Lower Florida Keys hospital board seeks new operators as lease ends

The Lower Florida Keys Hospital District board voted on January 16 to commission an independent facility-condition assessment and to move forward with drafting a request for proposals seeking potential operators for Lower Keys Medical Center when the current 30-year management lease with Community Health Systems expires in 2029.

Board members authorized hiring consultants and legal counsel to shape the RFP but agreed to delay issuing the formal solicitation until the facility assessment, estimated to take about 60 days, can be incorporated. Officials said the pause is intended to give prospective operators accurate information about the condition of the building and the capital investments that will be necessary to maintain or replace it.

The decision marks a shift from the possibility of an automatic renewal of the existing management agreement and responds to months of community advocacy. Local groups, including Our Hospital Key West, pushed for a transparent, competitive process that would allow nonprofits, regional health systems, or other suitors to submit proposals. Advocates framed the move as an opportunity to secure a long-term partner committed to local priorities and to explore whether a purpose-built replacement facility could be developed with grant support.

For Monroe County residents, the board’s vote affects more than governance. Operator selection will influence the range of services available locally, the timing and cost of necessary upgrades, and workforce stability at the hospital. By incorporating an independent assessment into the RFP, the district aims to give bidders a realistic estimate of required capital spending so proposals can include credible plans for financing repairs, retrofits, or new construction.

The strategy also preserves a planning horizon. With the CHS management lease not expiring until 2029, the district has time to evaluate competing models, negotiate terms that protect local control and continuity of care, and pursue external funding sources. Community members have expressed interest in nonprofit operators and regional systems that might qualify for grants or philanthropic support to build a modern facility tailored to island needs.

Board leaders retained consultants and lawyers to draft an RFP that reflects those considerations and to ensure compliance with procurement rules. The independent facility-condition assessment is expected to be completed in roughly two months, at which point the district will incorporate its findings into the RFP package and set a timeline for soliciting bids.

This process will unfold over the coming year, offering multiple moments for public review and input as the district evaluates operator proposals and financial commitments. For readers, the immediate takeaway is that the board has rejected a simple renewal and opened a transparent path toward determining who will run Lower Keys Medical Center and what the hospital will look like going forward. Expect to see the assessment results in about 60 days and subsequent RFP details once the board integrates that information and sets a bidding schedule.