Leading Rural Health Care

Rural hospitals face no shortage of complex problems, and Don Carpenter believes the solution often starts with getting the data right. In this episode, Carpenter, CEO of Cedar County Memorial Hospital, shares how his background in Lean Six Sigma and project management shapes his approach to leading a critical access hospital. He discusses rebuilding trust in the community, restoring service lines like surgery and stroke certification, and why he believes rural hospitals do their best work when they collaborate rather than compete. Carpenter also reflects on his transition from Nebraska to Missouri and the lessons he's carrying into his first CEO role.

What does it take to turn around a struggling rural hospital? In this episode, Bill Hellebusch, Administrator of Hermann Area District Hospital, walks through the financial and cultural turnaround he led since becoming CEO in 2023 — from tackling a revenue cycle in crisis to rebuilding employee and community confidence. Hellebusch also reflects on stepping away from his role last year, and the community and staff support that brought him back. He shares how partnerships with regional systems have strengthened patient care, including during a mass casualty event that tested the hospital's readiness, and offers his perspective on payer relations, bond restructuring and the future of rural health policy in Missouri.

Rural health care in Missouri is fragile, and Ric Ransom knows it firsthand. As CEO of MU Health Care, Ransom leads the University of Missouri's academic health system while navigating many of the same pressures — workforce shortages, reimbursement gaps, rising costs — that rural hospitals face at a different scale. He shares how his legal background shapes his approach to partnerships, why he describes the state of rural health care as "fragile," and how MU Health Care has responded when hospitals in Boonville, Fulton and Mexico closed. He also discusses expanding specialty care access, the promise and limits of technology, and why workforce investment is one of his biggest sources of optimism.

What does it take to turn around a rural hospital in under three months? In this episode, Steve Henson, CEO of Ste. Genevieve County Memorial Hospital, shares the story behind his fast-moving restructuring plan and the unconventional career path — from ambulance driver to attorney to hospital executive — that prepared him for it. Henson discusses the realities of critical access hospital finances, the growing impact of Medicare Advantage on rural hospital margins, and why rural hospitals function as economic engines for their communities. He also shares his approach to building trust with staff quickly, including the informal leaders every organization relies on. This episode offers a clear-eyed view of the financial and leadership challenges shaping rural health care today.

Earning trust is the foundation of leadership—especially for a leader stepping into a century-old organization. In this episode, Matt Fry, president and CEO of Freeman Health System in Joplin, Missouri, shares what it takes to lead a locally owned, nonprofit health system through a period of growth and change.  As the first CEO hired from outside the organization in its 100-year history, Fry explains how presence, humility and a willingness to be vulnerable is helping him build trust with his team and community. He also discusses empowering his leadership team, advancing quality through lean process improvement and integrating behavioral health across the system. This conversation offers a candid look at the mindset required to lead rural health care forward while keeping people and communities at the center.

Rural hospitals are often misunderstood, underfunded and underestimated, but they are also some of the most innovative health care organizations in the country. In this episode, Alan Morgan, CEO of the National Rural Health Association, shares a national perspective on the forces shaping rural health care today.  Drawing on more than 35 years of health policy experience, Morgan covers the real reasons rural hospitals close, what the Rural Health Transformation Fund could mean for the future, the ongoing battle over the 340B drug program and why collaboration — inside and outside the hospital — is the defining trait of successful rural health leaders.  He also offers a direct challenge to rural leaders: tell your story, because it matters more than you think.

Rural health care leaders are finding new ways to solve old problems, and Carroll County Memorial Hospital in Carrollton, Missouri is proof of what's possible. In this episode, Scott Thoreson, President and CEO, and Dr. Andy Horine, family physician and the hospital's first Chief Medical Information Officer, share how a fiercely independent, non-tax-supported critical access hospital has built a national reputation for quality while investing boldly in the future of rural health. They discuss the hospital's innovative partnership with UMKC and a new Student Learning Center, which includes a state-of-the-art Anatomage table used to train medical students and high school health occupations students, and is doubling as a recruitment strategy. They also address the role of technology and AI in improving both physician experience and patient outcomes and share what's ahead for Carroll County Memorial Hospital as health care continues to change. This episode offers a front-row look at two leaders who believe that in rural health care, relationships, culture and community investment aren't just nice to have — they're the strategy.

A nursing career that started 30 years ago laid the foundation for one of rural Missouri's experienced health care leaders. In this episode, Darinda Dick, President and CEO of Western Missouri Medical Center in Warrensburg, shares how her clinical background informs every decision she makes as a CEO. From earning a CMS five-star quality rating to building a thriving physician enterprise and expanding breast imaging access through the hospital's foundation, Darinda brings passion and practicality to rural health care leadership. She also reflects on the value of independence, the role of MHA and what rural leaders need to focus on right now.

In rural communities, a hospital is more than a place for care—it's a foundation for stability, growth and connection. In this episode, Tina Gillespie, CEO of Harrison County Community Hospital, shares how her organization is investing in the future of care in northwest Missouri. She discusses the journey to build a new hospital, the role of financial strategy in sustaining services and the importance of keeping care close to home. Gillespie also highlights how rural hospitals support their communities beyond clinical care, from workforce development to economic impact. This conversation offers insight into the decisions and leadership required to keep rural health care strong.

Rural health care leaders are making complex decisions every day to keep care local and accessible. In this episode, Todd Ahrens, CEO of Hannibal Regional Healthcare System, discusses how he navigates those decisions through a balance of risk, mission and long-term strategy. Drawing on his experience as an attorney and a health system leader, he shares how his perspective on risk has evolved, why growth is necessary for sustainability and how strong community connections shape decision-making. He also addresses workforce challenges, capital investment decisions and the increasing importance of advocacy. This episode highlights the mindset required to lead through uncertainty while keeping patients and communities at the center.

Rural hospitals are often misunderstood, yet they play a critical role in keeping communities healthy and economically stable. In this episode, Karla Clubine, CEO of Pershing Health System, shares what it really means to lead a critical access hospital in today's environment. Drawing from her clinical background, Clubine explains how she approaches leadership decisions, balances patient needs with financial realities and works to expand access through partnerships and technology. She also discusses workforce challenges, the importance of community support and why changing perceptions of rural hospitals matters. This episode highlights both the challenges and the opportunities shaping the future of rural health care.

Rural health care leadership has never been more complex. Financial pressure, workforce shortages, stakeholder expectations and regulatory demands are testing leaders across Missouri. In this episode, Nate Blackford, Senior Vice President of Membership Services at the Missouri Hospital Association and former president of Mosaic Medical Center in Maryville, helps kick off the new Leading Rural Health Care podcast. Blackford shares lessons learned from leading a rural hospital through system transition and the pandemic, talks about the challenges facing leaders and ways to address them and explains how the Missouri Hospital Association can be a support resource.