Citizen & Community Advocates for Best-In-Class Hospital Operator
Our Initiatives
and Q&A
Initiative #1​
It's time we talk about the elephant in the room.
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Access to healthcare in Key West can be a significant challenge. As a Public Hospital, our current agreement with Community Health Systems (CHS) drafted nearly 30 years ago has no performance standards or contractual requirements for healthcare services, and no minimum percentage of profit which is required to remain invested into the community. This was a significant oversight, and as locals we've been enduring the consequences since.
Notably, LKMC is a highly profitable operation, reporting an average of $25 Million annually to AHCA on average over the past ten years, and at a percentage of profit this is significantly higher than the national average. How much of the $25 Million per year average hospital Net Income is being reinvested back into our community, matters. One potential suitor, Mount Sinai, has committed to leaving all Net Operating Income from the hospital within the Keys, a considerable opportunity for expanded services and our local healthcare personnel.
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Initiative #2
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To bring local citizens, healthcare personnel stakeholders, expert legal and consulting, and the Hospital District Board together to assist in finalizing an RFP and attaining a hospital operator which would provide our community, including our local healthcare personnel, with the best possible hospital for our community.
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To stay informed or become one of our Citizen Advocates, please let us know here!
Q&A
Sometimes we have more questions than answers, and that's okay.
It's a process.
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Updated October 2nd, 2025
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Should our community, through the Lower Florida Keys Hospital District Board, seek competitive and alternative Hospital Operators given the current Hospital Group (CHS) lease ends April 2029?
For us, this was an obvious, yes. And this answer is what started Our Hospital Key West in early 2024. While there was initial reluctance by some to keep the status quo Hospital Operator, we're pleased that as of this update the Hospital District Board is now seeking a competitive process (also referred to as a Request for Proposal, or RFP) which provides a guideline for other hospitals to bid on our next sole community hospital lease.
Should our Hospital District Board seek (a) specialty legal firm and (b) specialty consulting firm to guide them through the process of a competitive bid process for our hospital?
For us, another BIG YES to both. Our Hospital District Board members are volunteer fiduciaries, and currently meet once monthly. Navigating an RFP is an incredibly intense and unique process given it's a public hospital and there are endless community healthcare considerations. Because our Hospital District Commissioners are fiduciaries to us, our perspective is they simply cannot rely on their own personal judgement or experience as a basis of objectivity to meet their roles as fiduciaries without both specialty legal and specialty consulting guidance.
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As of this update, the Board has hired Akerman LLP (a well regarded law firm) for the legal expertise for the process, but the Board has yet to officially determine whether, or which consulting firm choose.
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We strongly encourage the Board to proceed with the selection of a specialty consulting firm capable of navigating the responsibility of our sole community hospital requirements. Further, we encourage the Board to allow Akerman LLP to engage the consulting firm directly for an added "safe-mode" level of fiduciary once "which" consulting firm to use has been made.
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Our advocates and members are aware the cost to engage specialty legal and consulting is extensive. We're also aware the Lower Florida Keys Hospital District Board has sufficient liquid assets to engage these experts. Our perspective is navigating the responsibility of our Public Hospital for the next generation requires the best possible expertise to serve our community.
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Do we need a new Hospital facility? Is our current Hospital suitable for the next 30 years? Wouldn't it be more practical to build a new Hospital as opposed to requiring a new lessee to invest in a facility which is likely unsuitable for the next generation, or in disrepair?
We hear these questions frequently, and they're each worth considering. We don't have an answer or a recommendation to these questions because the answers require a detailed analysis of each consideration for a reasonable conclusion. Certainly, an inspection of the facilities is needed to contemplate these questions. We suspect a new facility may ultimately be the best choice, but that's only a hunch at this point. And if a new hospital facility becomes the best option through an objective analysis, is it under the District, or does a hospital operator build it and operate it? All good questions, and the answer lies in the objective analysis, not sentiment.
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Is "The District" even necessary at this point?
Good question. At this point, yes, because it's the current framework. In the future, depends on the structure of the next hospital operator. Lease versus own. Time will tell.
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To stay informed or become one of our Citizen Advocates, please let us know here!
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If you're a Lower Florida Keys resident, including from Big Pine to Key West, PLEASE CLICK HERE TO TAKE OUR RESIDENT SURVEY! Your name will remain confidential, and the data will be shared with the community and participants drafting and authorizing the RFP and lease process.
