A generation of health care leaders has reached retirement age, and hospitals are starting to feel the effects. According to the American College of Healthcare Executives, hospital CEO turnover increased in 2009 to 18 percent nationwide, up from 14 percent in 2008. The increase makes it the highest turnover rate since 1999 and only the fourth time the turnover rate has reached this level since tracking began in 1981.

Since 2001, turnover has hovered at 14 or 15 percent annually, with one jump to 16 percent in 2004.

"While there are many factors in play, I believe the primary driver for this increase in CEO turnover is the retirement of health care leaders in the baby boomer generation," says Thomas C. Dolan, Ph.D., FACHE, president and CEO of ACHE. "These findings underscore the need for health care organizations to have good succession planning in place to ensure organizational success when changes in senior leadership occur."

ACHE's CEO turnover reports are based on changes in an organization's chief executive officer as reported to the American Hospital Association.