The Chief Executive Officer is the only employee of the District who is
hired directly by the Washington Township Health Care District Board of
Directors. Annually the Board reviews the CEO’s performance as required
by the employment agreement. As a part of that process, the Board considers
data provided by an independent health care compensation consultant, Integrated
Healthcare Strategies/Arthur J. Gallagher & Company (IHS), and any
and all other factors the Board considers important. The Board then decides
whether or not base salary should be adjusted and whether to make an award
of “at-risk” compensation. At this time, the Board also considers
whether to make any other revisions to the Chief Executive Officer’s
The District has a long-standing philosophy of wage parity for all employees,
which includes the CEO. Wage parity means the CEO is not paid at the top
of the scale nor is she compensated towards the bottom. The District’s
compensation philosophy of marketplace parity establishes a base salary
for the CEO at around the 65th percentile of her peer group and total
cash compensation for the CEO in the range of the 75th percentile of her
peer group with a maximum possible “at-risk” award in the
range of 20% of base salary. Benchmarking executive compensation based
on peer group data is a standard practice for establishing reasonable
compensation for executives working for non-profits. The District’s
compensation philosophy not only reflects the District’s long standing
philosophy of wage parity for all employees but also acknowledges the
CEO’s 30-plus years of experience as a health care executive.
The IHS report provides the Board with appropriate comparability data in
accordance with IRS regulations. In its report, IHS reviewed background
data on the District for the 2017-2018 fiscal year. IHS compiled data
on compensation levels for California health care systems similar to WHHS
in size and complexity using data from IHS’s proprietary database
and salary surveys. Based on the foregoing, IHS prepared market charts
summarizing compensation survey data at the 50th percentile, 65th percentile, 75th percentile and 90th percentile for the California peer group. The charts are prepared for
both base salary and total cash compensation (which includes the potential
“at-risk” award.) “At-risk” incentive opportunities
for Chief Executive Officers in the California peer group range from a
median target opportunity of 25% of base salary to a median maximum opportunity
of 35% of base salary.
The CEO’s current base salary of $840,320 is 3.29% below the 65th percentile target of $868,000.
With regard to consideration of an award of “at-risk” compensation,
the District’s compensation philosophy has been to target a maximum
possible “at-risk” award of 20% of base salary with total
cash compensation in the range of the 75th percentile of the California peer group. As noted above, the median target
opportunity for Chief Executive Officers in the California peer group
is 25% of base salary. An award of 25% of base salary would equal $210,080
for a total cash compensation of $1,050,400 which is still less than the 75th percentile.
Historically, the Board has considered a number of factors in determining
the amount of the “at-risk” portion of the CEO’s compensation.
These factors include a consideration of various accomplishments during
the past fiscal year. The Board has considered other accomplishments in
determining an award of “at-risk” compensation.
Washington Hospital’s fiscal year end 2017-2018 results were again
exemplary and the numerous successes across the board demonstrated the
collegial effort exerted by all levels and functions in the organization.
The Hospital’s financial results for fiscal year ending 2017-2018
exceeded expectations, with the actual GASB total margin of $46,785,000
(9.3%) being above the budgeted $36,447,000 (7.3%). The actual FASB margins
of $32,768,000 (6.5%) were better than the budgeted $20,209,000 (4.1%).
With positive variances in net income in both GASB and FASB accounting
formats of 28.4% and 62.1% respectively, the Healthcare System had a very
The construction of the Morris Hyman Critical Care Pavilion was completed
on time and on budget. The Hospital held a Ribbon Cutting celebration
and a Public Open House for the Pavilion in September 2018. The Pavilion
opened for patient care on November 13, 2018. This project, which has
exceeded expectations, is a beautiful hospital, seismically sound, Trauma
Center capable, and provides double the number of critical care beds and
68 new single occupancy med/surg beds. The Hospital kept its covenant
with the voters of the District: that the project be on time and on budget
which is altogether rare for public works projects.
By any standard, Washington Hospital Healthcare System experienced a rigorous
survey schedule which included:
- The Joint Commission Full Hospital Survey
- The Joint Commission Clinical Laboratory Survey
- The State of California GACH Survey
- The Cancer Program Accreditation
- The Joint Commission Advanced Primary Stroke Program Survey
- The Breast Health Program Accreditation
- The Nursing MAGNET Program Survey
The Hospital was highly successful in all the above-mentioned surveys,
receiving the maximum period of accreditation and the distinction of being
recognized by those bodies for many “best practices.” Additionally,
CMS conducted a Validation Survey which resulted in minimal suggestions
for improvement and correction.
