Latest / Becker’s Healthcare Podcast / Perry Sham, Chief Financial Officer at Niagara Falls Memorial Medical Center

Transcript

Perry Sham, Chief Financial Officer at Niagara Falls Memorial Medical Center · Becker’s Healthcare Podcast

• 0:00
  This is Madeline with the Becker CFO and
• 0:02
  revenue cycle podcast. And I'm excited to be
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  joined today by Perry Sham, CFO of Niagara
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  Falls Memorial Medical Center in New York. Perry,
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  thanks for joining me.
• 0:12
  Thanks. Nice having me, Madeline.
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  So, Perry, before we kick things off, could
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  you share with our listeners a little bit
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  about your background in health care and,
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  more on Niagara Falls Memorial Medical Center?
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  Yeah. Absolutely. So I've actually I'm fairly new
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  to Niagara Falls and Niagara Falls Memorial Medical
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  Center. I've been here for about three months
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  as their CFO. But prior to that, I
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  was a CFO of this hospital in Long
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  Island.
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  And then prior to that for about, you
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  know, little under twenty years, I did a
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  lot of consulting work for hospitals across the
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  country, really a lot of work in financial
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  improvement.
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  But a little bit about the hospital. You
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  know, the hospital is sits right outside Buffalo
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  for, for the folks who don't know where
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  Niagara Falls is. It is in the Niagara
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  Falls County.
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  The hospital itself, it is about a 171
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  bed hospital.
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  It's the only full service hospital in Niagara
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  County, and it does have comprehensive services. So
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  we have behavioral health, we have cath lab,
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  stroke care, oncology.
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  Our ER actually has a CPEP program. That's
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  a comprehensive
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  psych emergency program.
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  Not every ER has that. And we have
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  a very strong women's health program, OB GYN,
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  labor and delivery,
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  that program itself is very, very strong.
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  I appreciate you sharing that there, your background.
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  And and to your point, I mean, the
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  women's health is so important right now in
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  hospitals and other facilities just given a lot
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  of the closures we're seeing. So appreciate you,
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  just highlighting that there.
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  So, Perry, to kick us off, I you
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  know, here we are in 2026, few months
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  in, and you've been at the organization also
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  for just over a few months. But, you
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  know, as you're kind of getting settled in,
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  what are some financial trends or shifts maybe
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  that you're keeping a pretty close eye on
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  in the industry,
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  and why are these specific trends so important
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  to you from that financial lens?
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  Yeah. There's kind of two
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  there's kind of two points that's,
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  probably
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  important for a lot of organizations
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  in New York,
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  specifically.
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  The one that's really cliched, and I'm sure
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  you've heard it on every
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  other interview you've had is just the rising
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  cost. But the reason you part it is
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  prob is because it's such it's such an
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  enormous
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  growth every year over year. And so, you
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  know, there are just kinda natural inflationary costs
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  that hospitals get as
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  any other business. But then we also get
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  a lot of costs imposed on us, you
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  know, via regulation. So we have
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  increased services that we need to provide via,
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  like, transparency rules. We need to do additional
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  things now. To get our accreditation, we have
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  these kinda new requirements where we need to
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  just buy new things.
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  We have new regulations on, like, cybersecurity.
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  And so
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  it it really even just to hit our
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  cybersecurity requirements, there are additional costs. And then
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  we also have kinda natural increased labor costs
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  as well. And so those things, I know
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  you've probably heard it
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  many, many times.
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  But those things,
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  you know, we see it year over year,
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  and 2026
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  is no exception.
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  Yeah. On the other side and kinda this
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  is kind of burning the candle from both
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  ends.
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  We are
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  worried about revenue decreases. So not just even
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  holding flat, but
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  reductions in revenue and in New York specifically
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  and and probably a number of other states.
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  You know, we
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  were effectively losing
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  some coverage on the essential plans. And for
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  our hospital and for a lot of safety
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  net hospitals,
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  that is a significant source of revenue.
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  We haven't seen really where
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  that settled out in the governor's budget yet.
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  We do have an idea of, like, how
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  that'll land, so I don't think we'll lose
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  that revenue entirely. I think it'll probably convert
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  to something else. But,
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  but that still
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  is gonna be a a reduction in revenue
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  overall
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  for this hospital and for a lot of
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  safety net hospitals in New York.
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  I was gonna just say for for all
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  these unknowns and things just in in terms
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  of cost and revenue, could you share how
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  you and your finance team are kind of
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  working together to combat this?
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  Yeah. We're,
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  you know, we're trying to find some creative
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  ways. Also, there's two approaches. One, we're trying
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  to find some creative ways to
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  find additional revenue. Right?
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  Whether it's volume growth or, you you know,
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  alternate lines of business,
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  that's even still
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  kind of back to the fringes.
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  Ultimately, we're gonna
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  we're looking for volume growth in some of
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  our key areas.
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  And I think that'll combat some of, you
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  know, some of these losses.
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  A lot of hospitals
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  in in New York and kinda in this
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  region have had to make some tough decisions
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  also in regards to cost reduction. And so,
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  you know, I think that,
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  you know, we're taking a very
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  careful look at how we can how we
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  can approach really
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  a breakeven point.
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  Yeah. But,
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  you know, but but it's difficult. I think
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  the folks here are very, you know, responsible,
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  very good stewards of
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  the resources, the dollar resources that they do
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  have. And so there's really not much
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  to cut for the most part.
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  And so I think for us here, specifically,
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  we're gonna look try to figure out how
