Clark County commissioners have overseen University Medical Center for as long as anyone can remember.
But Commissioner Rory Reid wants to form an independent board to govern the county-owned hospital and remove the commission from UMC's daily operations.
Reid offered few details about how the new board would be formed and how much authority the commission would retain, but the basic idea already has drawn support from most commissioners.
He will propose the change at UMC's board of trustees meeting on March 17. Commissioners make up the trustees' board.
Creating a politically neutral body staffed with medical experts is vital to running UMC effectively and transforming it into a teaching hospital, Reid said.
"We need a new governance," he said. "It's one of the steps along the path."
He joins former higher education Chancellor Jim Rogers in calling for an independent board. Reid recruited Rogers last year to explore how the county might turn UMC into a teaching hospital.
Reid said Commissioner Chris Giunchigliani's recent clash with hospital officials was not the catalyst for the proposal, insisting that he had thought about moving in this direction long before her "dust-up."
Giunchigliani met with emergency room nurses and other staff in a break area after she learned that UMC managers had decided to lay off 16 nursing assistants without telling union leaders.
An emergency room manager stepped in and ordered nurses back on the floor to care for patients. Her abrupt tone angered Giunchigliani.
The dispute boiled over at the March 2 commission meeting, erupting into a heated exchange between Giunchigliani and an emergency room official.
Rogers wrote Reid a scathing letter that condemned Giunchigliani's conduct as "outrageous and destructive" and imperiling efforts to recruit top-tier partners needed for a teaching hospital.
This spat is a prime example of why a separate board must be formed to remove politics from the hospital's operations, Rogers said.
"That's the problem with the County Commission -- they are constantly interfering," Rogers said.
"Anything that isn't done for the strict service of patients ... possibly compromises the patient care."
Commissioners have no right to meddle in day-to-day tasks such as hiring and firing workers, tending to patients and buying hospital supplies, he said.
UMC might need 10 years to evolve into a teaching hospital, Rogers said, but an independent governing board could be set up next week.
It would be staffed with people in the medical industry, such as doctors, hospital administrators and perhaps insurance agents, he said.
Whoever chooses board members would decide whether to include UMC officials in the mix.
The board could give financial reports to the commission every few months, Rogers said. A charter could be written to detail the board's overall authority, he said.
Commissioners were mostly receptive to the idea.
"I think it's a critical first step to getting the hospital back on track," Commissioner Larry Brown said.
He agreed that the board should be staffed with health care professionals whose sole concern is running an efficient hospital. And the board must oversee the hospital without political interference, he said.
Commissioner Susan Brager agreed.
"It (the board) needs to be independent, and we need to look at what other hospitals have done," she said.
Giunchigliani, though, said the commission must retain some oversight, especially when it comes to funding.
"We're still liable, and our taxpayers are still liable," she said. "We're in a different role from a private hospital."
She questioned whether Rogers had gotten UMC staffers' opinions about forming a new panel or was simply reacting to her conflict with hospital officials.
Commissioner Lawrence Weekly said he suggested months ago that the county create a board of experts who can devote the necessary time to running the hospital but no one listened to him.
A governing board can't work in a vacuum, Weekly said. It must inform employees of decisions that affect them, and it should report to the commission about money, he said.
"Especially if we're still on the hook financially," Weekly said.
Commissioner Steve Sisolak said he supports having experts oversee the hospital.
"I've run a business, but a hospital is not a regular business," Sisolak said. "You're dealing with complicated issues -- Medicare, Medicaid funding."
Sisolak said he doubts that politics could ever be erased. Picking board members is itself political, he said.
Rogers conceded that no governing body can be "pure."
"What you can do is minimize politics," he said.
Contact reporter Scott Wyland at firstname.lastname@example.org or 702-455-4519.