Editor’s note: According to medical staff, TFHS chief human resources officer, Alex MacLennan, has returned from administrative leave.


In a dizzying turn of events, set in motion at the end of April, the local hospital district has effectively let go of its CEO and is now talking about shifting its management style.

At the district’s April 25 board meeting, Tahoe Forest Health System Chief of Staff Dr. Joy (Johanna) Koch shared her concerns about the local medical community “crumbling” with president and CEO Harry Weis at its helm.

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“The medical staff has profoundly low satisfaction scores with high burnout rates and has for over 4 years, as you all well know,” Koch told the board during public comment, adding that there is little confidence in Weis by such staff. “We do not find him to be forthright, honest, or transparent with us … Mr. Weis has been disruptive to the medical staff since he arrived, and the behavior exhibited has only escalated even more rapidly in the last few years.”

Weis sat two seats away from Dr. Koch as she spoke.

A week later TFHS announced that Weis was to retire 19 months from then, on Jan. 2, 2026. The timeline would allow Weis and the board of directors to hire a recruiting firm to find and transition in the next head of the district.

“I have been in discussion with our thoughtful board of directors on my retirement for the past several months, and we have agreed on my retirement date,” Weis stated in the press release. “I have chosen to make this announcement today, as May 2 is a very special day for me, marking the 47th anniversary of my humble privilege to serve in healthcare.”

Then two “listening sessions” were held May 14 and 15 to allow TFHS medical and supervisorial staff free discussion about the state of the district, with board members present. The following day, on May 16, after a closed-session board meeting, Weis was placed on immediate administrative leave by the directors.

In response to allegations that Weis led the district with an iron grip, at a June 6 special board meeting a new leadership model — known as dyadic — was discussed as an option to be installed in Weis’ wake, one that pairs a physician and non-physician as leaders for healthcare oversight. The board approved to open negotiations with WittKieffer, an organizational development firm, for a possible contractual agreement to find TFHS’s next CEO through a national search, and to research possible re-shifting to dyadic leadership. Updates will be made at future board meetings.

“Going forward, we’re trying to look at a more collaborative system in our hospital,” said Director Bob Barnett during the meeting. He continued, “One of the issues we wanna look at is what is the best government system for our hospital? Do we want an autocratic CEO? Do we want a more collaborative CEO? Do we want a dyadic relationship going forward with our CEO?”

The approach, as well as comments and statements made in recent months during public meetings and directly to Moonshine Ink, is a response to what many felt was a lack of transparency and a culture of retaliation under the former CEO.

Doctors James Schlund and Jeffrey Fountain, both radiologists, expressed gratitude in a letter read aloud at the May 25 board meeting for the board placing Weis on administrative leave, noting the move “forever changed the trajectory of our health system. For that brave decision, we emerge into the light and opportunity to embrace change. A change that will be more than changing a name on a door, but much needed structural change, a change to advance and become the system our community needs and deserves.”

As of press deadline, details of Weis’ departure — such as whether the former president and CEO will be terminated with or without cause, and timeline for hiring his replacement — are not final. Chief Operating Officer Louis Ward is serving as acting CEO in addition to his COO duties.

Medical staff members remain wary of speaking with the media due to ongoing fear of retaliation, even with Weis’ separation. “We all assume Harry will come after us for libel,” one current medical staff member told Moonshine.

Weis declined to respond to the Ink’s request for comment.

Contractual benefits

The average tenure of a healthcare CEO in the U.S. is 6.6 years, according to a 2023 report from Crist Kolder Associates. Weis joined TFHS on Dec. 7, 2015, and thus was coming up on 8.5 years in the position.

HARRY WEIS was placed on administrative leave from the Tahoe Forest Health System on May 16. He started the CEO and president role in December 2015. Courtesy photo

Judy Newland, a former COO for TFHS and administrator at Incline Village Community Hospital who retired in 2022 after 42 years, spoke at the June 6 meeting of Weis’ success in the expansion of services and team members. “I want to thank him for the services that I get as a Truckee community member,” she said. “I’m not here to speak about what happened the eve of [May] 16th. I’m just here to say, this is what I wish I had said to the community members of Incline Village [at a recent IVCH open house] and thanked him for supporting their needs by expanding healthcare services.”

