BOARD CHAIR REPORT – November 2025

November 19, 2025

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BOARD LETTER TO THE COMMUNITY – November 2025

Dear Sonoma Valley Community,

This month, we celebrate new leadership. Over the past several months, Sonoma Valley Hospital has welcomed two key C-suite leaders, and we are grateful to attract such talent to our Valley despite the well-known challenges of recruiting in a high cost of living region. Leadership is about vision, inspiration, and clear communication. We see those qualities in our new Chief Executive Officer Kelley Kaiser and our new Chief Medical Officer Dr. Patrick Okolo. It is a privilege for our hospital and community to benefit from their experience and commitment. On behalf of the Board, I want to extend a warm welcome and my sincere appreciation for choosing Sonoma Valley Hospital and Sonoma Valley.

Chief of Staff Report
Chief of Staff Dr. Amara reaffirmed that the Medical Staff shares SVH’s focus on maintaining, improving, and restoring the health of everyone in our community. He noted ongoing challenges related to medical staff turnover and emphasized the importance of partnerships, including the Sonoma Valley Community Health Center, in delivering coordinated care. A new Quality Committee led by Dr. Rainow has been formed to sustain and advance our already strong quality outcomes. Dr. Amara extended heartfelt thanks to Dr. Seric Cusick for nearly a year of service as Interim CMO, and welcomed Dr. Okolo and CEO Kelley Kaiser. Looking ahead, recruitment and retention, particularly in primary care, remain priorities, and broader political and economic forces continue to shape the healthcare landscape.

SVH Foundation Annual Report
The Foundation launched the My Hospital campaign in July, reaching the community with more than 350 mailers and over 3,100 emails and inviting neighbors to share and support care close to home. Between July and September, community members contributed $280,000 to the Foundation in response to the campaign. In 2025, to date, the Foundation provided $1,600,000 for the Outpatient Diagnostic Center, $1,390,000 for the Physical Therapy Expansion, and $220,000 for ICU renovations, investments that translate directly into access and quality. The year-end effort for 2025 focuses on raising $1,000,000 for a new Stryker Operating Room Integration System, with more than $210,000 raised to date. The Stryker system is the heart of our surgical services; it is a sophisticated platform that connects surgical equipment, imaging devices, displays, and data systems. Our current system was installed over a decade ago and will soon become obsolete. Community support will replace it with the next-generation platform to enhance safety, efficiency, and patient outcomes.

Administrative Resolution Approved
The Board approved a resolution designating administrative responsibility and bank signature authority to CEO Kelley Kaiser and Board Chair Wendy Lee Myatt. This action enables the District to efficiently execute or accept licensing citations, grant applications, and other official documents related to Sonoma Valley Hospital, while maintaining strong governance and oversight.

Audit
The annual financial statement audit for the year ended June 30, 2025 was completed on time with strong results and was approved by the Board. We extend appreciation to the Finance team for their diligence and to Lois Fruzynski for her leadership throughout the audit process.

Line of Credit Renewal
To support day-to-day liquidity, the Board will consider Management’s request to renew and expand the existing line of credit with Summit State Bank, the District’s primary short-term working capital source. The Finance Committee approved the proposal on October 28, 2025. If approved, the available credit would increase from $5.5 million to $10.5 million, enhancing flexibility during timing differences in reimbursements and supplemental funding.

Chief Medical Officer Report
Dr. Okolo noted that SVH was healthy in 2017 and 2018 before the pandemic’s impact on volumes. The hospital has since rebounded and is holding steady in 2025. Continued focus on recruiting primary care physicians and strengthening specialty coverage will build needed redundancy, protect capacity, and sustain services for the community.

Chief Executive Officer Report
Interim CEO and Chief Financial Officer Ben Armfield reported that volumes continue to trend upward, particularly across the outpatient setting. While inpatient activity was soft, growth in other areas produced a banner month and confirmed the strong operational footing established in recent quarters. The Emergency Department recorded 975 visits in September(an average of 32.5 per day); for the first quarter of FY26, SVH is averaging more than 33 visits per day, nearly 30 percent higher than FY23 levels. Surgical volumes exceeded budget by 15 percent, led by orthopedics and gastroenterology. Outpatient activity also advanced, with approximately 6,200 visits in September (excluding the ER and outpatient surgery), about 10 percent above budget. MRI volumes set a new all-time high of 250 exams in September after a record 230 in July, with a brief August dip due to staffing. Referrals continue to grow from Sonoma Valley and across the North Bay, including more than 30 UCSF physicians, reflecting rising visibility and trust in SVH’s imaging services.

On behalf of the Board, I want to thank Interim CEO and CFO Ben Armfield for his steady leadership over the past year while our CEO search was underway; we’re grateful for his service to the team and the community.

Capital Projects
Work at the Outpatient Diagnostic Center has entered the final phase to secure permanent MRI occupancy. The Physical Therapy Expansion is complete, and we celebrated a wonderful Grand Opening on October 16 at 5:00 PM, thanking the many community members whose generosity made it possible. California Department of Public Health (CDHP) completed its survey on October 29, and the hospital received authorization for full occupancy. The ICU Refresh is fully complete, with all six rooms operational since August 2025.

Chief Financial Officer Report
September delivered another solid month. Operating EBDA with parcel taxes was $362,000 versus a budget of $206,000. Operating revenue totaled $6.74 million (about 11 percent over plan) on the strength of outpatient, surgical, and emergency services, with gross charges nearing $34 million (about 20 percent over budget). Operating expenses were $6.38 million (about 8 percent over budget), primarily due to higher people costs to staff sustained demand and a temporary catch-up of medical claims in the captive. Through the first quarter of FY26, operating revenue is 11 percent above budget and operating expenses are 5 percent above budget. Cash collections were $4.9 million, exceeding the monthly goal for a third consecutive month; overall cash on hand is trending lower as expected ahead of Rate Range IGT funding in January.

Quality Committee Work Plan
Second Vice Chair Dan Kittleson presented the 2026 Work Plan for the Quality Committee, which the Board approved. The plan continues our focus on evidence-based care, patient experience, and timely performance improvement.

As we head into the holiday season, I am grateful for the dedication and compassion of every member of the Sonoma Valley Hospital team. Thank you to our physicians, nurses, staff, Foundation partners, volunteers, and community members for supporting high-quality care close to home. I wish you good health in the weeks ahead, and I encourage everyone to be well and stay connected.

Warm regards,
Wendy Lee Myatt
Chair, Sonoma Valley Health Care District Board