Legacy Health, an eight-hospital system based in Portland, Oregon, faced severe financial headwinds and an uncertain future. A non-profit organization that includes a Level 1 Trauma Center, children’s hospital, behavioral health hospital, ancillary clinics and outpatient facilities, Legacy had bond covenant issues, experienced turnover in its executive leadership team – including the loss of both its CEO and CFO – and was struggling to implement unfunded state mandates, including restrictive nurse staffing ratios and a presumptive charity regulation.
Legacy’s Board of Directors determined the system needed a capital partner. To that end, the system entered a Letter of Intent with Oregon Health and Sciences University in September 2023, reaching a definitive agreement in May 2024 with the expectation to close in early 2025.
Legacy partnered with Warbird Healthcare Advisors in the early stages of the planned merger, securing a seasoned, strategic chief financial officer who had significant experience in transactions and integrations. The CFO’s initial scope of work was to serve on an interim basis as the transaction advisor for Legacy’s leadership and board, but as the merger process shifted, so did the role.
In May 2025, both Legacy and OHSU opted to terminate the transaction. Legacy’s leadership – including CFO – had to immediately adjust and reorganize. Instead of focusing on the merger, they had to clarify ongoing operations and bolster the organization’s financial results. They also had to face complicating factors with national healthcare pressures, including new administration, legislative shifts and regulatory changes that all pose significant Medicaid funding cuts and other challenges.
Summary of Work and Areas of Focus
Crucially, Warbird's CFO was able to pivot quickly from a transaction focus to ongoing operations and finance, with no hesitancy or loss of efficiency.
Throughout the partnership, the CFO:
Assessed Legacy’s financial opportunities and risks, engaging with key leaders to immediately undergo operating expense containment and ongoing control of costs, while capitalizing on revenue enhancement opportunities
Delivered actionable insights to guide high-stakes decisions as the system adjusted its focus and strategic plan
Partnered with Legacy’s CEO, Board of Directors and external stakeholders to shepherd the organization through the transaction
Stepped in for operational control of Legacy’s entire finance function
Worked with banks and ratings agencies to stabilize Legacy’s external financial reputation
Warbird Healthcare Advisors delivers the leadership of seasoned healthcare CFOs when organizations face turbulence and transition.
Our national network of senior finance executives – proven practitioner leaders who have sat in the CFO chair for healthcare providers across the country – provide steady-hand guidance to restore confidence and build long-term financial resilience. We partner with CEOs, boards and finance teams to evaluate business needs, identify opportunities and implement solutions that strengthen operations, stabilize performance and drive measurable results.
Outcomes
Improved financial operations and increased senior leadership engagement in operational finance
Managed covenant compliance and external communications (banks, ratings agencies and auditors) with rigor and transparency
Drove supply chain discipline, revenue cycle reform and multiple margin improvement initiatives
Engaged with other senior leaders and the CEO to build a short-term strategic plan for organizational and financial success
CFO Advisory & Leadership Solutions
Turning Financial Uncertainty into Stability and Performance
Hospitals and health systems are under unprecedented financial pressures. Rising costs, shifting reimbursement models and leadership transitions can destabilize even the strongest organizations. Warbird Healthcare Advisors provides the steady, proven leadership of experienced healthcare CFOs – delivering clarity, continuity, and results when you need them most.
The Challenges We Solve
Leadership Gaps: Organizations struggle when CFO roles are vacant or in transition.
Financial Volatility: Uncertainty in budgets, reimbursement and cost management creates uncertainty and risk.
Operational Strain: Finance and accounting teams face overwhelming demands without clear direction.
Blind Spots: Long-term planning, physician alignment and capital projects require seasoned oversight, so no details or consequences are missed.
Board & Executive Needs: Senior leaders and governing boards need reliable data, insights and recommendations to make confident decisions.
How Warbird Helps
We deliver a full suite of CFO advisory and leadership services designed to stabilize operations, strengthen financial performance and guide organizations through challenging or transitive periods with:
Executive Advisory: Act as a strategic partner to the CEO, CFO and Board of Directors, reviewing metrics, processes and financial performance to uncover hidden opportunities
Interim CFO Leadership: Embed into the CFO role to ensure seamless leadership and stability that drives transformation and accelerates improvement
Strategic & Financial Planning: Guide long- and short-term planning, including annual budgets, capital projects and facility master planning
Physician & Revenue Strategies: Assess and refine physician arrangements, optimize cost reports and identify new revenue streams
Financial Operations Excellence: Develop and advise enterprise-wide best practices, including balance sheet strength, performance metrics and capital strategy
Decision Support & Governance: Prepare clear, accurate analyses and reports that inform leadership, Boards, and committees
Mentorship & Transition: Support and mentor incoming CFOs, ensuring long-term success and continuity
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