MUSCATINE, Iowa — Muscatine County voters overwhelmingly approved a referendum Tuesday that one member of the Unity Healthcare Board called the community’s “best chance of maintaining local, quality health care.”

Ninety-six percent of voters, or 2,717 ballots cast, were in favor of transferring ownership of the Unity Hospital building and grounds from the elected Muscatine General Hospital Board of Trustees to Unity Healthcare, an independent nonprofit corporation in Muscatine.

“We’re certainly pleased to see the level of the support from the community,” Charles Vesey, a member of the Unity Healthcare Board, said this morning.

Fewer than 10 percent of registered voters, only 2,830, participated in the election, according to unofficial results. The ballots have yet to be canvassed by the Muscatine County Board of Supervisors.

Dr. Douglas Dawson, a sleep medicine and ear, nose and throat specialist at Unity Hospital who serves on the Unity Healthcare Board, said passage of the referendum was “absolutely essential” for Unity Hospital’s future.

The hospital is struggling financially to compete with eight other health care organizations within a one-hour drive. As a “tweener” hospital, it is too large to receive federal reimbursements that assist smaller hospitals but so small that it lacks resources and medical specialties to compete with larger facilities.

The Unity Healthcare Board is pursuing a partnership with Rock Island, Ill.-based Trinity Regional Health System; but its directors, according to Dawson, had clearly said they wouldn’t pursue that partnership if the referendum had failed.

Unity Healthcare —formed in 1999 through a merger of Muscatine General Hospital, Community Health Resources and the physicians clinic —owns the hospital business and equipment and leases the building and grounds for $1 per year.

The lease includes an option for Unity Healthcare to purchase the property for $1 in 2024. Approval from voters Tuesday will allow the sale this year.

Vesey said the sale to the Unity Board will take place soon, followed by the affiliation within a few months.

The Unity Healthcare Board must control all of the hospital’s assets in order to affiliate with, or become a subsidiary of, Trinity and its parent company, Iowa Health System. The Des Moines-based nonprofit corporation operates seven large and 14 rural hospitals, and 71 physicians clinics in Iowa, Illinois and Nebraska.

Trinity and Iowa Health System would absorb Unity’s “crushing debt load” of approximately $18 million, Dawson said.

The hospital would not be sold to Trinity, Vesey said previously.

Title to the hospital and its property would remain with the Unity Board, said its attorney David Meloy.

Vesey said the Board would continue to choose doctors, determine services and provide long-term planning for Unity Hospital. However, Meloy said, Unity Healthcare would become a part of the Iowa Health System network as opposed to an independent corporation.

Representatives from Trinity and Unity would serve on each others’ board.

“It’s about the future and having healthcare accessible in the community,” Vesey said of the affiliation.

The Muscatine General Hospital Board of Trustees would have the option to repurchase the hospital as an independent organization if Trinity ended the affiliation in the future.