Hospital Authority committee refines FY26 CEO objectives amid financial, EHR and staffing concerns

The Hospital Authority committee met in midday session and worked through a draft of fiscal year 2026 CEO performance objectives, focusing discussion on market growth targets, financial reporting fixes identified in a KPMG review, and outstanding data issues tied to the Cerner electronic health record system.

Board members said the committee’s goal is to deliver a finalized assessment form to the full board before July so a new or continuing CEO will know year‑one expectations. Interim CEO Dr. Elders participated in the discussion and answered questions about operational and financial constraints.

Why this matters: The objectives will drive how a future CEO is evaluated and tied to compensation. Board members repeatedly emphasized that unclear measurement language could produce misleading pass/fail outcomes and urged numeric or graded metrics to make evaluations transparent and actionable.

Board discussion and key changes Board members proposed several substantive changes: replace a line-item reference to the Cerner vendor with a broader technology-and-innovation objective; convert hard pass/fail metrics to a graded 1–5 scoring system with clearer definitions; and refine growth and financial targets to account for the hospital’s current deficit and ongoing financial infrastructure work.

On growth, the draft included a target to “increase the number of patients seen at all clinics and hospital by 15%.” Several board members called 15% a stretch for FY26 and suggested a graded or tiered approach (for example, partial credit for 0–2%, 2–4%, etc.) so that bonuses reflect degrees of achievement rather than an all-or-nothing threshold. Dr. Martin proposed awarding graded points based on incremental growth; Dr. Otter warned a 15% goal may be “very stretched” given current conditions.

Financial controls and KPMG The committee revisited financial-leadership objectives after several members described ongoing problems with accounts-payable delays and audit timing. The draft called for accounts‑payable delays under 60 days; board members and interim leadership agreed that 60 days is likely unrealistic in the near term and discussed a 90‑day target or language that calls for a “significant reduction” in days outstanding rather than a fixed cutoff.

Dr. Elders, the interim CEO, told the committee: “there's not anybody that's probably gonna be able to catch this up to 60 days without a large, you know, input of cash. I'll I'll be honest.” The committee also retained an audit-timing metric (audit finalized by Oct. 31) to align with Metro’s finance office filing needs.

EHR, data and technology Members debated how to treat Cerner in the evaluation. Several said Cerner implementation is substantially complete but that the hospital still lacks reliable data outputs necessary to measure financial and clinical performance. One board member said Cerner had, to date, “cost more money than we thought” and that implementation temporarily reduced patient volumes. The committee agreed to broaden the objective from a Cerner-specific line to a technology-and-innovation objective with measurement criteria that tie technology use to operational efficiency and growth.

Quality, staffing and customer service Quality and patient-satisfaction metrics were presented as measurable items the CEO could be held to, including HCAHPS and Press Ganey targets. The draft included specific survey goals (HCAHPS at 80%, Press Ganey engagement score 4.11) and a target for employee engagement and exit-interview completion. Dr. Elders recommended excluding departures for retirement or relocation from turnover calculations and suggested being cautious about setting turnover targets in a transition year.

Scoring, weights and timing The draft form currently lists each objective as a 1% weight toward a 5% bonus pool. Board members asked staff to rewrite the form to show how a 1–5 performance score maps to percentage payout. Committee members also discussed defining what a 3, 4 and 5 concretely look like (for example, 3 = meeting expectations, 4 = exceeds, 5 = consistently exceeds) so candidates and the CEO know what performance earns higher scores.

Procedural steps and next actions The committee approved the meeting minutes from the May 29, 2025 meeting and instructed staff to produce an amended assessment form for review. The committee set a follow-up meeting at 2:30 p.m. July 31 to review final edits and planned to include the assessment form in the full board packet seven days before the July board meeting so the full board could vote to ratify the form at that meeting.

Votes and formal actions The only recorded formal vote in the committee transcript was approval of the minutes from the May 29, 2025 meeting; the motion carried with affirmative responses recorded as “Aye” and the chair announcing “Motion passes.” No other formal motions or final votes on the FY26 objectives occurred at this meeting.

What remains open Key numeric targets remain under discussion (growth percent, accounts‑payable days, turnover threshold). The KPMG review will continue to inform how financial metrics are finalized. The committee asked staff to circulate a revised form and scoring rubric, and to gather comparator CEO-assessment practices from other public hospitals to inform final language.

Context and accountability Committee members emphasized the objectives should be revisited annually and used to cascade measurable goals to executive leaders and service lines. Several members said they wanted the form to produce timely, transparent performance conversations with the CEO (or interim CEO) and not to create surprise at year-end.

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