Harvard University Case 15 District Hospital a Lesson in Governance

Case 15 District Hospital A Lesson in Governance

Cynthia Mahood Levin Healthcare Consultant, Palo Alto, CA

Kurt Darr The George Washington University, Washington, D.C.


Barclay Memorial Hospital (BMH) has enjoyed a reputation for excellent medical care in an affluent community for over 70 years. In the mid-1940s, its community was mainly agricultural, but urbanization was beginning. Hospitals in the region were operating at capacity. Community members and physicians proposed a solution to the problem of overcrowding at local hospitals: form a hospital district supported by the community through a tax. Voters approved the hospital district in 1945 by a 5 to 1 margin. The first decision was to select a 15-acre campus. In 1947, voters approved an $8 million bond issue to finance construction and operation of a 275-bed hospital. The tax district spans seven townships that elect five district community members to a governing board for the district hospital’s four entities, which include the hospital, joint ventures that operate an urgent care center and a hospice, and the hospital foundation.

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