49-15 City, LHA, Cleveland Clinic Master Agreement

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(e) In the event that the Clinic acquires or leases additional property contiguous to the FHC Site to be used to make additional parking spaces available to the FHC that is reasonably deemed by the Clinic to be an appropriate replacement for the ER Parking Lot spaces, the spaces leased to the Clinic under the Parking Lot Lease, and depicted in green on Exhibit A, may be proportionately reduced by up to 25 spaces and the City and the Clinic will appropriately modify the Parking Lot Lease. (f) The Clinic contemplates continuing to lease parking spaces in the North Garage or will make alternative arrangement to accommodate a portion of the parking needs of the FHC. 2.3 Post - Construction Obligation of the Clinic to Operate FHC. The Clinic will open the FHC as soon as reasonably practicable in the judgment of the Clinic taking into account patient safety, legal requirements, prudent planning, construction considerations and other facts and circumstances. Upon opening, the Clinic will staff, own, operate, and manage the FHC. While the Clinic owns and operates the FHC, the Clinic will expend the capital required to maintain the safety and appearance of the FHC in a manner consistent with the Clinic's other family health centers. The Clinic contemplates that the services available at the FHC upon the commencement of FHC operations will initially consist of the services described on Exhibit C. As determined by ongoing evaluation of community need and utilization, the FHC may offer extended hours and weekend availability for certain services. Due to the uncertainty regarding and the potentially rapidly changing nature of the approach to delivering health care services, the parties acknowledge that it will be necessary for the Clinic to continually re- evaluate the services provided at the FHC. Part of the Clinic's process in monitoring and evaluation of health care needs of the Lakewood community and its residents will include the Fairview Hospital Community Health Needs Assessment, which will include a separate section on the City of Lakewood. Therefore, based upon the Clinic's assessment utilization of health care services and regulatory concerns, and in consultation with the FHC Community Advisory Board (defined below), as appropriate, the Clinic may modify the services listed on Exhibit C as necessary to address the results of such evaluation, subject to Section 2.4. 2.4 Emergency Services at the FHC. The parties recognize and agree that there is a present need for an emergency department in Lakewood, available on a 24 hours a day, 7 days a week, 365 days a year basis ( "24/7/365 basis "). The Clinic will address this need by opening the FHC with an emergency department that operates (a) on a 24/7/365 basis that has capabilities to treat emergency medical conditions, which are those conditions that rise to a level that manifest themselves by acute symptoms of sufficient severity such that immediate medical attention is necessary, and (b) at a level of service generally consistent with (or greater than) the level of service that is being offered in the Hospital's emergency department as of the Effective Date. The need for emergency services may change with time and, given current industry circumstances, it is difficult to predict such change. The ongoing evaluation of emergency services will be done consistently with Section 2.3 above. For so long as the Clinic owns and operates the FHC, the Clinic agrees to provide emergency services on a 24/7/365 basis in Lakewood. 2.5 Population Health Management Programs; LGBT Clinic. 4 11938585.11