Board Meeting Highlights
October 28, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.$2 Million Technology Grant Awarded
John C. Fremont Healthcare District received a $2 million Year 1 award through the California Rural Health Transformation (CalRHT) Technology Grant, supporting efforts to modernize healthcare technology and improve coordination across the District. The District is awaiting final award notification and payment.
The funding presents an opportunity to move toward a more integrated electronic health record (EHR) system, connecting clinical services, patient information, billing, and operational departments that currently rely on separate systems.
Potential investment priorities include:
Electronic health record modernization and system integration
Electronic health record modernization and system integrationImproved clinical documentation and care coordination
Cybersecurity and technology infrastructure
Staff training, implementation, and long-term system sustainability
The District will finalize project priorities and implementation plans in accordance with grant requirements. Year 1 funding must be spent by September 30, 2027. Additional funding opportunities may be available in future years but are not guaranteed.
Board Approves $7 Million Distressed Hospital Grant Application
The Board approved moving forward with a $7 million application to the California Department of Health Care Access and Information (HCAI) Distressed Hospital Grant Program.
The proposed funding would support five strategic initiatives focused on strengthening financial sustainability, improving hospital operations, and expanding access to local healthcare services.
Key investment areas include:
Financial Performance: Modernizing billing and revenue cycle processes to reduce denials, improve collections, and strengthen financial stability
Care Delivery & Productivity: Improving patient room technology, communication systems, and workflows to support staff efficiency and patient experience
Expanded Local Services: Evaluating opportunities to increase surgical and outpatient treatment capacity, improve access, and keep more healthcare services close to home
The application deadline is November 9, 2026. Funding remains subject to state review and approval.
Additional Grant Funding Opportunities
District leadership shared updates on several additional funding opportunities supporting healthcare access, patient experience, and workforce development.
These include:
Central California Alliance for Health: Seeking up to $500,000 in potential support for programs and services, including the Community Health Worker program and Northside Clinic
Flex CARE Grant: Requesting $15,000 to improve patient communications, educational materials, patient experience surveys, and hospital signage
Flex Conference Grant: Pursuing a $1,500 funding opportunity to support professional development and rural healthcare education
These opportunities are part of ongoing efforts to secure external resources that support the District's operations and community healthcare needs.
September Financial & Operational Update
The Board received the District's September 2026 financial report, reflecting continued growth in patient activity alongside ongoing financial improvement efforts.
Fiscal year-to-date highlights included:
Operating revenue of approximately $9.49 million, an increase of $1.92 million compared with the same period last year
An operating loss of approximately $944,000
An overall year-to-date gain of approximately $819,000 after non-operating revenue
Approximately $16.7 million in cash and investments, including $15.1 million in restricted funds
Approximately 14.5 days of operational cash on hand
The District continues to prioritize financial stabilization, improved collections, expense management, and maintaining sufficient operational cash.
Patient Volumes Continue to Grow
Patient activity increased across several District services during the first three months of the fiscal year compared with the same period last year.
Highlights included:
Clinic visits increased 17%, reaching 4,388 visits
Emergency Department visits increased 6%, reaching 2,149 visits
Swing Bed patient days increased 23%
Acute patient days increased 6%
Average daily inpatient census increased from approximately 7.2 to 9.7 patients
These increases reflect continued demand for local healthcare services and reinforce the importance of strengthening staffing, workflows, and operational capacity.
HCAI Loan & Measure O Updates
The Board received updates on existing HCAI loan funds and Measure O revenues supporting the future hospital project.
As of September 30, 2026:
Approximately $14.65 million in Measure O revenue had been recorded
Approximately $4.63 million had been spent toward the future hospital project
Approximately $10.39 million remained available for qualifying Measure O expenditures
Approximately $4.02 million in HCAI loan proceeds remained available for qualifying disbursements
The District is requesting state authorization to use eligible remaining HCAI loan proceeds and associated earnings for essential operating expenses, including payroll, provider payments, and medical supplies.
Any changes to the approved use of these restricted funds require written authorization from HCAI.
The District is pursuing an additional 12 months of HCAI loan forgiveness, potentially providing approximately $2.1 million in payment relief, subject to state approval.
Revenue Cycle Improvements
District leadership provided an update on ongoing efforts to strengthen billing accuracy, claims processing, and financial reporting.
The District is working to identify and correct longstanding system configuration issues, manual billing processes, and gaps in charge capture and payment posting.
Current priorities include:
Improving registration and insurance verification accuracy
Strengthening coordination between clinical, registration, and billing teams
Reviewing older accounts receivable balances to determine collectibility
Improving Swing Bed billing workflows and claim classification
Reducing billing delays, denials, and rejected claims
Establishing reliable performance measures and reporting
These improvements are intended to strengthen financial performance while creating more efficient and consistent processes for patients and staff.
Clinic Quality & Preventive Care
The Board received updates on ongoing quality improvement initiatives focused on preventive care, chronic disease management, and patient outreach.
Notable progress included:
Blood pressure control improved to approximately 72% in October, exceeding the established performance goal
The District achieved 100% of its performance target for the 2025 Glycemic Status Assessment quality incentive measure
Continued improvements in depression screening and follow-up documentation
Expanded outreach efforts to support breast cancer screening, cervical cancer screening, and well-child visits
The District is also exploring the feasibility of mobile mammography services in underserved communities, potentially including North County, El Portal, and Catheys Valley.
These efforts aim to improve access to preventive services and help patients receive recommended care closer to home.
