It’s not even the middle of the year yet, but multiple healthcare CEOs and one healthcare president have already bid their organizations adieu. Though seen by some as abrupt, their resignations follow months of struggle, whether financially or otherwise, at their respective institutions.

KentuckyOne Health CEO Ruth Brinkley. Brinkley is the latest hospital CEO to resign, announcing late last week that she will be stepping down from her post on July 14, according to Insider Louisville. Her decision comes only a week after the Louisville, Kentucky-based system unveiled plans to sell Jewish Hospital and other Louisville facilities due to “significant challenges.”

KentuckyOne has been plagued with troubles for a long time. It accumulated losses of nearly $300 million in fiscal years 2010 to 2014, and cut 150 jobs last month.

University of Utah Health Care CEO Dr. Vivian Lee. In late April, Lee stepped down from her post as CEO, dean of the medical school and senior vice president for health sciences of the Salt Lake City-based organization, according to The Salt Lake Tribune. The resignation was effective immediately.

Lee’s resignation came after she fired Huntsman Cancer Institute Director Dr. Mary Beckerle, who was later reinstated. Her firing of Beckerle drew heavy criticism from the Huntsman family, particularly Jon Huntsman Sr., who later referenced Lee’s ties to entrepreneur Dr. Patrick Soon-Shiong.

Baptist Health CEO Steve Hanson. After approximately four years as CEO, Hanson announced his departure, effective “immediately,” in late March, according to WDRB. The Louisville, Kentucky-based organization, which has had financial troubles as of late, reported a $41 million loss in the fiscal year ended August 31, 2016. In mid-March, it also unveiled plans to eliminate 288 jobs.

MD Anderson Cancer Center President Dr. Ronald DePinho. In early March, DePinho relinquished his title as president of Houston, Texas-based MD Anderson, according to STAT. He did so in an unexpectedly frank video during which he apologized asked forgiveness for his “shortcomings.”

“I’ve done my very best,” DePinho said.

He left the organization less than two weeks after the announcement, according to the Houston Chronicle.

DePinho’s tenure was marred by turmoil. MD Anderson lost $267 million in fiscal year 2016. The organization announced almost 1,000 layoffs in January of this year.

Swedish Health Services CEO Tony Armada. Armada resigned from the Seattle, Washington-based organization in February, less than two weeks after a Seattle Times investigation into practices at Swedish Neuroscience Institute on the Cherry Hill campus, according to the Puget Sound Business Journal. The investigation revealed an increase in the number of procedures at the facility, which had the highest Medicare reimbursements per inpatient visit of any hospital in the United States with at least 150 beds.

A Swedish spokesperson told the Puget Sound Business Journal that Armada’s decision was personal.

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