Talk of a Middle Keys taxing district to support Fishermen’s Community Hospital in Marathon has been ongoing for five months now. 

In an effort to increase transparency, hospital officials held an at-times tense forum on Aug. 13 at Marathon Government Center to hear from residents, some of whom urgently wanted to have their questions answered or information clarified. 

Roughly 65 people attended the meeting to hear more information about the Board of Monroe County Commissioners-approved taxing district. It was first approved in June and covers a 23-mile stretch. The tax will be .05 mills or less for a maximum of 10 years without a public referendum; the county commissioners approved it for a second time in July, unanimously.

Baptist Health South Florida bought Fishermen’s Community Hospital in 2017. Shortly after, it was destroyed by Hurricane Irma. 

The goal is to raise about $15 million, over at most 10 years, from the tax. Another $15 million is being raised through philanthropic efforts in the community. So far, $6 million has been raised through donations.

The tax, which will roll out in 2019, covers properties between MMs 40 and 63, including Duck Key and Key Colony Beach, and will go toward indigent care – losses incurred from patients with no insurance and unpaid hospital bills. 

Most resident questions Tuesday revolved around indigent care, financial information and the new hospital. The questions were submitted anonymously and read aloud to the board members. 

What does “indigent care” mean and how much has been lost because of it? 

Indigent care defines a patient without health insurance or one who cannot pay for the care they receive. Fishermen’s CEO Rick Freeburg said almost 30 percent of the patients seen since Baptist bought the hospital in 2017 were not able to pay for their care. 

“I just got numbers from our CFO that indicated in the first nine months after the hurricane, the first nine months of the fiscal year running from Oct. 1 to Sept. 30, we have lost over $9 million,” said Jay Hershoff, chairman of the Mariners and Fishermen’s Hospital Foundations. “When you look at those numbers, it’s about a million a month, then add another $2.5 million on top of it to pay the physicians to stay in town and work.”

That’s on top of the $24 million in debt Baptist incurred in buying the hospital.

Has Baptist received any insurance money yet from the storm?

Hershoff said Baptist has not received the first dollar in reimbursements yet from the Federal Emergency Management Agency or from its post-storm insurance claims, the total amount of which he could not provide. 

In the meantime, a hard-sided inpatient temporary hospital opened in July, at a cost of $5 million – $2 million more than originally anticipated, Freeburg said.

The unanticipated cost came from Johnson Portables having to build the hospital in Michigan and transport it to Marathon. Construction itself cost $3.6 million. 

Where can we see financial information?

Because Baptist Health is operated as a non-profit, their financial information is available to the public online – search “baptist health south florida, financials.” The report includes a balance sheet, statement of operations as well as an independent audit report. 

Would Baptist have left town without the taxing district?

“The mission was to help this community. We’re not going to leave,” Hershoff said.



The new replacement hospital is expected to include 24/7 emergency services, outpatient observation beds, a medical/surgical inpatient unit for patients requiring admission and an intensive care unit for critical patients with constant monitoring.  

It will go up on the same property at MM 49 oceanside and will take up 40,000 square feet. The new hospital will be slightly smaller than the old hospital and will not have a maternity ward. 

It will not have as many beds as the 25 it had.

“It wouldn’t make sense to have 25 beds,” Hershoff said, adding that 85 percent of services at Baptist’s hospital in Tavernier, Mariners Hospital, are outpatient services. “That’s the way health care is going. We expect it to be the same level in Marathon.”

It will also have space for support services such as laboratory, dietary, pharmacy and cardiopulmonary services. Occupational and physical therapy will also be available.

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