Stewardship Over Spotlight: Sean Granahan and the Quiet Turnaround of The Floating Hospital

Some leadership stories begin with ambition. Sean Granahan’s began with a piece of paper slid across a diner table — instructions to shut down a 160-year-old institution.

The Floating Hospital, one of New York City’s oldest charities, was deeply in debt, operationally strained, and facing an uncertain future. In that moment, Sean wasn’t asked for a vision or a long-term plan — he was simply asked, “What do you think?” 

What followed was not a dramatic rescue or a flashy turnaround, but a decades-long act of stewardship rooted in kindness, discipline, and an unwavering belief that some organizations are worth saving precisely because of the people they serve.

The Tailspin:

Sean Granahan did not arrive at The Floating Hospital looking for a lifelong mission.

A regulatory lawyer by trade, he had spent the previous two years on a high-profile insurance lawsuit. By the end of it, Sean admits he was “looking for a break.”  

“I think I'll do something that isn't really going to be that stressful,” he told himself. “I liked in-house companies better, and so I spoke to the firm and we talked about a couple of different client opportunities.”

Sean began advising hospitals struggling to keep the lights on — a task he now believes turned into a “lifelong crusade.” 

One of those clients was The Floating Hospital. 

What began as pro bono legal work slowly turned into something deeper. He took on HR responsibilities, handled operational issues, and helped navigate a difficult arbitration involving a former CEO.

Then came the dinner on the Upper West Side.

“They handed me a sheet of paper, and the sheet of paper was my boss's resignation and instructions to close the hospital,” he recalls.

The organization — 160 years old — was deeply in debt, deteriorating, and on the brink of collapse. Sean wasn’t given much time to reflect.

“You just have an opportunity to react,” he says.

What drove his response wasn’t strategy or ego — it was people. “The Floating Hospital is a very kind place where a lot of kind people work,” he says. 

“I thought this odd group of people should be able to persevere. There should be a place in New York City for a group of just exceptionally kind people who are interested in doing exceptionally kind things.”

So Sean asked the board for six months.

“Give me six months and if I can sort this out for you, I'll sort it out,” he recalls. “And if I can't sort it out for you, I'll close it and I'll close it without any liability.”

Those six months became the foundation for a complete organizational reset.

The Work:

Sean leaned on an unconventional background — years as a bartender, experience running HR and logistics in long-haul trucking, and an instinct for operational flow. 

He considered The Floating Hospital “a logistic driven charity” — something Sean understood well.

“What I actually had to go back and learn at that moment primarily was some of the nonclinical administrative aspects of the job,” he says. 

He learned the work firsthand — filing medical records, registering patients, observing staff — because bureaucracy wasn’t an option. They simply couldn’t afford it.

“The Floating Hospital is a true charity,” he shares, “So we had to all know the work.” 

Financially, the situation was dire. “We had a 2.78 million budget, and we had a $5.9 million Medicaid bad debt write off.”

“We had to reconcile basically an obliteration of our book, and we had to decide from a risk perspective whether we were going to roll the dice and work off a cash basis for two or three years, or were we going to focus on the book and try to build the book back to life.”

Sean believes cash was the only solution to the problem. “So we focused on cash, and frankly, we never looked back.”

That led Sean to make a defining decision. 

Operationally, the care model itself needed rethinking. Homeless families, for example, were being split across providers.

Sean changed the model entirely — moving to family practice doctors so entire families could be seen together.

“That was to me, the most critical aspect of what we did to turn things around.”

Governance followed a similar reset.

“All the board members that were there in the six months,” he says, “They all left.”

What replaced them was a different kind of culture — long-tenured staff, deep trust, and radical collaboration.

“We hired the best people we could find and in doing that, we hired an incredibly diverse group of people,” he shares, a decision that provided him with entirely different perspectives on similar problems. 

Scale followed focus. The hospital hit a $10 million threshold in just 18 months — then kept growing.

“Today we're about a $35 million organization.”

The Tailwind:

For Sean, leadership has never been about ownership — it’s about stewardship.

“I view my role more as a steward,” he shares, “to keep it for the next person and to deliver it in good order.”

That mindset extends to succession, which Sean approaches openly and intentionally.

“It's a topic of conversation,” he says. “I want to retire in about three years, four years and I already have a successor.” 

He believes transparency creates stability.

“When people have been here a long time knowing their successor,” he says, “it creates a stability in the group.”

Looking ahead, Sean doesn’t measure success in expansion alone. He measures it in continuity, care, and conscience.

“I want to be able to look back at this time and say that I left the place in good hands and I left it well.”

His story is a powerful reminder that not all leadership is loud — and not all transformation comes from disruption. Sometimes, the most enduring impact comes from staying, listening, and choosing to do the right thing when walking away would be easier.

To hear more about Sean Granahan’s journey, the turnaround of The Floating Hospital, and what stewardship leadership really looks like, listen to the full episode of re:Purpose with Buddy Teaster.