The John C. Fremont Healthcare District Board of Directors unanimously approved a new four-year contract for CEO Stacey Kuzak with a base salary of $410,000.
The contract includes an annual retention bonus of $25,000 for each year she stays with the district, and a potential 10 percent in performance incentive pay up to $41,000, which could bring her total compensation to $476,000 per year.
The incentive pay is at the discretion of the board and would be based on “mutually established organizational goals and strategic priorities,” according to the contract.
The lucrative, long-term contract amounts to a vote of confidence for Kuzak during a critical juncture for the district as it continues to wrangle a revenue cycle that leaves too much money figuratively sitting on the table, and as the district prepares for construction of a new hospital to be completed after 2030.
It offers some stability for a district that has gone through a revolving door of nine CEOs in the last four years.
Kuzak replaced CEO Fred Vitello, who resigned in October 2025. Kuzak had been working under a temporary agreement with an annual salary of $385,000.
The board discussed Kuzak’s new contract July 22 in a closed door session. There was no discussion by the board when it approved the contract later in the afternoon in open session.
The board did not discuss benchmarks for receiving the 10 percent bonus pay, which will require board approval.
Board Chair Rose Fluharty said the board reviewed comparable
CEO salaries for healthcare districts in California. The district has not provided those comps to the Mariposa Gazette.
Revenue cycle headaches
The district ends its fiscal year this month with a $6.7 million operating loss, about $247,000 worse than last year.
The loss reflects the district’s troubles in accurately and timely billing third-party insurers.
Those delays and errors significantly impact reimbursement and dramatically reduce the amount of money that can be recaptured in subsequent billings.
Consider what happened in June. The district’s net income was $273,979. But the net cash from operating activities was in negative territory by $464,599.
The revenue cycle troubles persist despite the district paying millions of dollars in the last few years to nearly a half-dozen consultants to get a handle on its receivables and payables.
The district’s new Chief Financial Officer, Jennifer Mitchell, told the board they have recently conducted yet another assessment of the revenue cycle, discovering record keeping errors and a system bloated with unnecessary and outdated information.
“I want to be fully transparent,” Mitchell told the board. “We’re dealing with a system that has not been maintained that has a lot of cleanup that is needed.”
Kuzak chimed in that it is an extremely complicated process where changing even one element of the system has downstream effects.
“Before it was like dense fog. You couldn’t see through it, but now we’ve clearly identified several areas that we’ll be working on to definitely see an impact on revenue,” Kuzak said.
Mitchell added that some of the problem areas have been identified in just the last week and a half, leading to the recapture of $600,000. That money will be accounted for in the next fiscal year, she said.
‘Long way to go’
In the big picture, Mitchell continues to emphasizes the positive, including a strong cash position of nearly $21 million.
But most of that money is restricted for construction of the new hospital. Only $6.5 million is unrestricted and can be used for operating expenses.
The layout of the summary financial presentation for the board of directors has changed somewhat, making the district’s true financial condition slightly more difficult to decipher.
The district is no longer reporting the number of days it can operate with its cash on hand, which is considered an important metric of financial stability for critical access hospitals like John C. Fremont.
The layout of Mitchell’s monthly snapshot for June highlighted year-to-date revenue of $46,197,205, but that figure is total gross revenue, a fairly meaningless figure without accounting for contractual and bad debt write offs.
A more meaningful figure is total operating revenue of $29 million, which compares unfavorably with total operating expenses of $35 million.
Former board member Suzette Prue warned the board that the big picture isn’t nearly as rosy as the board or hospital executives may like to believe.
“The loss is a little bit more than last year, but there’s several things Jennifer (CFO) is not aware of and new board members are not aware of,” Prue told the board.
Prue said last year’s losses included a $1 million loss from Home Health and Hospice, which was shut down in April 2025. There was another $1 million in bad debt write off. This year also included a 10 percent price increase, she said.
“So if you make all of those adjustments, this year you lost $7 million. Last year with those adjustments you lost $4.3 million,” she said.
“So that’s quite a big difference and it’s something to be concerned about. You still have a long way to go to correct things,” Prue concluded.
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