Hospital Quality & Patient Experience
The Board received updates on Emergency Department performance, patient throughput, and ongoing hospital quality improvement efforts.
The District reported an average Emergency Department length of stay of approximately 2 hours and 30 minutes for patients not admitted to the hospital, compared with a reported California average of approximately 2 hours and 59 minutes.
Hospital quality priorities include:
Monitoring Emergency Department returns within 72 hours and hospital readmissions within 30 days
Reviewing clinical patterns to identify opportunities for improvement
Strengthening sepsis care protocols and staff education
Using patient experience feedback to guide improvements
Improving clinical documentation, communication, and care coordination
These initiatives support the District's continued focus on patient safety, quality, and accessible healthcare.
John C. Fremont Hospital Foundation Update
The Board received an update highlighting the Hospital Foundation's continued support of local healthcare.
Recent highlights included:
An $8,000 blood gas analyzer donated by a private donor
The Foundation welcoming Mary Jensen to its Board
A record $44,000 in sponsorships for the annual Black & White Ball fundraiser
The Foundation continues to support healthcare equipment, programs, and initiatives benefiting patients and the community.
Board Governance & Oversight
The Board addressed several items related to governance, financial oversight, and future meeting operations.
Finance Committee: The Board approved moving forward with the Finance Committee, with its initial meeting to be scheduled before the December 16 Board Meeting.
Board Meeting Location: Discussion regarding relocating regular Board meetings to the Mariposa County Board of Supervisors Chambers was tabled until November.
Board Resignation: The Board discussed Director Teresa Johnson's resignation from her current term, effective November 18, 2026, just two weeks before the term's scheduled expiration on December 2. No action was taken due to the short remaining period. Any potential vacancy associated with her upcoming term would be addressed separately through the appropriate Board vacancy process.
Looking Ahead
The District's ongoing priorities include:
Strengthening financial sustainability and revenue cycle performance
Pursuing grant funding and responsible use of available resources
Modernizing technology and improving coordination across departments
Advancing future hospital planning and financing
Expanding access to preventive care and local healthcare services
Supporting quality improvement and patient experience
Strengthening Board governance and financial oversight
The next Regular Board Meeting is scheduled for November 18, 2026.
Official Board agendas, meeting materials, and approved minutes are available here.
October 14, 2026 Special Board Meeting - Community Town Hall
This summary highlights information shared during the District's October 14 Community Town Hall and is not a substitute for the official Special Board Meeting Minutes.Watch the Town Hall Recording
The full October 14, 2026 Community Town Hall recording is available here:
VIEW RECORDING HERE
John C. Fremont Healthcare District hosted a Community Town Hall at the Mariposa County Board of Supervisors Chambers to share updates on the future hospital project, financial planning, quality improvement initiatives, patient access and long-term District priorities.
The evening also included an opportunity for community members to ask questions and engage directly with District leadership and the Board of Directors.
Measure O: Community Investment in the Future Hospital
District leadership reviewed how Measure O funding is supporting the future hospital project.
As of August 31, 2026:
- Approximately $14.26 million in Measure O revenue had been generated.
- Approximately $4.47 million had been spent on qualifying project expenditures.
- Measure O continues to serve as a key component of the District's overall hospital financing strategy.
Future Hospital Project: Where We Are
The future hospital project continues through the state design review process with the California Department of Health Care Access and Information (HCAI).
The project is currently in the first of three anticipated HCAI review cycles. Four review areas have returned comments, with the project team awaiting structural review comments before completing revisions and moving toward the next review cycle.
Project leadership shared the following anticipated milestones:
- August 2027: Target for completing permitting and approvals
- Late 2027 into early 2028: Construction bidding and contractor selection activities
- Spring 2028: Anticipated construction mobilization
The District also discussed California's seismic compliance requirements and confirmed that an initial six-month extension has been granted, with additional extensions potentially available through the applicable state process.
Future Hospital Financing
The District confirmed that its USDA Rural Development loan pre-application has been submitted and is awaiting feedback.
The USDA process includes preliminary review, financial feasibility evaluation and, if invited, a full loan application.
Leadership also discussed an alternative financing strategy involving sales tax revenue bonds supported by Measure O.
The District continues evaluating financing options while strengthening operational performance and long-term financial sustainability.
Improving Billing & Revenue Cycle Operations
District leadership shared progress on efforts to improve billing accuracy, reduce manual processes and strengthen financial performance.
Current initiatives include:
- Improving insurance eligibility verification and patient registration
- Correcting billing and claim-processing issues
- Improving payment reconciliation and financial reporting
- Evaluating automation and system improvements
- Strengthening coordination between clinical, registration and billing teams
Improving Clinic Access & Preventive Care
The District shared several initiatives focused on making healthcare easier to access and helping patients receive recommended preventive care.
Recent improvements include electronic clinic check-in, online registration options, outreach to patients overdue for preventive services and additional attention to referral processing.
Reported progress included:
- Blood pressure control improved from 48% in April to 71% in October, exceeding the District's stated goal.
- Over a two-month period, outreach efforts supporting children's well-child visits included 210 outreach attempts, 77 appointments scheduled and 49 completed visits.
- September clinic activity included 877 kiosk check-ins and 742 completed electronic questionnaires.
Looking Ahead: Strengthening Healthcare Close to Home
District leadership outlined priorities for the next 12 months, including:
- Strengthening financial sustainability and pursuing available funding opportunities
- Modernizing technology and reducing manual workflows
- Improving patient communication, navigation and overall experience
- Exploring expanded infusion services and additional specialty care
- Evaluating opportunities to expand Northside Clinic access
- Developing a coordinated long-term strategic plan
Community Questions & Discussion
The Town Hall concluded with an extended question-and-answer session.
