Lower Keys Medical Center, Key West’s hospital on College Road, last year sent a profit of $31 million home to Brentwood, Tennessee, where its corporate owner, Community Health Systems, is located. 

The profit was surely good news for CHS, but not so much for the Key West community, Key West City Commissioner Sam Kaufman said at the Sept. 14 meeting, where officials had asked hospital CEO David Clay to provide an update on the hospital.

“I’m looking at the 2022 audit report and it raises a lot of concerns for me, a lot of concerns,” Kaufman said after Clay’s presentation. “We have a deficit of physicians. We don’t have a cancer center. We don’t have a first-class cardiac care center. …  And there doesn’t seem to be a plan to rectify this. But what I do see is $31 million in profit for 2022; $31 million going from our hospital to Brentwood, Tennessee. And that’s great. You’re doing a great job — for Community Health Systems.”

It’s been seven years since Lower Keys residents and officials demanded improvements from the 167-bed Lower Keys Medical Center. 

Then-hospital CEO Nicki Will was replaced in the interim by CHS executive Steve Pennington, who permanently appointed David Clay as CEO in 2016.

Clay and his family relocated to Key West, bought a home here and inherited a wealth of complaints and shortcomings at Lower Keys Medical Center. Keys residents often were charged $50,000+ for helicopter flights to mainland hospitals aboard a for-profit company called LifeNet, when a flight by county-operated medical helicopter Trauma Star would have been free for residents.

There were dire complaints about the level of care, questionable billing practices and aggressive collections tactics. The hospital was rated a 1-star facility by the federal Centers for Medicare and Medicaid Services. 

Today, Lower Keys Medical Center is a 4-star hospital, Clay told the city commission during his report and before Kaufman began his criticism.

City officials had asked Clay for the update given mounting concerns in the community about Genesis Cancer Center closing due to bankruptcy, and doctors leaving or switching to concierge-based care.

Clay detailed the progress that has been made since 2016.

In addition to the four-star rating, the hospital recruited additional specialists, including a pulmonologist, orthopedist, a gastroenterologist, an ob/gyn, an outpatient surgery center and a women’s imaging center for mammography and other services.

Clay acknowledged the staffing challenges that the health care industry faces nationwide, particularly since the COVID pandemic.

“Commissioner Kaufman, I appreciate your comments and with regard to the cardiac and cancer centers, I’m already talking with our upstream partners to make that happen. But the care is better and we’re going to continue to get better. I stand by my comments and the numbers speak for themselves.”

Clay was referring to metrics such as patient care outcomes, patient surveys and the increase from a one- to a four-star rating. 

But Kaufman pushed back on the number of $31 million.

“Let’s be real,” Kaufman said. “The lack of confidence in our hospital is destabilizing for our community. Our community needs better. We need Brentwood, Tennessee to put a chunk of that $31 million back into Key West and into a cancer center here. Let’s get this done.”

Commissioner Lissette Cuervo Carey also raised concerns about the lack of psychiatric beds for adolescents in Key West.

“When a kid gets Baker Acted, they get sent to Miami,” she said, referring to the use of crisis services for individuals with mental illness. 

Commissioner Billy Wardlow acknowledged the improvements that Clay has made and the challenges he continues to face in the industry, but also raised concerns about retention and recruitment of nurses.

Commissioner Clayton Lopez also pointed out the improvements, but also said that the retirement, departure and overall aging of local physicians couldn’t have come as a surprise to hospital administrators. 

Clay promised to keep the commission updated on his continuing efforts.

Mandy Miles drops stuff, breaks things and falls down more than any adult should. An award-winning writer, reporter and columnist, she's been stringing words together in Key West since 1998. "Local news is crucial," she says. "It informs and connects a community. It prompts conversation. It gets people involved, holds people accountable. The Keys Weekly takes its responsibility seriously. Our owners are raising families in Key West & Marathon. Our writers live in the communities we cover - Key West, Marathon & the Upper Keys. We respect our readers. We question our leaders. We believe in the Florida Keys community. And we like to have a good time." Mandy's married to a saintly — and handy — fishing captain, and can't imagine living anywhere else.