When Princeton (NJ) HealthCare System decided to rebuild its 310-bed acute care hospital and skilled nursing facility, the risks were understood to be high, particularly given the competitive market in a state where more than half of the hospitals operate at a loss. To minimize project risks, efforts were undertaken to strengthen the role of the board of trustees and its oversight capabilities.

The January Center Voices column authored by Princeton HealthCare System President and CEO Barry Rabner discusses many of the steps the system took to ensure effective and informed board oversight of the project. Examples include:

• Changing board membership to reflect the makeup of the community served by the system and establishing term limits for trustees and officers.
• Re-evaluating and strengthening trustee skill sets in areas such as finance, accounting, construction and project management, real estate, government relations and information technology.
• Reorganizing the Audit Subcommittee of the Finance Committee as an independent committee of the board. Establishing a Board Replacement Project Oversight Committee, which meets monthly.
• Sharing the project budget and timetable monthly with the Executive Committee of the board and at all board meetings, as well as on the password-protected board Web site. Project information also is shared with the Executive Committee of the medical staff and at quarterly medical staff meetings.
• Increasing the frequency of Finance Committee meetings from six to 12 annually.
• Adjusting the owners', directors' and officers' insurance to match the financial risks associated with the project.

The January Center Voices column will be published in the upcoming issue* of Trustee Magazine, and will be available to Center members beginning January 1 via the Center's Web site.

*Note: Also included in the this issue of Trustee are the results of a survey on the board's role in capital allocation and project oversight conducted by the Center, the Health Research & Educational Trust and Navigant Consulting. Survey results will be discussed in more detail in the next Center News and Updates.

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