Leading Rural Healthcare Transformation with Holly McCormack

Summary

---

Podcast Summary: Leading Rural Healthcare Transformation with Holly McCormack

Podcast: Becker’s Healthcare Podcast
Host: Laura Deardo
Guest: Holly McCormick, CEO of Cottage Hospital
Date: May 21, 2026

---

Episode Overview

This episode focuses on rural healthcare transformation, workforce strategy, and the leadership approaches needed for sustainability and innovation in critical access hospitals. Holly McCormick, CEO of Cottage Hospital in New Hampshire, shares her organization’s challenges and accomplishments, offering insights on communication, employee retention, and adapting to ongoing changes the healthcare sector faces.

---

Key Discussion Points & Insights

1. Introduction and Organizational Background

• Holly McCormick introduces herself as a registered nurse and CEO of Cottage Hospital, a 25-bed critical access hospital in Woodsville, New Hampshire, with a 10-bed geriatric psych unit and a rural health clinic.
• Emphasis on specialized services, trauma designation, and integrated behavioral health in their rural health clinic.
  (00:56)

2. Current Leadership Priorities

• Main Challenges: Managing payer changes, monitoring revenue and expenses, rapidly evolving technology (especially AI), and the broader push for rural health transformation.
• Holly says,

  "It's hard to say that I'm focusing on any one thing because there's so many things..." (01:40, Holly McCormick)

3. Rural Health Transformation: Opportunities & Vision

• The rural health transformation program provides opportunities to expand service lines and retain patient care within the local community.
• Mission-driven approach:

  "Somebody's zip code should not dictate the kind of care that they get... they can get the right care, best care, close to home." (02:30, Holly McCormick)

4. Navigating Financial Crisis and Workforce Pivot

• Faced a significant financial challenge a year ago with a -16% margin, largely due to spending on travel staff.
• Set urgent organizational goals to reduce travel staff, invest in current employees, and return to sustainability.
• Achievement: Decreased use of travel staff by 70%.

• "We really had to invest in our people, and that was step number one to success... It was not a smooth road to get there." (03:10, Holly McCormick)
  "I’m proud of the accomplishment. We did decrease our amount of travelers by 70%." (04:47, Holly McCormick)

5. Organizational Readiness & Communication Lessons

• Key learning: Communication is critical, especially when implementing difficult changes.
• Reflections on staff anxiety over travel reduction and the need for consistent, transparent messaging, especially among nurses.

• "Communication, communication and making sure that the message that you're sending out is the message that you mean to send out." (03:54, Holly McCormick)

6. Metrics for Workforce Strategy Success

• Success measured by reduced travel staff, improved recruitment and retention (hired about 40 nurses in four months), and lower turnover rates.
• Honest assessment of onboarding processes and continued commitment to improvement.

• "In a small critical access hospital, that's a lot of nurses... looking at turnover rates... having the ability to look back on that honestly." (05:20, Holly McCormick)

7. Leadership in the Face of Uncertainty

• Decisiveness needed for any new initiatives—must add real value, whether monetary or in terms of employee satisfaction.
• Value-driven approach to new undertakings, with a focus on employee retention.

• "Anything that we take on extra, there has to be a value add for it... Employee satisfaction, which then relates to employee retention." (06:25, Holly McCormick)

8. Retention and Culture Initiatives

• Besides compensation and benefits, transparency and tying individual roles back to the larger mission are critical for retention.

• "The why for what they do... tie whatever we're doing back to our mission and making sure that everybody realizes how important they are..." (07:10, Holly McCormick)

9. Foundational Leadership Mindsets

• Most important leadership habit: Keep everyone engaged and aligned to a shared strategy.
• Consistent communication of vision at every level ensures coordinated action amid uncertainty.

