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SEBASTOPOL – With Palm Drive Hospital emerging from years of struggle, bankruptcy, a series of CEOs and with a new sense of optimism about its future, interest has intensified in the race for board seats on the health care district that oversees operations of the 37-bed facility.

Amid the search for a permanent chief executive and a return to solvency, a field of candidates has emerged for board seats in the Nov. 2 election, a stark contrast to years prior when seats went uncontested and interest languished.

Three seats are open on the five-member board – two four-year terms and one two-year term – and six candidates are vying for them, all offering what they think is the best direction for the hospital.

Four candidates are running for the two four-year seats, and two candidates are running for the two-year seat.

Some consensus is clear among the candidates on improvements that need to be made and the need for stability, yet there are notable differences as well.

The hospital entered into a three-year, $250,000 annual agreement with Tennessee-based hospital management company Brim Healthcare Inc. last year. While no one disputes Brim played a key role as the hospital emerged from financial disarray, opinions differ on what level of involvement Brim should now have with Palm Drive.

“Brim has made significant contributions to the hospital,” said Jared Dreyfus, an attorney and current board member of the Palm Drive Foundation who is running for the two-year seat.

But, he added, “It is now falling short of goals set for it both by itself and by the hospital. Unless those problems can be redressed, the relationship should be re-examined.”

Mr. Dreyfus is not alone in the critique of Brim. Jim Maresca, an investment adviser and former executive director of the Russian River Chamber of Commerce, shared the skepticism that Brim is the best operator for the hospital, saying it has not appointed a permanent CEO within the 120 days it said it would upon entering the contract with Palm Drive. This, in turn, hurts physician recruitment and undermines a sense of stability, he said.

“Part of my concern with some of the current members is that they are overly deferential to Brim,” Mr. Maresca said, adding that he and Mr. Dreyfus are running a joint campaign. Mr. Maresca said he is running at the urging of Dan Smith, the board treasurer and former board president.

But Nancy Dobbs, the current board president who is running for another four-year term, said the critiques of Brim are unwarranted, and the hospital would not be in the position it is today without Brim.

“I would say that’s an unfair and improper critique of Brim,” she said, countering that Brim was asked to keep the interim CEO and CFO on board until a bond sale of $10 million was completed so as not to disrupt the process.

A letter dated Aug. 11, 2010, from Brim Board of Director’s Vice Chairman Dave Woodland states Brim “was prepared to begin the recruitment process near the end of 2009 but was instructed not to do so due” to the “bond issuance process and the need to demonstrate continuity of management at that time.”

Added Ms. Dobbs, “That may be one of the distinguishing factors of my campaign – that I and the majority of the board feel Brim has done a great job. It’s hard to understand why some feel they haven’t.”

Chris Dawson, who was appointed to fill a vacant seat in July and is running for a four-year seat, said he, too, was pleased with Brim’s overall performance, but added that certain elements of the contract with Brim could have been better.

“Generally I think Brim is doing a very good job,” he said. “They have brought stability and resources that are needed. The challenge I see is that the original contract with Brim was not well-crafted in terms of performance standards.”

Linda Johnson, who has previously served on the board and is running again for the two-year seat against Mr.  Dreyfus, also said Brim has done a fair job, particularly given where the hospital stood previously – mired in more than nearly $6 million in operating losses in 2007 to now having about $2.7 million remaining from the bond sale earlier this year.

“I can say that I’m thrilled to death with where we are today,” she said. “The hospital may not be doing great, we can’t take our eye off it, but the difference between now and then is huge. The biggest thing was obviously getting out of bankruptcy. We weren’t rated very high, so Brim brought that back to the board – getting out of bankruptcy and putting forth a bond issuance. That was a major turning point.”

Mr. Dawson said an ad-hoc committee was formed in July to monitor the relationship with Brim and to identify “measurable performance standards that we can review in open session of the board.”

A sixth candidate, Jim Horn, who is the current president of the Gravenstein School District Board, was on vacation and could not be reached.

While disagreement is centered on the relationship with Brim, one clear consensus emerged among candidates: physician recruitment and retention is vital to Palm Drive’s success in the future, as is the expansion of the Palm Drive Medical Clinic.