Several years of uncertainty over the future management of Boone Hospital Center ended Monday when the Board of Trustees announced the county-owned medical center will resume operation as an independent provider at the end of 2020.

The hospital has been run under a management lease, currently held by BJC HealthCare of St. Louis, since the late 1980s. Monday’s announcement was made during a regular board meeting by chairman Brian Neuner, who followed it by announcing he would resign from the board after more than 12 years in office.

The board had the option of finding another management company or moving forward as a locally-controlled, independent hospital, Neuner said.

“We are now focused on the independent hospital option and are working to ensure this option will give us the ability to meet patients’ needs for generations to come,” Neuner said.

Going independent will give the hospital flexibility to partner with local physicians and other health care providers, Neuner said. It would place the future of the hospital under the local authority and allow it to reinvest every dollar it makes into patient care.

BJC did not allow partnerships with physicians or joint ventures in which the hospital and the physicians share revenues.

The decision took almost three years, after BJC indicated it did not wish to sign another term.

“When you’re unwinding a 30-year relationship, it presents a unique challenge,” Neuner said.

As it considered the future of the hospital, the board issued a request for proposals that drew interest from University of Missouri Health Care, Kansas City-based St. Luke’s Hospital and Duke LifePoint Health Care, a for-profit company based in Brentwood, Tennessee. For most of 2017, the trustees were in exclusive negotiations to partner with MU Health, but the two could not agree to terms.

The decision would ensure the long-term financial sustainability of the hospital, Neuner said. It would also improve its ability to recruit doctors and nurses.

The board is consulting with advisors to finalize the hospital’s future direction, Neuner said.

“If you want Boone to succeed, you have to choose Boone,” Neuner said of the hospital. “You have to use Boone. You have to promote Boone.”

The hospital has struggled to show a surplus in recent years, in part due to accelerated depreciation on BJC’s investments in hospital facilities and equipment. The hospital posted an operating loss of $13.4 million in 2018, $11 million more than the $2.1 million loss projected by BJC.

Dan Atwill, presiding Boone County Commissioner, said he’s pleased to see a resolution to the hospital’s operation. The county owns the hospital.

“It’s good to see the trustees moving forward with confidence and determination,” Atwill said.

A decision on the hospital’s lease was expected in June.

rmckinney@columbiatribune.com