HJAR May/Jun 2021

50 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF ARKANSAS RURAL HEALTH EXECUTIVE LEADERSHIP is critical to the success of any organization — particular- ly for hospitals and health systems facing new regulatory and financial challenges. The need for strong and steady leadership has never been greater, yet turnover rates for top executives in America’s hospitals are high. CEO turnover rates average 18% to 20% per year, with turnover rates as high as 30% in some states, according to a report by the American College of Healthcare Executives. The complications of unstable leadership can have significant short- and long-term impacts on a hospital, quality of care and COLUMN RURAL HEALTH the broader community. “Leadership is the single highest predic- tor of rural hospital success, and today’s CEOs in many of these communities are leaving their positions too often,”says NRHA CEOAlanMorgan. “With CEO turnover rates exceeding 20% in many communities, this means that one in five CEOs are leaving their positions regularly.” Morgan adds that along with other pressures inherent in today’s changing healthcare environment, these same hospitals can be at further risk of closing. With healthcare rapidly evolving, hospitals and health systems are exploring different paths to transform their organiza- tions. With these needed changes for sur- vival come the need for strong, knowledge- able leadership. Taking matters one step further, rural fa- cilities also need an educated, well-informed and engaged board of directors. Boards are typically unpaid positions at nonprofit hos- pitals, and requiring continuing education is often a reason to not join or maintain memberships on rural boards. Other fac- tors that may be relevant to a rural hospital CEO’s strained relationships with the hos- pital’s board include cultural misalignment, Rural Hospital CEO TURNOVER In 2019 I was fortunate enough to be selected to participate in the National Rural Health Association’s (NRHA) Rural Health Fel- lows program. The fellowship program consisted of networking with rural fellows throughout the country, education on ru- ral health policy procedures and updates, and the responsibility of submitting and presenting a policy paper that would serve as a tool for NRHA to move forward rural health issues with recommendations for policy changes. I was lucky enough to be partnered with Matt Shahan, a rural hospital CEO from North Dakota, to write a brief on rural hospital CEO turnover, which has been a growing concern amongst rural healthcare providers. I would like to share parts of the policy brief with you.