Along with the times and in the midst of global competition, to maintain its existence, health services have experienced rapid changes and advances in terms of organization, human resources, systems, equipment technology et cetera. This will affect the existence of health facilities, including hospitals. Hospitals that are successful in adapting and changing are the ones that will survive amidst the competition. The purpose of this study is to explore the change management efforts implemented by hospital in order to maintain its existence amidst very tight competition for health services. This research was conducted at Sekarwangi Hospital, Sukabumi, Indonesia. To obtain data, researcher conducted observations, interviews and discussions. The results showed that the BLUD Sekarwangi Hospital was already made and still making changes to maintain its existence. The implementation of financial management which is more adaptable to its needs, the application of service standards following the National Hospital Accreditation Standards (SNARS), and the enhancement of hospital type service were efforts of change management in hospitals. Every policy has pros and cons, as well as hospital policies in implementing change management, which have encountered several obstacles.