• "We all have to be rowing a ship in one direction... We do recognize that there's uncertainty, but making sure that everybody is working in that same direction." (07:55, Holly McCormick)

---

Memorable Quotes & Moments

• On the mission of rural healthcare:

  "Somebody's zip code should not dictate the kind of care that they get..." (02:30, Holly McCormick)

• On navigating staffing challenges:

  "We did decrease our amount of travelers by 70%." (04:47, Holly McCormick)

• On the power of communication:

  "Communication, communication and making sure that the message that you're sending out is the message that you mean to send out." (03:54, Holly McCormick)

• On leadership during uncertainty:

  "We all have to be rowing a ship in one direction..." (07:55, Holly McCormick)

---

Timestamps of Important Segments

• 00:56 — Holly McCormick introduces herself and Cottage Hospital
• 01:40 — Top leadership priorities: payers, technology, and rural transformation
• 02:08 — Vision for rural health transformation and patient care equity
• 03:03 — Navigating the financial crisis and workforce pivot
• 03:54 — Communication lessons in organizational transitions
• 05:12 — Metrics and feedback on workforce improvements
• 06:25 — Value-driven approach to new organizational initiatives
• 07:06 — Retention, culture, and mission alignment
• 07:49 — Leadership mindset and team alignment amid uncertainty

---

Conclusion

This episode shines a light on the unique challenges and innovations within rural healthcare, emphasizing the importance of clear communication, mission-driven leadership, and constant adaptation. Holly McCormick’s experience at Cottage Hospital offers valuable lessons in workforce strategy, retaining talent, and ensuring that rural communities receive equitable care close to home.

Transcript

[A]

At Insight Global Health, we are dedicated to helping you and improving healthcare for everyone. That means building stronger teams and delivering sustainable solutions that truly make a difference. We offer a full spectrum of talent and technical services and deliver cross industry expertise to bring you innovative best practices to solve the problems that we face in healthcare. We're not just promising you results, we are delivering them. Visit [e-mail] this is Laura Deardo with

[B]

the Becker's Healthcare Podcast. I'm thrilled today to be joined by Holly McCormick, who's the CEO of Cottage Hospital. Holly, it's a pleasure to have you on the podcast today.

[C]

Happy to be here. Thanks for having me.

[B]

Absolutely. Now I'm excited for our discussion. I know we're going to talk a lot about leadership, some workforce, some technology, but really, really focused in on how you're thinking about the future and what's going to be important for you in the next couple of years. So excited for that. But before we dive in, can you introduce yourself and your role and the scope of your organization?

[C]

Sure. My name is Holly McCormick, I'm a registered nurse and I am the president and CEO of Cottage Hospital in Woodsville, New Hampshire. I have been with the organization for 16 years now. Prior to being the CEO, I was the chief Nursing officer there. And Cottage Hospital is a critical access hospital. We have 25 inpatient beds and we also have the distinction of having a 10 bed geriatric psych distinct part unit, inpatient unit. We maintain a trauma designation, a Level 4 trauma designation and we also have a rural health clinic located across the street from our campus that has multi specialty, including integrated behavioral health.

[B]

That's amazing to hear. And you know, considering everything that you're working on today, what's commanding most of your time and attention as a leader?

[C]

It's hard to say that I'm focusing on any one thing because there's so many things to talk about. There's changes that are happening with our payers. We have to keep our eye on our revenue and our expenses at all times. We need to have a focus on what is going on in the arena around AI that is changing at lightning speed. So constantly evaluating technologies available to us out there. And also let's not forget rural health transformation because that is top of mind for everybody, especially in the critical access space.

[B]

I can imagine. And you know, when you think about the rural health transformation, in the rural health transformation program, how do you see that really making changes or pivots, what's could potentially come from that for you?

[C]

We see that as an opportunity to expand in various areas that perhaps we could not have afford afforded the technologies to implement to do so. So we're looking at things where we can grow our service lines, but ways that we can keep our patients in our community. I frequently say that somebody's zip code should not dictate the kind of care that they get, and we want to make sure that they can get the right care, best care close to home.

[B]

That makes a ton of sense, and it's really inspiring to hear and think about and have as a mission. Now, in the last year, that was marked by a lot of rapid change. What decision or pivot required most leadership conviction from you, particularly when it came to aligning people, resources, or capabilities?

