Quick question - is there a preference somewhere to set hierarchical fields to only display their last item? For example, Billings is a child location of Montana. Users only want "Billings" to show when selected.

for accounts, entities, and items, yes. Home > Set Preferences "Only show Last subxxx" (General tab). Locations I don't believe this is possible on a sublist, but you can do some formulas to back into it on a saved search.