While managerial flexibility remains a key part of the skill set for COOs, having the discipline to withstand competing agendas is a necessary attribute, says Ben Breier, COO of Kindred Healthcare in Louisville, Ky. The investor-owned post-acute-care company operates 89 long-term acute-care hospitals as well as other facilities, including nursing and rehabilitation centers, across 28 states.
Breier, who has held the title since 2010 and was a Modern Healthcare Up & Comer that year, says he feels the pressures of competing agendas particularly when reviewing capital expenditures. As far as the administrative staff, Breier calls the COO the last line of defense. Staff from various departments will make their cases for money, and as COO, keeping a friendly and professional rapport with staff is important. But friendliness sometimes takes a backseat to ensuring efficiency, he says, “And you've got to say no.”
Dealing with daily operations complicates matters for Breier, who also plays a leading role in developing the company's longer-term strategy. Breier describes the COO as more of a “free agent,” someone who is called on to juggle a variety of situations. In that role, he sees a huge benefit from developing relationships with staff in all departments. “I really can look across the entire organization and see what needs my personal touch today,” Breier says.
Acting as a liaison between Kindred President and CEO Paul Diaz, three division presidents, and the company's board of directors requires finesse, Breier says. When offering suggestions, the COO must take extra care to respect the various levels of expertise these hospital officials possess and show trust, he says.
“It's a complicated, political process at times,” Breier says. “You have to have great communications, great leadership skills, and I think, have to be a bit of a politician to work behind the scenes and get things done.”
So why should this responsibility fall on the shoulders of the COO?
“I guess no one else can do it,” Breier jokes.
Breier is proud of his previous field experiences. He worked as president of Kindred's rehabilitation division, Peoplefirst, for five years before being named corporate COO. He also was senior vice president of operations and vice president for operations at Concentra, now a division of Humana.
Breier says the breadth of his experience allowed him firsthand knowledge of various aspects of healthcare. “There needs to be a willingness to take on new responsibilities,” he says of COOs. “Some don't necessarily want to get hands-on experience. But you really need to get into the dirt to get out there and do the work.”