by selecting it from the drop down list OR if your #1 risk is not provided in the drop down list, please select "OTHER" and in the space provided, please type the risk.

For Risk #2: if you know of things being done either at your Hospital or at Corporate to help manage/mitigate the risk, please describe below:

Please indicate your #3 risk, by selecting it from the drop down list OR if your #1 risk is not provided in the drop down list, please select "OTHER" and in the space provided, please type the risk.

For Risk #3: if you know of things being done either at your Hospital or at Corporate to help manage/mitigate the risk, please describe below:

Please indicate your position:

Please indicate your facility: