Part of the audit would include an investigation into the shooting that occurred at the hospital on Nov. 26, 2008, when former CPH employee Joseph Marchetti entered the building the day after he was fired, and fatally shot one of his supervisors and wounded another.

Board member Norm Olson made the motion to reconsider the audit.

"I feel that over the past couple of years this service area board has been marginalized," Olson said.

He said he was most concerned with the operation and the management of the hospital.

This was the second time in as many months that the board looked at the issue. At its September meeting the motion was defeated. Olson later requested that it be brought back up for reconsideration.

Discussion consumed most of the nearly three-hour meeting, and dozens of people packed the Kenai River Center to follow the proceedings and give comments.

Of the 16 who spoke, all were favor of an investigation.

Most said they were either current or former hospital employees, though some said they had no connection other than being community members.

Allegations of sexual harassment, unfair labor practices, management misconduct and abuse were commonly brought up in the sometimes emotional testimonies.

Sarah Anfeldt, of Kasilof, who said she worked at CPH for three years as a financial counselor, told the board she left her job earlier this year as a result of both policy changes at the hospital and some life changes.

While she did not go into any specifics, she said the policy changes would have resulted in her eventual "termination."

"I can tell you it was awful what I went through," she said, visibly beginning to tear. "I loved my job at CPH. It's been four months and it's still hard for me,"

She said she's been disappointed with the direction the administration has taken the hospital.

"I'm appalled at how things have changed there. It used to be a family," she said. "I think a lot of people just want it back that way."

She spoke of her relief that an audit might be conducted, saying, "This audit, I saw it in the paper, and to me it was a prayer being answered."

Misty Rose, of Kenai, who identified herself as a housekeeper at the hospital for nearly four years, gave the evening's most emotional testimony.

Rose struggled to tell her story, sobbing as she told the board that she was asked to change in her supervisor's office on her first day at work.

She went on, alleging that she had endured inappropriate touching and was forced to listen to jokes and stories that were sexual in nature.

She said when she tried to complain or seek help she was retaliated against, and often forced to do demeaning or dangerous work as a result.

As examples, she said her "punishments" included cleaning the grooves on an elevator floor and working near "asbestos pipes."

She said her former supervisor had ultimately been transferred to another part of the hospital and she no longer worked under that person.

She also said she's still being threatened, and pointed directly to senior management.

"I'm a simple person, I'd like my manager to hear what I'm saying and just take care of it," she said. "All these things could have been dealt with easily."

Hospital Chief Executive Officer Ryan Smith and several members of his administration were present in the audience throughout the meeting, but never responded to any of the allegations.

On Oct. 13, Smith declined to comment on the board's decision, saying he would address the matter at the borough assembly meeting later that evening.

He told the assembly that the hospital administration always has cooperated with the assembly and borough mayor, and would continue to do so regardless of the service area board's actions. He said further discussion of specific allegations should be done in executive session.

Smith said he's made quarterly reports to the assembly, and said none of those reports contained any allegations of bullying by hospital administration until union representatives showed up.

Public comments at the Oct. 12 service area board meeting were also notably laced with union sentiment.

While the nurses union continues to negotiate its contract with the hospital, 208 "non-professional" CPH employees, as termed by the National Labor Relations Board, are to vote on Oct. 15 on whether they'll unionize.

Tim Evans, of Sterling, told the board he thought the push for unionization was relevant to the investigation.

"I guess I'm a little confused as to how we can separate the need for an operational audit and the discussion on the organizational drive (for a union)," he said.

The board chose to use a memorandum, provided by the borough's legal department, listing the obligations the nonprofit, CPGH Inc. has to the borough and service area in running the hospital.

Some of the key eight points the board wished to focus on included their adherence to state and federal laws, regulations and rules governing hospitals; mandating hiring policies that prohibit discrimination; and an investigation into the shooting, among others.

Board chair Neal DuPerron said he planned to deliver a letter with the recommendation to the borough mayor on Oct. 16.

The mayor then has the discretion to pass the recommendation on to the assembly, which will choose whether or not to proceed with an audit.