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Research Brief

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Highlights: The average annual turnover rate in Georgia rural hospitals between 2011 and 2017 was 24%, with a low of 17% in 2012 and in 2015 and a high of 37% in 2016. Between 2011 and 2017, rural hospitals had on average, approximately two CEO changes, with 46% reporting three or more CEO changes. Annual turnover rates were found to be consistently higher in rural prospectively paid (PPS) hospitals, compared to Critical Access Hospitals (CAHs).

Background: Hospital chief executive officer (CEO) turnover rates have increased nationally over the last decade, increasing from 15% in 2007 to 18% in 2017, and after reaching a peak of 20% in 2013 (American College of Healthcare Executives [ACHE], 2008; ACHE, 2018). Unexpected leadership turnover can be disruptive for organizations operating in an ever-dynamic environment like healthcare. The existing literature indicates an inverse relationship between CEO turnover and hospital performance, with a stronger negative impact of turnover on performance in nonprofit hospitals (Brickley & Van Horn, 2002) and among small rural hospitals (Alexander & Lee, 1996).

In 2018, the American College of Healthcare Executives (ACHE) estimated the CEO turnover rate in Georgia hospitals to be 20%, higher than the national rate of 18%. There is, however, a dearth of literature on CEO turnover in rural hospitals in the state. The purpose of this research brief is to describe CEO turnover in Georgia’s rural hospitals between 2011 and 2017.


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