BOCA RATON — Fiscally ailing Boca Raton Community Hospital said Thursday it replaced its CEO for the second time in 10 months, paid $29 million for a defunct loan deal and filled key executive positions with turnaround specialists.

"We felt we needed to speed up our turnaround strategies," said Richard Schmidt, chairman of Boca Community Hospital's board of trustees.

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The 400-bed, nonprofit hospital is still reeling from a $110 million loss, nearly half of it stemming from failed plans to build a $300 million academic medical center.

Jerry Fedele, a former Pittsburgh hospital executive, is the new chief executive. He replaces Rick Van Lith, who took the post in January. Van Lith replaced Gary Strack after the hospital disclosed it was losing tens of millions of dollars in 2007.

Fedele is managing director of FTI Cambio, the company Boca Community hired in June to aid turnaround efforts.

The hospital also hired Karen Poole, an executive of FTI Cambio, as its new chief operating officer. A Cambio official is also the hospital's chief financial officer.

Van Lith spent most of his short time at the helm of the hospital trying to restore trust with local doctors concerned about the impact of the planned medical center.

Fedele knows the importance of physician relationships. After more than three years as CEO of West Penn Allegheny Health System in Pittsburgh, the board removed him when doctors complained that they lacked confidence in him.

However, as a senior vice president at Western Pennsylvania Hospital, Fedele was credited with helping to rescue the hospital from deep financial distress.

Boca Community is not broke. Its foundation has $140 million, making it one of the richest hospital foundations in the state. But only a couple of years ago, the assets totaled $240 million.

Its most recent multimillion-dollar bill came due when it had to pay off a loan deal. Ideally, the deal locked in a low interest rate for the hospital's planned borrowing of $300 million to build the academic medical center. When the project died, and the $300 million loan wasn't needed, the hospital was obligated to pay a fee that could have gone as high as $50 million. The final bill was $28.9 million, borrowed from the foundation.

Although the hospital's fund-raising continues doing well, Schmidt acknowledges some donors' confidence has been shaken. "They want to know how fast we are going to clean up our act," he said.

"This place ought to be very successful," Fedele, 55, said of Boca Community. He noted the hospital has a strong base of Medicare patients, few uninsured patients and a supportive community. Still, admissions are down 10 percent to 15 percent in the past couple of years, and the hospital faces intense competition from Delray and West Boca medical centers, both owned by Tenet Healthcare Corp.

Fedele said the hospital plans to reduce its 2,100-employee workforce but could not say how much would come through attrition or if layoffs would be necessary.

Boca Community officials say the hospital is not for sale - but acknowledge several investor-owned hospital companies and nonprofit hospitals have made inquiries about whether the facility might be on the block.