The Audrain Regional Medical Board of Directors is seeking guidance from Hannibal Regional and Bates County Memorial hospitals as grassroots efforts to bring a hospital back to Mexico continue.

At the Audrain Regional Medical Board of Directors July 29 meeting, Donna Corrado, president of the board, presented a patient transfer agreement, sent by Gregory Weaver, CEO of Bates County Memorial Hospital, to board members for review. She said the transfer agreement is the first step in establishing a critical access hospital.

“Without a transfer agreement, you cannot even apply for a certificate of need to open a critical access hospital,” she said. 

Corrado said she had been in contact with several hospital leaders, including Weaver and Todd Ahrens, president and CEO of Hannibal Regional Health Systems, regarding her intentions to open a hospital in Mexico without Boone Health. She added that Ahrens was “quite willing to sign” a patient transfer agreement.

“We have not asked them for anything other than a signature,” she said.

Maintaining local control

What prompted the Audrain Regional Medical Board of Directors to seek hospital partners on its own was a loss of trust in an existing letter of intent signed by Boone Health, the city of Mexico, Audrain County Health Department and Audrain County Commission. 

“It was written to protect the developer more than the entity trying to start a hospital,” Corrado said.

The formal LOI, which was signed Oct. 14, 2024, confirmed Boone Health’s intent to continue discussions regarding the establishment of a new Medicare-certified critical access care facility in Mexico. The city, county and health department, or “municipalities,” as they are referred to in the LOI, are responsible for establishing the critical access facility while Boone Health or its strategic partner would operate it.

Corrado said the lack of local control is concerning considering what happened in the years leading up to the closure of Audrain Medical Center.

“I want to make sure we have a fair amount of local control,” she said, adding that there was none with SSM, Ziva Medical or Noble Health, which owned AMC. “If it’s done the way that it is outlined at this point with Boone, we will have zero control and I don’t want that.”

Weaver provided guidance on what should be considered if the Audrain Regional Medical Board of Directors were to write its own LOI. In an email to Corrado, he outlined “structural mechanisms for autonomy,” which included a master service agreement framework, supermajority voting rights and a strict termination clause.

Boone Health’s LOI

At the meeting, Corrado criticized the LOI’s ambiguous timeline and questioned whether it remains enforceable. 

The termination clause of the LOI states that the agreement can be terminated following the expiration of the exclusivity period, which was 120 days after the letter was signed. However, according to the exclusivity clause, that period is automatically extended for 45 days at a time as long as the parties continue to act in good faith.

Christian Basi, director of marketing and communications with Boone Health, confirmed in an interview with The Ledger that the LOI is still active and valid. Representatives of the city, health department and county commission formed the Audrain County Healthcare Government Committee, which Basi said continues to meet regularly with Boone Health leaders to discuss the project.

Another portion of the exclusivity clause states that the LOI will be terminated if the municipalities seek or entertain offers or negotiations with any other entity or person other than Boone Health. Presiding Commissioner Alan Winders said that since the Audrain Regional Medical Board of Directors does not represent the municipalities, its efforts do not threaten to violate the LOI. 

“They are not a party to the LOI and do not represent or speak for Audrain County, Mexico or the ACHD,” Winders said in an email. “The LOI continues to be in effect and we will continue to honor it as a good partner should. Boone Health continues to move forward in their process, and I am encouraged by their progress.”

Boone’s search for a strategic partner 

According to previous reporting, the Audrain County Healthcare Government Committee announced its support of Boone Health seeking a strategic partnership with another health care facility on July 9, 2025. At that time, Basi said Boone hoped to have a finalist partner identified in early 2026 with any final agreement completed by fall 2026.

On Oct. 13, Brady Dubois, Boone Health president and CEO, said that Boone had narrowed the search down to three finalists, and he hoped to announce the strategic partner by December 2025 during a public joint-session meeting.

When December came and went with no announcement, Corrado said she and her board began discussing if it was time to move forward with another hospital. 

At the meeting, board member Dr. Peggy A. Barjenbruch, a Boone Health physician in Mexico, said Boone Health has selected a strategic partner, but she was not told who it was. 

“We are not at a point where we can discuss that publicly just yet,” Basi said in an interview with The Ledger. “What I can tell you is that our due diligence and our work on that is continuing and we have been making some significant progress. When we do make an announcement, it will be done very publicly.” 

Next steps 

Corrado said the board is actively working on the patient transfer agreement. 

Once approved, she plans to send it to Hannibal Regional. She also said she intends to write another letter to Boone Health and the Audrain County Healthcare Government Committee outlining her plan and offering assistance on behalf of the board. 

“Every time we have offered ourselves to Boone, we are summarily ignored,” Corrado said. “That’s why we’ve gone forward.” 

If nothing happens after that, Corrado said the board will look for a site to build a critical access hospital of its own. 

The Audrain Regional Medical Board of Directors is seeking a 6-acre property near the airport. Corrado said the location will have to be approved by the Department of Health and Senior Services, but once that is done, the board can start fundraising. 

At the meeting, the Audrain Regional Medical Board of Directors reported an account balance of $160 — $100 was provided by Corrado, and each board member contributed $10. No fundraising efforts have been made at this time and Corrado said the fund balance is there to cover licenses and fees to maintain its 501(c)(3) status. 

“If Boone started tomorrow, I would stop,” Corrado said.