What are the red flags for Leslie (Les) Hirsch, FACHE?

AHA Dossiers Power Map About

Leslie (Les) Hirsch, FACHE

Trustee, term 2025-2027

President & CEO | Saint Peter's Healthcare System

Last verified November 4, 2026

6 Red Flags

Affiliations

•President and CEO of Saint Peter's Healthcare System in New Brunswick, N.J., since 2017, after joining as president in 2015. The flagship is the 478-bed Saint Peter's University Hospital, sponsored by the Roman Catholic Diocese of Metuchen and a major clinical affiliate of Rutgers.
•AHA Board of Trustees: elected for a three-year term that began Jan. 1, 2025; he is listed on the current AHA roster.
•Chair of AHA Regional Policy Board 2 (New Jersey, New York, Pennsylvania) concurrent with his board term, after several prior terms on that board.
•Chair of NJHA HealthPAC, the New Jersey Hospital Association's political action committee.
•Chaired the New Jersey Hospital Association board in 2015 and 2016.
•Board member of the New Jersey Chamber of Commerce, Middlesex County Crime Stoppers and the Hope Through Education Foundation.
•Previously CEO of Saint Clare's Health System in Denville, N.J. (about seven years), Touro Infirmary in New Orleans (from August 2005), Exempla-Saint Joseph Hospital in Denver, and Cooper Health System in Camden, N.J.
•Fellow of the American College of Healthcare Executives for more than 30 years.

Financial / Compensation

•The FY2024 Form 990 for Saint Peter's Healthcare System Inc. (EIN 26-2019056), the parent management entity, reports Hirsch's compensation at $1,737,001 plus $314,342 in other compensation, about $2.05 million in total, up from about $2.02 million ($1,703,149 plus $315,335) in FY2023.
•Hirsch is paid through the parent entity. The hospital's own 990 lists him at $0 direct pay and shows the $1.74 million as compensation from a related organization.
•Saint Peter's University Hospital (EIN 22-1487330) reported $650.1 million in revenue, $609.4 million in expenses and $40.7 million in net income in FY2024, roughly double the $19.0 million it earned on $584.6 million in revenue in FY2023. Net assets rose to $370.9 million.
•The parent entity reported $61.7 million in revenue in FY2024 and listed $7.76 million in executive compensation, or 12.7% of its expenses.
•S&P upgraded Saint Peter's University Hospital from BBB to BBB+ (stable) on Oct. 16, 2025, citing positive operating margins, declining leverage and solid balance-sheet metrics.
•Moody's affirmed the hospital's Baa2 rating and revised its outlook to positive in late 2025, signaling a possible upgrade within 12 to 18 months.
•Saint Peter's University Hospital is a 478-bed acute-care teaching hospital, a state-designated children's hospital and a regional perinatal center with a Level IV NICU.

Lobbying and Political

•Saint Peter's began federal lobbying in 2026: lobbyist Kyle Mulroy registered for the system (posted July 7, 2026) on hospital reimbursement and Medicare and Medicaid payment policy.
•Saint Peter's third-quarter 2026 LDA report says the lobbying sought FY2027 congressionally directed funding (an earmark) for an Obstetric Emergency Services Facility. No dollar amount for lobbying income or expenses was reported.
•As chair of NJHA HealthPAC, Hirsch oversees how New Jersey's hospital industry directs campaign contributions to state legislators. The PAC's totals are filed with the New Jersey Election Law Enforcement Commission and did not surface in searches.
•NJHA (EIN 21-0618622) is a 501(c)(6) trade association that lobbies Trenton and Washington on Medicaid payment, charity care funding, site-neutral payment and tax exemption.
•As RPB 2 chair and AHA trustee, he helps set the national agenda the AHA lobbies for, while running the PAC that funds the state lawmakers who vote on New Jersey hospital payment.

Revolving Door

•He holds three linked roles at once: state PAC chair (NJHA HealthPAC), regional AHA policy chair (RPB 2) and national AHA trustee.
•His New Jersey Chamber of Commerce board seat adds a business-lobby channel to his hospital-lobby roles.

Home System Record

•Saint Peter's and Atlantic Health System signed a definitive agreement in July 2024 for Saint Peter's to join Atlantic. The two systems mutually terminated the deal in October 2025, citing 'changes in the national healthcare landscape.' Hirsch said Saint Peter's was 'disappointed by this result.'
•That was the second failed combination for Saint Peter's: federal regulators had earlier blocked its proposed merger with RWJBarnabas Health.
•After the Atlantic deal collapsed, the two systems said they would keep existing collaborations such as the Healthcare Transformation Consortium, which jointly bids out third-party administration of their self-insured employee health plans.
•Saint Peter's is investing about $36 million in new ICUs on its New Brunswick campus: an $11 million pediatric ICU (8 to 14 beds) partly funded by a state appropriation in the FY2024 budget, and a $25 million adult ICU (doubling to 24 beds) expected by mid-2027.
•At his previous system, Saint Clare's Health System, deficits grew from $14.8 million in FY2010 to $25.8 million in FY2011, and the Catholic nonprofit was sold to for-profit Prime Healthcare through a court-supervised process.
•No Lown Institute fair-share figure for Saint Peter's surfaced, and its Schedule H charity care spending is not broken out in the extracted 990 data.

Litigation and Scrutiny

•No 2025 or 2026 lawsuits, settlements, False Claims Act cases or state enforcement actions naming Saint Peter's surfaced in news and legal-database searches.
•The failed RWJBarnabas merger, blocked by federal antitrust regulators, is the system's most significant past regulatory clash.

Red Flags

The man who chairs the New Jersey hospital PAC also sits on the national board and chairs the regional board that sets AHA policy; no recusal or separation policy is public.

Hirsch's pay rose to about $2.05 million in FY2024 at a single-hospital Catholic system, and executive pay ate 12.7% of the parent entity's expenses.

Saint Peter's doubled its net income to $40.7 million in FY2024 and won a credit upgrade while also taking state budget money for its pediatric ICU and lobbying Congress for a federal earmark.

Two attempted combinations, with RWJBarnabas (blocked by regulators) and Atlantic Health (abandoned in 2025), show a CEO repeatedly trying to sell or merge the independent hospital he runs.

Saint Clare's lost money at an accelerating rate on his watch and ended in a sale to a for-profit chain, which he publicly called 'a significant milestone.'

Ultimate governance of Saint Peter's rests with the Diocese of Metuchen, which limits public visibility into how executive pay is approved.

Pattern Summary

Hirsch is the trade-association insider type: a career CEO who has led four hospital systems in three states and stacked state PAC, regional AHA and national AHA roles on top of a roughly $2.05 million tax-exempt salary. His hospital doubled its net income in 2024 and won a credit upgrade, yet still seeks state appropriations and, since 2026, a federal earmark. Two failed merger attempts show he has kept shopping the independent hospital to bigger systems.

Leslie (Les) Hirsch, FACHE

Red Flags

Sources and Citations