CMH Regional Health System (CMH) is close to reaching a decision regarding possible affiliation with a larger health care system.

Andy Riddell, CMH president and chief executive officer, said Monday that the CMH Board of Trustees will accept one of three current recommendations, which will be presented to the Clinton County Commissioners for their action. The intention is to make that presentation to the commissioners on Dec. 21. Because Clinton Memorial Hospital is a county hospital, the commissioners will make the final decision.

After over a year of research and analysis, CMH officials have arrived at three possible recommendations for the trustees’ and commissioners’ consideration:

1. Pursue acquisition of CMH, which would require a public competitive bidding process. This would ultimately result in the sale of the county hospital, which would then become either a for-profit or a not-for-profit corporation.

2. Convert CMH to a tax-exempt 501(c)(3) non-profit Ohio corporation, with the new non-profit corporation affiliating with another non-profit health care system.

3. CMH remain independent, but converted to a non-profit tax-exempt 501(c)(3) Ohio corporation.

Currently there are three organizations in discussion with CMH regarding possible affiliation:

— TriHealth, which is based in Cincinnati and a non-profit 501(c)(3) organization.

— LifePoint Hospitals and The Christ Hospital, which are not affiliated. LifePoint, based in Brentwood, Tenn., is a for-profit organization. The Christ Hospital, located in Cincinnati, is not-for-profit.

— RegionalCare Hospital Partners, also based in Brentwood, Tenn., is a for-profit organization.

TriHealth has been in discussions with CMH for several months. LifePoint and Christ Hospital entered the picture in the fall. RegionalCare is the most recent organization to join the discussion.

CMH had hoped to arrive at a decision well before this on possible affiliation, but factors resulted in a delay.

“The process has taken longer than expected,” Riddell said. “Part of the delay has been the uncertainty in the economic environment. Organizations are much more cautious, which in turn required a lot more due diligence and pushed the timeline out further.”

CMH embarked on a process to find a health care partner about one year ago due to a variety of factors, most of which, Riddell said, are financial and growth-related. A Request for Proposals (RFP) was sent out one year ago, but the actual process started in December 2007 when CMH’s Advisory Clinical Strategy Team made the recommendation to move toward affiliation.

As part of the RFP process, CMH involved administration and trustees, as well as physicians, community leaders, CMH employees and members of the community. The detailed research and analysis which has taken place during the past year as also involved medical staff, management and non-management employees and community leaders.

“I have said from the beginning that this is a morphing process, which basically means that what we started with will change and morph into something completely different in the end,” Riddell said. “A year ago, the asset purchase option wasn’t even on the table, but now it is and it is something we are considering.”

The final recommendation, he said, will be based on criteria developed from the RFP which includes medical staff needs and support, growth strategies, financial support, management/employee philosophy and culture fit.

CMH officials will be involved in a series of information meetings in the coming weeks to community service groups and elected officials, leading up the meeting of the CMH Board of Trustees to consider which of the three options to pursue and present to the commissioners. The first of these will be a presentation at the Wilmington Kiwanis Club at noon on Thursday, Nov. 19, at the Wilmington Presbyterian Church.

The planned Dec. 16 meeting of the board of trustees will come the day before Riddell’s scheduled retirement.