Transcript Piedmont Healthcare - Programs & Affiliates

Navigating the Uncertainties of
Acquisitions, Governance and
Strategic Planning
July 2013
Robert J. Di Vito, JD, CHRC
Chief Operating Officer
[email protected]
404.605.2798
Agenda
 Overview of Piedmont Healthcare
 Strategically aligning the Piedmont Healthcare Foundation
 Measuring Success: Team & Individual
 Engaging the Foundation Board; Restructuring the Board Committees
 Acquiring & Dissolving the Henry Medical Center Foundation
slide 2
Agenda
 Overview of Piedmont Healthcare
 Strategically aligning the Piedmont Healthcare Foundation
 Measuring Success: Team & Individual
 Engaging the Foundation Board; Restructuring the Board Committees
 Acquiring & Dissolving the Henry Medical Center Foundation
slide 3
History of Piedmont Healthcare
1905:
Piedmont
Sanatorium
founded by
Drs. Ludwig
Amster
and Floyd
Wilcox McRae
1957:
moved to its
present address
on Peachtree
Road
1925:
name changed to
Piedmont Hospital
slide 4
1983:
Piedmont
Healthcare, a
not-for-profit
organization,
as Piedmont
Medical Center
1976:
Piedmont
Hospital
Foundation
incorporated,
501(c)(3) tax
exempt status
obtained
1997:
Piedmont
Fayette opens
1994:
Piedmont
Medical Care
Corporation
and Piedmont
Physician
Group formed
2007: Piedmont
Newnan acquired;
Piedmont Heart
Institute formed
2004:
Name changed to
Piedmont
Healthcare;
Piedmont
Mountainside
acquired
2012:
Piedmont
Henry joins
PHC
2011:
Foundation
name changed
to Piedmont
Healthcare
Foundation
2013:
Henry Medical
Center
Foundation
dissolved; all
assets moved
to Piedmont
PHC in 2013
VISION
2020
By 2020, Piedmont Healthcare will be nationally recognized as a
Top 10 community healthcare system where patients want to go
for a superior healthcare experience, dedicated professionals
want to work, and the best physicians want to practice.
PHC
Piedmont
Atlanta
Piedmont
Fayette
Piedmont
Mountainside
Piedmont
Medical Care
Corporation
Piedmont
Heart
Institute
529 beds
157 beds
42 beds
245 MDs
85 MDs
slide 5
Piedmont
Newnan
Piedmont
Henry
Piedmont
Clinic
Piedmont
Foundation
143 beds
215 beds
851 MDs
3100 Donors
Piedmont Healthcare:
On the Map
slide 6
Agenda
 Overview of Piedmont Healthcare
 Strategically aligning the Piedmont Healthcare Foundation
 Measuring Success: Team & Individual
 Engaging the Foundation Board; Restructuring the Board Committees
 Acquiring & Dissolving the Henry Medical Center Foundation
slide 7
Foundation’s Mission
Provide sustainable resources of private
support for Piedmont priorities.
slide 8
Piedmont Healthcare Foundation Org Structure (February 2013)
PHC
EVP & CAO
Ed Lovern
PHCF Board of
Directors
President, Piedmont
Healthcare Foundation
Mendal Bouknight
Director, Principal Major
Gifts
Sarah Batts
Director, Major Gifts
James Gates
Chief Operating Officer
Robert Di Vito
Director, Major
Gifts
Kelly Loftin
Director
Annual Giving &
E-Philanthropy
James Tobias
Grants & Finance
Officer
Anna Johanson
Outreach
Specialist
Felicia Brown
Project
Coordinator
Carmen Smith
slide 9
• PHC Finance
• PHC-Wide Fund & Grant
Managers
• Decision Support
Waters Pavilion
Liaison
Lillian Thornton
Gift Processing
David Tatum
Donor Relations
Officer
Erica Nelson
Office
Coordinator
Omega Burnett
Sixty Plus
Program
5 FTEs
Where Will Piedmont Healthcare Be In 2016?
