As governance becomes more complex, the list of fundamental practices increases in order to help boards frame their work more effectively and streamline their decision making. Governance structures, processes, and practices continue to change to meet the demands of the organization, the community, and the legal and regulatory environment. The Governance Institute surveys U.S. not-for-profit hospitals every other year and, although the framework of the surveys remains similar, the information sought varies from year to year. This year’s survey is longer than in previous years, with more governance structure and more governance practice questions.
This year’s report presents results by topic. The first section of the report focuses on governance structure and offers comparisons and variations by organization type. The second section reports prevalence of adoption of recommended governance practices and board performance, covering the fiduciary duties of care, loyalty, and obedience, and the six core responsibilities: financial oversight, quality oversight, setting strategic direction, self-assessment and development, management oversight, and advocacy.
We have expanded the number of appendices—readers have access to further results detail in the report appendices as well as online-only appendices (see links below). Detail is provided by organization type, size (using the number of beds as a proxy for organization size), and AHA designation.
Click on the following links to download appendices not included in the full report:
Appendix 4: Governance Structure and Practices—Systems
Appendix 5: Governance Structure and Practices—Independent Hospitals
Appendix 6: Governance Structure and Practices—Subsidiary Hospitals
Appendix 7: Governance Structure and Practices—Government-Sponsored Hospitals
Appendix 8: Allocation of Decision-Making Authority—Subsidiary Hospitals
Appendix 9: Composite Scores Overall and by Organization Type—Board Performance and Adoption of Practices
2009 List of Recommended Governance Practices
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