Boone Health is asking the Boone County Commission to approve the sale of county-owned land and buildings following a nearly year-and-a-half long search for a strategic partner — but the public still does not know the identity of the organization selected to buy them.
The Boone County Hospital Board of Trustees considered 17 potential buyers during its search. Eleven organizations signed confidentiality agreements, four submitted initial proposals and the trustees have selected a buyer, to be announced Thursday. According to the documents submitted to the county, the proposed sale is valued at $36 million.
But Boone Health officials have not publicly identified that organization.
County commissioners questioned the process during a meeting on Tuesday, including why the search was conducted largely confidentially and why members of the public had no opportunity to weigh in before trustees selected a buyer.
Commissioners noted during the meeting that Boone Health carries debt that the proposed sale is intended to pay off. The hospital also received a $475,000 American Rescue Plan Act allocation from Boone County in 2024, and part of its governing body is publicly elected — factors that make the organization and its future a significant matter of public interest. The commissioners are now being asked to consent to the transaction under Missouri law.
Boone Health CEO Brady Dubois said the search for a strategic partner began in July 2025 as hospital leaders looked for a way to maintain and expand health care services in Columbia and prepare for growing financial pressures.
"We want to position Boone [Health] while it's still in a strong position to be able to weather those storms," Dubois told commissioners.
Only the sale of the hospital's physical property is currently subject to public approval, as the county owns the property. The sale of the health system will be handled separately and privately between Boone Health and the yet-to-be-disclosed buyer.
Hospital leaders said a partner could provide capital for expansion and deferred maintenance, including a proposed expansion of Boone Hospital's emergency department.
Boone currently operates a 16-bed emergency department while seeing about 38,000 emergency room patients each year, Dubois said.
Boone Health officials said they hired a consultant, Juniper Advisory, to help identify potential partners who’d be compatible with Boone Health's approach to patient care.
During the Commission meeting, Presiding Commissioner Kip Kendrick questioned why the process involved such a high level of confidentiality.
"There'll be a decent amount of people who feel that they should have a voice in this process, in this decision as well," Kendrick said.
Kendrick asked whether Boone Health could identify the 17 organizations involved in the search.
Boone Health officials defended the confidentiality agreements, saying they are standard practice during major business transactions because organizations exchange sensitive financial and operational information.
"If you don't have the freedom to have free and open dialogue without it being on every social media site on earth, no one would ever do business with anyone else," Dubois told the commissioners.
Commissioners are now tasked with considering whether the transaction is desirable for Boone County.
In a phone call with KBIA, Boone Health spokesman Christian Basi defended the process, including arguing the public did have the opportunity to weigh in.
"The trustees that are elected by the Boone County voters are, as the County Commission and all of those people are elected by the public," Basi said. "The public has had representatives as part of the conversation as this process has moved along."
However, Basi said the identity of the buyer remains confidential because of the non-disclosure agreements involved in the transaction.
Commissioners also asked about what the transaction could mean for Boone Health employees and patients.
For instance, the sale might not guarantee retaining jobs for all current Boone Health employees. Dubois said the proposed partner would offer employment to the health system's approximately 2,300 employees who are “in good standing.”
Hospital leaders said they want to expand access to care by increasing the number of physicians, advanced practice providers and other staff. They also said the system wants to continue supporting rural communities that depend on Boone Health for specialized care.
Dubois said they visited facilities operated by the selected organization and conducted months of due diligence before reaching a decision.
The Boone County Commission will hold a meeting at 1:30 p.m. Thursday to announce its decision. The meeting will be open to the public.