Community members raised questions about the future hospital's estimated costs, construction and financing timelines, Measure O revenue assumptions, loan and grant funding strategies, and the District's long-term financial outlook.
District leadership and Board members discussed the current planning assumptions, financing alternatives and the importance of continued public reporting as additional information becomes available.
Thank You, Mariposa County!
Thank you to everyone who attended in person or virtually, submitted questions and participated in the discussion.
The District remains committed to sharing updates, listening to community feedback and strengthening access to quality healthcare close to home.
View official Board agendas, meeting materials and approved minutes.
September 23, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.Future Hospital Financing Moves Forward
The Board received an update on financing efforts for the future hospital project, including a presentation regarding the U.S. Department of Agriculture (USDA) loan process.
The Board unanimously approved moving forward with submission of the USDA loan pre-application, representing another step in exploring financing for the future hospital project.
The Board also received updates regarding Measure O funding and the District's HCAI loan.
Financial & Operational Update
The Board received the District's August 2026 financial and operational update.
Key points included:
Year-to-date operating revenue totaled approximately $6.01 million, an increase of approximately $848,000 compared with the same period last year
The District reported a year-to-date operating loss of approximately $1.02 million
After non-operating revenue, the District reported an overall year-to-date gain of approximately $182,000
Several areas continued to show increased patient activity, including Emergency Department visits, inpatient census, Swing Bed utilization and clinic visits
Leadership continues to focus on financial stabilization, liquidity, revenue performance and improved financial reporting.
Revenue Cycle Improvements
District leadership provided an update on ongoing work to strengthen billing and revenue cycle operations.
Current efforts include:
Implementing real-time insurance eligibility verification
Correcting clinic billing and provider enrollment issues
Processing previously missing claims
Improving payment reconciliation
Developing automated claim work queues
Reviewing scheduling and patient access workflows
Evaluating opportunities to improve the use of existing billing and electronic health record systems
Future reporting will increasingly focus on measurable results, including clean claims, denials, accounts receivable and cash collections.
Medical Staff Revalidation Survey Update
The District received written correspondence from the California Department of Public Health (CDPH) on September 3, 2026 confirming that John C. Fremont Healthcare District is in Substantial Compliance with the Medical Staff Conditions of Participation.
The revalidation survey, conducted August 6-7, followed up on corrective actions and oversight processes implemented after the December 2025 survey.
Ongoing efforts include continued implementation of MedTrainer, routine medical staff file audits, improved organization and accessibility of medical staff documentation, and continued monitoring to support ongoing compliance.
Specialty Care & Provider Access
The Board unanimously approved seven updated provider agreements supporting continued access to specialty and clinical services.
The agreements support:
Dermatology
Infectious Disease/HIV consulting
Gastroenterology
Rheumatology
Cardiopulmonary medical direction
Neurology
Laboratory medical review
The updated agreements are part of ongoing efforts to maintain and strengthen access to healthcare services for the community.
JCF Hospital Foundation Update
The Board received an update from the John C. Fremont Hospital Foundation highlighting its continued support of local healthcare through equipment purchases, programs, scholarships and community fundraising.
The Foundation has provided approximately $125,000 in combined equipment, program and scholarship support over the past three fiscal years.
Recent support has included medical equipment such as IV pumps, a ventilator, infant and neonatal equipment, a defibrillator and wheelchairs, as well as employee scholarships.
The District and Foundation continue to strengthen coordination while the Foundation remains an independent nonprofit organization with its own Board, finances and philanthropic mission.
Board Governance & Oversight
The Board took several actions aimed at strengthening governance, financial oversight and Board operations:
Established a new Finance Committee, with Director Jon Wurl serving as Committee Chair and Vice Chair Teresa Johnson serving as the attending director
Appointed Directors Jesse Bullis and Rob Fox to the Ad Hoc Replacement Hospital Committee
Approved a new Board of Directors onboarding binder to provide Board members with consistent information, resources and governance materials
Directed that the onboarding materials also be made available digitally on the District website
The Board also continued work on meeting procedures, policies and ongoing Board education.
Community Town Hall
The District's next Community Town Hall will be held:
Wednesday, October 14, 2026
6:00 PM
Mariposa County Board of Supervisors Chambers
The Town Hall will provide an opportunity for the community to hear District updates and learn more about current initiatives and future planning.
Next Steps
The Board and District leadership will continue to focus on:
Financial stabilization and revenue cycle improvements
Future hospital planning and financing
Regulatory compliance and survey readiness
Maintaining and expanding access to healthcare services
Strengthening Board governance and financial oversight
Community engagement and transparency
The next Regular Board Meeting is scheduled for October 28, 2026.
Official agendas, materials, and approved minutes are available here.
August 26, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
FY 2026-27 Budget Approved
The Board approved the District's FY 2026-27 annual budget.
The budget projects $35.2 million in net operating revenue and $4.6 million in full-year income, including non-operating support. The budget also identifies a projected $725,000 operating loss, with continued focus on revenue cycle performance, labor and provider costs, expense management, and monthly financial monitoring.
Employee Compensation & Benefits
The Board approved several actions related to employee compensation and benefits:
Completion of the remaining retroactive pay balances for bargained employees
A Paid Time Off (PTO) cashout option for eligible employees
A rate increase for non-bargained employees
These actions support continued implementation of employee compensation and benefit commitments across the District.
