What keeps community hospital CEOs up at night? Finances, government mandates and personnel shortages

Once again, hospital CEOs ranked finances as their top concern, according to the American College of Healthcare Executive’s annual survey of the most troubling issues confronting hospitals.

Government mandates were second on the list, followed by personnel shortages, ACHE announced.

The survey was completed by 299 community hospital chief executives, who ranked the 10 issues that affected their hospitals in 2017 in order of how pressing they are and identified specific areas of concern within each of those issues.

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“Assuring patient safety and providing quality care is the No. 1 job of hospital leaders," Deborah J. Bowen, president and CEO of ACHE, said in the announcement. "The survey results indicate that leaders are addressing the challenge of doing so in a changing and uncertain financial and regulatory environment. That personnel shortages have become one of the top three concerns suggests that hospitals are keeping their attention on attracting and retaining a talented workforce to ensure the short- and long-term needs of patients can be met."

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The biggest financial challenges involved Medicaid reimbursement (71%), increasing costs for staff and supplies (64%) and reducing operating costs (57%). The CEOs also noted concerns with government funding cuts (56%), bad debt (54%) and competition from other providers (48%).

The most troublesome government mandates included CMS regulations (70%), regulatory uncertainty that affected strategic planning (67%), cost of demonstrating compliance (54%), and state and local regulations and mandates (51%).

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For staffing, the CEOs were most concerned with shortages of registered nurses (69%), primary care physicians (63%) and physician specialists (52%).