A hospital system in Northern California was facing a serious financial crisis, with escalating labor costs and underperforming service lines threatening operational continuity. As CHRO, I joined the executive turnaround team with a clear mandate: stabilize the system and restore financial health—while honoring the mission and minimizing harm.

The Approach

Labor represented the single largest expense and the most complex area to navigate. I led a multi-disciplinary team to:

• Audit all pay practices, including differentials, premium time, and scheduling patterns
• Identify “pay leakage” that had gone unchecked due to outdated systems and legacy policies
• Partner across finance, clinical operations, and HR to align real-time labor data with care delivery goals
• Work closely with internal talent to lead targeted cost-reduction analysis
• Guide the development of a labor negotiation strategy rooted in both fiscal realism and respect

As part of this effort, we also facilitated an organizational redesign and workforce realignment process, which included the reduction of 186 positions. It was one of the most difficult leadership moments of my career—but it was handled with transparency, dignity, and a deep commitment to support affected employees through the transition.