Optimization & Preparation Strategies
 Breakeven on Medicare
 Enhance Revenue Cycle
 Improve Quality Outcomes
 Establish Culture of Safety & Reliability
 Improve Satisfaction – Patient, Physician,
& Employee
 Explore Opportunities to Acquire / Partner
with Other Providers
 Expand Ambulatory “Footprint”
 Differentiate & Grow
Srv / Srv Lines
 Secure & Grow
Physician Base
2014
Optimize &
Prepare
slide 10
2016
Better
Transformed
& Repositioned
Transformational Strategies







Focused on Cost Management
Show a Margin on Medicare
Horizontal Integration as Appropriate
Built Infrastructure for Community Health
Built Infrastructure to Reduce Variability
Prepared for Value & Mgt of Payment Risk
Increased Alignment, Engagement, and Strategic
Involvement of Physicians
 Increased Patient Engagement
 Recognized by the Community as the Leading
“Value” Provider
Where Piedmont Must Evolve Its View of Philanthropy by 2016
From Traditional
 Tool for raising money
 Logo, Look, Language
 Needs
 Organization
 Deliver Programs
 Market At . . .
 Send Money
 Donors
 Emotional Reaction
 Power of a Few
2013
Optimize &
Prepare
slide 11
2016
Better
Transformed
& Repositioned
To Breakthrough








What Piedmont stands for
A compelling mission, vision, values in action
Strategic Priorities
Cause
Deliver Outcomes (Value)
Community of Believers
Shared Values
Voice of Many
Where Will The Piedmont Foundation Be In 2016?
Nice to Have/Appreciated
 Passive Board – No Governance
 An Afterthought for Projects or “Needs”
 Vaguely Reported
 Respectable ROI
 Set annual targets based on three-year
rolling average.
2016
Better
Transformed
& Repositioned
Essential/Strategically Engaged
2012
Optimize &
Prepare
slide 12
 Empowered Foundation Board – Strong
Governance
 Aligned and at the table with the Strategic Plan,
Senior Leadership and Capital Planning
 Fully Transparent
 Strategic ROI/Production Dollars/Net Raised per
FTE
 Set fund raising goals/campaigns based on
donor-fundable priorities across the system.
Defining Essential
Activity
Current State: Nice to Have
Future State: Essential
Fundraising Goal
Internal to department; Finance doesn’t
report to leadership or Boards
External fundraising goal; Finance reports
to leadership and Boards; relied on by the
System
Return on Investment
Target set internal to department
Target set by Foundation & System
Leadership;
Priority Setting
Foundation & each entity determines
strategic priorities for fundraising
During each budget cycle, Foundation &
System determine fundable projects &
reach agreement on financial goal
Spending
Funds either not used or used when
remembered
Spending part of culture; budgets
established and funds utilized
Staff Deployment
Centralized, with some alignment to
individual entities
Centralized, all aligned to system priorities
Board Engagement
Knowledge of fundraising goals
Ownership of fundraising goals
External Contribution
Reporting
Contributions not consolidated on any one
entity IRS 990
Consolidate on to PHCF IRS 990
slide 13
Current Piedmont Healthcare Foundation Structure
• PHCF Board reorganized in Feb 2011
• Assures Piedmont’s philanthropic support is generated and stewarded into
valuable gifts meeting the immediate and future healthcare needs of the
region.
• PHCF Operates as Type III Supporting Organization
• Foundation under PHC
• Contributions and grants are received by Foundation
• Contributions and grants recorded on individual entity’s financial statement and
990’s; beginning FY2012, summarized on Foundation’s 990, Schedule A & O
• Foundation Responsible for Solicitation; Donor Stewardship/Relations
• Entity Finance Departments Responsible for Fund Accounting and Budgeting
slide 14
Recommended Piedmont Healthcare Foundation (PHFC) Structure
• Operate as a Type 1, 501(c)(3) supporting foundation
• Contributions and grants received, recorded and maintained on PHCF’s financial
statement and 990
• Transfer funds to entity when costs are incurred
• Establish single PHCF Finance Person; reporting to PHC CFO or Controller with
dotted line to PHCF
• Governance, PHCF accountable to PHC Board and CEO of PHC
• Operationally, PHCF staff report to the CAO
• Rationale
• Models the benchmarked organizations nationally and in Metro Atlanta
• Allows for full PHCF Board oversight
• Consolidates Solicitation, Donor Stewardship/Relations and Fund Accounting under
one entity
• All gifts can be made payable to PHCF
Next Steps
• Determine oversight role of PHCF and PHC Boards
• Determine Board committees and reporting
• Align Foundation with Piedmont system priorities
slide 15
Summary of Financial Operating Models
Comparable Healthcare Foundations
Issue
Piedmont
Wellstar
Banner
Sharp
Intermountain
Shepherd Center
Grady
Gwinnett
Medical
Center
Tanner Medical
Revenue reported
on Foundation
990?
