Conversion Evaluation Frequently Asked Questions

• Lee Health is proud to have served the communities we call home for 107 years. The health system has grown from a single downtown hospital that opened in 1916 to the integrated health system it is today.
• In its first 50 years of operation, Lee Health was a private nonprofit health system. In 1968, Lee Health began operating as an independent special healthcare district created by the Florida Legislature and governed by an elected Board of Directors.
• At the heart of Lee Health is our safety-net mission—the commitment and ability to treat patients regardless of their economic status. In 2022, Lee Health provided more than $80 million in Charity Care and had an overall Community Benefit of $165 million.
• Although a public health system, Lee Health receives no direct tax support for its operations.

In 2023, the Florida Legislature made changes to the Lee Memorial Health System Enabling Act authorizing the Board of Directors to evaluate Lee Health’s governance structure and determine whether the interests of Lee County residents are best served by converting Lee Health to a private nonprofit entity.

• At the Aug. 31 Board Meeting, the Board approved commencing an evaluation of the benefits to the residents of Lee County of converting Lee Health to a private nonprofit entity.
• The evaluation will be conducted by an independent evaluation firm, as required by the Enabling Legislation, and could take up to 180 days.
• Significant work must be done to gather the facts, analyze the impacts of such a decision and consider and weigh all implications of returning to a private nonprofit entity.

• The independent evaluation is only the first step of a process that would require public meetings, two more votes by the Board of Directors and one vote by the Lee County Board of County Commissioners.
• If, after the evaluation, the Board determines the interests of the residents of Lee County are best served by changing back to a private nonprofit entity, the Enabling Legislation authorizes the Board to attempt to negotiate and draft a proposed agreement with the Lee County Commission setting out the terms of the conversion, with a focus on maintaining safety-net services.
• Upon agreement to terms by the Lee Health Board of Directors and the Lee County Commission, Lee Health would convert to a private nonprofit entity, continuing to serve as the region’s only safety-net health system.
• Each step of the process presents an opportunity for the Board to reassess the pros and cons of converting to a private nonprofit entity and whether to proceed forward or stop the process.
• Throughout the process, there will be public information distributed and opportunities for feedback.

• A lot has changed in how healthcare is delivered since Lee Health became a public entity in 1968. And as the healthcare landscape continues to evolve, Lee Health needs to evaluate the best way to continue meeting the growing needs of our community.
• In 2019 Florida repealed significant portions of its long-standing Certificate of Need (CON) program. The repeal made it easier for most health systems to expand their services. Lee Health does not have that same flexibility because its Enabling Legislation places certain limitations on the health system’s specified geographic region (Lee County and as defined in the Enabling Act).
• Health systems across the country are facing historic financial challenges. As expenses grow faster than revenue, many health systems are operating at a loss. While Lee Health has managed a gain from operations most years and has reinvested those funds back into services for our community, we are not immune to the rising costs and declining reimbursement. Lee Health must evaluate the best way to remain financially strong.

Patients will continue to receive the best care possible, and the day-to-day experience will not noticeably change.

The transition to a private nonprofit entity will not change the day-to-day experience of staff nor anyone’s current role.

The Public Student Loan Forgiveness Program is offered to borrowers employed by nonprofit entities. If Lee Health converts from a public governmental entity to a private nonprofit entity, Lee Health would remain a qualifying employer for this program and Lee Health employees would still be eligible to participate in the student loan forgiveness program that exists today.

• The governance models are very similar.
• Both public entities and private nonprofit entities reinvest gains from operations into the services provided to the community.
• A Board of Directors would still govern Lee Health if it transitioned to a private nonprofit entity, but the members would no longer be publicly elected.
• Lee Health’s governance practices are governed by the Enabling Legislation and Florida law applicable to public entities.
• The governance practices of private nonprofit entities are governed by Florida law applicable to not-for-profit corporations.

The Florida Legislature authorized Lee Health’s publicly elected Board of Directors to decide whether to transition Lee Health from a public entity to a private nonprofit entity.

No. There are no offers or overtures to buy Lee Health and our leadership is not considering a sale.

Lee Health will continue to be led locally, with its leadership and operations based in Lee County.

The Enabling Legislation requires hiring an independent firm after the Lee Health Board of Directors decides to evaluate returning to a private nonprofit status, as they did at the Aug. 31 meeting. The work will include collecting relevant information, analyzing the consequences of such a decision and considering all implications to determine whether a change would benefit Lee County residents. The independent firm will assess how transitioning to a private nonprofit entity would impact the people Lee Health serves and employs and the viability of the safety-net system. This review will include but is not limited to the continuance of safety-net services, impacts on indigent care, long-term economic outlook, impact on medical provider recruitment, bonding capability, sovereign immunity, student loan forgiveness for employees, and many others. Information about the ongoing evaluation process, and answers to questions, will be regularly updated on this webpage and shared in future FAQ documents, such as this one.