Replacement Hospital Project
The Board received an update on the future hospital replacement project.
Current work includes:
Awaiting first-review comments from the California Department of Health Care Access and Information (HCAI)
Revising project drawings once HCAI comments are received
Developing an updated construction cost estimate
Preparing the USDA Rural Development pre-application for submission in September
As of July 31, approximately $9.64 million in Measure O funds remained available for qualifying project expenditures.
Revenue Cycle Improvement
The Board received an update on efforts to strengthen the District's revenue cycle, including patient registration, eligibility, charge capture, coding, claims, denials, and payment processing.
Current improvement efforts include:
Reducing manual processes and duplicate work
Improving system integration and automation
Strengthening billing and compliance controls
Improving charge capture and claim accuracy
Targeting claim errors and denials
The monthly denial percentage reported in the presentation declined from approximately 40% in May to approximately 31% in July as the District continues identifying and addressing underlying workflow, system, and process issues.
Patient Volumes
The Board received July patient volume updates showing increased activity across several District services.
Highlights included:
763 Emergency Department visits, a 4% increase over the comparable prior-year period
July recorded the highest monthly Emergency Department volume in the previous 12 months
1,533 clinic visits, approximately 16% higher than the comparable prior-year period
Inpatient average daily census increased compared with the prior-year period
Community Town Hall
The Board selected Wednesday, October 14, 2026 at 6:00 p.m. for a John C. Fremont Healthcare District Community Town Hall.
The Town Hall will be held as a Special Board Meeting and will provide an opportunity for community members to hear District updates and participate in the conversation.
Additional information will be shared as the event approaches.
Exploring Additional Workforce Housing
The Board authorized the CEO to continue discussions with Mariposa County regarding a Letter of Intent related to the Missouri Gulch property.
The potential partnership could expand the number of housing units available to the District for workforce housing. Any future agreement would be subject to additional development and applicable approval processes.
District & Community Updates
The Board also received updates on community outreach, marketing, patient experience, and communication initiatives.
Recent efforts included:
Expanded clinic marketing through digital advertising, radio PSAs, and community partnerships
Participation in Back to School events and Soccerfest
Continued promotion of providers, same-day appointments, and Saturday clinic availability
Positive patient feedback recognizing compassionate and attentive care across District services
Completion of the FLEX Grant project focused on patient communication, education materials, PEAKS Patient Experience Cards, staff education, and English/Spanish resources
Successful tools and feedback processes developed through the FLEX Grant will continue beyond the grant period.
Official agendas, materials, and approved minutes are available here.
August 4, 2026 Special Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Regional Partnership Exploration
The Board met in a Special Meeting to consider a proposed regional partnership between John C. Fremont Healthcare District and Oak Valley Hospital District.
District leadership discussed opportunities to collaborate in areas including:
Workforce development
Shared services
Technology modernization
Operational support
Regional healthcare collaboration
Leadership emphasized that the discussion centered on exploring opportunities that could strengthen healthcare services for both communities while preserving each district's local governance.
Board Action
Following discussion and public comment, the Board unanimously approved a non-binding Letter of Intent between John C. Fremont Healthcare District and Oak Valley Hospital District.
The Letter of Intent authorizes District leadership to continue discussions and negotiate a proposed Support Services Agreement, which would return to both Boards for future review and consideration.
The approved Letter of Intent will also support the District's application for California Rural Health Transformation (CalRHT) grant funding.
Next Steps
District leadership will continue working collaboratively with Oak Valley Hospital District to develop a proposed Support Services Agreement.
Any future agreement will be presented to the Board for public review and consideration before any final action is taken.
Future updates will be shared as progress continues.
Official agendas, materials, and approved minutes are available here.
July 22, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Board Governance & Policies
The Board reviewed and approved several governance and administrative updates designed to strengthen organizational oversight and Board operations.
Topics included:
Adoption of updated administrative policies
Approval of a revised Board Code of Conduct
Review of the Board of Directors position description
Continued onboarding of newly appointed Board members
Community & Board Engagement
The Board received updates regarding the upcoming November 2026 Board election and ongoing Board education efforts.
Board members also shared information gathered from outreach with healthcare leaders and other California healthcare districts to support continuous improvement and governance best practices.
Hospital Foundation Update
The John C. Fremont Hospital Foundation provided an update on recent fundraising efforts, donor engagement, and upcoming community events supporting patient care and District programs.
Financial & Operational Update
District leadership presented June 2026 financial results and operational updates.
Discussion included:
June unaudited financial statements
Fiscal performance and cash position
HCAI loan update
Measure O funding update
District patient volumes
Development of the FY 2026-2027 operating budget
Leadership also shared continued work to strengthen financial reporting, internal controls, revenue cycle performance, and long-term financial sustainability.
Hospital Operations & Patient Care
Department leaders provided updates on several initiatives focused on improving patient care, quality, and operational performance.
Highlights included:
New hospital replacement project progress
Survey readiness and standardized processes
Nursing and clinical quality initiatives
Human Resources and workforce development
Community Health programs, including clinic initiatives and the Ryan White Program
Outreach, marketing, and community engagement activities
Board Actions
The Board took action on several items, including:
Approval of the CEO Employment Agreement
Approval of an electronic medical record interface agreement
Approval of revised Board bylaws
Approval of establishing a standing Finance Committee
Updates to Board committee assignments
Next Steps
The Board and District leadership will continue focusing on:
Financial stewardship and budget adoption
Strengthening governance and Board development
Enhancing patient care and operational performance
Advancing the new hospital replacement project
Community engagement and organizational transparency
Future updates will be shared as progress continues.
