PKU Muhammadyah Hospital is a hospital that spesialized in the field of health care under the central leadership of Muhammadiyah. the increasingly sharp competition and fast in the field of technology led to drastic changes in each organization, thus requiring human resources that have the ability to provide excellent service and can provide the value of customer satisfaction ( customer satisfaction) is oriented to the vision and mission of the organization (customer value) organization so as to bring the human resources that have expertise and unique capabilities. in order for the hospital to survive and thrive adjust competitive conditions increasingly competitive, the hospital should have a competitive advantage (competitive advantage ) to be the best by the way should strive to improve the quality of human resources starting from the head down to subordinates and reliable management system. this research used mixed method with the quantitative and qualitative approaches. use primary data in the field was obtained from interviews, groups discussion and questionnaire to all levels of managers. the research was conducted in September 2015. The object of research is leadership and management(the peak level manager, the mid-level manager, the lower level manager) at PKU Muhammadiyah hospital in Yogyakarta. The result showed that the leadership and mangement skills (finance, human resources (HR), quality, medicine information system and equipment) of top manager is (likert scale = 3) while the middle and lower managers considered not sufficiently competent (likert scale = 2).