Mihaljevic has led the health system since 2017, overseeing an enterprise that includes a main campus in Cleveland, 18 hospitals, and facilities in Florida, Nevada, Abu Dhabi, London and Toronto. In mid-November, as COVID cases were surging in northeast Ohio, mirroring spikes across the country, he noted the trend was "perhaps the most sobering situation during this pandemic." The clinic came under criticism in the fall for its handling of protocols after President Donald Trump and others attending the Sept. 29 presidential debate in Cleveland tested positive for COVID-19.