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Citizen & Community Advocates for Best-In-Class Hospital Ownership

Our Initiatives

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Initiative #1

It's time we talk about the elephant in the room. 

The elephant is the relationship between the Citizen's of Key West and our Hospital, Lower Keys Medical Center. Or rather, the current operators of our Hospital, Community Health Systems (CHS), a for profit Public Company headquartered in Franklin, TN., who's lease ends on April 30th, 2029 with no provision for automatic renewal.

When CHS purchased Lower Keys Medical Center through it's highly-leveraged buyout of HMA in 2014, CHS owned 206 Hospitals. Touting their expertise in Hospital management and goals of superior profits through efficiencies of scale and operations, CHS positioned itself as one of the largest publicly traded hospital companies in the United States and a leading operator of general acute care hospitals in communities across the country.

As of April 30 2024, CHS has divested / sold 65% (135) of their Hospitals, including 7 in Florida in between 2020 and 2023, leaving them with 71 remaining hospitals including Lower Keys Medical Center. In early 2024 CHS leadership reiterated to investors it's evaluating additional hospital sales which could yield more than $1 Billion, allowing it to shed debt and turn its balance sheet.


A summary of CHS's self disclosed risk factors can be found in their 2023 Year End SEC 10-K Filings (available under our "News & Updates" section).

Why does all this matter? Because in addition to its highly leveraged position, and self-disclosed risk factors, CHS had a Net Income Loss in 2023 of $133 Million, a Net Income Loss first quarter 2024 of $41 Million, adding to the pressure to maintain its debt covenants which is often resolved by "divesting more Hospitals".

And of course, aside all of CHS's financial hardships are all the consumer and regulatory scandals and lawsuits, leaving us at (OHkw) wondering "why would anyone renew our Hospital lease with CHS" given there are numerous other Hospital Operator alternatives for us to consider who haven't divested the majority of their hospitals, and aren't selling Hospitals to reduce debt.

It's a reasonable question, right?

For context, our Public Hospital is the responsibility of The Lower Florida Keys Hospital District, (aka "The District"), governed by State appointed Board of Commissioners. Currently, our District Hospital also includes the Hospital Facility formerly known as The dePoo facility on Kennedy Drive (long story, see our Who's Who for more information). "The District" board of commissioners have both the authority, and the responsibility over which Hospital Operator is chosen due to our geographically vulnerable community. Protecting us, and our healthcare is "The District's" fiduciary duty and purpose.


On February 12th, 2024, Our Hospital Key West (OHkw) advocate Spencer, along with other OKhw Healthcare, Legal, Business and Citizen advocates presented to "The District" Board Commissioners publicly available financial and historical information regarding CHS, and cautioned "The District" commissioners on renewing the lease with CHS. Our "Caution" presented expressed that given CHS's divesting of 65% of its Hospitals, their self-disclosed risk of the potential need to divest others, that granting an extension on the remaining 5 years of their lease would increase the value of the Hospital to the benefit of CHS, in the event they decided, or were forced to divest it.


Additionally, we made a public request that "The District" consider financially sound Hospital Operator alternatives given the remaining lease term, and to consider comparative levels of care which these operators may be willing to provide our community, and, to open these discussions to the public. Echoing our sentiments, Sam Kaufman, City of Key West Vice-Mayor also advocated for openness, and alternative Hospital options given the future expiration of CHS's lease with our District Hospital in 2029. 

Initiative #2

To educate Key West Residents and Community Stakeholders on the many important dynamics of our Lower Keys Medical Center Hospital, and how these dynamics profoundly affect our day-to-day lives.


To facilitate competitive Hospital offerings from leading South Florida Hospital Groups which are financially stable, well-regarded and well-rated, such that our Community and the Lower Florida Keys Hospital District can make an objective determination as to which Hospital Owner / Operator is truly in the best interests of our community, versus a presumption that CHS should receive a lease extension at the end of their lease on or before April 30th, 2029.  

Initiative #3

To be facilitators of information for our community. To seek solutions with all parties, such that the Quality and Reliability of our Key West Hospital System best serves the people of Key West.


To hold the Lower Florida Keys Hospital District, and their Board of Commissioners accountable to their purpose and fiduciary duty, which requires that our Hospital be “For the Preservation of the Public Health, for the Public Good”, and which is “Necessary for the Preservation of the Public Health and Welfare of the District and Inhabitants Thereof”.  

Our core principle is that existing Hospital Ownership / Operation (CHS) should not be the "presumptive next Owner / Operator" when their lease ends on April 30, 2029. Further, given that CHS has already expressed their interest in negotiating a new lease (December of 2023), OHkw believes that a quantitative comparison of other Hospital Ownership / Operators is also now necessary, which would be inclusive of Levels of Care which would be offered to attain the responsibility and privilege of being our sole Acute Hospital provider as of May 2029. OHkw intends to explore these options and publish the findings for all stakeholders for their consideration.


Only through an objective comparison of numerous Hospital Operators inclusive of all aspects for considerations, can any of us be certain which Hospital Operator is truly in our community's best interest for our future.

To become one of our Citizen Advocates, please let us know here!

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