A Hard Lesson Learned: How One Executive Hire Nearly Bankrupted My Treatment Center, and How You Can Avoid the Same Trap

As the CEO of mental and behavioral health treatment centers, I’ve seen firsthand the transformative impact that thoughtful leadership can have on patient outcomes and organizational growth. In our field, making the right hiring decisions isn’t just about cultivating a strong business—it’s also about safeguarding the people we serve and maintaining an environment where quality care thrives. Unfortunately, I learned this truth the hard way when I put my trust in an executive recruiting firm that promised a perfect fit for a vital leadership role. The result was nearly catastrophic.

My Costly Mistake

A few months ago, our treatment center was on a strong upward trajectory. Our reputation was building, our patient satisfaction levels were trending up, and our financial performance was steadily coming up. As we grew, we were struggling with a billing manager. and oversight of the internal billing function. I decided that it was time to bring in a dedicated Director of Billing—someone with the specialized expertise to streamline our revenue cycle management, optimize reimbursements, and ensure compliance with the unique complexities of OON mental and behavioral health billing.

To fill this critical position, I engaged a reputable behavioral health recruiting firm who had  been trying to gain business. They claimed decades of combined experience and presented a seemingly foolproof vetting process. They assured me that the candidate they found was thoroughly vetted, a seasoned professional who could navigate our industry’s nuances with ease. I believed them. After all, this was what I was paying them nearly $16,000 for: Peace of mind and the promise of top-tier talent. The candidate sounded good in interview meaning more than likely they were probably coached. They knew all the right things to say. 

Within two months of the new Director of Billing’s start date, however, our company was on the brink of financial disaster. This supposed “expert” failed to perform even the most fundamental tasks correctly. Basic billing codes were submitted incorrectly, and reimbursements began plummeting. Our reimbursement rates, once stable in the 40% range, tumbled into the low teens, costing us millions of dollars in lost revenue. Critical processes like peer reviews and level-of-care submissions were mishandled, and negotiations tanked.

In a matter of weeks, what had been a well-oiled machine of revenue generation and compliance fell into chaos. By the time the truth came out—that the candidate had exaggerated their experience and didn’t fully understand our billing processes by their own omission—it was too late. Our finances were already in jeopardy. I had no choice but to make an agonizing decision: lay off our entire internal billing department during the holiday season and bring in an external billing team to keep the company afloat. This emergency measure helped us stabilize, but the damage to our bottom line and morale was incalculable, and we still aren't out of the woods.

The True Cost of Trusting the Wrong Recruiter

What still stings is the absence of accountability from both the placed candidate and the recruiting firm. Once the situation deteriorated, the candidate admitted, somewhat sheepishly, that they were in over their head and never truly understood what was required of them. But where was the accountability from the recruiting firm that had placed this individual? They did not step forward to accept responsibility for their failed vetting process. They had already collected their check and were still trying to collect more money, opposing reticular late fees because while we were trying to fix the revenue damaged from their placement, they still wanted to collect on another job they filled. As far as I could tell, we had become another cautionary tale.

This experience taught me some invaluable lessons. If you’re running a business in the mental or behavioral health space—or any highly specialized niche—please take heed. Executive recruiting firms may talk a big game, touting their “proven processes” and “extensive networks,” but at the end of the day, some will say or do anything to secure their commission. This doesn’t mean all recruiters are bad actors, but you must approach these partnerships with a healthy dose of skepticism. I also realize and the experience has taught me to hover over everything and everyone until they have proven themselves. I personally was involved in so many things because I was repairing and rebuilding two entire programs from the ground up. I relied on this position tremendously and it took it toll. So at the very end of the day the buck stops with me.

Tips for Avoiding the Same Trap

1. Vet the Recruiter Before They Vet Your Candidates:  

   Ask potential recruiting firms for client references, and actually call those references. Inquire about the longevity of placements, the success rates of their recommended candidates, and how the firm handled any challenges or disputes.