There is no doubt the health system thrived in many ways under Weis’ guidance, even amid the Covid-19 pandemic and “a greatly toughening local and national healthcare economic environment,” as Weis himself noted in a June 2023 budget and financial forecast update. Some examples from that same report:

  • Provider clinic visits have grown from approximately 47,000 per year in Fiscal Year 2015 to approximately 117,000 in FY ’22 to approximately 128,000 in FY ’23.
  • The opening of a new and greatly expanded primary care clinic on the second floor of the 3-story medical office building.
  • The commencement of performing GI surgeries at Incline Village Community Hospital for the first time in many decades.
  • Expanded hours and 7 days a week urgent care in Truckee and 6 days a week in Tahoe City and in Incline Village.

Another banner accomplishment was the hospital district’s assistance in founding the Truckee Tahoe Workforce Housing Agency in 2020, which envisions a community where all local employees have access to affordable, quality residences. Stephanie Holloway, Placer County deputy CEO, described Weis as “a dedicated leader to addressing the housing challenges in our region.”

For fiscal year 2023, Weis earned a base salary of $792,004, plus additional incentives and benefits. The CEO’s incentive compensation relied upon the hospital district meeting or exceeding certain markers in such categories as finance, service, quality, growth, and people. For example, under the service category, during 2023, TFHS must have met or exceeded an average 94.2 Press Ganey Patient Satisfaction (a popular healthcare survey platform) score, which it did with 95.25.

Since 2020, Weis has received his full incentive compensation, approved unanimously by the board each year. In 2023, Weis’ full payout of salary plus the incentive compensation plan, which added another 30% of his base salary, yielded $1,029,605.20. That amount does not include benefits.

Because the board has not yet determined whether Weis is leaving for cause, whether he’ll receive his base salary and health insurance for 18 months is unclear. A “for cause” dismissal by the board would mean immediate termination of payment and benefits. Termination for cause, as outlined in the most recent contract, includes the employee engaging in fraud or gross misconduct, using alcohol or drugs that impedes performance of duties, convicted of a felony involving moral turpitude, and more.

Burned out

Moonshine reported on recent burnout trends in Healing Healthcare Burnout, published April 2023. The article spoke to startling information presented at an August 2022 board meeting — that TFHS experienced top-percentile burnout among its primary care and advanced practice providers — and efforts to improve the staggering numbers.

In regular updates to the board since the 2022 report, Chief Medical Officer Dr. Brian Evans presented the steps being taken to strengthen a highly engaged work culture that inspires teamwork and joy. In July 2023, a leadership rounding (or proactive executive/employee interactions) program began, ensuring “each area of our organization receives focused rounding by senior leadership regularly,” per the staff report. “Rounding goals include: harvesting wins, identifying process improvement areas, participation in huddles and relationship building.”

But these efforts didn’t stop the mounting frustrations.

The district created a wellness officer position to serve as a point person on physician burnout who advocates for team members to executive staff. Dr. Josh Kreiss, who began his work with TFHS in early 2021, took the role in November 2022, 3 months after the notable August board meeting, but resigned a year later “with statements of difficulty making changes at organization/administration to improve well-being,” noted an anonymous medical staff member familiar with the situation. (The wellness officer position remains unfilled as of press deadline.) “Also, Dr. Reini Jensen resigned from our [Joy in Medicine] committee where she was one of the original founding members but has also expressed challenges at affecting organizational changes on provider well-being.” The committee, created just before the pandemic, serves to work closely with and provide resources to medical staff to reduce burnout.

NEW TRAJECTORY? “It is our belief that we are now faced with an amazing opportunity to see the district continue to move forward in a positive direction with an emphasis on communication, transparency, and teamwork,” said Julie Morgan, president of the Employee’s Association of Professionals for the TTHS hospital union, at a June 6 special board meeting. Photo by Alex Hoeft/Moonshine Ink

This same person told the Ink of retaliatory behavior they and others experienced under Weis’ leadership, such as people losing opportunities for advancement.

“Anyone who was on the out with him [was targeted],” this person described. “He had open discussions with leaders that [those on the outs with Weis] were not to be provided any leadership opportunities or that they were to be targeted for ‘not meeting the employee code of conduct’ anytime they questioned him or questioned his decisions.”

