Main purpose of this study is to provide some managerial suggestions for local small and medium-sized hospitals that are in poorer business environment than large hospitals such as university hospitals, in managing the manpower efficiently, improving business performance and enhancing competitiveness, by empirically investigating the relationship among competency, organizational structure and business performance. Major results are as follows: First, regression analysis for the effects of hospital competency on nonfinancial performance revealed that marketing competency, intangible resource competency and financial resource competency, in that order of importance, had significant influence on nonfinancial performance. Second, regarding the analysis of the effects of hospital competency on financial performance, financial resource competency, marketing competency and intangible resource competency, in that order of importance, significantly affected financial performance. Third, as for the moderating effect, significant result was obtained in an interaction between hospital competency and organizational structure. Financial resource competency had a positive significant impact on nonfinancial performance. However, it had negative significant impact on it by interactive effect with organizational structure.