Monroe County Hospital’s Chief Executive Officer, Casey Fleckenstein, BSN, RN, has been named to Becker’s Hospital Review’s 2026 list of Women Hospital and Health System Presidents and CEOs to Know. The list recognizes 236 women leading hospitals and health systems across the country, and Fleckenstein certainly earned recognition this year through her dedication to advancing health care in Monroe County.
Fleckenstein’s path to CEO started in a high school classroom. As a teenager in Forsyth, she completed clinical rotations at Monroe County Hospital through a health occupations class and that early exposure to patient care stuck with her. She went on to spend more than two decades at MCH, working her way through bedside nursing in the Medical Surgical Unit and Emergency Department, then into Post-Anesthesia Care, Emergency Management, and Case Management, before being named Chief Nursing Officer.
The hospital she now leads was not always on solid footing. In mid-2023, Monroe County Hospital was burning through its reserves fast enough that closing was a real possibility. That November, the Hospital Authority Board brought in Aletheia Health Partners, a management company focused on rural hospitals, to help turn things around. Aletheia leaned on Fleckenstein from the start, promoting her to CNO while preparing her for a larger role and drawing on her firsthand knowledge of what had and hadn’t worked at MCH in the past. In 2025, she became Hospital Administrator, and in January 2026, the Hospital Authority Board voted to name her Chief Executive Officer.
“Casey brings over 20 years of knowledge to this role, and her passion for her hometown and commitment to the hospital’s success is unmatched,” said Kerry Trapnell, Chief Administrative Officer of Aletheia Health Partners. “She is exactly the kind of leader rural healthcare needs, someone who knows the community because she is part of it.”
Under her leadership in 2024, the hospital grew its Swing Bed program and added specialty care to its medical office suites, giving Monroe County residents more options for care close to home. In 2025, she led MCH to complete the pediatric readiness requirements for the Kids Alliance for Better Care, a partnership with Mercer University School of Medicine, Mercer’s Georgia Rural Health Innovation Center, and Children’s Healthcare of Atlanta. That same year, the hospital completed a soft reopening of its operating room and began performing cardiac procedures, with a full reopening planned for 2026, and Hometown Health named Monroe County Hospital its 2025 Hospital of the Year. In addition, the Monroe County community recently recognized the hospital as the best place to work, best in medical imaging and lab, best mammography services and best caregiver.
Fleckenstein is a lifelong resident of Forsyth and is raising her three children in the same community she serves. That local, personal stake in the hospital’s future is part of what Becker’s recognized in its 2026 list, which highlights women who are expanding access to care and building workplace cultures where both providers and patients thrive.
“I’m so excited about the future,” Fleckenstein said. “With our amazing team and the support of Aletheia Health Partners, we are going to do great things for this community.”
This recognition follows Fleckenstein’s earlier selection to Becker’s Top 146 Rural Hospital and Health System Presidents and CEOs to Know list in May 2026, and comes as Monroe County Hospital continues its broader turnaround, including the reopening of its operating room and ongoing exploration of facility renovations to expand care access for the region.
Monroe County Hospital is a 25-bed critical access hospital in Forsyth, Georgia, providing 24/7 physician-staffed emergency care, general medical and surgical services, Swing Bed rehabilitation, imaging, and laboratory services to Monroe County and the surrounding area.
Contact: Monroe County Hospital 88 Martin Luther King Jr. Dr., Forsyth, GA 31029 478-994-2521. https://www.monroehospital.org.