The radiology department at TFHS, multiple people noted, was greatly impacted with Weis as CEO, specifically in regard to the outsourcing of work to artificial intelligence software.

“Weis’ management crippled many departments in the hospital — most notably primary care, behavioral health, [and] specialty outpatients,” shared an anonymous district doctor via email. “Many of our current availability crunches could have been handled very differently to accommodate the growth in our community. Radiology was the final straw and a more blatant change of contract with a willingness to lose our valued radiologists in exchange for lesser quality remote radiologists. Radiology is a critical piece of safe, high-quality patient care for all, but especially ERs, trauma programs, cancer centers, orthopedics, and urgent care.”

Another major concern with Weis’ reign: transparency.

The Joy in Medicine committee has distributed multiple internal surveys to understand burnout at TFHS. The most recent one, distributed June 2023, asked such questions as “During the past month, have you felt burned out from your work?” and ‘‘During the past month, have you worried that your work is hardening you emotionally?”

The district declined to share results with Moonshine due to their classification as confidential internal working documents, which are protected as privileged trade secrets under Evidence Code section 1060, Government Code section 7927.705.

One medical staffer said even those who took the survey weren’t allowed access to the results, only a “super vague” summary.

“There has to be transparency to this community [about] what is going on,” said Pam Hobday in public comment at the April 25 board meeting of the frustrations around TFHS culture and management. Hobday, along with her late husband, Tom, were honored by TFHS naming an annual award after them: the Tom and Pam Hobday Spirit of Giving Award. She continued: “If this impacts patient care, the community needs to know about it. I know you’re supposed to be a policy board, not involved in operations, but anything that impacts this community, we need to have transparency and have a say in.”

Hobday called for there to be a public update on culture surveys, “the best that we could legally.”

At the May 14 and 15 staff listening sessions, which were likely integral to the board’s decision to place Weis on administrative leave the very next day, the CEO’s retaliatory behavior was brought up.

Both nights, medical staffers told Moonshine, the chief human resources officer, Alex MacLennan, was defensive about critical statements made over Weis’ management and questioning that solutions would be found.

“At one point [MacLennan] goes, ‘I’m insulted that you guys say this is a smoke show and nothing’s gonna happen,’” said an individual who attended the first night. “And people were like, ‘Well, this has all been reported before. Nothing’s happened. So why would you be at all surprised?’”

Multiple people left crying the second evening after MacLennan tossed or pushed a microphone at a commenter “in a frustrated way,” said one attendee. According to medical staff, MacLennan was placed on administrative leave in response to professionalism concerns. The district declined to confirm.

Wong also declined to comment for the board of directors on the shifting administration, citing personnel matters. “As for the physician burnout issues, those are somewhat separate issues,” she noted.

“Going forward, we’re trying to look at a more collaborative system in our hospital.”

~ TFHS Board Director Bob Barnett

Two board seats are up for election in November: Wong’s and Bob Barnett’s. That may spur continued change at the hospital district, though some remain hesitant.

“There have been substantial concerns from the medical staff for years,” emailed the anonymous doctor. “Probably 6 to 7 years at least. They were brought to the board many times and the board was divided about even investigating the CEO.” This person cited board directors having “rose-colored glasses by the financial successes” of Weis.

“I’m skeptical that the board will do what’s necessary to change the culture of the organization, which means significant turn of work,” another person said. “The real question is, is the board ready to commit to real change? ‘Cause all these leaders that Harry brought in, he built the culture. The only way to change that is to get rid of his leaders.”

Community members urged transparency and thoughtfulness at the June 6 special meeting as decisions continue to be made. “Be very, very careful about the manner in which you want to reorganize the structure of the hospital,” said Andy Homer, a 50-year local resident, to the board during public comment. “Take a lot of input and you’ll get a great outcome. Follow the right process.”

Author

  • Alex Hoeft

    Alex Hoeft joined Moonshine staff in May 2019, happy to return to the world of journalism after a few years in community outreach. She has both her bachelor's and Master's in journalism, from Brigham Young University and University of Nevada, Reno, respectively. When she's not journalism-ing, she's wrangling her toddler or reading a book — or doing both at the same time.

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