For Tim Powers, CFO of the Idaho Hospital Association, rural healthcare is not just a career, it is a calling. On The CereCore Podcast, he shares how decades of turnaround leadership and a front row seat to community challenges inform his advocacy today. From Medicaid expansion and labor shortages to cybersecurity and revenue cycle strategies, Tim offers perspective and practical advice for leaders navigating today’s headwinds.
Stream the full episode to hear his journey from hospital fix-it guy to statewide advocate, why culture is a non-negotiable in talent retention, and how partnerships like CereCore can strengthen financial resiliency for rural hospitals.
Tim’s career in healthcare began in turnaround work, where he thrived on helping “needy organizations” find stability. A chance phone call led him to Gooding, Idaho, where he stepped into a financial leadership role at a new critical access hospital that was struggling without leadership.
“What struck me,” Tim recalls, “was this big, beautiful asset sitting in the middle of the desert — but it was rudderless. No cash reconciled in over a year, no leadership, and no employed physicians.”
Through grit, mentorship, and a focus on building community trust, Tim and his team not only stabilized the hospital but grew its services. He later became CEO, leading strategic expansion into underserved communities.
Similar turnaround work in Nevada further shaped his perspective. There, he guided a hospital through an EMR conversion, COVID-19, and even a ransomware attack. Each challenge underscored the need for strong leadership, trusted partnerships, and relentless advocacy.
Today, as CFO of the Idaho Hospital Association (IHA), Tim applies those lessons at a statewide level. More than half of IHA’s members are critical access hospitals. For many of them, thin margins and limited resources make advocacy essential.
“We expanded Medicaid in Idaho in 2018, and it improved net patient revenue by about four percent for hospitals. That four percent is the difference between keeping the doors open or closing for many rural providers,” he explained.
The threat of reversing Medicaid expansion highlights how legislative decisions directly affect hospital solvency. Tim emphasized that IHA’s role is to lobby, educate, and protect members from harmful legislation while advancing policies that strengthen access to care.
At the end of each legislative session, IHA publishes a “scorecard” of outcomes. “This year most of it was green, but it gets harder every year. Advocacy is the bedrock that allows our hospitals to survive,” he said.
Labor costs and shortages continue to strain rural hospitals. Competing with larger systems that have deeper pockets is nearly impossible. For Tim, the solution is culture.
“Our competition went after our caregivers. I could not outspend them, but I could create an environment where people wanted to stay,” he said.
He encourages hospital leaders to invest in positive energy, recognition, and creating a workplace people are proud of. “That culture is your competitive advantage.”
During his tenure in Nevada, Tim faced the trifecta: COVID-19, an EMR conversion, and a ransomware attack. The experience was a wake-up call.
“Our CIO had been asking for budget to strengthen cybersecurity for years, but the board had repeatedly denied it. After the attack, when we presented the risks, the million-dollar security expenditure passed immediately.”
For Tim, the takeaway is clear. Boards must understand the risks of data breaches, and hospital leadership must communicate them effectively. “It is not a matter of if, it is when,” he said.
Tim closed the conversation with advice for healthcare leaders who may feel overwhelmed.
“You cannot operate in a silo. Pick up the phone and call your neighbor CEO. Call me. The more collaborative we are, the better solutions we can create.”
For him, rural healthcare is not just about numbers on a balance sheet but about community. “There is not a better job on the face of this earth than to take care of people in the community you live. We do God’s work here.”
Advocacy sustains access. Legislative decisions directly affect rural hospitals’ survival. Associations like IHA play a critical role in protecting members.
Culture is a differentiator. Hospitals cannot always compete on salary, but they can create an environment employees do not want to leave.
Cybersecurity cannot wait. Leaders must help boards understand the risk and invest before an attack happens.
Collaboration is essential. No hospital leader should face challenges alone. Peer support and partnerships strengthen resiliency.
Stream the full conversation with Tim Powers on The CereCore Podcast to hear more stories of resiliency, leadership, and why advocacy is vital to the future of rural healthcare.