The average healthcare CFO tenure runs 4.7 years, according to research from Crist Kolder Associates. Garrick Stoldt’s run at Saint Peter’s Healthcare System has about quadruple that, and outlasted many of his peers.
Mr. Stoldt has served as vice president and CFO of the New Brunswick, N.J.-based health system for 21 years. Though trained as a CPA, Mr. Stoldt said his academic grounding in economics instead of accounting shaped how he approached the role from the start. He spent the early part of his career in Medicare and Medicaid cost report audits and public accounting before moving into health system finance. That experience allowed him to turn the system around from one where debt outpaced cash and investments to one where cash and investments were four times larger than debt.
“I have a huge unique amount of experiences because of my education and background,” he said during an interview with the “Becker’s Healthcare Podcast.” “That has helped me quite a bit in my career.”
The balance sheet he found when he arrived reflected a system that had leaned on debt to fund its operations and growth. The one he manages now looks different in almost every dimension.
“Twenty-one years ago, long-term debt was about 30% higher than our unrestricted cash and investments,” Mr. Stoldt said. “So it’s been a long-term play in order to right-size the balance sheet and make it stronger. The key thing was capital control and limiting debt. It’s a financial discipline that takes time to make it happen, and we’ve done that. We’ve had small amounts of debt taken on, but it’s very strategic, and we’ve also been able to do things to improve our operations.”
One concrete illustration of how that principle translated into practice: energy. Facing aging infrastructure and rising energy costs, Mr. Stoldt pursued a sustained program of efficiency upgrades, funded largely with government and incentive capital rather than the health system’s own balance sheet. Saint Peter’s now operates near the lowest energy cost per square foot of any healthcare facility in New Jersey.
“When we look at the graph of the last 15 years, our actual spend on energy has declined about 45%,” said Mr. Stoldt. “That’s just one of the strategic elements we use. We would have had to replace most of the infrastructure and energy anyway, but [using government funding] helps quite a bit.”
With the balance sheet stabilized, Saint Peter’s has entered a more active growth phase: ambulatory buildings, a new on-campus specialty pharmacy and a push into independent physician group partnerships across central New Jersey. The financial strength Mr. Stoldt has spent two decades building is what makes that expansion possible on the health system’s terms.
“Gaining market share and going out further than our normal reach is certainly part of our long-term strategy,” he said.
Leadership is also essential. The right leaders make a big difference and can transform cultures from toxic to trusting, from in debt to positive cash flow.
“Trust is probably the best word you can use to describe this industry, especially between healthcare providers and patients, but it’s also among management and leadership,” Mr. Stoldt said. “When you have transparent leaders and they give you their thought process, they give you the ability to act on your own.”
