BusinessTN

One might be hard-pressed to find someone better suited for BusinessTN's first ever CFO of the Year honor than a man named Cash. After all, at Franklin-based Community Health Systems, folks sometimes joke that executive vice president and CFO Larry Cash changed his name for the job. Of course, that's not the case, nor, as he is most often asked, is he related to the Man in Black, Johnny Cash.

Name associations aside, however, the 59-year-old Cash gets plenty of name recognition on his own, particularly in the health care industry, as the No. 2 executive at the largest publicly traded hospital operator in the country. Since Cash came on board at CHS in 1997, CHS's revenues have climbed from $742 million to more than $7 billion in 2007. Earnings before interest, tax, depreciation and amortization (EBITDA) have increased from $122 million in 1997 to $993 million in 2007.

Last year, he led efforts to acquire Triad, the 52-hospital public company based in Dallas, Texas. The move more than doubled CHS's size and left critics wondering whether the largely non-urban hospital operator could assimilate the new hospitals and manage the $9 billion debt it incurred in the transaction. But in addition to driving revenue growth and overseeing major acquisitions and divestitures, Cash is heavily involved with operations (CHS doesn't have a COO), and his reputation as a top CFO rests as much on his extensive knowledge of the health care industry as on his transparency in communicating with investors and analysts.

"He clearly is the best in the industry," says Wayne Smith, chairman, president and CEO of CHS. "He has outperformed everybody."

One might expect such praise from the man who handpicked Cash to work for CHS more than 10 years ago. Smith, himself tapped as the company's president and CEO shortly after private investment firm Forstmann Little purchased CHS in a $1.1 billion leveraged buyout, knew he needed a CFO in whom he could trust. He needed someone who not only understood the business but was "on the same page in terms of how we approach our operating procedure."

"We already had a view of how to operate together, and the company benefits from that," Smith says. "There's not a lot of start and stop. We know the path and how to get there."

Their rapport stems from long association. The pair first crossed paths back in 1973, when Smith arrived on the job as a first-time CEO at a Humana hospital in Waverly, Tenn., where Cash was working as an internal auditor. After serving in various other positions on his way up the Humana ladder, Cash, along with three other executives, was charged with creating Humana's group health business in 1983. In 1986, Smith was brought into that division as the executive vice president (and later, president). Cash, as the senior vice president of finance and operations, worked for him from then until 1996, when both men left Humana. Prior to accepting Smith's (and Forstmann's) invitation to join CHS, Cash served as vice president and group CFO of Columbia/HCA Healthcare Corp. in Nashville.

Once reunited, it didn't take long for Cash and Smith to establish their now trademark approach to hospital management—standardizing and centralizing almost every aspect of hospital operations.

"When we started, that page was probably less than two-thirds full," says Cash, pointing to a slide from an investor presentation that now details 24 functions that Cash and Smith have standardized/centralized. "We wanted to improve the company, and this looked like a good way to make people understand that you can take a lot of confidence in what we do and what we say we're going to do."