Grady Memorial Hospital officials today announced the four finalists to take the helm of the long-distressed hospital that is struggling to rebuild itself with new leadership.

The selection of a new CEO marks a major step in setting Georgia's largest and busiest hospital on a new track, and it is the first major test for a new board of directors with a corporate Atlanta emphasis.

Grady leaders said they are pleased with the caliber of candidates and hope to select the new CEO in a few weeks.

The finalists all have years of experience running hospitals with big budgets and large staffs, some of which are affiliated — like Grady — with major medical teaching institutions. Some have run trauma centers on par with Grady, which is the only Level 1 trauma center in metro Atlanta. And some bill themselves as turnaround artists who have track records working to improve struggling institutions.

The finalists include Gregory Burfitt, who until recently was the CEO of Centura Health System in Colorado, overseeing 12 acute care hospitals; and James Burkhart, president of Shands Jacksonville Medical Center, a large Level 1 trauma center in Florida.

In addition, the Grady officials are eying Michael Young, who has been CEO for the past three years of the Erie County Medical Center Corp. in upstate New York, and Dr. Michael Keith Butler, who for the past year has led the seven hospitals in the Louisiana State University Health Care Services Division.

The selection of a new CEO marks a major step in the effort to rehabilitate a historic Atlanta institution that has struggled to stay open for years, running multimillion-dollar deficits and using outdated equipment.

"Then we can start to put together and implement a turnaround plan," said Pete Correll, head of the hospital board of directors. "We can stop looking backward and start looking forward."

The search that began over a month ago at first attracted some 30 candidates. Correll said board members interviewed three candidates Wednesday.

Correll acknowledged that the hospital missed its self-imposed deadline to name a new chief officer in June and said the search has proved more difficult than expected.

In particular, some candidates were deflected by the Georgia law requiring that the names of finalists for such public positions be made public. Some, he said, did not want current employers to know they were looking only to be passed over.

Others bowed out after learning the troubling financial condition of Georgia's largest and busiest hospital and the public scrutiny its leaders endure, he said.

According to their resumes, all the candidates had experience in financial management, planning, controlling costs, generating revenue and negotiating contracts. The winner will need all those attributes to save Grady hospital, a sprawling institution that sees close to a million patients a year, has 950 beds and manages a $730 million budget.

Grady's problems reflect many of the maladies hurting health care across the country, including a lack of privately insured patients, dwindling government payments, rising health care costs and years of neglect of facilities and equipment.

In addition, the new Grady CEO must try to turn around a tendency toward leaders coming and going within a year or so, unable to negotiate the minefield of intense community and racial politics, as well as the well-publicized public scrutiny that define Grady.

Importantly, the finalists do not include current interim CEO Pam Stephenson, the head of the Grady hospital authority who assumed the helm after the authority fired Otis Story in January. Stephenson drew political heat as she served in the $600,000 CEO job, as well as being a member of the Grady authority and its new nonprofit board of directors.

Burfitt has served as a CEO at a half-dozen hospitals since the late '70s, most recently at Centura in Colorado. There he oversaw 12 hospitals, eight senior service facilities, and seven home care and hospice facilities, according to his resume.

He said he directed significant improvement in the financial performance of the hospital, its public perception and employee and patient satisfaction.

Burfitt also has a Georgia connection, in that he served as senior vice president for the southern region of Tenet HealthSystem from 1999 to 2004. Working out of the regional office in Atlanta, he was responsible for overseeing a six-state area consisting of 21 hospitals.

Burkhart, as CEO of Shands Jacksonville, said he led a major financial turnaround of the hospital that was near bankruptcy, according to his resume. He increased working capital, decreased the debt ratio and cut the costs of supplies.

He said he led an effort to reduce employee turnover and implemented a diversity council that helped enhance the employee work environment.

Young, as head of the 550-bed Erie County hospital in upstate New York, noted that the facility, associated with the University of Buffalo, scored high on trauma outcomes and had the number one ranked kidney program in western New York.

Young also said in his resume that he reduced emergency room delays, which are a problem at Grady, and increased admissions and revenues.

Butler, who has been interim CEO at the LSU health care services division since last summer, said in his resume that he oversees seven hospitals with 1,556 licensed beds.

Prior to that, he was chief medical officer for the division since 1999.

He touted his efforts in working through Hurricane Katrina and improving the hospital's work with congestive heart failure, asthma and cancer screening.