NEW SMYRNA BEACH — The news was no April foolin’. After six years of a turbulent courtship, a spoiled engagement, and other relationship foibles, Adventist Health Systems quelled rumors and rumblings by swallowing the big fish April 1.

Around the same time, Adventist changed Bert Fish Medical Center’s name to Florida Hospital New Smyrna. The $40 million deal closed with a pledge from the Altamonte Springs-based nonprofit hospital system to invest $35 million in Volusia County. The hospital group plans to enhance the emergency department and surgical services, spiffy up the hospital exterior, create private patient rooms, and bring the hospital’s information technology system in line with Florida Hospital’s.

The 112-bed acute care hospital provides outpatient and surgical services, cardiovascular care and a stroke program, oncology, radiology, wound care, and a bustling emergency department. From 2011 to 2014, the Florida Hospital Association (FHA) named Bert Fish, New Smyrna Beach’s largest employer, the Best Hospital Workplace for Small Hospitals.

The Six-Year Engagement

Originally, the Florida Hospital-Bert Fish deal was planned for July 1, 2010, after the Southeast Volusia Hospital District Board of Commissioners voted 4-2 to exclusively negotiate the merger of both facilities. Before that, Daytona Beach-based Halifax Health and Titusville-based Parrish Medical Center were also wooing Bert Fish. The $51.1 agreement in 2010 also included the option to acquire Bert Fish in 2015.

In 1966, the nonprofit Bert Fish Foundation donated the hospital to the Southeast Volusia Hospital District, a special taxing district created by Florida lawmakers in 1947 that collects tax dollars from southeast Volusia residents to cover the cost of indigent care. The philanthropic organization filed suit against the merger in August 2010 on the basis the deal was made behind closed doors, perhaps because of personal financial gain.

After Circuit Judge Richard Graham voided the Florida Hospital-Bert Fish agreement on the grounds the closed-door negotiations violated the Sunshine Law, Bert Fish bypassed Halifax Health and Parrish Medical Center to negotiate exclusively with Naples-based, for-profit Health Management Associates (HMA). When Community Health Systems (CHS) acquired HMA, negotiations ended. CHS, also a for-profit hospital system, was uninterested in acquiring the facility.

Cue the Locusts

For a spell, Florida Hospital might have seemed jinxed. Around the same time the judge’s ruling came down, Health Central, another hospital Adventist was pursuing, chose to merge with Orlando Health. Also during the gap between Bert Fish merger talks, former Florida Hospital CEO Lars Houmann was busy fielding legal woes for the healthcare system. (Houmann was promoted to Adventist executive vice president on Dec. 1, 2015.) Within the last year, Adventist has settled the infamous whistleblower case for $115 million and the leftover chemotherapy drugs case for $2 million. Last Thanksgiving, Florida Hospital in Tampa drew headlines for a murder-suicide, after the stepfather of a female shot her and then himself. Both were visitors to the Hillsborough County hospital. Controversy swirled when Florida Hospital continued construction of its $3.5 million lab in DeLand after the discovery of unmarked graves on the site.

The Southeast Volusia Hospital District also seemed snake-bit. The unique district, with seven governor-appointed commissioners, remains one of few special tax districts in Florida charged with levying taxes to support the hospital’s indigent care. The district had weathered troubled waters, from a move to purge the Board to requesting new appointments for three board members whose terms had expired. Property tax hikes for Edgewater, New Smyrna Beach, Oak Hill and some of Port Orange didn’t sit well with residents. Former Bert Fish CEO Bob Williams and District lawyer Jim Heekin had come under fire for perhaps gaining financially from the merger, thus bringing closed-door negotiations under scrutiny. Williams was ousted.

The Bert Fish CEO role has also been problematic. Ed Noseworthy, Robert Deininger, and Steve Harrell have shared the post since 2010.

The Second Go-Round

At the time of the merger announcement in November 2014, Daryl Tol, then a regional CEO for Florida Hospital’s Volusia-Flagler market, said: “The best way to characterize it is we’re getting engaged. Now, we have to do the hard work that comes before we officially get married.” Since then, Tol has been elevated to CEO of Florida Hospital and Adventist Health System’s Central Florida Region.

In November 2014, Florida Hospital and Bert Fish began the laborious process of ironing out wrinkles for the final transaction, which included a plan to cut the district’s hospital taxing rate by 70 percent over seven years, starting with a first-year 15 percent reduction. Establishing an endowment could eliminate taxes by 2023.

With the transaction completed, Bert Fish joins Adventist’s East Florida Region as the sixth medical center in Volusia and Flagler counties. Overseen by CEO Rob Fulbright for the East Florida Region, other facilities in the portfolio include Florida Hospital DeLand, Florida Hospital Fish Memorial in Orange City, Florida Hospital Flagler in Palm Coast, Florida Hospital Memorial Medical Center in Daytona Beach, and Florida Hospital Oceanside in Ormond Beach. Florida Hospital has been busy in Volusia County. The healthcare system recently established a $14.5 million outpatient center near Interstate 95 in New Smyrna Beach, and Centra Care in Port Orange.

The deal also gave Florida Hospital 23 medical centers along Central Florida’s Interstate 4 corridor, from Daytona Beach to Tampa Bay. With 46 hospitals and roughly 8,200 licensed beds in 10 states, Adventist represents the nation’s largest Protestant non-profit health system.

Trickle Down Effects

Halifax Health, whose request for another consideration was denied in original negotiations, lost out in another matter. With the Bert Fish deal, Florida Hospital replaced Halifax Health as the exclusive healthcare provider for Daytona International Speedway through 2028.

After the ink dried, Bert Fish CEO Steve Harrell expressed enthusiasm moving forward. “We’re all pleased,” he said, “to see this agreement come to fruition.” A week later, Ken Mattison replaced Harrell as CEO of Florida Hospital New Smyrna. Until May 1, Mattison also remained CEO of Florida Hospital Flagler. Mattison is former CEO of Florida Hospital Waterman and Jellico Community Hospital.

On May 1, Ron Jimenez, MD, took the CEO post at Florida Hospital Flagler. A gynecologist, Jimenez had been CMO of Florida Hospital Memorial Medical Center in Daytona Beach since 2009. He relocated from North Carolina, where he was CMO of Park Ridge Health in Fletcher. Jimenez, a former Resident Teacher of the Year at the University of Florida, will oversee completion of Florida Hospital Flagler’s 32-bed expansion.