AVAILABLE NOW
Lead Without Guessing
For Federally Qualified Health Centers
A CEO’s framework for success, growth and financial strength. Finance is not responsible for, nor able to change, actions of staff outside their control, such as provider production. But if finances fail, the question is never simply “Is finance to blame?” The real question is:
Is this a financial department systems and reporting problem, or an operational problem?
It may be one. It may be both. And it may be something deeper, like unclear expectations, weak leadership handoffs, misaligned incentives, or a culture that avoids performance conversations.
Regardless, when there is failure, the CEO takes the heat. That is not unfair; it is the role. But it is also exactly why this book exists: so you can lead with clarity, build systems that surface truth early, and create accountability that doesn’t depend on heroics.
Because the CEO’s responsibility is not to do everyone’s job. The CEO’s responsibility is to ensure the organization can do its job.
“An invaluable partner to True Health for the past 13 years, offering strategic guidance and operational support in several key areas. The team has a deep understanding of federally qualified health center challenges, workflows, and processes. Further, the leadership of Karen Hughes and her team is remarkable which sets this organization apart from others.”
—Janelle Dunn, CEO, True Health, Sanford, Florida
“My relationship with Joel Hughes dates back to 2002, and it remains as strong today as it was when it began. As the organization grew over the years, I've had the privilege of working alongside his expanding team as well.
What drew me to Joel from the start — and what has kept me loyal all these years — is something that may sound simple but is actually quite rare: I never felt like a client. From my very first interactions with Joel, it felt like he was a genuine extension of my own team. He brought the same level of care and investment to my clinic that I bring as its CEO, and that kind of partnership is not something you take for granted.
Over the past 24 years, Joel and his team have stood with me and the organizations I've led through some of our most difficult stretches, and through some of our most rewarding ones. In every season, their involvement has made both me and my clinics stronger.”
—Dr. Albert Pacheco, Ph.D., Chief Executive Officer, Imperial Beach Community Clinic, San Diego, CA
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About the Authors
Karen Creveling-Hughes
Karen Creveling-Hughes is an author, CPA and former CEO of Community Link Consulting. For more than three decades, she has worked alongside health center leaders across the country, helping them connect strategy, finance, governance and organizational effectiveness to build stronger organizations.
Known for her ability to simplify complex challenges, Karen brings a practical, systems-level perspective shaped by experience in public accounting, internal audit, executive leadership and consulting.
She is passionate about helping health center leaders navigate complexity with greater clarity and confidence through writing, speaking and industry engagement. She lives in Spokane, Washington.
Joel Hughes
Following several years' work in public accounting, Joel became the first CFO for a small community health center in Washington. Four years later he took on the CFO role in a larger health center and then served as CEO for an Idaho healthcare start-up. In 1999 Joel founded Community Link Consulting to develop administrative and business support systems that meet the complex needs of Federally Qualified Health Centers. Offering direct, industry-appropriate guidance, he helped clients improve their financial, operational and management functions—always with deep respect for each client's unique history and community needs. It is an unsubstantiated but likely claim that Joel has been the CFO for more community health centers than anyone in the nation.