Rural Healthcare and Critical Access Hospitals

David Kobis was tasked with taking over and running a heavily distressed County-owned and operated health system in upstate New York with $65M in net revenue, 62 acute beds, 138-bed SNF, and 25-physician medical practice. The health system was losing more than $2M/month and approaching default. Responsibilities included handling financial improvement and turnaround performance, physician/employee relations, service delivery, strategic planning, regulatory compliance and quality assurance. 

* Led successful financial turnaround of organization in less than 3 years, turning a $24M operating deficit to a positive operating margin by the end of 2024. Health system had the first positive operating margin by year-end 2024 in more than a decade.

* Developed strategic turnaround plan in collaboration with hospital board and County legislature. Secured $7M in emergent County funding within first 90 days to avoid default. Worked with County and State to obtain continued emergent funding for FY 2023. 

* Reduced operating deficit by $15M by year-end 2023 through combination of expense and revenue improvements, including recruiting new physicians, reducing nursing agency expenses, right sizing the workforce, restructuring contracts, negotiating improved commercial payor rates, and revenue cycle enhancements. 

* Successfully grew operating revenue by 26% from 2022 to 2024, from $65M to $82M, through Critical Access designation, improved payor contracting, 340B programming, service line growth, and IGT funding. 

* Led the conversion of hospital to Critical Access designation in 2024, boosting revenue by $5M annually and providing long term financial sustainability to the health system and County. 

* Led the successful closure of hospital’s struggling obstetrical program, saving $3M in annual expense. Partnered with other area hospitals to provide continuity of material health programming. 

* Brought in new senior leadership team including CFO, COO, CNO, and SNF Administrator. 

* Successfully added clinical programming and recruited new physicians including orthopedic surgeons, general surgeons, cardiologist, urologist, pain management, neurology, infectious disease, and primary care providers.