In the historic vote to join Cleveland Clinic, the Indian River Medical Center board of directors was voting itself out of existence. That dissolution hasn’t happened yet, of course; the deal isn’t expected to be final until early next year.

But at some point in the coming months, a new board will come into existence to govern Cleveland Clinic Indian River, the hospital’s future name.  Meanwhile, the elected Hospital District Board will remain in place, its trustees serving as proxies for taxpayers in ownership of the hospital’s real estate.

All concerned were warned in the partnering process that changeover in leadership would be challenging at points, but at least the new Cleveland Clinic Indian River board will have some familiar faces that could ease the transition.

A point-by-point look at the makeup of the new board-to-be should reassure residents that Vero’s small-town hospital isn’t going to disappear, that familiar voices could still hold sway.

Nor will the voting powers of certain members go away (was misstated in an earlier article), including those who will serve ex-officio – appointed as a result of their jobs. As explained by IRMC’s lead attorney for the transaction, Lou Glaser, the new Cleveland Clinic Indian River governing board will actually include one more voting member than the existing IRMC board.

Once the deal with Cleveland closes – maybe December, but more likely January or even February, according to consultants – the new board will take over.

Like the old group, it too will have 17 members, including three who are on the existing board, all residents of this county. The chair of the Indian River Foundation gets another seat at the table as an ex officio director – currently that is Tony Woodruff. Another director will serve ex officio – whoever is in the job of Hospital District Chair, currently Marybeth Cunningham.

Still another local – not on the board of the hospital, and not on the Hospital District Board – will be picked by Cleveland Clinic executives from a slate provided them by the Hospital District Board. That person, referred to as the community representative, will be able to vote too.

Then there will be two physicians from the hospital staff. And finally, nine people chosen by Cleveland Clinic. A glance at the boards of directors of other hospitals taken over by Cleveland indicates many if not most of those board members will likely be familiar in the community. Bankers, funeral home directors and real estate brokers all got picked for other Cleveland Clinic boards.

So the only person left standing when the music stops? The president of the hospital, who will not have a seat on the new board. Not ex officio, not voting.

As for the Hospital District Board, whose members are elected or in some cases appointed by the governor when a resignation occurs, they still own on behalf of the taxpayers the hospital buildings and land. They get to be landlords, minus the plumbing repairs, and minus the rent checks – by the terms of the takeover deal, Cleveland’s rent is prepaid through 2034.

The Hospital District board also will continue in its state-mandated mission to reimburse healthcare agencies for services provided to low-income residents who don’t qualify for Medicaid.

 As for the new CEO of Cleveland Clinic Indian River, Cleveland Clinic is known for appointing physicians from within the organization as president/CEO.

But not always.

In December, Dr. Neil Smith visited Vero along with Cleveland Clinic top executives. Smith is president of Cleveland Clinic Fairview Hospital and an independent physician. He still practices family medicine in Cleveland and owns his practice.

And before Smith, a registered nurse led Fairview; she went on to become chief operating officer in Abu Dhabi.

The presence of these two was meant to indicate that Cleveland Clinic is open to independent doctors, and also, that there is room at the top for nurses.