[C]

A little less than a year ago, we were facing a negative 16% margin, and we knew that was not sustainable. And when we looked at where our largest spend was, our largest expenditure, it was on travel staff, and we knew we had to do something about that. And so I, along with my team, set goals that we needed to meet before the end of the fiscal year in order to turn that around. And it was not easy, but we did it. We decided we really had to invest in our people, and that was step number one to success. And then we had to set targets, and we had to meet those targets. And so I'm happy to say that we were successful in that, but it was not a smooth road to get there.

[B]

I can imagine such a challenging moment. So how did that time challenge your assumptions, and what did it change about how you approach decision making? Talent or organizational readiness?

[C]

Today, I would say organizational readiness is a topic that I think we can all learn more about. And I think the root of that is communication. Communication, communication and making sure that the message that you're sending out is the message that you mean to send out. When you talk about a reduction in travel, what that meant. For a little while, some of our staff were working longer hours, and that was difficult. And when they heard, you know, a reduction in the travel workforce, everybody wonders, what does that mean to me? But what we needed to do is making sure that we were fairly compensating our staff, and that when we were asking a little more for them, that they were feeling that appreciation. And so looking back now, a year, almost a year later, I think we could have done a little bit better job of communicating consistently, particularly with our nursing staff. But I will say that it was a necessary route that we had to take, and I'm proud of the accomplishment. We did decrease our amount of travelers by 70%.

[B]

That's incredible. And it really is helpful to understand that goal and then being able to reach that goal. And I can imagine your teams being able to be flexible enough to work with whatever was in mind. And to that point, what signals or metrics while your workforce strategy is actually working in, where are you still experimenting or course correcting?

[C]

So the signals that tell you that it's working, obviously, is we have a decreasing the amount of travelers within the organization, but we also need to look at our recruitment and retention. So we were able to recruit almost 40 nurses in the span of about four months, which if you're in a large system, sounds like nothing. But when you're in a small critical access hospital, that's a lot of nurses. But then we have to look at this now that we're almost a year out, and how many of those nurses that we did recruit to did we manage to retain? And so looking at those numbers and our turnover rates and then having the. The ability to look back on that honestly and say, what could we have done better with this? You know, the onboarding process is something that I think that we would reevaluate now. But also I have to give kudos to all of the nurses and their leaders for making this a successful initiative.

[B]

That's incredible. And, you know, I. To be able to have that type of team that can be strong and make us successful, bringing in additional nurses. And really, it's really an important thing to be able to do. And from your perspective, I know there's a lot of forces to think about when you're reshaping healthcare. What do you believe leaders need to be more decisive about? Especially when you're balancing speed, risk, and having the right teams in place?

[C]

I think when we're looking at whatever we're doing now, anything that we take on extra, there has to be a value add for it. Hospitals are operating on negative margins, razor thin margins. And we need to make sure that wherever we're focusing our time, there's a value add. And that value add could be monetary, but that value add could look like something like employee satisfaction, which then relates to employee retention. And so making sure that that is top of mind.

[B]

I can imagine that that employee retention piece I hear a lot is so critical and so helpful, you know, for organizations that are trying to grow and stabilize the workforce. Is there anything you're doing differently to think about that retention piece differently?

[C]

We're making sure that we do the base things that, you know, everybody should have in places that you have fair compensation and benefits packages. But also, I think a very important part of our culture is transparency, and I think it matters to people, the why for what they do. We need to tie whatever we're doing back to our mission and making sure that everybody realizes how important they are to what we're trying to do and the mission for why we come to work every day.

[B]

That makes a ton of sense, and I can imagine it's a real stabilizing force. Now, before I wrap up, I wanted to ask, as uncertainty has become more the norm in healthcare, what leadership habit or mindset has been most critical in keeping your organization and your people moving forward?

[C]

I think it's making sure that we're keeping everybody engaged and that I am clearly communicating to my team what our vision is, what our strategy is so that they can clearly communicate that to the rest of their team. We all have to be rowing a ship in one direction. We all have to be working towards the same goal, and I think that that is very important. We do recognize that there's uncertainty, but making sure that everybody is working in that same direction.

[B]

Holly, thank you so much for your time today. This has been such a fun conversation. I learned a lot and look forward to connecting with you again soon. Thank

[C]

you.