Dear Friends

2008 was a year of great beginnings at Cleveland Clinic. We opened new facilities, welcomed new leadership and inaugurated new programs and services. At the same time, we prepared to meet the challenges of a changing economic environment. Today, our finances are sound. There is a steady demand for our services. We continue to carve out a distinct identity based on quality, transparency and patient experience. As we move into 2009, our focus is the patient; our mission to provide clinical care, research and education; our determination to give our community the best experience in healthcare.

Cleveland Clinic achieved unprecedented transparency in all forms of reporting in 2008. Our Institutes published 14 Outcomes Guides, with information on patient volumes, mortality rates, techniques, services and innovations. We are determined to compete on quality, and provide whatever data is necessary to allow fair comparisons among providers. We also became the first major medical center to freely disclose the relationships of our staff physicians and scientists to industry, including speaking and consulting relationships, and to make this information part of our public staff directory.

We pursue a total patient experience that is second to none. Our chief experience officer (the first in medicine), M. Bridget Duffy, MD, is leading the assessment of all our facilities and services for comfort, compassion and healing ambience. New programs and policies are being implemented. Already we have seen patient satisfaction rise above the national average, and Ombudsman complaints drop by more than 40 percent. We have made corporate diversity an enterprise goal under the leadership of our first chief community relations and diversity officer, Anthony Stallion, MD.

In national reputation, Cleveland Clinic is once again among America’s four leading hospitals in U.S.News & World Report’s annual “America’s Best Hospitals” survey. Our cardiac services are a ranked first in the country. Rheumatology has joined our urologic and digestive disease programs among the nation’s top two, with our orthopaedics, kidney disease, ophthalmology, rehabilitation and cancer services all moving up one place in 2008. In other awards and honors, Cleveland Clinic won the American Group Medical Association’s 2009 Preeminence Award; and Cleveland Clinic nurses once again earned the highest rating of the American Nurses Credentialing Center: Magnet™ status.

Of course, the high point of the year was the dedication of the Sydell and Arnold Miller Family Pavilion and Glickman Tower. We are grateful to the thousands of generous donors who made it possible for us to complete this, the largest expansion project in our history. These magnificent new buildings have transformed our main campus, improved access and added 100 new hospital beds, giving us a million additional square feet of patient care area. As the Sydell and Arnold Miller Family Heart & Vascular Institute and Glickman Urological & Kidney Institute move into their new homes, we are renovating the areas they vacated for the use of other clinical programs.

Cleveland Clinic Regional Hospitals (Hillcrest Hospital, South Pointe Hospital, Huron Hospital, Lakewood Hospital, Fairview Hospital, Marymount Hospital, Lutheran Hospital, and Ashtabula County Medical Center) have emerged as providers of choice in their communities. Their financial operations have exceeded national benchmarks. Hillcrest Hospital is now a construction site, as we build a $160 million addition. We opened the new Lerner School for Autism to more than 100 students at the Cleveland Clinic Children’s Hospital Shaker Campus. We expanded our network of family health centers with a new facility in Brunswick. Cleveland Clinic in Florida enjoyed success at its Weston location, and opened new outpatient facilities in West Palm Beach. Construction of Cleveland Clinic Abu Dhabi, a full-scale hospital and clinic in the United Arab Republic, is underway.

Our advantage is summed up in the formula, Innovation x Empathy: Innovation to achieve quality, affordable healthcare; Empathy to reach the emotional core of the patient experience. Cleveland Clinic is well-positioned to meet the challenges of the current economic environment. We have a long tradition of triumphing over historical adversity. Our patients and community can count on our ongoing commitment to their health and well being. We go into this crisis strong. We will emerge from it even stronger.

Sincerely,

Delos M. Cosgrove, MD

CEO and President

A. Malachi Mixon III

Chairman, Board of Trustees