No
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
Where do funds
reside?
Entities
Foundation
Foundation
Foundation
Foundation;
swept to entity
at end of year
Entities
Foundation
Foundation
Foundation
Who can “spend”
restricted funds?
Department
/Service Line
Manager
Foundation
Board
CEO/CFO
Approval;
Foundation
board for larger
expenses
<$25,000:
Managers
$25,000
Administrators
Foundation
Board
CFO & Foundation
Executive Director
Foundation
President
Department/ Hospital President
Service Line & Foundation
Manager
President
Timing for spending
restricted funds
Budget cycle
Anytime
Anytime
Budget Cycle
Budget Cycle
Budget Cycle
Budget Cycle
Budget Cycle
Budget Cycle
Agreements in
place between
Foundation and
Finance
No formal
agreements
Draft policy
No formal
agreements
No formal
agreements
No formal
agreements
No formal
agreements
No formal
agreements
Unknown
No formal
agreements
Foundation
Role/Responsibility
Foundation
deposits funds
directly with
entity; tracks
inflows
Operations
director tracks
inflows/outflows
; liaises with
Accounting
Operations
Operations
director tracks
director liaises
inflows/outflows;
with Accounting liaises with
Accounting
Operations
director liaises
with
Accounting
Foundation liaises
with dedicated FTE
in hospital’s
finance
department every
night.
Accountant and
Director of
Finance with
Foundation
liaise with
hospital as
needed.
Unknown
Foundation staff
member liaises
with finance as
needed.
All
Reconciliation
Finance
and reporting
Role/Responsibility
slide 16 of restricted
funds.
Enters
adjustments in
General Ledger
Enters
adjustments to
funds in
General Ledger
Enters
adjustments to
funds in General
Ledger; prepares
form 990.
Dedicated FTE
within hospital’s
Enters
finance department
adjustments to
to enter
funds in
adjustments to
General Ledger
funds in General
Ledger daily.
Enters
adjustments to
funds in General Unknown
Ledger as
needed.
Enters adjustments
to funds in General
Ledger as needed.
Agenda
 Overview of Piedmont Healthcare
 Strategically aligning the Piedmont Healthcare Foundation
 Measuring Success: Team & Individual
 Engaging the Foundation Board; Restructuring the Board Committees
 Acquiring & Dissolving the Henry Medical Center Foundation
slide 17
PHCF – Return on Investment; FY2014 Goal
Fiscal Year
Total Budget
Total Raised
ROI
Net Raised
FY 2004
$725,090
$3,067,132
$4.23
$2,342,042
FY 2005
$1,166,950
$6,021,463
$5.16
$4,854,513
FY 2006
$1,153,815
$4,996,021
$4.33
$3,842,206
FY12 Marcus
Gift
Years of Pledge
FY 2007
$1,426,991
$16,553,098
$11.60
$15,126,107
$13,270,000
5
FY 2008
$1,310,352
$7,862,114
$6.00
$6,551,762
FY 12
FY 2009
$2,128,993
$6,876,648
$3.23
$4,747,655
$19,792,579
Total Raised
$9,140,010
Total Raised
FY 2010
$1,979,276
$6,017,000
$3.04
$4,037,724
-$13,270,000
Full Marcus
$0.00
Full Marcus
$2,654,000
Yearly Share
$2,654,000
$9,176,579
Adjusted Raised
$11,794,010
Yearly Share
Adjusted
Raised
Total Raised
ROI
FY 2011
$2,046,950
$8,243,099
$4.03
$6,196,149
FY 2012
$1,751,748
$19,792,579
$11.30
$18,040,831
$5.24
FY 2013
$2,250,000*
$9,140,010
$4.06
$6,890,010
$5.24
Adjusted FY 13
ROI
Adjusted FY 12
ROI
$4.03
FY 11 ROI
Total Budget
Target Raised
Target ROI
$1,922,322
$9,295,916
$4.84
* Estimated
slide 18
3 year Average
$7,373,594
$4.84
$2,654,000
FY 13
Total Expenses
Target FY
2014
Net Raised
Amt Considered in each year
Target FY14 ROI
Piedmont Healthcare Foundation
FY2013 Metrics through June 30, 2013
Category
Total Dollars Raised
FY 13 Actual
$9,194,010
(102% of Goal)
Spent Dollars
$5,353,576*
(Thru May 31)
(54% of Goal)
Active Donors
3,100
(88.6% of Goal)
FY13 Target
$9,000,000
$10,000,000
3,500
*Approximately an additional $5M has been identified by fund managers as having
been spent, Foundation is working with PHC Finance to ensure restricted funds are
transferred to offset these expenses.
