HJAR May/Jun 2021

52 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF ARKANSAS RURAL HEALTH regional health-related boards and national organizations. • REVIEW THE COMPENSATION PROCESS . The board should have a formal compensation committee to ensure compensation is tied into a performance evaluation processes so the CEO knows what’s expected. Utilizing third-party data, consultants, and other trusted sources will allow the board and the CEO to be more comfortable with the result. • CREATE A SUCCESSION PLAN. With a for- mal succession plan in place, it is easier to identify leaders who could step in on an interim basis or for the long term. Succession planning in rural leadership is becoming increasingly more diffi- cult as the pool of potential leaders is shrinking. Finding individuals willing to take on the stresses and potential risk of such a high-profile position is difficult at face value. • PROVIDE BOARD SUPPORT. The board must either support the CEO or make a change in leadership. When a CEO is uncomfortable in their position or the support of their governing body, the organization will become stagnant. When the CEO does not feel they are supported, they will not be creative or forward- thinking, nor will they be willing to make decisions necessary to move the organization forward. • ENCOURAGE MENTORSHIP . Rural CEO can equip themselves with a mentor for support and prevention of turn- over and burnout. Outside resources (state hospital associations, American Hospital Association, National Rural Health Association) can prevent rural hospital CEO burnout and provide sup- port through mentors and roundtables with other rural CEOs. • PROVIDE BOARD TRAINING. While this may be viewed as an unnecessary ex- pense or something an organization cannot afford in a given year, refusal to have an educated board that under- stands the CEO’s struggle will only lead to increased friction. Just as the CEO needs to be equipped with the tools to do their job, it is also essential that the board is equipped with the tools and knowledge to perform their duty in the limited time commitment they are tasked with. Certain organizations present opportuni- ties for hospital support, such as American Hospital Association, National Rural Health Association, state hospital associations and state offices of rural health. These organiza- tions can help support rural hospital CEOs and the board of directors in a number of ways. While there are no recommended pol- icies to address rural hospital CEO turnover, there are a few structured programs that could encourage rural hospital boards of directors and administrators to become bet- ter educated and prepared for their roles: • An accreditation process for rural hospital CEOs and/or board mem- bers, which would involve structured education designed to prepare them for their roles. There could potentially be tiers designed for beginning admin- istrators/board members and more experienced ones. These programs could be hosted in conjunction with association meetings or completely on their own. • Arural CEO/hospital board academy at the state or national level, which could be facilitated virtually or in real time by an experienced team. The academy could be offered annually or throughout the year and designed to educate and support participants throughout their tenure. There could also be a continuing support piece for alumni of the academy who could con- tinue to meet annually. Some states have mandated such pro- grams to prevent more rural hospital clo- sures. n REFERENCES American Hospital Association. (2019). Rural report. Accessed Aug. 7, 2019 American College of Healthcare Executives (2019). Hospital CEO Turnover Rate 2018. Retrieved from :https://www.ache.org/learning-center/research/ about-ceos/hospital-ceo-turnover/hospital-ceo- turnover-rate-2018 Morgan, Alan. (June 2018). National Rural Hospital CEO Turnover Study. Chief Executive Officer of the National Rural Health Association Barto, S. (May 17, 2018). Preventing unnecessary CEO turnover in rural and critical access hospitals. Rural Voices. National Rural Health Association. Re- trieved from https://www.ruralhealthweb.org/blogs/ ruralhealthvoices/may-2018/preventing-unnecessary- ceo-turnover-in-rural-and-critical access hospital American College of HealthCare Executives (Feb. 21, 2019). Hospital CEO Turnover at 18% for Fifth Year in a Row. Retrieved from: https://www.ache.org/about- ache/news-and-awards/news-releases/hospital-ceo- turnover Yaffee & Company. CEO Turnover in Rural America Insights Gleaned Beyond the Data. A Study based on Insight, Experience, and Conversations A Mixed Meth- ods Approach; PowerPoint presentation National Rural Health Association CEO Turnover in Rural America Insights Gleaned Beyond the Data. A Study based on Insight, Experience, and Conversa- tions A Mixed Methods Approach; PowerPoint pre- sentation “The departure of a rural hospital CEO can cause cost cutting, service closures, and staff reductions, as well as halt growth and development activities, such as construction projects, the purchase of new equipment, and strategic planning.”