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A Board Effectiveness Checklist For Nonprofit Healthcare Boards

A Board Effectiveness Checklist for Nonprofit Healthcare Boards


Fluctuating reimbursements. Increasing healthcare costs. Regulatory burdens. Limited resources and staffing. Patient access and equity. Recognize all of these challenges facing your nonprofit healthcare organization?  

Addressing these challenges requires proactive strategic planning, effective governance, strong leadership, and continuous adaptation, to ensure the sustainability and success of nonprofit healthcare organizations in delivering quality care and meeting the needs of their communities. 

Just as community healthcare organizations strive to achieve sustained growth and reduce risk, board members also need to strive to perform at their peak in overseeing the institution. Today’s nonprofit healthcare boards have to be bold in their actions and decisions while being transparent and inciting trust. 

How does your nonprofit healthcare board measure up against these top 10 characteristics on our board effectiveness checklist? Are you hitting 10 out of 10? 

Board Effectiveness Checklist for Nonprofit Healthcare Boards

1. Establish a Stronger Partnership with Management

The board and the senior management team will position themselves better to achieve their goals when they work together to create a more cohesive, collaborative working partnership with each other. Making this adaptation requires them to be curious, ask hard questions, encourage healthy/open debates over tough decisions, and form a united front.

Both parties must be willing to put all the issues on the table. Boards will need to avail themselves of help from technology including dashboards and metrics to provide up-to-date information for better decision-making while also increasing transparency.  

2. Get Back to Governance Basics

Examine the quality of your board orientation training. This is a good place to start getting back to the basics of good governance. Orientation training should focus on the board’s fiduciary responsibilities individually and as a whole board. Board orientations should include a review of the duties of care, loyalty, and obedience.

Impress on new board members that they need to act in the best interests of the institution according to its mission and needs at all times. Board members should be encouraged to offer their individual opinions and still support the decisions of the whole board. 

3. Strengthen the Relationship with the CEO

For a community healthcare organization to achieve a higher level of performance requires a close working relationship between the board and the CEO. From their partnership will come thought leadership. The CEO needs support from the board to be successful in their role.

Both parties need to understand the scope and limits of their responsibilities. At the same time, boards need to be careful not to overstep management’s role and give the necessary room to achieve their goals. 

Download the Board Effectiveness Checklist to identify areas of improvement and apply best practices for a more effective, productive and successful board.


4. Choose the Board Chair Wisely

The board chair must also adapt in their role to meet the needs of today’s nonprofit healthcare organizations. The person who serves in this position is a valuable liaison between the CEO and the board. This position requires an understanding and respect for healthcare and the unique challenges that are inherent in the sector.

In building a relationship with the board, the board president should feel confident enough to speak with candor and still be mutually supportive. The board president should also have an interest and familiarity in strengthening the relationships with the organization’s external and internal stakeholders.

5. Focus on Modern Governance

As with any other board leadership position, board members must be willing to objectively assess their own performances. They need to be willing to uphold and enforce the main governance policies such as the Code of Ethics, Code of Conduct, and Conflict of Interest.

Board composition is a major modern governance issue and volunteer boards should ensure they have the right talent on the board to lead the institution into the future. Board composition should focus on improving diversity and independence. Governance technology such as a board portal by BoardEffect can be a huge advantage for boards that are committed to working efficiently. 

6. Make Efficient Use of Time

Making use of governance technology will free up hours of board time because it automates many of the basic board duties. In addition to that, nonprofit healthcare boards should carefully consider how many board meetings they need to do their jobs effectively. Establishing and using committees is a good way to fully vet the issues and make recommendations to the board while freeing the board up to work on strategic issues. 

7. Be Proactive About Enterprise Risk Management

Healthcare nonprofit boards are responsible for overseeing risk management. This responsibility requires working with the administrators to understand the organization’s risk tolerance. The board should be instrumental in weighing risks and opportunities and planning to mitigate risks as necessary. In particular, cybersecurity, ransomware and hacks are one of the key risk factors that community healthcare boards are facing. 

8. Community Focus

Nonprofit healthcare organizations are uniquely positioned to understand the needs of minorities, women, and other underserved populations within their communities. Creating relationships with stakeholders and individuals enables nonprofits to target healthcare services that reflect the economic conditions of their community. This also helps deliver on diversity, inclusion and access targets that your nonprofit healthcare organization has set.  

9. Practice Shared Governance

Practicing good governance is everyone’s responsibility. That comes together when the board and administrators work together toward a culture of shared governance. All leaders need to recognize the importance of collaborative decision-making and encourage it. The rapidly changing landscape of healthcare services increases the governance challenges of overseeing organizational issues, tackling cyber risk and keeping pace with regulatory changes.  

10. Focus on Accountability

Board members have a duty to make good decisions on behalf of their healthcare community and stakeholders while watching their budgets carefully. Good governance practices are essential in this area. 

The key to nonprofit healthcare board effectiveness in these volatile times are collaboration, board engagement, and continually practicing good governance. 

BoardEffect, a Diligent brand, provides many valuable benefits for community healthcare organizations, from secure communications, easy access to key documents, streamlined agenda and meeting management, to peace of mind against evolving risks and potential costs. We’re passionate about the work of boards, which drives how we develop the BoardEffect solution, working with 14,000 mission-driven organizations supporting a modern approach to governance and powering them to meet their purpose. 



Jill Holtz

Jill is a Content Strategy Manager at Diligent. Her strategy background and content expertise working across a variety of sectors, including education, non-profit and with local government partners, allows her to provide unique insights for organizations looking to achieve modern governance.

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