Entity Total Pledges/Cash
Atlanta
$5,053,902
Corporate
$1,081,265
Fayette
$406,224
Foundation
$402,333
Heart Institute
$1,747,052
Henry
$237,665
Mountainside
$44,900
Newnan
$220,668
slide 19
Service Line Total Pledges/Cash
Cardiovascular
$2,217,411
Oncology
$1,924,068
Neuroscience
$55,885
Transplant
$750,806
Women's Services
$1,555,008
Unrestricted
$420,552
Other
$2,270,280
PHCF’s Metrics, Continued
$
$
Average Gift over $10K**
Average Gift under $100K
Community Outreach
# of Tours/Events
# of Participants
# of Fundraising Events
Funds Raised $
Piedmont-led FE ROI $
Internal (Monthly) Waters Pavilion
Occupancy Rate (thru June 2013)
Net Income (thru May 2013) $
Staff Moves
Identify/Qualify
Cultivation
Solicitation
Donor Relations
Close
Number of Donors (88.6% of goal)
** Not including gifts over $1M
slide 20
FY 2013 Actual
FY to Date
81,073
FY 2013 Target
Annual
1,104
18
1647
13
243,183
2.51
46%
50%
396,767
178
245
179
2190
48
3100
3500
All Entities
FY 2013 Grants and Funds Spending Detail: $11,121,729
Expenditures through March 31 - All Entities ($3,924,148)
Unrestricted
Employee Financial Assistance
$375,508.00
$71,690.00
Patient Financial Assistance
$251,738.00
$1,261,256.00
Program Support
Research
$15,301.00
Education
$242,231.00
Community Support
$754,596.00
Capital: Equipment
Capital: Construction
$927,278.00
$24,550.00
Pending Expenditures - All Entities ($7,197,581)
Employee Financial Assistance
Patient Financial Assistance
$85,000.00
$107,558.00
Program Support
Research
$506,375.00
$0.00
Education
$40,329.00
Community Support
$65,000.00
$3,735,059.00
Capital: Equipment
Capital: Construction
slide 21
$2,658,260.00
FY 2014 Grants and Funds Budget Detail for all Entities
$9,694,900*
All Entities ($9,694,900)
Unrestricted
Employee Financial Assistance
$275,000.00
$120,000.00
Patient Financial Assistance
$437,725.00
$2,796,028.52
Program Support
Research
$76,000.00
Education
Community Support
$1,150,911.00
$1,053,719.00
Capital: Equipment
Capital: Construction
slide 22
* $1, 427,896 of the budgeted spending is from endowment distributions
$2,110,816.00
$1,674,700.00
Robert Di Vito
OBJECTIVE
STATUS
COMMENTS
Identify, assist in preparing and submit $1,000,000 in grants
As of 1/31/13 - Submitted $1,788,087 in
grants and proposals including Komen, ITJ,
CME Grants and Harris Trust
Optimize the operational functions of the Foundation to efficiently and
effectively record, administer, steward grants and gifts
Acknowledgement Letters are still going
out later than required. David, Anna, Jamie,
Carmen and Erica refining processes.
Continue to lead the work with PHC Finance to ensure the timely
recording and reporting of gifts and grants
On-going. Monthly meetings continuing;
Many outstanding items with some
progress; Anna is now sending reports to
PHC Finance. Robert met with Marie
Gaffney to discuss continuing challenges.
