I ran real command centers before I started building them for business owners.
Josh Thompson, founder of Koen Advisors. Fractional CFO for $5 to $50 million owner-operated businesses.
The short version
Today I run Koen Advisors, a fractional CFO practice for $5 to $50 million owner-operated businesses. I've run more than 40 engagements at that scale, worked as sell-side CFO on five closed transactions, and guided a home-services client from $3 million to $10 million in revenue and a 10x EBITDA exit. Before that, I was COO of a 25-person accounting and consulting firm and fractional CFO for clients with more than $250 million in combined revenue, and we grew that firm from zero to $2.5 million in two years.
The discipline behind the work comes from the Army, where I spent over a decade running hospitals and finance organizations. My seats included CFO of a 1,700-employee hospital with a $135 million budget, CFO of the Walter Reed Army Institute of Research with a research budget over $2 billion across 4 continents, and chief of staff inside a health system with 23 hospitals, 150,000 employees, and a $12.8 billion budget. Numbers at that scale force habits that matter just as much in an owner-operated company. The two that stuck with me are knowing costs cold and watching cash forward instead of backward, and both only work when one person owns every number.
I also served as CEO of a 120-bed trauma hospital in Kuwait, and as CEO of a 148-bed field hospital with 500 staff that stood up the first U.S. government COVID vaccine site and screened more than 40,000 Afghan refugees. In those jobs, a command center was a real room where the data stayed live and every number had a name attached to it. Decisions got made the same day the numbers moved.
Healthcare is the flagship specialty because it's where I come from. I ran hospitals, I hold a master's in health administration, and I'm a Fellow of the American College of Healthcare Executives. When a physician-owned practice hands me a case-level export, I know what I'm looking at.
Koen Advisors exists because I kept meeting the same owner: a $5 to $50 million business, a decent bookkeeper, and nobody turning the numbers into decisions. Hiring a full-time CFO at market rates of $275,000 to $500,000 all-in made no sense at their size, so I built the command center for them and took accountability for the numbers myself.
Credentials, for the record
- MBA and MHA (Health Administration), Baylor University
- B.S. Aerospace Engineering, Embry-Riddle Aeronautical University
- FACHE, Fellow of the American College of Healthcare Executives
- CDFM, Certified Defense Financial Manager
- Lean Six Sigma Black Belt
- U.S. Army finance and executive roles, 2012 to 2023, budgets from $135 million to $12.8 billion
Why a live dashboard instead of a monthly deck
The typical fractional CFO deliverable is a monthly slide deck. It looks tidy, but it shows up late and nobody opens it a second time. I build the dashboard first because that's how command centers work: the people who act on the numbers see current data every week. The monthly review still happens, but it becomes a working session about what to do next instead of a review of history.
Start with the Margin Map
Three weeks, $7,500 flat, and if it doesn't identify at least 3 times its fee in margin opportunities, you don't pay. If you continue to a retainer, the full $7,500 is credited to month 1. Book a call and we'll see if it fits.