OCEANSIDE -- In the aftermath of a third defeat at the polls, hospital directors said Wednesday that they feared for Tri-City Medical Center's long-term future, but they largely stood behind the administration team that runs the aging facility's day-to-day operations.

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Nearly one month of mail-only voting ended Tuesday with Proposition A failing to earn the two-thirds majority it needed from voters in Carlsbad, Vista and Oceanside.

On Wednesday the registrar's office in San Diego counted 1,110 of the measure's remaining 1,460 ballots. Though Prop. A's approval rating nudged from 62.36 percent to 62.51 percent, the remaining 350 ballots yet to be counted were nowhere near enough to close the gap.

Tri-City's seven-member board of directors voted unanimously, with the urging of hospital administration, to place Prop. A on the ballot in a tough economic climate with unemployment rates increasing and home values deflating.

Surveyed by telephone Wednesday, most of the board members said they stood by their decision and that they did not blame the administration for the string of defeats at the polls. Tri-City lost two $596 million bond measure attempts in 2006.

Longtime board member Darlene Garrahy, a retired nurse, said she continues to believe that Tri-City Chief Executive Officer Arthur Gonzalez, and the team of vice presidents he brought on board, have done good work for the hospital despite the bond failures.

"Under the current administration's leadership, the hospital has slowly become more and more financially secure," Garrahy said. "I think that we need to do more work to understand what happened with the proposition."

Board members Madeline Rodriguez, David Tweedy, Ron Mitchell and Chairman Larry Schallock said they continue to support Tri-City's current administration. Member RoseMarie Reno had no comment.

Member Kathleen Sterling, who has jousted with Gonzalez on a range of issues over the last four years, said Wednesday that she thought the board should take this opportunity to reconsider all of its financial obligations, including the money it spends on administration and outside consultants.

"We can't seem to get a bond passed, and we need to start doing our homework on this," Sterling said.

Mitchell, another longtime board member, said Wednesday he simply could not condemn anyone for failing to reach a two-thirds majority, the highest electoral bar in the state. By comparison, he noted, school bonds only require a 55 percent majority.

"I'm very supportive of our leadership," Mitchell said. "I think a two-thirds vote is a very difficult vote to win in our community."

Indeed, Tri-City's margin of loss has only grown since 2006. In June of that year the hospital missed the mark by only 400 votes, but Prop. A missed by closer to 6,000 votes.

Board members are scheduled to discuss Prop. A results during their regular meeting at 3:30 p.m. Thursday. They generally said Wednesday that they fear for Tri-City's future in a hospital market where their competitors, Palomar-Pomerado Health in Escondido and Poway and Scripps Memorial Hospital in Encinitas, are embarking on massive construction projects.

"It's going to be harder on our emergency room, because people are going to have to wait longer," Rodriguez said. "I think the biggest challenge is going to be, how are we going to continue to do a good job with space restrictions?"

Those restrictions will increase as Tri-City approaches a state mandate to update or close its two oldest buildings. One of those buildings houses the hospital's intensive care and neonatal intensive care units.

The hospital has maintained, through a series of public meetings, that it cannot afford to replace the buildings on its own, and may have to close them by 2013, as mandated in a statewide earthquake safety law.

Schallock said it is likely that Tri-City and other hospitals cannot afford to build new facilities, and that Tri-City likely will ask for some sort of reprieve on the 2013 deadline from the California Legislature.

"They are going to have to decide if they are going to be rigid or not," he said. "We will just have to see how it turns out."

Board members generally did not want to discuss the possibility of a fourth bond, saying they would prefer to consult with their fellow trustees before forming an opinion on whether a fourth bond might be attempted.

Tweedy, however, was emphatic that another bond would be folly.

"No way, not if I have anything to do with it," he said, adding that voters have spoken clearly about their aversion to another tax levy.

Rodriguez and Schallock agreed, at least for now.

"Unless the economy turns around, I don't see that (a fourth bond) happening any time soon," Rodriguez said.

Contact staff writer Paul Sisson at (760) 901-4087 or psisson@nctimes.com.