Paula Vasco-Knight, 53, broke down as she changed her plea on the second day of her trial at Exeter Crown Court.
She used £11,072 of NHS cash to pay her husband Stephen, 46, for work on an equality and diversity publication called Transform, which never existed.
Her husband also changed his plea to admit fraud.
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Former nurse Vasco-Knight, of Runcorn, Cheshire, shook and sobbed uncontrollably as she changed her plea to one of the two charges of fraud she faced.
Recorder Don Tait adjourned sentence until March but warned the Vasco-Knights that a "custodial sentence is a distinct possibility".
He told the jury: "As far as Mrs Vasco-Knight is concerned, she has fallen a long way, hasn't she, but that is her responsibility."
Vasco-Knight was CEO at the South Devon NHS Foundation Trust and the national lead for equalities for NHS England when the offence occurred.
The newsletter was commissioned by her in April 2013 and produced by her husband's firm Thinking Caps that July, the court heard.
But it was a "sham", cut and pasted from a research paper by the Kings Fund charity, said Gareth Evans, prosecuting.
He said Vasco-Knight's failure to declare an interest in Thinking Caps was a criminal offence and a "massive breach of trust and abuse of her position as chief executive".
Vasco-Knight later tried to blame Habib Naqvi, a senior manager in the NHS, for commissioning the newsletter.
Mr Naqvi, 28, of Bristol, was cleared of two counts of aiding and abetting.
The prosecution offered no evidence on the second fraud charge against Mrs Vasco-Knight of swindling £9,000 from the NHS.
She and her husband were released on bail to 10 March for sentencing.
Sue Frith, managing director of NHS Protect, which conducted the investigation, said Vasco-Knight's meteoric career path had been "an inspiration to so many" and her fraud was a "huge disappointment and shock to many".
A former NHS equality boss has been warned she could face jail for swindling £11,000 by diverting funds to her husband.