July 6, 2026
WILLIAMSON HEALTH REACHES STRATEGIC PLANNING DECISION;
ANNOUNCES INTENT TO SELL TO ASCENSION SAINT THOMAS
Decision comes after two-year process aimed at ensuring exceptional healthcare for Williamson County residents into the future
FRANKLIN, Tenn. – The Williamson Health Board of Trustees (Board), the governing board of the independent, nonprofit, regional healthcare system based in Williamson County, unanimously voted earlier today to proceed with a change of ownership to Ascension Saint Thomas. Board Chairman Bo Butler announced the decision to the Williamson County Board of Commissioners at a special called meeting on Monday, July 6.
“From the outset, our Board was in full agreement that we preferred to remain independent,” said Butler. “At the same time, our fiduciary responsibility required that we look beyond our personal preferences to focus on ensuring that Williamson Health continues to lead the way, while strengthening our culture, clinical excellence and service to the community for generations to come. Now, what started as a prospect that none of the trustees wanted to consider has turned into the possibility of a future filled with even greater promise from our joining with Ascension Saint Thomas.”
The decision comes after a two-year strategic planning process driven by the Board’s commitment to ensure that Williamson Health is able to continue its mission of serving the Williamson County community well into the future, knowing there are many significant challenges facing the healthcare industry. In July 2025, the Board announced its intent to explore all possible pathways forward through two newly formed subcommittees to review options for remaining independent as well as a potential change in ownership through a Request for Proposal (RFP) process.
The Board initially distributed the RFP to 28 qualified local, regional and national healthcare organizations. From this group, 11 organizations moved to the first phase of the process with four health systems providing initial proposals. Ascension Saint Thomas, HCA Healthcare (HCA) and Optum ultimately provided final proposals. The Optum proposal was moved to the Independence Subcommittee for final review because it presented a 10-year partnership agreement, not an outright sale, thus potentially supporting the option to remain independent. The Board expressed deep gratitude to HCA and Optum for the significant amount of time, resources and thoughtful planning each put toward Williamson Health’s strategic planning process.
“In addition to the evaluation of the Board’s foundational goals and objectives for a potential sale, the Board felt a unanimous and overwhelming sense of confidence and connection with Ascension Saint Thomas. Sometimes the most important considerations during monumental decisions like this are the intangible instincts that emerge during the process,” said Butler. “For us, the cultural fit, like-minded community-focused mission, commitment to our employees and medical staff, and plans to quickly invest capital to achieve our shared vision for how Williamson Health should evolve in the future – while also honoring our legacy – all combined to make it clear that Ascension Saint Thomas is the best partner for us moving forward.”
The proposed transaction comes with an economic value of nearly $1 billion, which would be a historic deal that not only greatly benefits Williamson Health patients, employees and medical staff, but also the overall Williamson County community. As presented, the proposal includes a substantial purchase price, significant capital investments, upgrades to the system’s electronic health records, service line enhancements and expansions, commitment to charity care, and the continuation of current community programs like emergency medical services (EMS) and athletic trainers for local high schools.
If approved, the proposed transaction covers all assets and operations of the Williamson Health system, including the workforce, land, buildings, equipment and more for Williamson Medical Center, Bone and Joint Institute of Tennessee, Williamson Health Medical Group, Williamson Health Outpatient Imaging and Lab Services, as well as the Williamson Health Foundation (honoring all donor recognitions and requests made through transaction closing) and the continuation of Williamson Health Emergency Medical Services (EMS) through an interlocal agreement with the County. Ascension Saint Thomas expressed its praise for all aspects of Williamson Health’s operations, including its multiple clinical partnerships, and Williamson Health looks forward to many ongoing discussions about how to collaboratively continue elevating the services offered to the community.
“Ascension Saint Thomas is firmly supportive of who we are, how we operate and how we fulfill our important community-focused mission,” said Williamson Health CEO Phil Mazzuca, “Ascension Saint Thomas’s intent is to support the strong culture and workforce we already have in place while also bringing much-needed capital to invest into our people, as well as our tools, technologies, facilities and services. That was very important to the Board, particularly Ascension Saint Thomas’s leadership team’s appreciation of our talented, hardworking and compassionate employees and medical staff.”
Over the next several weeks, Williamson Health and Ascension Saint Thomas will be working collaboratively with their teams of advisors and legal counsel – including the County Commission’s legal counsel – to draft a non-binding LOI that will be presented to the County Commission for approval.
“Generally, an announcement like this would not take place until a signed LOI is in place,” Butler said. “However, due to Williamson Health’s Private Act Hospital District status and our desire to involve the County Commission in the development of the LOI – not just the Definitive Agreement – we wanted to announce the Board’s decision prior to finalizing the LOI. As such, we do not have final details we are able to discuss at this point, but we look forward to sharing more as the process advances.”
Once the LOI is signed and approved by the County Commission, a similar negotiating, drafting and approval process will occur for the development of a Definitive Agreement. If the County Commission approves the Definitive Agreement, the proposed transaction must then be subject to applicable regulatory review and approval processes. The timing for these approvals is yet to be determined, but it will likely be in the 2027 or 2028 calendar years before the transaction is complete.
