Elected Boards No Way to Run a Hospital

Cheryl Clark, March 31, 2011

The outrageous and disruptive antics of the 397-bed Tri-City Healthcare District's elected board in Oceanside, CA are nationally known. They tell a cautionary tale about why it's a bad idea to let voters choose who governs a hospital.

Tri-City has "become kind of notorious or infamous around the country with those of us who practice in the field of governance for not-for-profit organizations," said Ed Kazemek, founder and chairman of Accord Limited of Chicago, a healthcare governance consulting firm.

Take, for example, these excerpts from last Friday's San Diego County Grand Jury report on Tri-City, entitled "Dysfunction Run Amok."

"Board meetings are conducted in an unprofessional and disruptive manner. A board member routinely manipulates the proceedings and intimidates other members," the report notes.

"This member has been censured by the Board six times since mid-2010. Meetings feature heated arguments and occasional name-calling. A board member routinely questions items on the agenda, focuses on the minutiae of administrative operations and monopolizes meeting time with time-consuming, unproductive, or irrelevant discussions."

The report goes on to describe the district's serious financial problems "due to poor investment returns, unorthodox financial reporting by the Medical Center's previous management team (who were removed by the board in December 2008) and the alleged failure of an outside auditor to follow generally accepted accounting procedures." Those resulted in a $10.5 million loss in June 2010 atop an $18.5 million loss in fiscal 2009.


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