Each month, millions of board members meet to provide leadership to thousands of churches, hospitals, schools and other nonprofit organizations. Their decisions impact tens of millions of jobs and billions of dollars of allocation. However, there is very limited research on the leadership provided to these boards. This article reviews data collected from 123 board members serving 34 Adventist Health System hospitals. It asked them to provide their perceptions of their chair\u27s leadership behaviors and effectiveness and compared that data to hospital outcome data in the form of patient satisfaction, clinical and financial data. Findings suggest that transformational behaviors and, to a lesser extent, transactional behaviors are central to members\u27 perceptions of chair leadership effectiveness. To the contrary, chair laissez-faire leadership behaviors were viewed as ineffective. In addition, those chairs with more education were perceived as more effective and a higher level of chair education was a predictor of larger financial margins. Findings also suggest that younger chairs are a predictor of financially sound hospitals
