How should a health center Board evaluate its own performance, and what practical ways can it use to identify and address governance weaknesses?
A Board of Directors should view a self-evaluation as an opportunity for continuous improvement rather than a test of individual performance. At least annually, the Board should assess how effectively it fulfills its core governance responsibilities, including oversight of the CEO, financial and clinical performance, strategic planning, compliance, community needs and Board development. A structured, confidential survey can help directors assess meeting effectiveness, understanding of their roles, quality of information provided, participation, decision-making and the Board’s relationship with management. Results should be discussed collectively, with the goal of identifying a few priority areas for improvement rather than assigning blame.
Governance weaknesses can often be identified through practical indicators such as poor meeting attendance, excessive operational involvement, unclear roles between the Board and CEO, inadequate financial or quality oversight, ineffective committees, difficulty reaching decisions, or insufficient representation of the health center’s patient community.
Once the Board identifies weaknesses, it should develop a simple improvement plan with specific actions, responsible individuals and timelines. Solutions might include Board orientation and ongoing education, committee restructuring, clearer Board policies, improved dashboards and reporting, individual director development, or targeted training on HRSA governance requirements. Periodically revisiting the improvement plan allows the Board to demonstrate that self-evaluation is not simply an exercise, but a meaningful tool for strengthening governance and advancing the health center’s mission.
Vance Farrow is the Healthcare Industry Specialist for the Nevada Governor’s Office of Economic Development. He is responsible for supporting the recruitment, retention and expansion of healthcare professionals and businesses to strengthen the sector’s infrastructure within Nevada.
Mr. Farrow has received numerous gubernatorial appointments including Executive Commissioner for the Western Interstate Commission for Higher Education, in addition to the Governor’s Task Forces addressing Nevada Broadband, Graduate Medical Education, and Medicaid Innovation and Patient Protection Committees.
Prior to his position with the Nevada GOED, Mr. Farrow served as Chief of the Bureau of Cancer and Chronic Disease within the District of Columbia Department of Health, and has also served as Chief Operating Officer for an FQHC. He began consulting for MSCG in 2017 and has been reviewing and consulting with FQHCs and Lookalikes for more than 20 years.