Airica Steed, who became CEO of MetroHealth in December 2022, was fired Friday afternoon following a special board of trustees meeting.
The county hospital hired Steed after it ousted its former CEO, Dr. Akram Boutros, just months before his retirement.
Steed announced three weeks ago that she was taking medical leave, after which the hospital named Dr. Christine Alexander-Rager, a longtime physician and executive, as the interim CEO. The motion to fire her was approved by all members present.
MetroHealth’s board chair, Dr. E. Harry Walker, said in the meeting that the “board has lost confidence in Dr. Steed’s ability to lead the system.”
The board did not cite specific reasons for firing her. In a statement posted on the MetroHealth website after the meeting, the board said it disagreed with the Steed’s priorities.
“It has become clear that the Board and Dr. Steed fundamentally disagree about the priorities and performance standards needed from our CEO for MetroHealth to fulfill its mission,” Walker said. “We believe Dr. Steed’s performance is not meeting the needs of MetroHealth.”
Steed said through an attorney Friday evening that she was “stunned” by her termination and is considering suing MetroHealth’s board of trustees for “unlawfully” getting rid of her while on medical leave.
Public records obtained earlier by Signal Cleveland indicate tension existed between the board and Steed over her frequent travel — and the expenses and absences from the hospital related to those trips.
Steed earned a largely positive review conducted by the board, but her evaluation flagged some concerns
Steed, who has a doctorate of education in leadership, still received a largely positive 2023 performance review, which was completed in March 2024. She hit goals tied to the hospital’s performance that triggered a $381,000 bonus on top of her $900,000 base salary.
A report summarizing her performance review states that Steed met or exceeded expectations in categories of “mission strategy, quality safety and experience, financial management and community and external relations.”
The report said Steed only partially met expectations related to collaboration and building relationships with physicians.
Steed performed below expectations when it came to “effective leadership of the management team” and “relationship with the board and chair,” according to the summary report.
The report recommended that, among other actions, Steed “increase her visibility on campus,” though it made no mention of her travel. It also recommended that she “stabilize the leadership team during the second year.”
The full 2024 performance evaluation offers a more detailed view of her management and relationship with the board. Steed was reviewed through the eyes of 32 board members, top physicians and other staff, community leaders and Steed herself, according to the report. The full evaluation also includes anonymous comments from the people who participated in her review.
Respondents gave Steed an overall rating of 7.3 out of 10, with 34.4% selecting the highest possible rating. Steed herself – and community leaders – gave her the top rating.
Steed complained about former MetroHealth CEO in performance review comments
In general, the comments praised Steed for her work in the community, for raising the profile of the hospital and for guiding Metro through turbulent times, following both the COVID-19 pandemic and an abrupt and messy leadership change. But some respondents also raised concerns about Steed’s travel, lack of presence around the hospital and relationship with the board.
Here is a sample of the comments from her review:
“Dr. Steed has been honest, humble, and transparent with the [board of trustees].”
“CEO sometimes does not welcome all the board feedback on directions, which has resulted in some palpable tensions that will need to be worked on to overcome with some honest dialogue.”
“Dr. Steed has come during a very difficult year. She has had some big wins including getting an increase in funding from county council and hitting our financial targets. I am most concerned with an apparent lack of communication with the chair.”
“Not present very often – has not visited many of the sites which is feedback heard often during leadership and other rounding. … Requires an entourage when visiting an area or to attend a conference, etc.”
Steed responded to each question that solicited comments. She defended her work and said she overcame many hurdles. Here are some of her responses:
“Overall, I strongly believe that the relationship with the collective board has been favorable, however, there has not been adequate time in this first year given so many roadblocks and barriers on building a strong and trusting rapport, which I am confident will develop with time.”
“I need to stop being so hard on myself and take the pressure off. With all being said and done, this has been a wildly successful year despite all the challenges and I need to better appreciate that. I have made impossible possible across several areas.”
“I have not felt fully empowered to make management decisions that falls within the purview of the CEO, including necessary changes to the Executive Leadership team structure that impedes and effective Board/CEO relationship while also functioning in a perpetual state of ‘walking on eggshells’ and feeling ‘guilty until proven innocent’.
Steed also took aim at Boutros, the former MetroHealth CEO. She did not mention him by name but referenced him in her comments:
“I also want to put on the record that while I have had to endure some pretty challenging circumstances, including social media harassment/bullying/intimidation/character assassination by my predecessor, in no uncertain terms have I ever disparaged or represented the Board of Trustees in a negative light and I have zero control over baseless and unsubstantiated gossip. I have been on record of praising the Board of Trustees and will continue to do so in the manner in which I represent MetroHealth. My hope is that negative falsehoods are not taken at face value and that I be given the benefit of the doubt.”
Jason Bristol, an attorney for Boutros, disputed Steed’s characterizations of the former CEO.
“Dr. Steed’s statements about Dr. Boutros in her performance review are false,” he Bristol said. “Dr. Boutros left MetroHealth in a stellar financial condition. Dr. Steed had every opportunity to succeed, and she is solely responsible for what happened on her watch.”
Steed’s travel expenses drew board scrutiny
The full performance review did not offer insight into exactly how much time Steed traveled on hospital business. But the board analyzed her travel – and local business expenses – in a separate report, which Signal Cleveland obtained. The report, which covered 2023 and 2024, doesn’t address why the board asked for the review of expenses.
The report shows Steed traveled frequently, nearly every month, often multiple times a month. The trips were tied to healthcare and leadership conferences, some that featured her as a speaker or where she received awards.
The cost of her out-of-town trips – including airfare, hotels, car services, and meals – was $77,410 for approximately the last 18 months.
In June 2023, Steed attended seven out-of-town events, visiting New York City, Charlotte, Chicago three times, Washington, D.C., and Nashville, the report shows. In July of that year, she traveled to Seattle and Charleston. The following month, she went to Atlanta, Napa Valley, and twice to Chicago.
In March 2024, Steed traveled out of town five times to Washington, D.C., Las Vegas, Columbus, Orlando and Chicago. In April, she traveled four more times, to Laguna, California; Washington, D.C.; and twice to Chicago.
In June of this year, the board signaled it was not happy with the pace of Steed’s travel, passing a resolution meant to force her to seek prior approval for some expenses, in particular for out-of-country travel. Steed had planned to attend a health conference in Cape Town, South Africa, according to the report, which lists that trip as “canceled.”
In addition to travel, the analysis of Steed’s expenses examined the costs of her memberships in professional organizations, fees for attending local events, and business meals and related expenses. These costs totaled nearly $73,000 for 2023 and 2024.
The report, which details which restaurants and events she frequented, doesn’t provide an analysis of how her expenses compare to predecessors or if the expenses are inline with the hospital’s typical practices.
MetroHealth’s acting CEO this week announced cost-cutting measures meant to contain expenses during a challenging time in the healthcare industry and at the hospital. The plan was launched while Steed was still in charge, the hospital has said. Travel is one of the expenses the hospital said it planned to cut back on.
