Getting Your Volunteer Board Ready for Oversight, Insight and Foresight

Your volunteer board must stay one step ahead of evolving circumstances if your organization is to succeed in a complex and often uncertain operating environment. But how?

In a recent panel discussion at the 2023 LeadingAge Annual Meeting, industry experts explored trends in the nonprofit healthcare industry, as well as areas of risk and opportunity that should be on board agendas in 2024. They also discussed practical strategies to help give governing boards and executives the tools they need to work collaboratively as they plan and prepare for the future.

The expert panelists included Dottie Schindlinger, Executive Director at Diligent Institute and founding team member of BoardEffect; James “Jim” Pieffer, President and CEO at Presbyterian SeniorCare Network; and Laurence “Larry” Gumina, CEO at Ohio Living.

Their insightful discussion delved into:

• The importance of preparing board members and C-suite executives to meet new demands
• The difference between strategic and operational planning and why both are necessary
• How to equip board members and leaders to navigate the ever-changing regulatory landscape
• How technology can play a role in healthcare governance.

How to Get Your Volunteer Board Ready for Oversight, Insight and Foresight

1. When Board Structures Evolve

The panel got started with a discussion about the evolution of board structures. Larry described how his organization’s board has transformed to one that is now diverse in terms of skills, gender and geographic representation.

Larry shared that, early in his tenure, he heard one consultant make an interesting observation: “He looks around the room and he says, okay, by looking at the makeup of the board, Ohio Living cares for 75-year-old white men. And the board took a step back. I’ll tell you about the journey that we went on, but that was insightful.”

Jim then explained how his organization has transitioned from traditional homes for aging to become a Continuing Care Retirement Community (CCRC) with a focus on innovation and collaboration. The board has evolved alongside the organization’s growth, becoming more sophisticated and adapting to  changing needs and complexities.

Jim reflected: “What I’ve seen over my 38 years is a real evolution in our board structure. So, we were a fairly small organization, and our board — and it’s funny that Larry mentions this — was basically older, white men or ladies who happen to be like the head of our auxiliary. They were our board members right back in the day. And as we grew and changed, our board became more sophisticated, and it has changed and grown with us as well.”

The discussion also highlighted the need for organizations to adapt in order to ensure effective governance. Restructuring board meetings to be more generative and moving routine reporting to an operating board have allowed for diverse perspectives and enhanced collaboration, and also provided a proving ground for future board members.

The importance of committee structures was also mentioned — such as those for executive, governance, strategy and finance — delivering more efficient and effective board operations while ensuring robust decision-making takes place outside of formal board meetings.

“What I’ve seen over my 38 years is a real evolution in our board structure. So, we were a fairly small organization, and our board — and it’s funny that Larry mentions this — was basically older, white men or ladies who happen to be like the head of our auxiliary. They were our board members right back in the day. And as we grew and changed, our board became more sophisticated, and it has changed and grown with us as well.” – Jim Pfeiffer, President and CEO, Presbyterian SeniorCare Network

2. Why Diversity and Skill Sets in Board Composition Matters

The discussion then delved into the complex topic of diversity and skill sets within the boardroom, emphasizing the importance of a diverse range of skills, experiences and perspectives.

Larry shared Ohio Living’s approach of creating a governance nominating committee to assess board composition, identify skill gaps, and actively work on refreshing the board with diverse expertise. “We’ll go through a skill set matrix. We’ll then identify who’s turning off what areas, and we’ll also look at geography and gender. We then identify where our gaps are as our fiscal year comes to a close the end of June. And then we’ll hold ourselves accountable as board members.”

Jim added his organization has evolved board composition strategy by establishing three-year classes as a substitute for term limits. Similar to their CARF accreditation journey, recognizing the need for enhanced skill sets, they formed a separate governance committee. Beyond diversity around race, Jim said, “We’ve actively sought age and geographical diversity, realizing the importance of a well-rounded board that reflects the communities we serve.”

3. What Are the Risks and Opportunities in Healthcare Governance?

Both speakers highlighted the increasing complexity and operational pressures in the senior care industry. Access to capital, leadership turnover, and the need for a forward-looking vision have become crucial elements in the fiduciary responsibilities of the boards.

The emphasis is on the importance of a skilled board that can assess risks, capitalize on opportunities, and provide strategic guidance for sustainable growth.