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  we can grow.
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  Yeah. Well and that segues right into my
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  next question.
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  How are you seeing like, looking at smart
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  growth this year or even into next year
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  at Niagara Falls Memorial?
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  Maybe where are you seeing some big opportunities?
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  So we've seen some very good clinical success
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  or, you know,
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  in really, like, joint ventures and partnerships with
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  our hospital partners up here. We have kinda
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  two good ones.
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  One is our heart center here, which is
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  a collaboration between us, Catholic Health and Kaleida,
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  kind of the other
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  two hospitals in the Buffalo
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  area.
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  And,
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  what really this brings is really the comprehensive
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  expertise
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  in in those in that specialty.
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  We have another partnership with Roswell. It's a
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  distinguished cancer center up here for for our
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  oncology practice. And so we think, like, these
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  strong partnerships will,
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  one, drive clinical expertise, but, two, also help
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  us grow.
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  And, you know, we kind of touched on
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  to some of the uncertainties in navigating certain
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  headwinds in the industry.
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  What is a a solid leadership mindset that
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  you think will be most important for CFOs,
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  you know, navigating this year again into next
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  year?
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  I I think the best thing a CFO
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  can have,
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  especially in these
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  in these times, so this year, probably for
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  the next few years, is
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  is grit, is perseverance,
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  and really kinda
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  understanding that the work itself is important. This
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  is a tough
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  industry, and a lot of,
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  executives, you know, other executives are very talented
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  people. They have choices that they don't have
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  to be here. They don't have to argue
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  with vendors on on payables and, you know,
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  and have to deal with a lot of
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  the chaos,
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  in that role. And my whole kind of
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  message to them is, like, really kinda stick
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  with it.
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  You know,
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  these times won't last forever. Right? I I
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  do think we'll get we'll get through it.
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  But,
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  you know,
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  I don't wanna see a exodus of talent
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  in the industry. The thing I've read about
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  one CEO in DC who left after a
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  year and, you know, I don't wanna see
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  things like that happen kind of across across
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  the country.
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  Do you worry that that that's happening in
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  the in the CFO seat and and just
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  across the industry right now? Or have you
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  seen that trend at all and, you know,
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  why might we be seeing that, do you
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  think?
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  Yeah. No. I've seen that probably more in
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  the last two years than in the twenty
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  years before that.
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  It's it's a difficult job. So even without
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  all the pressures that you're seeing, you know,
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  this is a job, you you know, at
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  some times you have to be on call,
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  right?
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  It's
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  you manage a very kind of complex organization.
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  There are a lot of requirements for the
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  job itself, a lot of like, requirements to
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  regulatory
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  authorities, a lot of requirements
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  to the clinicians that, you know, that you're
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  responsible to,
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  you're responsible also to a board. And so
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  it's very easy to say enough with it,
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  right, I'm gonna pursue something else.
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  But, but we, you know, we don't want
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  to see good people kind of do that.
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  And we've seen a lot of shift in
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  the CFO role over the years. I mean,
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  just from, you know, coming out from behind
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  the desk, numbers crunching to even more that
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  communication
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  connector educational
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  space.
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  So what major decisions today do you think
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  require CFOs to think beyond that traditional financial
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  management
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  and act almost as like an enterprise strategist?
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  Yeah. I I think
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  the role
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  rather than really kind of being the lead
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  as a strategist is really a connector. Right?
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  And so how do you, you know, how
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  do you,
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  pull together clinicians,
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  departmental managers,
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  you know, stakeholders,
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  and
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  move them
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  in in a direction for the organization. Right?
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  And and and what I really mean by
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  that is, like, sometimes you'll you will need
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  to build bring up a new service or,
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  you know, work through a new initiative. And
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  a big part of the job isn't necessarily
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  to
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  make the decisions on that, but it's really
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  kinda pull the right folks together and provide
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  them with the information needed to to drive
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  that initiative. And so,
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  I think it's a slight twist on what
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  folks think as, like, hey. We're you know,
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  we need to be the ultimate strategist
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  versus,
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  you know, we are really kind of the
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  folks that just need to pull things together
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  and kinda help
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  shepherd it to the end.
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  The financial glue, essentially.
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  Yeah. That's a good way to put it.
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  Now, obviously, looking from last year into this
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  year, what would you say is one lesson
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  that you've carried into 2026
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  even in your new role,
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  that you're kinda leading with this year?
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  Yeah. I think it's, it's still very much
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  in the same vein. You know, to quote
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  the economist Herb Stein, you know, if something
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  can't go on forever, it won't, you know,
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  to paraphrase.
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  Yeah. And so that's a that's an important
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  lesson because, you know, as I mentioned,
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  it's a tough it's a tough market right
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  now, but it it won't last forever.
• 10:38
  Yeah. No. Definitely some good insights there. And,
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  again, Perry, what a what a pleasure it
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  was getting to chat with you this afternoon.
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  Thank you so much for being on the
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  podcast. I know I found it very insightful,
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  and I'm sure our listeners will too. And,
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  I look forward to connecting again soon.
• 10:53
  Alright. Same here. Thank you so much.