The lack of managers who have been trained on management results in less effective management systems. In general, management capacity has been classified as weaknesses in various areas of health managers' expertise. The success and future of an organization depends on the performance generated by the leadership of the hospital manager. As a complex organization, RS has interaction among various professions, so the conflict is not an abnormality that occurs in hospital is a characteristic of a hospital. Health services in hospitals is a comprehensive health service (comprehensive and holistic) which includes promotive, preventive, curative and rehabilitative. Hospital Health Promotion is an important part of health programs designed to bring improvement in the community as well as in the organization and environment as a process to improve the community's ability to maintain and improve their health. The purpose of this research are analyze the factors that affect the performance of manager in PKU Muhammadiyah Delanggu Hospital, Central Java, Indonesia. The analysis in this study using SEM analysis to test the performance model of hospital managers and hypothetical relationships that exist in the model. The findings in this study show the performance of hospital managers, from the five factors that predict, influenced by motivation, commitment and leadership. Two other predictors were found to have no significant effect, ie job satisfaction and organizational culture. Motivation becomes the factor with the strongest influence on performance. The strong influence after motivation is commitment and then leadership.