Larger meeting betw Fin and Found
happening on April 22nd
Other
Working with Finance to close Aux bank
accounts at PHH, PFH and PNH. Meeting
with Fin and Exec Teams at hospitals to
ensure process of recording gifts is
changed so that all contributions come to
PHCF
*COMPLETE*
slide 23
*IN-PROGRESS*
*INCOMPLETE*
Agenda
 Overview of Piedmont Healthcare
 Strategically aligning the Piedmont Healthcare Foundation
 Measuring Success: Team & Individual
 Engaging the Foundation Board; Restructuring the Board Committees
 Acquiring & Dissolving the Henry Medical Center Foundation
slide 24
Engaging the Board
• Began the journey three years ago
• Renamed Foundation from
associated with one hospital to
fund raising entity for all entities
• By-Laws revised
• Nominations became more
deliberate
• Core Group of Foundation
Members set the direction of the
Board
o Task Force Met with PHC
Executives
o Task Force is driving the
discussion
o More integration between PHC
and PHCF Boards
slide 25
Two staff on One Board Member Interviews Conducted
• As you saw in the presentation at the Retreat, our Foundation has undergone significant
transformation in the past several years. How do you envision the Foundation five years from
now? What changes would you like to see?
• Can you think of ways that you personally can help us?
• What Foundation Board activities would be meaningful for you to become involved?
• Our Board’s minimum contribution is $1,000. Several members have proposed raising the
commitment to $5,000 or $10,000. How do you feel about that?
• How committed are you to the mission and vision of this organization?
• Is the organization really doing what it says it is doing in the community?
• What do you look for in non-profits that you choose to support? How does Piedmont measure
up relative to other organizations you support?
• What would you do with your philanthropic support that would be the most meaningful to you?
• Review slide 12 from the presentation. What will it take for Piedmont and the Foundation to
accomplish the “what if’s?”
slide 26
What if…
• . . . Piedmont and the Foundation worked together to bring world class care closer to
home?
• . . . each Foundation Board member clearly understood and could articulate the case for
support?
• . . . ALL Piedmont boards were fully engaged and philanthropically supportive of our
vision?
• . . . the Atlanta community leaders and Piedmont partnered to transform healthcare for
Atlanta and the Southeast?
• . . . all Piedmont boards had increased giving capacity and joined us to achieve our
vision?
• . . . the Foundation staff and board members worked in tandem to share the Piedmont
promise with the community?
• . . . there was a state of the art facility that attracts world renowned talent to advance
treatment, innovation and education
slide 27
Overview of Interviews with Board Members
•
Organization of the Board
- On the right path
- Need more people connected to community and who can provide
impact gifts
- More accountability and decision making
•
Work of the Board
- Desire more engagement and connection to other Board members and
the organization
•
Fundraising Priorities
- OK with system priorities as long as there is clarity on how this impacts
the local entity and community
- Look for collaborative partners
slide 28
Overview of Interviews with Board Members
•
Level of Support Required
- 100% of all boards giving is non-negotiable
- $1,000 minimum is appropriate threshold with encouragement to give
more if able
•
Priority of Personal Giving
- Unrestricted (system, Southside and local) is supported as long as
priorities for unrestricted are clearly known and the organization uses
unrestricted gifts for those named priorities
- Must show strong accountability and stewardship
•
Is Piedmont living the Piedmont Promise
- Yes. . .
- However, requires more transparency on the priorities so the public
understands how the Piedmont Promise impacts them and the community
slide 29
New and Refined Board Committees
Executive Committee - Responsibilities: The principle responsibility of the PHCF Executive Committee is to hold the powers of the
board of directors between meetings include setting the Board Meeting agenda as well as to review, evaluate and recommend matters
to the PHCF Board of Directors. Structure: The PHCF Executive Committee consists of the Chairman of the Board and the Committee
Chairs.
Nominations & Governance Committee - Responsibilities: The Nominations & Governance Committee oversees the process for
nominating members and officers to the PHCF Board of Directors. The Committee is also charged with reviewing proposed changes to
the PHCF governance and presenting them to the full Board for consideration and action. Structure: The PHCF Nominations &
Governance Committee consists of no more than 8 members of the PHCF Board of Directors.
Contributions & Grants Policy Committee - Responsibilities: The Contributions & Grants Policy Committee serves the Foundation
through the development of new policies and review of existing policies for the disbursement and oversight of contributions and grants
made to any entity of Piedmont Healthcare. Structure: The PHCF Contributions & Grants Policy Committee consists of no more than 8
members of the PHCF Board of Directors.
