At one of the most turbulent and uncertain times in its history, Grady hospital will be run by a state legislator with no experience managing a major health center.

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The Grady hospital board ousted Grady chief executive Otis Story Monday night, effective immediately, and his position will be filled temporarily by the board's chairwoman, state Rep. Pam Stephenson.

Stephenson took over Tuesday and immediately met with staff.

The decision to fire Story apparently was made in a late meeting Monday. It followed the Grady board's vote to approve a long discussed plan to transfer daily management of the hospital to a nonprofit corporation.

Story is leaving after less than a year in the post, marking another speedy departure of a Grady CEO trying to turn around the financially imperiled medical system. Stephenson is the fifth CEO of Grady since 2005.

Story's relationship with the board has been troubled for months.

"The board decided to change its administration," said Stephenson. "The board members asked me to serve and I agreed."

Stephenson said she will give up her law practice to become a full-time executive for Grady and to continue to represent parts of DeKalb and Rockdale counties in the General Assembly.

Stephenson has a master's degree in health planning. She served five years as executive director of the Georgia State Health Planning Agency, where she was responsible for regulatory oversight of all hospitals in the state.

Dr. Christopher Edwards, the Grady board vice chairman, said Stephenson is "imminently qualified to run the state's largest public charity hospital... She is perfectly positioned to match the needs of the hospital administration with the needs and expectations of [the Grady board] during this transitional period."

Stephenson said she will continue to serve as the Grady board chairwoman and it's unclear when the Grady board will begin the search for a permanent CEO.

She is accustomed to 14 hour work days, Stephenson said, and she believes her appointment will give the hospital continuity in a time of change.

She will be paid a salary, she said, but it's unclear whether she'll get the $600,000 a year Story was paid.

Story did not return phone calls.

Story was appointed in April. People close to the hospital said his relationship with the Grady board turned sour in recent months.

"There must be communication between a CEO and a board, and there wasn't," said the Rev. Tim McDonald, a longtime advocate for Grady patients.

Grady board member Geoffrey Heard said he was dissatisfied with Story's performance.

"The position needed strengthening," Heard said Tuesday.

The hospital is so deeply in debt that officials last year said it was close to closing. It has run a budget deficit for a decade. It is now dealing with a negative report from the Joint Commission, a national accrediting agency, which endangers the hospital's accreditation. It needs millions of dollars to upgrade medical equipment and record keeping systems.

Some officials said Story's departure clears the way for new beginning for Atlanta's charity care hospital and top trauma center. But others fear that it adds to the hospital's instability at a time of major change.

"Grady has a lot of problems. It doesn't help that you have a CEO leaving," said Sen. Vincent Fort (D-Atlanta), who leads a group of health care advocates called the Grady Coalition. "[The Grady board] needs to reach out to assure the wider community that this doesn't mean Grady is in an uproar."

Board members publicly criticized Story in October for moving to close the hospital's outpatient dialysis services without conferring with them.

"The board has the responsibility to determine what services are closed, and his decision was somewhat premature," Heard said Tuesday. "Without that [service], people would die in the streets."

At the same time, some officials complained that the Grady board micromanaged the hospital and did not allow Story to do his job.

On the positive side, Story helped bring in an international consulting firm to find and fix inefficiencies in hospital operations.

Still, rumblings of the board's discontent with Story have been circulating for months. Fulton County Commissioner Robb Pitts said a Grady board member told him two months ago that the board was dissatisfied with Story's performance.

"They may have been looking for more leadership," Pitts said.

Story was hired after a year-long executive search. He had extensive experience in hospital management. He was working for a Chicago medical consulting firm and had served as executive director of St. John's Queens Hospital in Elmhurst, N.Y., and had worked in executive positions at hospitals in Jacksonville and Savannah.

He leaves as Grady prepares for some of the most dramatic changes in its 115-year history.

State and business leaders have crafted plans to boost the hospital's coffers with millions in private donations and increased state funding, but have demanded in return that the Grady board hand daily control of the hospital to a newly formed nonprofit corporation. The new board would have the authority to name a CEO and determine policy and medical services.

But Heard, the Grady board member, said the hospital leadership felt the need to take action.

"These are some of the things we needed to do, and we're moving forward," he said.