“While the transaction moves through the approval process, Williamson Health will continue to operate independently as we do today – with the same commitment to our mission of caring for our patients while also supporting and investing in our team members,” said Mazzuca. “I cannot express enough appreciation for our employees and medical staff for their professionalism and exceptional care they have provided for our patients despite the uncertainty of the past year. They are truly the heart of our organization, and we are proud to have found a partner that is committed to investing in our people above and beyond what we have been able to do as an independent health system.”
Below is an overview of the strategic planning process that led to this decision:
- In 2024, the Williamson Health Board of Trustees engaged in a routine strategic planning process to plan for the future of the health system. Based on multiple industry trends and financial considerations, it was determined that Williamson Health — despite its current strong financial position — would need an infusion of capital of approximately $150 million over the next five years, with continued funding required thereafter, to accelerate execution of operational and strategic objectives in Williamson Health’s mission to serve the community.
- Williamson Health was created in 1958 as a Private Act Hospital District, which was a forward-thinking, innovative structure allowing the health system to successfully and proudly fulfill its mission for nearly seven decades. With wisdom and resolve, the Board realized that Williamson Health was at a pivotal moment in time where it needed to identify the absolute best possible structure to carry Williamson Health forward through many future generations. With that in mind, the Board set out to explore all possible pathways – ones that could allow Williamson Health to remain independent as well as a potential change in ownership.
- To determine the best path forward toward securing this additional capital, the Board created two subcommittees: one to explore all options related to remaining independent and another charged with researching options for a potential change in ownership. The top priority for both subcommittees was to ensure Williamson Health continues to lead the way, strengthening its culture, clinical excellence and service to the community for generations to come.
- The Independence Subcommittee was focused on researching paths to remain independent and explored many widely different strategies. Ultimately, the Independence Committee concluded that none of the pathways they explored would allow Williamson Health to continue improving upon its standard of clinical excellence, expanding access to necessary services and securing long-term sustainability while also maintaining the special culture that has been intentionally cultivated by Williamson Health employees and medical staff and beloved by the community.
- From a timing standpoint, the Strategic Planning RFP Subcommittee discovered that the value and potential interest from larger healthcare organizations was very strong and timely given Williamson Health’s demonstrated track record of quality and operational excellence. This is a direct reflection of the exceptional work of Williamson Health’s employees and medical staff in establishing Williamson Health as the community’s trusted provider, as evidenced by continued national recognition for quality, safety and excellence. Armed with this information, the committee distributed an RFP.
- The Strategic Planning RFP Subcommittee explored a potential sale, assisted by a team of nationally recognized consultants, and, through the process, developed 11 primary goals and objectives that would be required of an acquiring organization. Those goals centered on Williamson Health’s people, culture, clinical outcomes, technology systems, breadth of services, legacy branding and more. The intent was to see if there were any potential partners that were a strong cultural fit aligned with Williamson Health’s mission and also committed to investing in making Williamson Health an even stronger version of itself for future generations.
- As the Strategic Planning RFP Subcommittee continued its thorough and deliberate process with the finalists that included review of significant amounts of data, numerous meetings, ongoing discussions to clarify issues regarding the final proposals and reverse due diligence site visits, the Board determined that the sale of Williamson Health is what will ultimately lead to our enduring legacy in the community.
To read more about this process, including the Board’s explanation of this decision by way of an open letter to the community, CLICK HERE to visit the “About Us/Board of Trustees” section of the WilliamsonHealth.org website.
If and when the transaction is completed, proceeds of the sale will first be used to pay off all current outstanding debt related to Williamson Health. There will also be transaction costs and other funds set aside for the wind down of the transaction and coverage of potential post-closing liabilities. The remaining proceeds would be allocated at the discretion of the County Commission.
ABOUT WILLIAMSON HEALTH | Williamson Health is a regional healthcare system based in Williamson County, Tennessee, with more than 2,400 employees across more than 30 locations and more than 900 physicians and advanced care practitioners offering exceptional healthcare across 60-plus specialties and subspecialties close to home. The flagship facility, Williamson Medical Center, which opened its Boyer-Bryan West Tower in 2024, offers extensive women’s services, state-of-the-art cardiology services, advanced surgical technologies, award-winning obstetrics and NICU, leading-edge orthopaedics, outpatient imaging services, and distinct comprehensive emergency and inpatient services for both adult and pediatric patients. Other Williamson Health service providers include Bone and Joint Institute of Tennessee, The Williamson Health Turner-Dugas Breast Health Center, Monroe Carell Jr. Children’s Hospital Vanderbilt at Williamson Medical Center, Williamson Health physician practices that are strategically located throughout the community, countywide Emergency Medical Services that include 18 rapid response units, Williamson Health Foundation, and multiple joint venture Vanderbilt Health and Williamson Medical Center Walk-In Clinics in Williamson County. Learn more about our many specialized services at WilliamsonHealth.org.
