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This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
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This is Madeline Ashley with the Becker CFO and Revenue Cycle Podcast, and I'm excited to be joined today by Robert Chestnut, Senior Vice President and CFO of LMH Health. Robert, thanks so much for joining me.
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C
It's great being here. Thanks.
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B
So excited to have you on today. And before we kick things off for listeners, do you mind just sharing a little bit about yourself and element?
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C
Sure. So I I've been in this role for a little less than two years. Prior to that, I was on the board of trustees for 11 years. So I have kind of an interesting perspective. LMH Health is here in Lawrence, Kansas. We sit about 45 minutes outside the Greater Kansas City area. We are the we have our university here, the University of Kansas. So we have 26,000 undergraduates here. Our community is about 100,000 and we have a service area that's about 125,000. We're 174 bed hospital. We do employ the majority of our physicians in our service area. So we have all of the service lines, orthopedics, cardiology, urology, and so forth. And then obviously a very large primary care division. So it's pretty much a health system, not just a hospital.
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B
And thank you so much for sharing. And again, as I mentioned, so excited to have you back on the podcast. I believe you and I connected in late July, early August for podcast. So excited again to dive deeper in here today and hear how things are going. And as you know, the industry continues to change. Probably even in the last few months since we connected last, we've seen so many changes, ebbs and flows. So could you share some of the broader challenges you're closely following right now in the industry and why you're keeping an eye on these from a finance perspective?
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C
Sure. I think immediately we're looking at what the impact's going to be on our market. With the ACA subsidies, it's hard to know exactly where that's all going to end up. We do have some exchange patients in our market and so we really won't know until their first encounters in 2026, if they've changed insurance, if they now are going to not have any insurance. So I think that's probably the largest one. We do have a pretty robust financial counseling group here at the hospital. So it's really we try to be proactive in that, but part of it's just that's a big unknown right now. So that's a big trend. I think the second trend we're looking at is trying to gauge what our inpatient census is going to be over the winter. Typically, as you know, I'm sure it's true of most hospitals that you have your highest census is probably starting now through, let's say February or March. Our census has been up during the even the summer. So we're kind of wondering what, what is that going to mean? Our census is going to be even that much higher in the winter or not. So that kind of impacts our staffing models and what we have to open and how we're doing that. So that's kind of on the ground a real macro trend that we're trying to figure out. So those are two things right now that we're really focused on.
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B
Yeah. And you, you know, I want to circle back because you touched a little bit on just the financial counseling group that you have right now and you know, everything around like this, ACA subsidies and just question marks and unknowns. Could you share a little bit about what those group meetings look like and maybe for some of our listeners who would be interested to figure out maybe a solid plan right now amid all this unknown.
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C
Well, I think that we're probably slightly unique simply because as a Seoul community hospital, we're the only game in town. So we feel a real obligation to provide that service to all of our patients. And whether it be navigating Medicare Advantage plans, whether it be navigating as you know, on the back end of 2026, I think that we will have a lot of involvement in Medicaid enrollment and the fact that they're going to have to Medicaid patients will have to qualify twice a year. You know, there's a lot there. From our standpoint, we just feel the obligation to be, I wouldn't say the one stop shop, but certainly the primary source of information for them to figure out how to navigate this whole new world that we're in as far as different changes in legislation, because it's just, it is for us unique. I think that, you know, for other systems, if you're in larger metro areas, maybe it's a little bit Different. But overall there are patients and our patients are critical to understand because the biggest concern I think we have as a system is to make sure that they're able to receive care. And so it requires more, in my opinion, more productivity to be more outreach than it is just kind of waiting to see what happens.
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B
Yeah. And you know, as, as a cfo, as a leader of the finance team, how are you ensuring to keep your team, you know, resilient and engaged right now? Maybe the secret sauce to success as you guys prepare and plan.
