The chief executive of the troubled Betsi Cadwaladr University Health Board (BCUHB) - which covers the whole of north Wales - has stepped down.
It was announced last summer that chief executive Mary Burrows and chairman Professor Merfyn Jones were leaving after a damning report.
It said the relationship between the two key figures had broken down.
On Tuesday, BCUHB said Mrs Burrows had stepped down by "mutual agreement" and a replacement was being recruited.
In June 2013, a report said operations had been delayed and waiting lists allowed to grow at hospitals in north Wales to avoid financial problems getting worse.
"Significant management failings" risked patient safety for under-reporting infections, it said.
Healthcare Inspectorate Wales and the Wales Audit Office found a series of problems at the health board, which runs Ysbyty Gwynedd, Glan Clwyd and Wrexham Maelor hospitals.
The breakdown of the relationship between chairman and chief executive compromised the organisation, they found.
After the report was published, Health Minister Mark Drakeford said he had accepted Prof Jones's resignation.
He said Mrs Burrows had also told him she intended to leave and the health board was working through the details of her departure.
On Tuesday, a statement from BCUHB - the largest health board in Wales - said: "Mrs Burrows has stepped down from the health board by mutual agreement.
"Work has commenced on the recruitment to the post of chief executive, which will be a key appointment for the board in moving forward.
"In the interim, the post of chief executive is held by Mr Geoff Lang on an acting basis."