Is your Board on-board for your next operational site visit?

If you’re reading this article, you probably know that a health center’s Board is fundamental to its success. The scope of the Board is diverse, encompassing operations, finance, strategic planning, QI, and center performance.

And if you’ve been following the FQHC Germane blog, you are also aware (hopefully!) that 2018 has brought with it changes to the operational site visit (OSV) model.

Today we will focus on those changes specifically related to your Board of Directors, and how you can ensure that your Board is prepared to ace your next OSV.

Basically, HRSA has decided to take a more in-depth look at Board Members’ roles and involvement in health center governance. Reviewers will expect a more involved and knowledgeable Board than they have in the past.

So, what exactly does this paradigm shift mean for your health center during your OSV?

Most likely, it will mean a change in the selection of Board interviewees and the types of questions reviewers ask, to include:

  1. An interview with a majority of Board members regarding receipt of health center data. Selection of Board members based on committee assignment may be a second option if a majority of the Board is not available.

  2. Questioning related to Board member oversight. Do your Board members understand what the required measures are, and are they provided with necessary data and reports to allow for proper oversight? Reviewer focus on financial and clinical measures may also be seen here.

  3. Inquiry regarding committee roles. Are Board members actively participating in meetings and assignments? How are you reviewing QI measures and corrective actions for improving outcomes? 

Below is a list of questions we recommend you know the answers to before your next OSV:

Board manuals and resource materials

  1. Are manuals and reference materials current and pertinent to understanding the center, operations, and metrics present and available? Are these manuals updated routinely?
  2. Are there resources available to assist Board members with questions?

New Board members

  1. Are new Board members oriented to the entity?
  2. Is there a formal process for onboarding new members?
  3. Do members have access to stakeholders when appropriate?
  4. How are new members oriented to bylaws and policies?

Updates on Board responsibilities

  1. Do Board members participate in annual internal and/or external in-services, conferences and updates on oversight requirements?
  2. Do Board members perform Board self-assessment?

Ongoing interaction with key staff and committee assignments

  1. Are Board members given appropriate access to key health center staff as appropriate to understand key operations, metrics, and variances?
  2. Are members given the access and support needed to actively participate in their committee assignments?
  3. Do committee members go above and beyond to ensure Board members understand information and data?

A good rule of thumb is that Health Center Boards should be as well-prepared regarding health center operations and metrics as core center staff. 

In addition to helping you during your OSV, making sure your Board is informed and able to do their job correctly is just good practice and will be a key component in the success of your health center.

Don’t be caught off-guard! If you have any questions, or if you would like to talk to us about scheduling a preparatory mock site visit for your health center, please don’t hesitate to contact FQHC Germane.


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Chuck Hutchings is a Senior Manager at FQHC Germane a health care consulting firm specializing in the needs of established, new and potential Federally Qualified Health Centers (FQHCs). FQHC Germane is a division of Germane Solutions.

Read more about Chuck here.

To contact Chuck, send him an email at CHutchings@Germane-Solutions.com.

To connect with Chuck on LinkedIn, click here.