To: Chief Executive Officers

From:Marcella McKay, Ph.D.

Re:2006 MHA Distinguished Hospital Trustee Award

MHA Distinguished Hospital Trustee Award recognizes an individualeach year who has demonstrated significant contributions in the field of hospital governance over a sustained period of time. The Trustee of the Year will be featured in a video presentation produced by Communications Arts and will be shown during the awards presentation. Last year’s winner was Michael Heidelberg from Singing River Hospital System.

ELIGIBILITY:The individual must be an active member of a hospital board (or its corporate board) that holds membership in the Mississippi Hospital Association.

CRITERIA: The recipient may or may not be professionally involved in the provision of healthcare services but must have made a significant impact and/or meaningful contribution to the hospital and community. The individual must be recognized by his/her peers as having a high level of proficiency and demonstrated competence.

PRESENTATION: The MHA Distinguished Hospital Trustee Award will be presented at the MHA Annual Leadership Conference

RULES: Nominations may be submitted by a Board Chairman, another Trustee, or Chief Executive Officer. Only one nominee per hospital may be submitted. Nominees submitted in previous years may be resubmitted for consideration.

AWARDS COMMITTEE: Named by the Chairman, MHA Board of Governors.

Deadline for nomination for the Distinguished MHA Hospital Trustee Award is March 31, 2006. Please find attached a description of the award and the nomination criteria. Please answer the questions provided when submitting your nomination and return by mail, fax, or email to:

Judith Forshee

Vice President of Education

MississippiHospital Association

P.O. Box 1909

Madison, MS39130

or email to:

NOMINATION FORM

2006 MHA DISTINGUISHED HOSPITAL TRUSTEE AWARD

Please include the following in your biographical description:

1.Name of Trustee Nominated

  1. Name of Hospital
  1. Leadership: Itemize the contributions to the continued viability of an institution through leadership in diversification, new ventures, mergers, affiliation, restructuring, change in administration, sale or expansion of services.
  1. Creativity: Utilization of creativity and innovation in leading the leading the hospital and/or health organization.
  1. Social Skills: Demonstration of the ability to build consensus and mediate disagreements.
  1. Analytical: Demonstration of the ability to analyze issues, define problems,bring issues to successful conclusion.
  1. Contributions: Contributions in health related initiatives over time or through a single program/event with the community at large.
  1. Special Leadership: Instrumental leadership in improving the hospital’s relationship with a specific segment of the community such as business leaders or seniors.
  1. Political Advocacy: Activities in political advocacy on behalf of a specific hospital or industry initiative or helping shape hospital-related legislation.
  1. Dedication to Learning: Continually tries to improve knowledge in healthcare issues and trends by attending forums, continuing education programs, reading professional journals, etc.

Nomination Submitted by:

Affiliation/Organization: