Frequently Asked Questions
You asked. We answered.
Keeping our community informed with accurate and up-to-date information is important to us. We’ve created this Frequently Asked Questions (FAQ) page to provide you with answers to as many questions as possible. It is important to know that we are still too early in the process to answer questions about the exact benefits or limitations of conversion – these questions are part of the evaluation process.
Check back often, as we will add questions and answers as we have additional information.
Community/General Questions
Patients will continue to receive the best care possible, and the day-to-day experience will not change.
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 our first 50 years of operation, Lee Health was a private nonprofit health system. Then, 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. This legal status has served the health system and the community well over the years.
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.
The business 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 current business practices as a public nonprofit entity are governed by the Enabling Legislation and Florida law applicable to public entities.
The business practices of private nonprofit entities are governed by Florida law applicable to not-for-profit corporations.
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 business structure and determine whether the interests of Lee County residents are best served by converting Lee Health to a private nonprofit entity.
A lot has changed in how healthcare is delivered since Lee Health became a public entity in 1968. 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. Subsequently, 65 new hospitals were announced to be built in Florida between 2020 and 2022. However, Lee Health has been largely excluded from this expansion because there are limitations to what geographic region we can operate in (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.
One option is to evaluate whether returning to a private nonprofit model from our current structure as a public nonprofit health system would be best for the residents of Lee County. Recent legislative changes allow the Lee Health Board of Directors to engage an independent firm to conduct such an assessment.
Physicians & Clinicians
In our current form as a public governmental entity, sovereign immunity provides Lee Health legal and financial protections for the entity and its employees. For employees, it means all negligence lawsuits must be brought against Lee Health and not against any of its employees. For Lee Health, potential damages are limited to $200,000 per claim with an aggregate limit of $300,000. Currently, Lee Health has a self-insured program combined with insurance protection for claims that exceed the sovereign immunity limits for covered losses.
If Lee Health reverts to a private nonprofit entity, sovereign immunity would not apply to Lee Health or its employees. Lee Health would modify its insurance program to protect the nonprofit entity and its employees from personal financial liability in the same way they are today, without deduction or impact on physician compensation. In addition, Lee Health would provide tail coverage, as we already do now.
招聘医生是具有挑战性的没关系ss of your structure. Lee Health’s recruitment efforts need to be strong, whether structured as a public health system or as a private nonprofit entity, and the reasons for people to join Lee Health’s team need to be strong regardless of entity structure.
While it is too early in the process to know for sure, conversion to a private nonprofit entity will likely have no impact (positive or negative) on compensation as the Anti-Kickback Statute, Stark Law and Fair Market Value standards will still apply.
Contracts would need to be reviewed on a case-by-case basis to determine geographic scope. However, generally, the non-compete provisions would be assignable to the new entity.
The medical staff bylaws in effect at the time of a conversion will remain the same.. Nothing in the law allows for a unilateral change in bylaws triggered by a conversion to a private nonprofit entity.
If Lee Health were to revert to a private nonprofit entity, it could keep a 403(b) retirement plan like it has today.
As a private nonprofit entity, Lee Health could also maintain a 457(b) retirement plan. However, under laws applicable to private nonprofit entities, the retirement plan would have different attributes compared to today’s plan. Specifically, as a governmental entity, Lee Health’s 457(b) plan is held in trust for participants and, as such, is not subject to claims by Lee Health’s creditors. In comparison, the assets of a private nonprofit 457(b) plan belong to the employer and are subject to claims of the employer’s creditors. Accordingly, Lee Health is exploring available roll-over options for participants in its 457(b) plan.
Team Members
No. Lee Health converting to a nonprofit private entity would not have an impact on team member salary or wages. We will continue to set salary and wages as we do now, which is based on the specialized skills necessary for each position and what is needed to be competitive in the marketplace.
The transition to a private nonprofit entity will not change the day-to-day experience of staff or anyone’s current role.
If Lee Health were to revert to a private nonprofit entity, it could keep a 403(b) retirement plan like it has today.
As a private nonprofit entity, Lee Health could also maintain a 457(b) retirement plan. However, under laws applicable to private nonprofit entities, the retirement plan would have different attributes compared to today’s plan. Specifically, as a governmental entity, Lee Health’s 457(b) plan is held in trust for participants and, as such, is not subject to claims by Lee Health’s creditors. In comparison, the assets of a private nonprofit 457(b) plan belong to the employer and are subject to claims of the employer’s creditors. Accordingly, Lee Health is exploring available roll-over options for participants in its 457(b) plan.
The Public Student Loan Forgiveness Program is offered to borrowers employed by nonprofit entities. If Lee Health reverts 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 programs that exist today.
有各种各样的私人非营利或方法ganization can be deemed eligible to become an NHSC-approved site. The ongoing evaluation will include a review of all the ways Lee Health could continue as an eligible NHSC-approved site if it becomes 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 process will be conducted by an independent evaluation firm, as required by the Enabling Legislation, and could take up to 180 days. Kaufman Hall, a recognized expert in this field of work, has been hired to conduct the evaluation.
Significant work must be done to gather all the facts and analyze the information that will help us determine the optimal structure for Lee Health. Lee Health must conduct appropriate due diligence and follow the process set forth by the Florida Legislature.
The Enabling Legislation requires hiring an independent firm after the Lee Health Board of Directors decides to evaluate returning to private nonprofit status, as they did at the Aug. 31 meeting.
The work will include collecting relevant information, analyzing the effect 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.
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 Lee Health’s leadership is not considering a sale.
Lee Health will continue to be led locally, with its leadership and operations based in Lee County.
The independent evaluation is only the first step of a process that would require a public hearing, 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.
在协议条款由李愈合th 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.
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.