Mother and child Hospital of (RSIA) ‘Aisyiyah Klaten, Hospital of PKU Muhammadiyah Yogyakarta and Hospital of PKU Muhammadiyah Bantul is generating a comprehensive organization with varied inter-professional connection, which might trigger an internal conflict. The lack number of managers who have been trained resulting ineffective management systems. Participants consisted of 29 people at Mother and child Hospital of (RSIA) ‘Aisyiyah Klaten, 13 people at Hospital of (RS) PKU Muhammadiyah Yogyakarta and 40 people at Hospital of (RS) PKU Muhammadiyah Bantul includes top managers, middle and bottom. Characteristic manager age ≤ 30 years 7.7%, > 50 years of 15.4%, age 31-50 years 76.9%. Length of employment ranges managers ranging from 4-23 years, years <5 years of 15.4%, year 6-10 years and 11-20 years amounts to at most 69.3%. The results showed that the leadership and management skills (finance, human resources (HR), quality, medicine information systems and equipment) of top manager assessed competent (likert scale ≥ 3) while the middle and lower managers considered not sufficiently competent (likert scale ≥ 2). Competence hospital managers is currently at an advanced level, means the managers can do the job effectively and confidently. Keywords: Competency; Leadership; Hospital managers; Managerial.