LUTZ BUSINESS INSIGHTS
Hospital Financial Governance
Julianne Kipple, Healthcare shareholder
The hospital board of directors’ role is to serve as the governing body of the hospital. The board is responsible for oversight of the hospital. Board responsibilities include making strategic decisions, hiring and monitoring an effective CEO, ensuring the hospital is providing quality care, overseeing the hospital’s financial wellbeing, staying educated in healthcare industry news and best practices, and representing the hospital in the community. The board is not involved in the day-to-day operations of the hospital. That is management’s responsibility. In today’s complex healthcare environment and responding to a global pandemic, the role of the board is as important as ever.
MISSION AND STRATEGY DEVELOPMENT
The board should develop and review the overall mission and strategy for the hospital. Establishing a mission statement will serve as a guide for long-term goals and policies for the organization. Part of this responsibility is making major strategic decisions on behalf of the hospital in this ever-changing healthcare industry. Setting the overall tone will impact the actions and decisions made by management.
CEO HIRING PROCESS
Effective board oversight includes the CEO hiring process. The hospital should establish a detailed CEO job description and set realistic expectations in line with its strategic goals. Once those key components are firmly established, the board is responsible for the ongoing review and evaluation of the CEO to make sure that these expectations are met. The board helps determine the big picture for the hospital and assists and supports the CEO.
MEDICAL STAFF CREDENTIALING
Board members should be in close communication with the CEO when hiring and reappointing providers. The goal is to ensure that the hospital reliably provides a high quality of care to patients. Part of the board’s responsibility is to oversee the medical staff credentialing process. The CEO must determine that:
- All hires are properly licensed in the state,
- There is evidence of proper and completed training from an accredited school,
- There has been no history of disciplinary actions taken by previous employers,
- Hires have proper and current malpractice insurance, and
- Valid board certifications can be presented.
The board should communicate with the CEO to ensure these measures have been followed and that changes are made should they be necessary.
FINANCIAL HEALTH OVERSIGHT
The board oversees the financial health of the hospital. In the healthcare industry, the board must understand and ensure that the hospital is best using its resources. With the COVID-19 pandemic, the provider relief fund, changing payment models, and cuts in reimbursement for critical access hospitals, it has become even more important for boards to have a thorough understanding of the financial wellbeing of the hospital and how to make strategic decisions. The board should build policies that allow them to reconvene regularly to ensure that financial goals are being met, whether via virtual meetings or in person. These regular checks allow the board to modify any goals that are not being met or allocate funds elsewhere to ensure the hospital is finding the best ways to earn a profit.
CONTINUED BOARD EDUCATION
In the healthcare industry, board education is of utmost importance. For the board to set a stable long-term direction for the hospital, members need to understand all the hospital services, needs, and trends in the healthcare environment. Board members should engage in continuing education to develop a high level of understanding of the hospital and the health care field, as well as areas most essential to effectiveness and performance. In the critical access hospital industry, there are specific financial and reimbursement issues that board members should understand to make fast and informed decisions.
The board also needs to make a strong effort to help the community succeed. One avenue to help the community and hospital succeed is to create and maintain a foundation that focuses on community outreach and fundraising. This creates a relationship between the hospital and community that fosters growth and support. For critical access hospitals, the relationship with the community is vital to the success of the hospital.
The board of directors can have a lasting and positive impact on not only the hospital but also the community. Educating and retaining effective board members can help hospitals navigate the complicated and changing healthcare industry. If you have any questions, please contact us. You can also learn more about the responsibilities of hospital board members in this article.
“Overview of Board Roles & Responsibilities” Boardroom Basics – Minnesota Hospital and Healthcare Partnership
“The Guide to Good Governance for Hospital Boards” – The American Hospital Association’s Center for Healthcare Governance (2009)
ABOUT THE AUTHOR
JULIANNE KIPPLE + HEALTHCARE SHAREHOLDER
Julianne Kipple is a Healthcare Shareholder at Lutz with over 12 years of professional experience in the healthcare industry. Her expertise is in accounting and consulting services for healthcare facilities, including outsourced CFO services, Medicare and Medicaid reimbursement, and Medicaid Disproportionate Share Surveys (DSH).
AREAS OF FOCUS
- Healthcare Accounting & Consulting
- Medicare & Medicaid Reimbursement
- Outsourced CFO Services
- Medicaid Disproportionate Share Surveys (DSH)
- Financial Support Services
AFFILIATIONS AND CREDENTIALS
- Healthcare Financial Management Association, Member
- American Institute of Certified Public Accountants, Member
- Nebraska Society of Certified Public Accountants, Member
- Certified Revenue Cycle Representative
- Certified Public Accountant
- Certified Healthcare Financial Professional
- BSBA in Accounting, with high distinction, Creighton University, Omaha, NE
- MBA, Creighton University, Omaha, NE
- Provider Relief Fund + Where Are We Now?
- Hospital Financial Governance
- Benefits of Medicare Interim Cost Report Template for Critical Access Hospitals
- Year-End Audit and Cost Report Planning, Preparation Tips
- Medicare Cost Report Electronic Filing
- Attention Kansas CAH's - Upcoming DSH Surveys
- Flex Monitoring - CAH Financial Indicators Released
- Provider Quality Reporting System (PQRS) + Merit-Based Incentive Payment System (MIPS) Transition Update
- CMS Medicare Outpatient Observation Notice (MOON) Form
- Hospital Board of Director Responsibilities
- Not-For-Profit Net Asset Classification Changes
- Healthcare Revenue Recognition & Self-Pay Contracts
- Changes in Accounting for Leases + the Impact on Healthcare Entities
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