Official agendas, materials, and approved minutes are available here.
June 24, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Board Governance & Procedures
The Board approved the consent agenda and adopted an updated meeting process based on the Rosenberg Rules to provide a clearer structure for agenda items, Board discussion, and public comment.
The Board also announced three Board seats that will appear on the November 2026 General Election ballot:
Two full four-year terms
One partial two-year term
The candidate declaration period will run from July 13 through August 7, 2026.
Hospital Foundation Update
The Board received an update from the John C. Fremont Hospital Foundation highlighting recent accomplishments, including:
Awarding scholarships to local students pursuing healthcare careers
Achieving Candid's Platinum Seal of Transparency
Providing $15,430 in equipment grants to the District
Raising more than $15,000 toward the purchase of five new IV pumps
Preparing to launch an employee payroll giving program through Paycom beginning in August
Financial & Operational Update
The Board reviewed the May 2026 financial report and ongoing efforts to strengthen the District's financial performance.
Key discussion points included:
Continued implementation of stronger financial controls and standardized monthly reconciliation processes
Evaluation of accounts payable automation to improve invoice processing and vendor payment tracking
Development of new finance key performance indicators and reporting tools
Plans to move toward quarterly rolling forecasts to improve budgeting accuracy and respond to changing operational conditions
Continued focus on revenue growth, patient volumes, and operational performance
Leadership reported that the District maintains strong liquidity while continuing efforts to improve operating margins and long-term sustainability.
District Volumes
The Board received updates on patient volumes across District services.
Highlights included:
Emergency Department visits averaging approximately 20 patients per day
Continued year-over-year growth in the inpatient average daily census
Stable performance in Clinic 1
Continued efforts to increase patient access and visit volumes in Clinic 2 and Clinic 3
Clinical Quality & Patient Care
The Board received updates on several initiatives designed to improve patient safety and quality of care, including:
Expansion of the Falling Stars fall prevention program
Updated post-fall huddles, supplies, and staff response procedures
Improvements to emergency response processes and pharmacy code carts
Respiratory care and ventilator training for nursing staff
Enhanced neonatal resuscitation training and updated neonatal and delivery equipment
Clinic Services & Patient Access
Leadership shared updates on efforts to improve access, quality, and efficiency within the clinics.
Current initiatives include:
Expanded Care Gap clinics focused on preventive health measures
Improvements to patient scheduling and communication
Development of electronic forms and documentation tools
Future implementation of patient check-in technology and electronic questionnaires
Continued efforts to reduce missed appointments
The Care Gap initiative has already contributed to increased preventive care appointments, including a significant increase in well-child visits.
Human Resources & Workforce Development
The Board received an update on workforce recruitment and Human Resources initiatives, including:
Continued recruitment for critical and hard-to-fill positions
Migration of recruitment and workforce data into Paycom
Ongoing implementation and correction of payroll processes
Continued collaboration with employee bargaining units
Strategic review of staffing needs and workforce priorities
Patient Experience & Community Outreach
Leadership reported positive early feedback from the new PEAKS Patient Experience Card initiative developed through the FLEX Grant.
Additional updates included:
Implementation of the Patient & Visitor Code of Conduct
English and Spanish signage and patient information materials
Participation in summer community outreach events
Planning for the District's 75th Anniversary celebration on September 18, 2026
Hospital Replacement Project
The Board received an update on the future hospital replacement project.
Topics discussed included:
Continued value engineering and review of construction options
Ongoing structural and civil engineering analysis
Continued coordination with HCAI regarding design review and permitting
Development of a new USDA funding pre-application
Continued review of project timelines and the potential need for an additional seismic compliance extension
Board Actions
The Board took the following actions:
Approved the consent agenda and prior meeting minutes
Approved renewal of BioFire equipment warranties supporting rapid pathogen testing
Postponed presentation of the FY 2026–2027 budget to allow additional review, planning, and stakeholder input
Next Steps
The Board and District leadership will continue focusing on:
Financial stabilization and stronger internal controls
Patient safety and clinical quality improvement
Workforce recruitment and development
Improving patient access and experience
Advancing the future hospital replacement project
Finalizing the FY 2026–2027 budget
Future updates will be shared as progress continues.
Official agendas, materials, and approved minutes are available here.
May 27, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.Board Appointments & Governance
The Board welcomed newly appointed Board Members Rob Fox and Jon Wurl during the meeting.
The Board also continued discussions focused on governance structure, financial oversight, and organizational planning.
Mission, Vision & Organizational Culture
District leadership shared continued efforts to integrate the organization's Mission, Vision, and PEAKS Guiding Principles into daily operations and workplace culture.
The PEAKS principles include:
Person-Centered
Engage
Accountable
Kindness
Service-Oriented
Leadership discussed ongoing efforts to strengthen teamwork, accountability, patient experience, and employee engagement across the District.
Financial & Operational Update
The Board received financial updates for April 2026 and fiscal year-to-date operations.
Key discussion points included:
Continued financial pressures related to lower-than-expected net revenue
Improvement in several patient volume areas, including inpatient census and Emergency Department visits
Ongoing efforts to improve revenue cycle performance, billing accuracy, and accounts receivable management
Expense management efforts, including reductions in purchased services and operational costs
Leadership also discussed plans to improve financial reporting processes, budgeting assumptions, and presentation clarity moving forward.
