One of the most critical relationships a Director of Facility Management can have is with the Chief Financial Officer (CFO) of the hospital in which they work. In 2024, we invited Robert Hacker, then Director of Facilities Management, and Jim Corwin, Chief Financial Officer, of Community Memorial Healthcare, Ventura County, CA, to the Healthcare Facilities Network.
In an enlightening conversation, Jim and Robert discuss the skills and competencies a facilities leader needs to collaborate effectively with their CFO.
Through real-world examples and direct quotes, Robert and Jim spotlight the evolving role of FM professionals in today’s financially constrained healthcare environment. (Note: Robert is now a Consultant for Hacker Innovative Solutions.)
Watch the full episode:
1. Understand Finance to Build Trust
A modern facilities manager must understand basic finance concepts. Robert shows strong understanding of payer mix, capitation, and how revenue streams affect FM operations.
“One of the things that I talk with Jim all the time about is how do we get paid…what is capitation? What does that really mean? I pay attention to what that payer mix is because all of a sudden, if we're starting to get more Medicare patients, there's an effect that is going to have an impact of me and the facilities department.”
Bottom line: Being able to discuss business cases in financial terms helps FMs frame needs in ways CFOs value.
2. Define What Matters Most
Robert illustrates the importance of planning infrastructure needs in tiers: must-do now, can-wait, and long-term. This method helps CFOs allocate scarce capital more effectively.
“I've got one elevator that's been down for four years... That one is not as important to me because it's in an older building... I have these three other elevators…that's a higher priority. Everything we do now kind of resolves around a business case.”
Bottom line: By linking each project to operational impact, FMs help ensure resources go where they’re needed most.
3. Build Confidence Through Communication
Jim noted that unlike many facility leaders he dealt with in the past, Robert builds trust by proactively engaging finance. He avoids surprises and communicates early.
“Robert reaches out, whereas most facility managers won't… He becomes a true gatekeeper for me and Community Memorial.”
Bottom line: Open dialogue helps both sides understand constraints and make better decisions. Avoiding surprises is key.
4. Tie Infrastructure to Operational Realities
Hacker connects infrastructure conditions to clinical realities. He notices patterns others may overlook, such as how payer mix affects HVAC complaints, parking issues, or theft.
“If we have minor accidents in the parking structure, it may tie to the payer mix. Two spaces are taken instead of one, maybe more vandalism or theft. I look at our reports and I can actually tie these things together.”
Bottom line: This awareness turns facilities into strategic insights for the CFO.
5. Align Budgets to Revenue Timing
Robert aligns project scopes with expected cash flow, sometimes stretching systems, sometimes accelerating action. He and Jim time facilities investments based on forecasted revenue availability.
“He might just do a smaller fix to drag it out till some funds come in... or he might do the opposite... Let's do a couple of big things right now,” says Jim.
Bottom line: This adaptability allows CFOs to manage risks without delaying necessary improvements.
6. Be Honest, Not Dramatic
Jim emphasized the need for facilities leaders to be transparent and realistic—not dramatic. For him, honesty is the foundation of trust.
“Be honest to your CFO. Don’t tell me there’s no other option if there is one. You can BS an honest person. I’m an honest guy, but just don’t do that. Be transparent.”
Bottom line: Being upfront about limitations and consequences builds credibility and helps to drive sound facilities investment.
7. Think Like a Strategic Partner
Robert doesn’t operate in a silo. He aligns decisions with enterprise strategy and asks smart questions that go beyond his department.
“If I'm going to spend a million dollars building this little clinic. Are we sure that’s the right thing to do and do we have an ROI?” says Robert.
“This pairing is probably almost more important than the CFO and the COO in some ways,” offers Jim.
Bottom line: Facility leaders who act like executive partners are valued well beyond their departments.
Key Skills for a Strategic CFO Partnership
| Skill | Description |
|---|---|
| Financial Literacy | Understands payer mix, capitation, and cost/benefit framing. |
| Prioritization | Presents critical, deferred, and minimal options to CFO. |
| Trust & Transparency | Engages proactively and communicates clearly. |
| Strategic Awareness | Connects facility issues to operational and clinical outcomes. |
| Collaborative Budgeting | Times projects based on available capital. |
| Realistic Framing | Does not exaggerate; explains needs in business terms. |
| Partnership Mindset | Thinks like an executive partner, not a cost center. |