John Fremont*

Significant instability in Board leadership (3 board resignations, and 6 interim/new Chief Executive Officers since 2022) and Executive C-Suite management led to the public's diminished confidence in the John C. Fremont Healthcare District. Response: The Board partially agrees with this finding. The three resignations referenced in this report; only one was during the current term and that was for personal reasons. However, some of the turnover in the Chief Executive Officer position was due, in part, to the regulatory requirement that general acute care hospitals must have, at all times, a named an administrator (i.e. Chief Executive Officer) pursuant to 22 CCR 70701. Due to this, when there was an unexpected departure of the Chief Executive Officer, the JCFHD Board was required to expeditiously name an interim administrator while the search for a permanent Chief Executive Officer was found. In general, recruiting for a Chief Executive Officer position in a rural area such as Mariposa has proven to be a challenge with either very few candidates responding, or those who do respond requiring a salary in excess of what the District can pay or being unqualified. £

The JCFHD Board of Directors withheld information between themselves leading to individual discontent and poor decision making. Response: The JCFHD Board disagrees with this finding in that JCFHD Board members withheld information from each other only to the extent necessary in order to comply with the Brown Act. The JFCHD Board has been diligent in seeking out and obtaining training in the Brown Act and takes our responsibility to comply with the Brown Act very seriously.

The JCFHD Board of Directors did not have an opportunity to vet interim CEO which led to a longer period until issues could be legally responded to and resolved. Response: We agree with this finding. This Board inherited an Interim CEO, whose vetting process was done through the previous Board and this current Board was not privy to the process. The last permanent CEO this current Board hired was vetted through an outside agency.

JCFHD Human Resources did not properly vet executive level positions leading to instability at C-suite level. Response: We agree with this finding. The previous Human Resources Personnel did not share vetting with the Board.

Multiple CEOs exceeded contractual spending limits without JCFHD Board notification eroding inherent checks and balances in organizational structure and straining the hospital financially. Response: We agree with this finding. The current Board took swift action to remove these CEOs.

The JCFHD found themselves behind in regular financial audits jeopardizing funding from governmental agencies. Response: We agree with this finding. This current Board only had two accounting issues that were inherited. Our audits were not completed in a timely manner, by an administration that was replaced two years ago and the audits were completed last fall. Our second problem was having a few of our monthly financials not completed on time. This was rectified in a few months when a previous CEO left. The problems were never due to "difficulties navigating the Brown Act, a lack of cooperation and the accountability between Board members, or inaccessible information"

Work and dialogue outside of regular, special, and emergency meetings between directors of the JCFHD puts the Board at risk of violating Brown Act practices. Response: While the JCFHD Board agrees that such conduct risks a violation of the Brown Act, the JFCHD Board disagrees with a finding that it has engaged in such conduct in that it believes it has been diligent in minimizing any work or dialogue outside of noticed meetings. The JCFHD Board takes its responsibilities under the Brown Act seriously. The JCFHD Board agrees to continue to monitor its conduct to ensure no inadvertent violation of the Brown Act occurs and to continue to receive such training on a regular basis.