Revenue Cycle & Accounts Receivable Improvements
District leadership discussed ongoing work to improve accounts receivable performance and reduce aging claims.
Current efforts include:
Weekly revenue cycle review meetings
Development of 30-, 60-, and 90-day action plans
Review of system workflows and billing processes
Audit preparation and reporting improvements
Leadership noted the long-term goal is to significantly reduce accounts receivable aging and improve days cash on hand.
New Hospital & Strategic Planning Update
The Board received updates regarding the new hospital project and long-term master planning efforts.
Topics discussed included:
Continued HCAI review cycles and regulatory coordination
Ongoing work with architects and construction partners
Planning timelines, permitting, and financing strategies
USDA loan planning and Measure O funding considerations
Long-term opportunities for future healthcare campus expansion and service development
Leadership also discussed the development of future planning tools and milestone timelines to help guide long-range facility planning efforts.
Measure O & Restricted Funds
The Board reviewed updates regarding Measure O funding and restricted project funds related to the future hospital project.
Discussion included:
Ongoing accumulation of Measure O funding
Project expenditures related to planning, engineering, and architectural services
Use of restricted HCAI funding and financial reporting improvements
Leadership emphasized continued efforts to improve transparency and clarity around financial reporting and project funding updates.
Next Steps
The Board and leadership will continue to focus on:
Financial stabilization and operational improvements
Revenue cycle performance and reporting enhancements
Regulatory compliance and quality improvement
Long-term planning for healthcare services and facilities
Continued development of the future hospital project
Future updates will be shared as progress continues.
Official agendas, materials, and approved minutes are available here.
May 20, 2026 Special Board Meeting Community Update
The Board of Directors of John C. Fremont Healthcare District held a Special Meeting to address Board vacancies.
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Board Leadership, Appointments & Action
The Board appointed two community members to fill current Board vacancies:
Rob Fox
Jon Wurl
The appointments support continued governance and Board operations while maintaining a full Board of Directors.
Official agendas, materials, and approved minutes are available here.
May 1, 2026 Special Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Board Leadership Actions
The Board formally accepted the resignation of Wendy Ryder-Priola & Craig Burchfiel from the Board.
The Board appointed Rose Fluharty to serve as Board Chair, Teresa Johnson to serve as Vice Chair, and Jesse Bullis to remain Secretary/Treasurer.
Continuity of Operations
The Board will continue its regular meeting schedule and ongoing work related to District operations, financial oversight, and long-term planning.
Next Steps
The Board is accepting letters of interest to fill the two vacancies on the Board until the general election in November 2026. Interested parties need to submit their letter of interest to windy.gonzalez@jcf-hospital.com by Sunday, May 17. The Board will then hold a Special Meeting Wednesday, May 20 to review all interested parties, with the possibility of appointing them during the meeting.
April 22, 2026 Regular & Finance Board Meeting Community Update
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Board Leadership Update
Board Chair Wendy Ryder-Priola announced her resignation from the role of Chair and will continue to serve as a member of the Board.
The board initiated leadership transition actions, with Vice Chair Rose Fluharty expected to assume the role of Board Chair.
Governance & Board Operations
The Board discussed steps to strengthen governance practices and meeting structure, including alignment with Brown Act requirements and board procedures.
Ongoing efforts will focus on improving consistency, accountability, and clarity in board operations.
Mission & Vision Integration
District leadership reaffirmed the organization’s Mission and Vision statements and emphasized their integration into daily operations, decision-making, and patient care.
Financial & Operational Update
The Board received financial updates for the fiscal year-to-date through March 2026.
Operations continue to reflect a year-to-date loss driven primarily by revenue underperformance
Expenses are being actively managed, though not fully offsetting revenue gaps
Cash flow, accounts receivable, and financial performance remain under close review
Leadership emphasized ongoing efforts to stabilize financial performance and improve revenue cycle operations.
Financial Strategy & Oversight
The Board received updates on financial strategy and planning:
A Chief Financial Officer has begun supporting the District’s financial reporting and planning efforts
Work is underway on forecasting, budget development, and audit preparation
The District is preparing a loan forgiveness application and exploring additional funding opportunities, including state and federal programs
Regulatory & Compliance Update
The Board reviewed updates on regulatory survey activity:
A recent survey resulted in a submitted plan of correction, currently under review
Monitoring and audit processes are in place for previously accepted plans
Follow-up survey activity is anticipated
Operational & Clinical Improvements
The Board reviewed ongoing efforts to improve operations, patient care, and service delivery:
Improvements in revenue cycle processes, including billing accuracy and payer system access
Increased point-of-service collections
Continued process improvements in outpatient procedures to reduce cancellations and improve coordination
An example of recent improvements included increased completion rates for outpatient procedures through enhanced coordination between clinical and administrative teams.
Grants & Program Development
The Board received updates on grant funding and program expansion:
Ongoing provider recruitment and workforce development efforts
New and pending grant opportunities to support patient outreach, care coordination, and service expansion
Equipment and technology investments to support clinic and hospital operations
Facilities & New Hospital Planning
The Board received updates on the new hospital project:
HCAI design review comments have been received and are being addressed
Updated cost estimates are in development to support future funding applications
Planning continues to align regulatory approvals, financing, and construction timelines
Board Actions
The Board took the following actions:
Approved prior meeting minutes
Approved a change order for civil engineering services related to site and parking improvements
Approved engagement of legal counsel to support medical staff bylaws and provider contracting
Next Steps
The Board and leadership will continue to focus on:
Strengthening financial performance and oversight
Advancing regulatory compliance and quality improvement
Improving operational efficiency and patient experience
Supporting long-term planning for facilities and services
Future updates will be shared as progress continues.