Allocations & Priorities Committee - Responsibilities: The purpose of the Allocations & Priorities Committee is to review, evaluate and
approve potential philanthropic resource allocation to Piedmont Healthcare and its entities. The Committee is also charged with
overseeing the development of cases for support, solicitation of gifts and establishing the guiding principles to establish philanthropic
priorities. Structure: The PHCF Allocations & Priorities Committee consists of no more than 8 members of the PHCF Board of
Directors.
Finance & Audit Committee - Responsibilities: The Finance and Audit Committee serves the Foundation through the reviewing and
monitoring of the Foundation’s operational, funds and grants budgets and developing and implementing audit processes to ensure
appropriate resource allocation and reporting to fulfill the PHCF mission. Structure: The PHCF Finance & Audit Committee consists of
no more than 8 members of the PHCF Board of Directors.
slide 30
Nominations Weighted Criteria
Reflection of
Community
Time to
Commit
Capacity
Influence in
Community
New
Board
Member
Professional
Affiliation
slide 31
Other
Volunteer
Experience
Donor
Agenda
 Overview of Piedmont Healthcare
 Strategically aligning the Piedmont Healthcare Foundation
 Measuring Success: Team & Individual
 Engaging the Foundation Board; Restructuring the Board Committees
 Acquiring & Dissolving the Henry Medical Center Foundation
slide 32
Acquiring and Dissolving the Henry Medical Center
Foundation
•
Henry Medical Center Foundation – Overview
o
o
o
o
•
•
•
April 1983 - 501 (c)(3) determined
2 person staff – “Supporting the work of Henry Medical Center and financially
provide the margin of excellence”
Funds raised overwhelmingly supported the general operations of HMCF
Special events and employee giving campaign were primary fund raising
strategies; three year return on investment was $.93
Prior to Acquisition – regular informational meetings between HMCF and
PHCF; discuss plan for the incorporation of HMCF into PHCF
At Acquisition
o Finalize plan to bring HMCF into PHCF
o Staff report to President and COO
o Board votes to be subservient to PHC
o Board votes on pathway to dissolution, by end of calendar year
After Acquisition
o Attorney draws up dissolution document; Board approves
o Prior to Dec 31, 2012, all funds transferred to PHC
o Prior Board became PHH Foundation Council
slide 33
Foundation Council
•
Foundation Council Structure
o
o
o
o
o
o
o
•
Terms of Service
o
•
10-15 highly influential community leaders
3 Council meetings per year
Foundation Staff will work with members to identify and to provide cultivation opportunities for major donors
Foundation Staff will provide training for Council Members interested in developing talking points regarding major gift
opportunities
Participate in ancillary opportunities outside designed to identify/cultivate donors
Participate in solicitation of gifts
Initial Council meetings will consist of tours of Piedmont priority needs and naming opportunities
The terms of service will be three-year increments
Foundation Council Member Expectations
o
o
o
o
o
o
o
slide 34
The purpose of the Council is to build friends and donors
Council members are expected to support the mission of Piedmont, by developing, implementing, and overseeing fund
raising strategies for Piedmont
Council members are expected to attend 75% of all council meetings during their terms
Council members are expected to lead the community by example in their own personal giving to Piedmont. It is
expected that these gifts will average $1,000/year and some may be higher depending on individual ability. Donors are
recognized for their inclusive giving including gifts directed to a specific program or service, unrestricted gifts, gifts in
honor or memory of individuals, and gifts to Piedmont special events (or to external events benefiting Piedmont if a
donation is given directly to the hospital)
Council members shall be advocates for Piedmont within the community
Council members shall identify a minimum of two (2) businesses/individual prospects annually and actively assist staff
with introductions, meetings and discussions related to philanthropy
Council members shall prepare and accompany staff in cultivation efforts with major prospects which the Foundation
Staff will research prospect and draft strategy
Outcome & Results and Lessons Learned from Acquisition
•
Outcomes & Results
o
o
o
o
o
•
Funds raised go to programs instead of general operating support
Employee campaign most successful ever – raised close to $100K
Fully integrated Raiser’s Edge
Reduced number of Special Events
Both legacy staff members transitioned out
Lessons Learned
o
Communications of expectations is critically important


o
o
slide 35
Unknowingly, Board and Staff were on a different page than PHCF Staff
Difficult for HMCF and Piedmont Henry to release special events – seen as
community relations events
Hospital and Foundation Operating Executives need to have regular
meetings
Don’t underestimate culture and community