How this Montana hospital went from a 2.5% to 10% projected margin

Since Julie Leonard became CFO of Libby, Mont.-based Cabinet Peaks Medical Center in January, the 25-bed critical access hospital has seen skyrocketing financial improvement, rising from a projected 2.5% margin by the end of its fiscal year in March to now being on track for an approximate 10% margin.

"We don't always agree, but we always collaborate," Ms. Leonard told Becker's. "I work super hard to make sure that we're doing every single thing that we need to do to capitalize on every single dime that we can get."

Ms. Leonard credited her strong working relationship with the hospital's CEO, Tadd Greenfield, who has helped with growth and vision. 

Since Mr. Greenfield started two years ago, the hospital has launched an orthopedics clinic with Julienne Lippe, MD, former orthopedic surgeon for the St. Louis Cardinals. Dr. Lippe has more than doubled her business since she started at Cabinet Peaks. The hospital currently has one general surgeon and a second one joining in October, Ms. Leonard said. 

Along with a swing-bed program, other areas of growth for the hospital include a daily census of between 10 to 15 patients, switching the hospitalist program from mid-level to physician-based and growth in the emergency department that averages 20 to 30 patients daily.

The hospital is also in the early stages of plans to build a 16,000-square-foot medical plaza across from the hospital that will feature pain management. 

"We have quadrupled our pain management," she said. "Just last month alone, they brought in almost a million dollars just in pain management."

Prior to her new role, Ms. Leonard served as CFO of Blue Springs, Mo.-based St. Mary's Medical Center. She has held several other healthcare CFO positions, including a dual CEO-CFO role at Pomeroy, Wash.-based Garfield County Hospital District.

"I love being a CEO, but I really love being a CFO way more," Ms. Leonard said. "When you're a CEO, it is completely different than any other job. You literally are responsible for every single thing that happens in a facility. The pressure is huge. So if I can at least understand that, then I can make sure that every decision that's being made has something to back it up."

Since her time at Cabinet Peaks, the hospital has also seen revenue increases, from a static average of $63 million over the last 10 years to around $83 million this year. 

Ms. Leonard's strategy for maintaining strong finances is having a solid revenue cycle team and making sure that every time a plan is made, the hospital gets the best reimbursement possible. 

Communication with employees and a strong culture are other areas that Ms. Leonard highlighted to ensure an organization's success, with the hospital working to be in the 75th percentile for employee pay in its 2030 strategic plan. 

"You have to believe in your CEO," she said. "You have to believe in what they're doing and know that they're taking you in the right direction."

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