Official agendas, materials, and approved minutes are available here.
April 2, 2026 Special Board Meeting Community Update
Special Meeting – Strategic & Master Planning Session #4
The Board of Directors of John C. Fremont Healthcare District held a special meeting on April 2, 2026 to conclude a series of strategic and master planning sessions focused on the future hospital campus.
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Meeting Focus
This meeting marked the fourth and final session in a series of planning discussions with the District’s architectural team. The goal of the session was to review refined planning options and identify next steps to support long-term decision-making for the hospital campus.
Key Topics Discussed:
Refined Campus Planning Options
The Board reviewed two primary planning approaches for the future campus:
1. Renovation and repurposing of existing facilities
2. Removal of existing structures and development of new clinical space
Discussion focused on comparing these approaches in terms of cost, long-term maintenance, operational impact, and flexibility.
Clinical Services and Future Program Planning
The Board discussed potential future services to guide facility planning, including:
Outpatient services such as physical therapy, infusion, and dialysis
Specialty care supported by rotating providers (e.g., cardiology, gastroenterology, nephrology)
Procedure-based services and supporting clinical space
Additional input will be gathered to help define service priorities and space needs.
Skilled Nursing Capacity and Demand
The Board reviewed planning considerations for skilled nursing services, including:
Target bed capacity and current demand
Opportunities to expand services while maintaining required minimum bed counts
The role of skilled nursing in long-term sustainability and revenue generation
Operational, Regulatory, and Cost Considerations
Discussion included factors that may influence future decisions, such as:
Licensing and regulatory requirements
Differences between renovating existing buildings and constructing new facilities
Long-term maintenance and lifecycle costs
Construction phasing to maintain operations during future development
Site Constraints and Infrastructure Considerations
The Board and project team discussed site-related factors that may impact planning, including:
Parking capacity and future expansion needs
Traffic flow and pedestrian safety
Helipad location and associated constraints
Infrastructure considerations such as utilities and potential future enhancements
Next Steps
The Board and project team will continue refining planning assumptions, including:
Defining service lines and program needs
Gathering input from clinical staff and stakeholders
Developing comparative cost information to support future decision-making
Future updates will be provided as planning progresses.
Official agendas, materials, and approved minutes are available here.
April 1, 2026 Board Meeting Community Update
Regular & Finance Meeting
The Board of Directors of John C. Fremont Healthcare District held its Regular and Finance Meeting on April 1, 2026.
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes.
Mission, Vision & Guiding Principles Adopted
The Board approved the District’s updated Mission, Vision, and Guiding Principles.
These statements will guide decision-making, patient care, and organizational culture moving forward, with a focus on delivering high-quality, compassionate, and accessible healthcare to the community.
Financial & Operational Update
The Board received an update on the District’s financial performance and operations through February 2026.
Clinic volumes showed mixed trends across service lines, with some areas experiencing growth while others saw declines due to factors such as temporary closures and shifting patient demand
The District continues efforts to balance operational sustainability with maintaining access to care in a rural setting
Regulatory & Compliance Update
The Board reviewed updates on recent regulatory surveys and compliance status:
Multiple routine surveys were completed with plans of correction accepted
A prior medical staff survey remains in progress, with follow-up review pending to confirm continued compliance
Financial Strategy & Oversight
The Board discussed ongoing financial planning efforts, including:
Preparation for a potential loan forgiveness application through the Distressed Hospital Loan Program
Approval of external financial consulting services to support financial oversight and long-term planning
Operational Improvements
The Board approved and discussed initiatives to strengthen internal operations, including:
Implementation of a new HR and payroll system to improve accuracy, reporting, and administrative efficiency
Continued efforts to standardize workflows and improve internal processes
Patient Experience & Communication
The Board reviewed efforts to improve communication and patient experience across the organization:
A quality improvement initiative is underway to standardize communication at check-in, during care, and at discharge
The initiative focuses on creating clear, consistent expectations for patients and families
Community Town Hall
A public community town hall has been scheduled to provide updates and hear directly from residents:
Date: April 18, 2026
Time: 2:00 PM
Location: Board of Supervisors Chambers, 5100 Bullion Street, Mariposa
The meeting will include updates on District and County matters and an opportunity for community input.
Next Steps
The Board and leadership will continue to focus on:
Financial stability and long-term sustainability
Regulatory compliance and quality improvement *Strengthening communication with patients and the community *Future updates will be shared as progress continues.
Official agendas, materials, and approved minutes are available here.
March 19, 2026 Special Board Meeting Community Update
Special Meeting - Future Hospital Planning Session
The Board of Directors held a special meeting on March 19, 2026 to continue strategic planning discussions related to the new hospital project.
Meeting Focus:
This meeting was the third in a series of planning sessions focused on evaluating options for future campus configuration, service delivery, and long-term operational sustainability.
Key Topics Discussed:
Campus Planning Options
The Board and project team reviewed multiple planning options for the future hospital campus, including approaches that would:
Repurpose portions of the existing hospital building
Expand clinical and outpatient services
Consolidate or expand skilled nursing capacity
Evaluate the potential removal and replacement of existing structures
Discussion included trade-offs between cost, operational continuity, and long-term flexibility.
