Podcast Summary: Becker’s Healthcare Podcast – September 1, 2025

Episode Overview

In this episode of the Becker’s Healthcare Podcast, host Laura Dearda sits down with Holly A. McCormack, DNP, RN, President and CEO of Cottage Hospital, a rural critical access hospital in northern New England. The conversation delves into successful workforce strategies, the unique challenges of rural healthcare management, leadership experiences, navigating financial pressures, the evolution of healthcare delivery, and what it takes to thrive as an independent hospital in today’s landscape.

Meet the Guest & Cottage Hospital (00:14–01:23)

• Holly McCormack:

  • Registered nurse by background; has spent 15 years at Cottage Hospital, transitioning from Chief Nurse to CEO.
  • Reflects a "grow our own" philosophy, exemplifying a clinical-to-executive career path.

• Cottage Hospital at a Glance:

  • 35-bed critical access hospital.
  • 25-bed main inpatient unit; unique 10-bed unit devoted to acute geriatric psychiatry.
  • Level IV trauma center.
  • Rural health clinic attached and multi-specialty RHC status.
  • Operates independently, serving a rural population.

Major Success: Reducing Traveler Reliance & Winning on Workforce (01:36–03:34)

• Workforce Challenges Post-Pandemic:

  • Struggled with staffing especially in nursing, nursing assistants, and radiology technicians.
  • High costs from reliance on travel staff were financially taxing.

• Bold Action: Nursing Pay Scale and Culture:

  • May 28 announcement of an aggressive new nursing pay scale to become competitive with academic centers.
  • Result: Hired 24 registered nurses, significant for a workforce of about 200 FTEs.
  • Traveler positions dropped from 21 in April (near all-time high of 23 during pandemic) to 10 by August—a 48% reduction.

“Since we did that on May 28, we have hired 24 registered nurses to our organization, which is incredible... If you count our per diems, 24 is significant.”
— Holly McCormick (02:23)

Driving Force Behind Nurse Recruitment (03:59–05:49)

• Key Factors in Attracting Nurses:
  • Positive, Nurse-Led Culture: Longstanding reputation as a supportive environment.
  • Career Pathways: Investment in a clinical ladder, succession planning, and visible examples—Holly herself rising from nurse director to CEO.
  • Financial Prioritization: Chose to invest in people over equipment this budget cycle, signaling strong value of staff development.

“I think this model that we’ve come up with, along with the investment, definitely shows that we value our staff.”
— Holly McCormick (05:46)

The Value of Clinical Leadership Experience (05:49–07:50)

• Unique Perspective of Nurse-Executive:
  • Direct bedside experience informs decisions about staffing and clinical care.
  • Deep understanding of workload complexity, not just patient numbers.
  • Ability to communicate credibly with clinical teams and relate to their daily challenges.

“I’ve held every position in nursing... I understand what those jobs entail and I understand how difficult the work is. Having walked in the shoes helps me make clinical decisions, it helps me make staffing decisions, and it helps me relate when there are problems in the hospital.” — Holly McCormick (07:16)

Top Current Issues for Cottage Hospital (08:06–10:20)

• 1. Government Payer Changes & Regulatory Uncertainty

  • Watching impacts from Medicare, Medicaid, and the "One Big Beautiful Bill Act" (OBBBA).
  • Curiosity and caution around rural health transformation provisions.

• 2. Workforce & Recruitment Challenges

  • Ongoing need for key staff, especially in specialty roles (rad techs, lab techs, RTs).
  • Limited training programs in the region create “employee deserts.”

• 3. Financial Efficiency & Technology Adoption

  • Margins remain tight; every investment must be scrutinized.
  • Exploring AI not just to augment but to supplement workforce and drive operational efficiencies.

“There are very few programs in this area in northern New England for rad techs or for respiratory therapists. And so that creates these little deserts in this area of those particular employees.” — Holly McCormick (09:36)

Opportunities for Strategic Growth (11:04–12:20)

• Expanding Outpatient Services:

  • Targeting growth by aligning specialty services to community need (e.g., neurology through regional provider partnerships rather than full-time hires).

• Behavioral Health:

  • Plans for expanded support—pre- and post-hospitalization—leveraging the hospital’s geriatric psychiatric unit as a community anchor.

“Those are a couple of opportunities that I think are right there for us... looking for ways to attract specialty providers... grow our behavioral health services.”
— Holly McCormick (11:04)

Leading Through Change: The Essentials of Modern Healthcare Leadership (13:18–15:07)

• Nimbleness and Focus:

  • Need to stay flexible, informed, and ready to pivot as regulations and community needs evolve.
  • Ongoing education, advocacy, and communication at state and federal levels are crucial.

• The Power of Partnerships:

  • Remaining independent but actively partnering with neighboring organizations to pool resources and services.
  • Commitment to advocacy, particularly to educate and influence policymakers about rural healthcare realities.

“We can still be independent, but we can develop those partnerships with other organizations around us so that we can support one another.” — Holly McCormick (14:46)

Memorable Quotes & Notable Moments

• “You know what it takes each day at the bedside to take care of our patients...you can’t just look at the model of X number of patients per number of staff—there’s nuance.”
  — Holly McCormick (06:25)

• “Being nimble all the time... It is important that we’re nimble. It’s important that we remain focused...so that we can make sure that our organization flexes as it needs to meet the needs of our community.”
  — Holly McCormick (13:30)

• “We’ve been here 122 years. We’d like to be here another 122.”
  — Holly McCormick (13:49)

Key Takeaways

• Workforce wins in rural healthcare are possible through bold investment and a strong work culture.
• Leadership deeply rooted in clinical experience builds credibility and alignment with clinical teams.
• Adapting to payer changes, recruiting niche specialists, and leveraging technology are front-of-mind challenges.
• Strategic partnerships and advocacy are essential to independent rural hospital survival.
• Nimbleness and continued organizational learning are critical to thriving over the next five years.