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Critics charge that the American healthcare delivery system is broken, that while consuming an ever-increasing portion of the Gross National Product, it fails to provide accessibility and quality. Many charged with fixing the system lack the tools to address the problem including an understanding of how the healthcare industry differs from other industries. This case study provides an overview of problems facing a cluster of hospitals owned by a large hospital corporation as it tries to compete in a continually changing environment. The case is based on an actual strategic plan prepared for the Utah division of HealthTrust, Inc and explains the steps one might follow in preparing a strategic plan. The names of all individuals have been changed. The case can be covered in one class period. Student preparation time is approximately two hours. The case can be used in any business course addressing the topic of strategic planning or in a course on health administration where the instructor wishes to provide the student with an overview of the problems facing large healthcare organizations. The case has a difficulty level appropriate to students who are juniors in a bachelors degree business program.