Larry pointed out that, “From a fiduciary perspective in our boardrooms, we have to make sure that we have a skillset that’s going to allow CEOs and C-Suite execs and the board to be able to assess the risks and the opportunities. Make sure you have the skill set in your boardroom to vet through these strategies because our world continues to change very rapidly.”

“From a fiduciary perspective in our boardrooms, we have to make sure that we have a skillset that’s going to allow CEOs and C-Suite execs and the board to be able to assess the risks and the opportunities. Make sure you have the skill set in your boardroom to vet through these strategies because our world continues to change very rapidly.” – Larry Gumina, CEO, Ohio Living

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4. How to Manage Board Education and Risks in Healthcare

Jim emphasized the critical role of board education in addressing emerging issues like cybersecurity, AI and changes in the healthcare landscape. There is a need for boards to stay informed about industry changes, manage risks, and understand the implications of new ventures.

He said, “I think board education is probably one of the most critical things that we do as an organization. As we change our portfolio, it’s critical that our board really understands the risks and issues.”

Larry agreed: “The more educated you are as board members, you’re going to set more effective vision strategies for your organizations.”

5. Challenge of Board Effectiveness and Alignment with Organizational Vision

The discussion then moved on to the challenge of ensuring alignment between the board and management on the purpose and vision of the organization.

Strategies such as regular communication, strategic planning during quarterly board meetings, and creating a balance between operational and strategic discussions were highlighted.

Larry said, “We make sure that communication is fluid, and that’s a never-ending job. There’s a balance, and I think it’s a healthy one in organizations that are healthy. That’s the respectful balance between operations and vision setting strategies.”

The conversation emphasized the importance of communication between CEOs and board chairs to avoid surprises and maintain transparency. Both Larry and Jim communicate frequently: weekly with key stakeholders, and monthly to touch base with the executive committee.

Jim advised, “Don’t be afraid to overcommunicate for a while until you get comfortable.”

6. Considering Mindset in Prospective Board Member Evaluations

When asked about the consideration of mindset when evaluating prospective board members, both speakers affirmed the significance of diverse mindsets. Larry emphasized the value of having a non-uniform board, leveraging everyone’s expertise and embracing diverse perspectives. “We don’t have a ‘yes’ board, and I don’t want one. I want to make sure that we’re taking advantage of everyone’s expertise, including the diverse mindsets of the team.”

Meanwhile, Jim reflected on how his organization cultivates new board members: “I think what we try to do is really take the time to talk about our purpose, our history, our mindset as an organization… How do you make sure that you’re bringing people in who are aligned, but that also people have diversity of thought?”

Dottie concluded the discussion by sharing a reflection from her own experience serving as nomination and governance chair on different boards.

“If every decision at every board meeting was just sailing through, then that meant we didn’t have enough different thinking on the table and we needed to mix it up. That was a big red flag for me.”

“If every decision at every board meeting was just sailing through, then that meant we didn’t have enough different thinking on the table and we needed to mix it up. That was a big red flag for me.” – Dottie Schindlinger, Executive Director at Diligent Institute and founding team member of BoardEffect

7. How Technology Can Be Used for Healthcare Board Governance

The panel next explored the role of technology and how it can help with alignment between the board and management, particularly on the purpose and vision of the organization. Specifically, they discussed how board management solutions, such as BoardEffect, can be used to enhance board efficiency and communication.

Both Larry and Jim highlighted the benefits of using BoardEffect for electronic access to board and committee materials, online voting and communication, all leading to increased efficiency.

Having used BoardEffect for the last 10 years, Larry said, “All of our board material, all of our committee material, it’s all electronic. Our boards have access to it. It’s fantastic. It adds efficiency, not doing board mailings as it’s all electronic. Board members can chat amongst themselves if they want. It’s an electronic filing cabinet and they can actually do an online vote on that as well. It’s just added significant value from the efficiency perspective of our board.”

Jim added that the library capabilities in BoardEffect have also helped staff and board members look up any document, from board minutes to bylaws.

“It’s also been very helpful to me from a board orientation perspective. You know, a new board member can come in, they can go back and look at what happened at the last meeting, or review bylaws or other issues. I think having all those tools in place has really helped us. It’s made my administrative assistant incredibly efficient over the years as well as some other folks within the organizations because that communication is key.”

BoardEffect is designed with the unique needs of volunteer boards in mind. Our board management software streamlines board processes, enhances communication and promotes accountability, helping you to become an efficient and effective board.

To learn more about how a BoardEffect board management system can serve your mission-driven organization and support your governance best practices, request a demo today.