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C
Right. Part of it's education, I think. You know, I have, I'm, I'm very blessed, I would think, to have a great team of directors that work me that actually have more insight into all the nuance of what's happening, whether it be in payer negotiate, you know, payers and what's happening in Medicare and what's happening with Medicaid and what's happening in coding, what's happening in procurement, so on. So I really encourage that they, they need to be the subject matter experts. I think secondly is just keeping them focused on what is our purpose. Our purpose is to provide high, you know, high quality patient care. It's easy to get kind of trapped in the numbers and to kind of become sort of siloed into the issues that you're having as a department as it relates to the rest of the ecosystem and healthcare. But we all have to kind of take a step back and realize why are we doing what we're doing? And, and that I think provides some motivation for them to say, ultimately I'm here to make sure that patients receive the best care they can.
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B
And as we're looking to the new year, I can't believe we're almost in 2026. But, you know, where's your mind at in terms of planning for next year? Maybe anything that you're keeping an eye on, trends wise, that we'll see next year?
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C
Well, I think that one of the things for us is that we, we're under a fairly expansive capital expansion right now. We've finished our cancer center this year and we are opening up a second cath lab sometime in late 2026, early 27 Heart Center. So we do have some pretty robust expansion plans. So there's a lot of planning behind that, obviously. And it does create some short term transitional issues because we have to, for instance, relocate our cardiologist for a period of time and we're moving a lot of things around. So that logistics, those logistics are always challenging. So that's one Thing for us, I think what we're probably looking at at a macro level is to make sure that we understand what the landscape is with our, our, our payer mix and, and, and just our regional market. Because even though we're Seoul Community Hospital, we do have, in the Kansas City market, we have HCA hospital there, we have a big advent presence there, we have other large, large groups there. So we always need to understand, you know, kind of what's going on and making sure that we don't see the kind of a lot of out migration from this market. So, so those are a couple of things that we have the, that we're paying close attention, attention to right now.
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B
And you know, with your experience and background in healthcare finance, what is or are maybe what are some of the biggest skills that CFOs need to hone in on right now, just amid all these changes?
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C
Well, I think to really understand the bigger picture and what I mean by that is that healthcare is a very complex ecosystem and to try to understand all the moving parts is challenging. It takes a village, it really does. It takes all of my colleagues that work with me in the finance group. It takes our operations directors, it takes our physicians. It's, you know, it is a big ecosystem to manage. So I think that what you evolve to is you're really realizing that you're well outside of just the financial picture, but just a lot of things that are happening that affect the financials, but trying to be out in front of it. I think in particular we're probably more focused right now to make sure how do we manage our labor. Labor challenges are fairly large. Probably the same issues that a lot of different systems are experiencing with the shortage of different skill sets being either nursing, medical assistants, phlebotomist, all of that. So one of the things we're also involved in is try to develop some programs, some training programs for some of those positions. Because I think that with the shortage of those skills in the market, you have to make up the difference. You're going to have to grow your own. That's a term that we use around here, is how do we give opportunities not only for colleagues that we have already in our system, but people in our community to really get involved in healthcare. Because I think if you look at the health at the long term, you recognize the fact that there's going to be less people and the demand is certainly going to continue to increase. So we have to find different ways to find the quality people to work for our organization.
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B
Yeah. And I've even seen and reported on here at Beckers. Some systems, some hospitals are focusing on, even high school, middle school students, you know, just introducing them to the world of healthcare, saying, hey, you know, come down the line, come work for us.
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C
Yeah, we have, we have a group here in Lawrence, a technical school called Peasley Tech. It's named after a gentleman that was really involved in the community. But they probably touch four or five hundred high school students every week. And you're absolutely right that getting them interested early and maybe some opportunities, because I think the big thing is to make them see that there are other pathways than just necessarily a college education to be really successful. And I think that we have to emphasize that because that is the way we're going to have a robust workforce.
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B
Right. And it's such a needed and important profession, so. Well, Robert, I really appreciate you hopping on this call and it was so great to be able to discuss with you, you know, again, some of the industry uncertainties we're seeing and, and how LMH Health is going forward, tackling it. So thank you so much for being on again. It's been such a pleasure chatting and excited to connect with you again in 2026.
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C
Okay, appreciate it.
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B
Sa.