New Era for Lee Health

Lee Health is looking to a brighter future with room to grow advanced services and facilities now that it has achieved the status of a private, not-for-profit hospital system.

At the beginning of November, Lee Health pivoted away from operating as a government owned healthcare provider and became a private, not-for-profit healthcare company that will continue to be community-focused for the residents of Southwest Florida.

The community and Lee Health patients should see very little change. In fact, Lee Health officials prefer to call the company a community-focused nonprofit health system rather than use the word private.

Much of what people know about and have come to expect from Lee Health will remain the same, including its leadership, board of directors and staffing. Lee Health's commitment to providing high-quality, compassionate care to every member of the community, regardless of their ability to pay also remains enshrined as a firm contractional agreement with the Lee County Board of County Commissioners, who approved the change in ownership. In exchange of this core promise, Lee Health retains ownership of its building, equipment and assets.

Patients and the community will see changes in the future, including newer, updated facilities, a new campus in Fort Myers and expanded services through partnerships and joint ventures. The company is looking into rehabilitation centers and expanded services in orthopedic and musculoskeletal injuries and disorders.

According to Lee Health President and CEO Dr. Lawrence Antonucci, the company's structural change is one of governance that came about in part from a Florida state bill in 2019 that struck down requirements to present a certificate of need and meet certain requirements before building new medical facilities. That state legislation left the door open for increased competition with private medical providers from other areas of the state looking to expand and move. As a result, 65 new hospitals were announced to be built in the state between 2020 and 2022.

"We had been evaluating our structure and its limitations for a while and knew we were going to have to do something differently for long-term sustainability to serve our community," Antonucci said.

Antonucci explained that although increased business competition is normally viewed as a good thing, in this case, the healthcare landscape was changing, but Lee Health's former structure was a major roadblock impeding Lee Health's ability to change with it, add new services and compete fairly.

Lee Health, which is Southwest Florida's largest healthcare provider, found itself at a difficult competitive disadvantage with the 2019 legislation. Because Lee Health has operated as a Lee County government entity for the past 60 years, it was limited to keeping its facilities within the county borders. Large new housing developments were opening in surrounding counties, in some cases, just across the county line. Nearly a quarter of Lee Health's patients lived outside of Lee County and that number was projected to grow.

In addition, as a governmental branch, strategic planning meetings were subject to state Sunshine laws, making it difficult to negotiate with potential strategic partners or enter into joint ventures to offer new and expanded services, particularly specialized outpatient care, to meet the needs of a growing regional population. Antonucci cited examples of outpatient care such as surgery centers and state-of-the-art rehabilitation facilities for patients recovering from a stroke or serious injury such as a hip fracture requiring specialized care.

"It was difficult to plan for our future and discuss preliminary ideas when our competitors were listening in and sitting right in front of us in our own meetings," said Antonucci. "Our competitors knew every move we were considering and with whom we were negotiating. We were also limited in the types of partnerships and collaborative joint ventures we could legally enter into under our government structure."

Lee Health officials came to a conclusion that a new structure was needed for the long-term health of the organization and began looking for solutions. In the fall of 2023, Lee Health undertook a three-phase process. It hired a nationally recognized research firm, Kaufman Hall & Associates, to conduct an evaluation on making the conversion. Kaufman's report showed that Lee Health should pursue it in the best interests of all stakeholders.

Next, the healthcare system worked with the Lee County commissioners to formulate and adopt a mission agreement document. After that, public hearings and town hall meetings were held with the public to vet the process. The final was completed on Oct. 28 when the five Lee commissioners unanimously voted in favor of the change that would loosen the strings attached to Lee Health while at the same time keeping assurances that the primary medical needs of the community would be met, including for those residents who could not typically afford to pay a private healthcare provider. An oversight board and independent auditor will ensure that Lee Health lives up to that promise.

Antonucci described the final decision to pivot from government-owned to a private company as a defining moment for the healthcare company and community. The decision and written agreement mean that the company did not just reshape its structure, but reaffirmed its promise to patients and the community that Lee Health will continue delivering high-quality care to the entire community regardless of ability to pay, and it will continue to upgrade its services and facilities.

For its first 50 years of operation, Lee Health was a private nonprofit entity. In 1968, it began operating as an independent special healthcare district under the state of Florida's regulations, which governed it until the Nov. 1 conversion.

Looking ahead, Antonucci sees Lee Health's role as a community-based healthcare provider increasing and not decreasing its role in Fort Myers. He points to the new 52-acre state-of-the-art medical campus the company is building along Colonial Boulevard. Projected for completion in 2027, it will replace the aging Lee Memorial Hospital on Cleveland Avenue. The new campus will include a 168-bed general hospital, medical offices for physicians and patients, an outpatient surgery center for orthopedics, along with a rehabilitation center. Other considerations for the site include a skilled care nursing facility and other specialized care services. Oncology and cancer care are other modalities Antonucci suggested for expansion.

Antonucci said Lee Health is in discussions with county commissioners on future uses for the property once Lee Memorial Hospital is torn down. Built in the 1960s, the aging building has outlived its usefulness as a general hospital.

In addition to Lee Memorial Hospital, Lee Health owns and operates Cape Coral Hospital, Gulf Coast Medical Center, Health Park Medical Center, the Rehabilitation Hospital and the Golisano Children's Hospital, which is the region's only dedicated children's hospital. Lee Health also operates several specialty care facilities and urgent care centers. ¦