A no-confidence vote against a hospital CEO is often — but not always — followed by a fairly quick exit.
Becker’s analyzed 12 instances over the past five years of medical staff and nurses’ unions expressing “no confidence” in their CEOs and tracked CEO tenure following the votes. The analysis found that a no-confidence vote is often followed by a CEO’s exit. The timeline, however, varies widely, and in several cases the connection between the vote and the eventual departure is unconfirmed. Some CEOs may have left for reasons unrelated to the vote.
By the numbers
Of the 12 CEOs who faced a no-confidence vote in this period:
- Nine (75%) ultimately left their roles.
- Seven (58%) departed within a year of the vote.
- Three (25%) remained in their roles as of Aug. 11, including after votes that came in 2025 and 2026.
- Two departures took considerably longer than a year, including one CEO whose exit was described as a planned retirement rather than a result of the vote.
The fastest exits
Governance structure appears to matter. Votes at small, independently governed hospitals were followed by fast board action, from within days to a few weeks.
Medical staff at North Country Hospital in Newport, Vt., voted no confidence in CEO Brian Nall in October 2022 over alleged management decisions that staff said created concerns about the hospital’s work environment. He resigned in the same month.
The United Nurses and Allied Professionals union at Eleanor Slater Hospital in Cranston, R.I., voted no confidence in interim CEO Jennifer White and several other clinical leaders in April 2021. A spokesperson confirmed Ms. White was no longer interim CEO a few days later.
Slower exits, and votes that did not lead to an exit
Across larger systems, and in cases where unions called the vote amid active labor negotiations, the outcome tended to look different — either a much longer runway to departure, or no departure at all.
At Minneapolis-based Hennepin Healthcare, the Minnesota Nurses Association, AFSCME Local 2474 and a paramedics and EMTs union voted no confidence in CEO Jennifer DeCubellis in November 2023 amid a dispute over her raise alongside proposed cuts to worker benefits. Ms. DeCubellis remained in the role for about 18 months before announcing her resignation, effective May 2025.
“Every leader has a season,” Ms. DeCubellis told the Hennepin Healthcare board of directors March 26, 2025, according to a system news release. “We are all destined for a specific purpose, and a strong leader passes the baton when the time is right. That time for me is now.”
Some CEOs do not step down but instead go on to retire. At MultiCare Health System’s Good Samaritan Hospital in Puyallup, Wash., the Washington State Nurses Association voted no confidence in CEO Bill Robertson in May 2023. Mr. Robertson announced his retirement roughly three years later, in June 2026 — a transition the system has described as a planned succession rather than a response to the 2023 vote.
Other leaders remain in their roles. At Kaiser Permanente, the Oregon Federation of Nurses and Health Professionals voted no confidence in CEO Greg Adams in December 2025, calling for an investigation into his fitness to lead. Kaiser characterized the vote as a bargaining tactic tied to ongoing contract talks, and Mr. Adams remains in his role.
At Uvalde Memorial Hospital in Texas, medical staff voted no confidence in CEO Adam Apolinar, BSN, RN, in March 2026. The hospital board called the matter resolved and reaffirmed its support for Mr. Apolinar, who remains CEO.
As the cases above suggest, where a CEO sits within a system’s governance structure appears to matter as much as the vote itself. These examples do not prove a no-confidence vote causes a CEO’s exit, however. Other factors, such as labor disputes, were often at play as well. They do suggest, though, that governance structure may play a role in what happens next.
Editor’s note: This analysis reflects Becker’s coverage of no-confidence votes targeting hospital and health system CEOs from 2021 through 2026 and is not necessarily an exhaustive list of every such vote nationally. A few cases involved a CEO named alongside other executives (COO, dean of medicine, chief medical officer) rather than the CEO alone.
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