The upper echelons perspective states that the backgrounds and experiences of strategic managers, especially CEOs, influence organization performance. This study seeks to determine if there is a corresponding variety in the demographic and experiential backgrounds of hospital CEOs relates to hospital profit status, rurality, and competition. Multivariable logistic regression is used to examine a sample of 407 hospital-CEO dyads, created by merging a nationally representative random sample of hospital CEOs (2009–2011), the American Hospital Association database (2013), and Medicare Cost Report Database (2009–2011). The results show significant differences between For-profit (FP) and Not-for-profit (NFP) hospital CEOs, as NFP CEOs are more likely to be older and to have longer tenures within their organizations than their FP counterparts. These results hold even as hospital’s organizational and environmental contexts become similar in terms of rurality and levels of competition. Given the finding that there are differences between hospital CEO backgrounds based on organizational and environmental contexts, future scholarship should examine the degree to which these differences influence hospital performance and care quality outcomes so that hospital governing boards might consider the degree to which executives’ demographic backgrounds and professional experiences align with the hospital’s strategic mission, vision, and goals.