The Board consists of twenty one trustees, seven from each hospital. Jesse R. Goodale III Chairs the Board, Patricia Stewart is the First Vice Chair, all serving two-year terms with the position of Chair rotating among the officers. The Board works closely with the three hospital Presidents, presently led by Robert Chaloner, a position that rotates every two years.

The parent board has the authority to approve operating and capital budgets; approve and submit all Certificate of Need applications; implement managed care and quality programs; establish affiliations and partnerships, including one with Stony Brook; and develop shared services and joint ventures.

The local hospital boards are responsible for maintaining current services and operations;

overseeing management; and developing and managing operating and capital budgets approved by the parent.