Among other quality initiatives, the Hospital participated in the National
Surgical Quality Improvement Program, achieving Exemplary Status. This
placed the Hospital in the top 10% of U.S. Hospitals for lowest mortality,
lowest complications, lowest surgical site infections, lowest morbidity
and lowest renal failure. The Hospital was further recognized for lowest
rates of readmissions in Orthopedic Surgery for Knee and Hip Replacements.
The validation received from all these surveys was matched by the recognition
of National rating organizations like Healthgrades. Washington Hospital
was named one of America’s Best Hospitals, and one of America’s
100 Best Hospitals for Orthopedic Surgery. Washington Hospital is the
only hospital in the Bay Area to be named one of Healthgrades’ America’s
Best Hospitals for Joint Replacement for seven years in a row. The Hospital
is also in the top 5% in the nation for Joint Replacement. Washington
Hospital was also honored as a five-year recipient of the Healthgrades
Distinguished Hospital Award for Clinical Excellence for consistently
providing comprehensive and clinically excellent care. Plus, U.S. News
& World Report recognized Washington Hospital this year as the number
five Best Regional Hospital in the San Francisco metropolitan area.
Healthgrades and U.S. News & World Report both recognized Washington
Hospital for Cardiac Care, receiving a Five Star Rating from Healthgrades
and a “High Performance Ranking” status from U.S. News &
World Report. We received the same recognition for Pulmonary Care from
these two organizations. The American Heart Association and American Stroke
Association granted Washington Hospital their “Target Stroke Honor.”
Washington Hospital also received the 2018 Get With the Guidelines Stroke
Honor Roll Elite Plus GOLD PLUS Achievement Award.
Washington Hospital has also initiated planning for the new Fremont Office
Building, sequencing the physical consolidation of the Medical Foundation.
Another significant accomplishment occurring this year has been the work
of a multidisciplinary Medical Staff Bylaws Committee which included representation
from the Board of Directors and Administration. The process was remarkably
collegial and collaborative and produced a workable document that meets
the requirements of The Joint Commission and the State of California.
The Medical Staff approved the new bylaws at their September meeting.
This past year the Washington Hospital Healthcare Foundation launched a
Capital Campaign. While the campaign is a multiyear effort, and is still
underway, it is notable that the Foundation has already exceeded the campaign
goal of $5,000,000, with $5,500,000 on the books.
In the arena of Human Resources, the Hospital concluded negotiations successfully
with Local 20.
Washington Hospital has not been immune to the National phenomenon of increased
violence in Emergency Departments, which is why the Hospital has intervened.
Hospital leadership met with staff who have been subjected to this treatment
and devised a new organizational response to these incidents that are
addressed by calling Code B.E.R.T. The code summons help for an embattled
employee. When one insurance carrier, BETA, was on site for training,
their staff witnessed a Code BERT and asked for the Hospital policies
and procedures stating that this was a best practice that would be shared
with other BETA insured organizations. Further plans include seeking legislation
in Sacramento that will make it a felony to assault Emergency Room personnel.
Such legislation already exists in 42 of the 50 states.
The Hospital also implemented the EDIE system, which stands for Emergency
Department Information Exchange. This system exists throughout Washington
State, Oregon, and most of California. Additionally, the Hospital also
composed a Visitor’s Manual advising our visiting public of their
responsibilities while on Hospital premises.
This past year, the Nation has been shaken by the press coverage of the
Opioid Addiction Crisis, which is why the Hospital invited Dr. Anna Lembke
to address the hospital community. Her presentation was rebroadcasted
on our local access cable channel to assure greater dissemination of this
critically important information. Within the Hospital’s Medical
Foundation, new monitoring systems of opioid prescriptions were also implemented.
The Hospital has also been very pleased to discover the expertise in disaster
preparedness of Dr. Alan Spira, a Hospital Emergency Room physician. The
Hospital has retained his services and received an exhaustive assessment
of Emergency Preparedness. Although Dr. Spira has been deployed to “parts
unknown,” the Hospital is working through his critique and making
the recommended changes to the Command Center and to the Disaster Plan.
Earlier this year, the Hospital also worked with the Fremont Police Department
on an Active Shooter Drill in the Morris Hyman Critical Care Pavilion
before it was occupied by patients.