Clinical Services and Space Planning
The Board discussed future service needs and space considerations, including:
Behavioral health intake and proximity to the emergency department
Outpatient services such as physical therapy, infusion, and specialty clinics
Laboratory and pharmacy placement
Imaging services, including potential placement of MRI within the hospital building
The importance of aligning facility design with clinical workflow and patient safety was emphasized.
Skilled Nursing Facility (SNF) Capacity
Discussion included planning considerations related to skilled nursing services, including the number of beds, location within the campus, and potential operational and regulatory implications.
Operational and Regulatory Considerations
The Board reviewed factors that may impact planning decisions, including:
Regulatory requirements and licensing considerations
Construction and design constraints
Parking and traffic considerations
Potential cost differences between renovating existing facilities and new construction
Strategic Planning and Next Steps
The Board discussed the need to further define service offerings, space requirements, and operational priorities to support ongoing planning efforts. Input from clinical staff and additional analysis will help inform next steps.
What Happens Next
The Board and project team will continue to refine planning options and gather additional input. A future meeting is expected to further narrow options and support decision-making.
Next Meeting
Next Special Planning Meeting: Thursday, April 2, 2026 at 2:00 p.m. in the JCFHD Board Room (5189 Hospital Road) and virtual via MS Teams. Everyone is welcome.
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes. Full agenda packets and approved minutes will be posted on our website once finalized.
Click here for more Board Meeting information.
February 26, 2026 Special Board Meeting Community Update
We held a special board meeting on February 26 focused on strategic and master planning for our new hospital project, specifically with what comes next after we meet the 2030 seismic deadline. This was Workshop #2 in our planning series, and we're grateful for the community's ongoing interest.
Quick Snapshot:
Meeting Objectives: We reviewed priorities for future services and guided the development of planning concepts to better serve community health needs.
Recap from Prior Session: Discussed key areas like community needs, current service gaps, and pressures on existing capacity and operations.
Future Planning Options: Explored scenarios for post-2030 improvements, including:
- Remodeling the existing building into expanded clinics, skilled nursing facilities (SNF), and behavioral health spaces.
- Options to expand SNF beds, add an MRI suite, grow medical/surgical areas, or build a new multi-office building (MOB) — even a two-level MOB with SNF on the upper floor.
- Addressed required upgrades to the current hospital, potential impacts on the new build, and code compliance.
Led by Cuningham: Our planning partners presented these options to help us choose the best path forward for sustainable, high-quality care.
Board Decisions:
Confirmed a preferred planning option to advance further refinement (details to be shared as they develop).
Outlined next steps, including additional workshops on March 19 and April 2 at 2:00 p.m. — join us in person (limited seating/capacity) or via Microsoft Teams.
No other major actions; this was primarily a discussion-focused workshop.
These plans aim to enhance access to care, modernize facilities, and prepare for Mariposa's growing needs beyond 2030. We'll keep you updated as concepts evolve.
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes. Full agenda packets and approved minutes will be posted on our website once finalized.
Click here for more Board Meeting information.
February 25, 2026 Board Meeting Community Update
Hello Mariposa neighbors,
This is our first official Board Meeting Highlights update. This will be a new way for us to share key takeaways from our meetings, to keep you informed and build transparency. We're excited to start this with our February 25 combined regular and finance meeting.
Quick Snapshot on Key Concerns:
Billing and Revenue Cycle: We're making strides with upward trends in cash collections and key metrics like higher clean claim rates and fewer lag days. Efforts are underway to tackle self-pay claims and registration errors, aiming to make billing faster and easier for patients.
Survey Corrections: Advancing smoothly (e.g., medical staff plan accepted; others in progress for areas like Ewing Wing, Radiology and Life/Fire Safety); all are routine and normal procedures for CDPH.
New Hospital Project: As many of you know, we've submitted our initial plans to the state (HCAI) and received positive feedback so far. The project is progressing steadily with ongoing design work and preparations for construction. We're addressing typical site challenges as they arise to keep things on track — more updates to come as we move forward.
Getting More Providers and Workforce Development: We've secured grants totaling over $233k to recruit nurse practitioners and doctors, helping expand access to care. Plus, we're pursuing a $50k tech grant for new equipment. On the workforce side, we're partnering in the Sierra K16 Collaborative to create local training pathways from high school to healthcare jobs, building a stronger team for the future.
Other Highlights
Acute census recently of 15 patients, all with a longer duration of stay, the highest we have had in quite some time!
Exploring a new HR/payroll system (Paycom) for better efficiency and compliance; bolstered IT cybersecurity through vulnerability testing.
Positive patient stories shared; upcoming blood drive announced for March 19, signup link on website and Facebook page.
JCF Hospital Foundation update: Fundraising for essential items like IV pumps and scholarships; upcoming community Thank You Card writing events at the Mariposa County Library (April 21 from 4pm-7pm and April 25 from 2:30pm-5pm). All are welcome to participate. Cards will be delivered to all staff during Hospital Week in May.
Board Decisions
Approved prior minutes, contracts, and holiday meeting date changes (Resolutions 2-26 and 3-26 for Nov/Dec 2026).
Okayed board attendance at community events (Democratic Club, Chamber Awards Dinner).
Next regular meeting: Wednesday, March 25, 2026 at 2:00 p.m. in the JCFHD Board Room (5189 Hospital Road). Everyone is welcome.
This summary is provided for general informational purposes only and is not a substitute for the official Board Meeting Minutes. Full agenda packets and approved minutes will be posted on our website once finalized.
Click here for more Board Meeting information.