2. Demand Transparent Processes and Criteria:  

   A reputable recruiting firm should be able to explain, step-by-step, how they screen and evaluate candidates. Ask them: How do you verify the candidate’s industry-specific knowledge? What kind of background checks, reference checks, and practical skill tests are administered? If the answers are vague or feel like “sales talk,” consider that a red flag.

3. Conduct Your Own Independent Assessment:  

   Even if you hire a recruiter, never outsource the entire vetting process. Develop your internal assessment tools. For specialized roles, create scenario-based interview questions that test real-world problem-solving abilities. Ask the candidate to explain how they would handle a specific billing discrepancy, walk through a hypothetical compliance audit, or address a common coding challenge. Make sure your internal subject matter experts sit in on these interviews.

4. Insist on Hard Evidence of Competency:  

   Don’t just take a candidate’s word—or a recruiter’s word—for their expertise. Request documented examples of their work, ask for data that shows past performance improvements, and verify certifications or licenses directly with issuing organizations. In fields like mental and behavioral health, where billing nuances are complex and critical, you must ensure the candidate can walk the walk.

5. Use Probationary Periods and Performance Milestones:  

   Negotiate terms upfront that allow for a trial period or conditional hiring agreements. Set measurable performance milestones that the candidate must achieve within a defined timeframe. If they fail to meet these milestones, you should have the contractual ability to sever ties without incurring massive costs.

6. Invest in Ongoing Training and Support Structures:  

   Even the most experienced candidate will need time to adapt to the specifics of your organization. Develop comprehensive onboarding programs and provide ongoing support. If you notice early red flags—like confusion over standard billing codes or a pattern of small errors—address them immediately. Don’t wait for minor issues to snowball into a crisis.

7. Be Prepared for the Worst-Case Scenario:  

   Have contingency plans in place before you make any executive hires. Outline a backup strategy if a key leader fails to deliver. This might mean maintaining relationships with third-party billing firms, cross-training internal staff, or keeping a short list of alternative candidates warm. Always have a safety net.

8. Prioritize Integrity and Cultural Fit Over Flashy Credentials:  

   It’s tempting to be dazzled by a candidate’s resume, industry jargon, or polished interview skills. Remember that sincerity, transparency, and a genuine understanding of the field are more important than any rehearsed soundbite. A candidate who truly knows their stuff will welcome in-depth discussions, detailed questions, and scrutiny of their credentials.

9. Seek Community Feedback:  

   The mental and behavioral health sector is relatively close-knit. Tap into professional networks, attend industry conferences, and ask peers about their experiences with various recruiting firms. Word-of-mouth recommendations can be more reliable than glossy marketing materials.

10. Consider Building an Internal Talent Pipeline:  

    Over the long term, invest in building and nurturing talent from within. Encourage your junior staff to seek further education and certifications, offer professional development opportunities, and identify high-potential team members you can groom for leadership roles. Internal promotions often bring a proven track record of cultural fit, established trust, and a deep understanding of your organization’s unique needs.

Paying It Forward

I’m sharing this story not to name and shame but to help others avoid the fallout we endured. In the world of mental and behavioral health, where compliance rules are intricate, reimbursements are closely watched, and patient well-being depends on smooth operations, a bad executive hire can be catastrophic. One wrong placement—especially in a role as critical as billing—can put your entire mission, your staff’s livelihoods, and your patients’ access to care at risk.

Because of my large social reach and future TV hosting spot, I now reach millions of people monthly across various professional and social channels, and I’m using that platform to warn others. If you’re serious about safeguarding your organization’s future, do your due diligence. Don’t be lured into a false sense of security by a recruiting firm’s promises. Remember that, ultimately, the responsibility for ensuring the right hire is yours. By applying these lessons learned and tips shared, I hope you can avoid the painful and near-catastrophic ordeal my organization endured.

If you want to know more or need specific guidance, feel free to reach out privately. Let my cautionary tale serve as a bulwark against the perils of placing blind trust in outside recruiters. In this high-stakes environment, knowledge, scrutiny, and vigilance are your best defenses.