Our partnership with ABC7 was initiated this year after participating in
an application process and being selected from the ranks of Bay Area hospitals
who also applied. With Washington Hospital material now airing on television,
there has been very positive community response. And while it is still
early in this partnership, it has proved to be beneficial.
This past year the Hospital continued its development and application of
Lean principles. So far, there have been eighteen workshops on a variety
of subjects including: Kaizen, Value Stream, 3P, and the Transition into
the Morris Hyman Critical Care Pavilion. The total number of attendees
at all Lean workshops is 467. Of those, 44 were physicians, 239 nurses,
and 184 hospital management. Fourteen staff members have received their
Washington Hospital’s partnership with UCSF has continued to grow
and develop. The Prenatal Diagnostic Center, led by Dr. Chyu, opened in
December 2017. Through UCSF, we recruited and hired a second Cardiovascular
Surgeon, Dr. Teng Lee, who came on board in November 2017. In January
2018, one-year-long clerkships for UCSF Family Medicine medical students
were initiated in our Medical Foundation. The Hospital also recruited
a second Radiation Oncologist in coordination with UCSF, who started in
September 2018. Also, in support of the Oncology Program, the Hospital
recruited a Clinical Research Coordinator to assist with the development
and implementation of clinical trials for our patients in coordination
The following Information Services projects were completed in the past year:
Epic Beacon module implementation for Oncology
Epic Bed Planning, Transport and EVS implementation
Morris Hyman Pavilion Network, Storage and Server Infrastructure Setup
New main hospital phone system
Instrument Tracking System for Sterile Processing and OR
Trackcore Tissue Tracker implementation
GE Viewpoint implementation for the Prenatal Diagnostic Center
EDIE System setup for ED and Urgent Care
XPer System upgrade for Cath Lab
Interface from Epic to Labcorp
Midas and Statit System Upgrades
Abbott Chemistry Analyzer Integration
Provation GI System Rollout to WOSC and WHHS
Data Loss Prevention security system rollout
Rollout of E-Prescribing Solution for Schedule II Drugs
Through the Hospital’s participation in the District Hospital Leadership
forums, the Hospital has been taking part in a program called PRIME (Public
Hospital Redesign and Incentives in Medi-Cal) which is administered by
the State of California. It applies federal funding derived from the 2014
waiver and furnishes seed money for programs that drive innovation and
transformation of care. Washington Hospital has multiple projects underway
and this year received $3,600,000 of the $3,800,000 we qualified for.
In the area of Commercial Insurance contracting, the Hospital successfully
completed negotiations with three of the major plans: Blue Shield, Aetna,
and United. The negotiated agreement with Blue Shield allows Washington
to once again be part of the covered California network. Additionally,
the Hospital was able to implement a relationship with CISCO, one of the
larger employers in the area. During the course of the year, our now former
stop loss carrier executed a substantial rate increase. The Hospital was
able to eliminate that pending expense by transitioning to a new carrier,
keeping Hospital rates flat.
Through the efforts of the Hospital’s Infection Prevention program,
C-Difficile Infection ratio continuously and significantly dropped, reaching
0.79 in the last reported quarter FY 2018.
Finally, hospital and health care system CEOs face unique challenges and
their pay reflects the complexity of the job. At Washington Hospital,
the CEO oversees all health care system operations, which run 24-hours-a-day,
seven days a week. Regardless of the challenges created, Washington Hospital
Healthcare System is vital to meeting the health care needs of the community
by providing a wide range of acute care and diagnostic services, supporting
public health needs and offering a myriad of other community services
to promote the health and well-being of the community.
Washington Hospital receives no taxpayer or government financial support
to cover its operations, aside from local voter-approved funds dedicated
only to capital improvement projects required by California’s unfunded,
state-mandated seismic standards. So, when reimbursements are reduced,
whether from government payors (i.e., Medicare) or from private payors
(i.e., insurance companies), the CEO must find a way to address reduced
reimbursements while still making sure that WHHS provides exceptional
quality of care for its patients and needed services for its residents.
At its November 14, 2018, meeting, the Board voted to adjust the CEO’s
base salary to $873,933, which is the 65th percentile of her peer group
and is consistent with the Board’s compensation philosophy. As a
result of numerous achievements noted by the Board of Directors, the Board
also voted to provide the CEO with an “at risk” compensation
award equal to 25 percent of the base salary which is also consistent
with the Board’s compensation philosophy.
The vote was unanimous.
To review the CEO's contract, click on the link below:
CURRENT CEO CONTRACT