You don't have to ask me twice to go to Florida in the dead of winter.

As I flew south to the Center for Healthcare Governance Winter Symposium in January, I suspected that most of the other attendees were feeling similarly giddy. There we'd be, bare feet in the warm sand, and as long as someone said the word "reform" once or twice a day—even if we couldn't hear it over the sound of waves from the Gulf of Mexico crashing on the beach—we'd consider ourselves up to date on health care governance issues.

Instead, the trustees I met made it clear that the Symposium could have been held in a Holiday Inn overlooking Chicago's Dan Ryan expressway and they still would have been there. In every keynote and breakout session, board members asked questions, offered perspectives and took notes. Between sessions, they swapped stories—the good and the bad—and shared advice.

Above all, I witnessed a level of dedication to and concern for their institutions and patients that I otherwise wouldn't have believed. Despite the beckoning tropical breezes, trustees wanted to capture every bit of information and guidance available to take back home.

Attendees shared many of the same concerns: staying in business as uncompensated care increases; warming up relations with physicians; and rethinking ownership status when a merger becomes more attractive or flat-out essential to survival.

The latter is the focus of our cover story. Bannock County, Idaho, commissioners made an initially unpopular decision when they decided to seek a for-profit buyer for the county hospital. Without this step, the hospital wouldn't be able to build a badly needed new facility.

The commissioners' courage, and the success of the unlikely partnership, will be inspiring to any board making tough choices for the benefit of their community.