From a communication perspective, what are the basic problems in this case?

Leo was a busy man. He had been given the task of supervising 21 hospitals located in eight different US states. He had run a large hospital earlier in his career, so he felt comfortable giving his CEOs advice about how their operations should run. This was a difficult time for his company, as it had just been created through an employee stock ownership plan, and cash flows had become extremely important for the company.
Leo’s charge was to increase the profitability of each of his hospitals and generate greater cash flows.
Leo was so busy that often he did not have time to speak directly to his CEOs. Consequently, most of his interactions with them took the form of memos, e-mails, and reports that he required his CEOs to produce.
These reports allowed him to understand the operations of the hospitals, from the current state of accounts payable to staffing ratios.