Independent nonprofit organization seeks to ensure exceptional healthcare for Williamson County residents into the future

Originally released Monday, July 14, 2025

The Williamson Health Board of Trustees (Board), the governing board of the independent nonprofit regional healthcare system based in Williamson County, is engaged in a strategic planning process to explore all possible options for maximizing its short-term health as well as its long-term viability. This includes understanding the fiscal needs over the next five years to remain independent and also the value and implications of potentially selling the system.

“Dynamic, healthy organizations shape their futures through strategic planning, rather than allowing the future to shape them,” said Bo Butler, Williamson Health Board of Trustees Chairman. “If we are not continually planning for the future, we cannot achieve our mission of ‘providing for the healthcare needs of our community.’ We are doing the difficult work today to make informed and strategic decisions that ensure a healthy and favorable future for our patients and staff as our community grows.”

Williamson Health’s strategic planning process is not only taking into account the growing needs of the community, but also those of its employees and medical staff. It is also addressing the fact that healthcare organizations, especially independent nonprofits like Williamson Health, are currently facing mounting pressures in the ever-evolving healthcare environment. These include, among others, increased staffing issues; inadequate reimbursements from insurance companies, Medicare, Medicaid and others; operating costs that are rising faster than revenues; shifts in care delivery models; erosion of high-margin services that help offset lower-margin services; and ongoing variability in the regulatory landscape, such as the legislative restructuring of Tennessee’s Certificate of Need (CON) program.

With this in mind, Williamson Health created a subcommittee of its Board of Trustees to gain a full understanding of the pathway to remaining independent, while also considering alternatives including a potential sale through a formal Request for Proposal (RFP) process. Williamson Health engaged highly experienced and reputable firms to guide this process.

One of these firms was tasked with evaluating a variety of factors – both local and national – ranging from future technology and service line needs to projected staffing costs and more. The subcommittee reviewed the financial projections for the next five years based on operational and growth opportunities. The data showed that, while Williamson Health is financially strong today, the system would need a significant capital infusion over the next five years to execute these important strategies and sustainably continue its mission.

Unlike larger healthcare organizations that can leverage shared resources to support growth and infrastructure, Williamson Health operates as an independent nonprofit, fully investing all earnings into its people, technology, services and facilities. While this investment model has enabled Williamson Health to remain the high-value, affordable provider for the community, it also limits access to additional funding. Securing the necessary future capital would likely require significant support from external sources of funding.

“While our system is currently fiscally sound, and we are reaping the benefits of our recent expansion, we – like many independent hospitals across the country – are experiencing significant challenges that are only going to intensify in the coming years,” said Butler. “Our Board is unanimously in favor of remaining independent. However, guided by our sincere commitment to act wisely, responsibly and in the best interest of those who rely upon us, we recognize our fiduciary responsiblilty to ensure that our community has access to high-quality healthcare well into the future.”

Armed with insights from its consultants, the Board determined it must consider the sale of Williamson Health as one alternative to maintaining and elevating the exceptional healthcare expected for the community through new services and increased capacity. At the same time, Williamson Health continues to explore options to remaining an independent entity, including pursuing alternative ways to access capital, thoughtfully considering all paths to preserve and strengthen the organization’s future.

Williamson Health is working with consulting firms experienced in mergers and acquisitions: Kaufman, Hall & Associates, LLC and Bass, Berry & Sims PLC, who will manage the process. Together with Williamson Health, they will create an RFP to send to qualified select local, regional and national healthcare organizations.

“We are fortunate to have such strong and valuable partners,” Butler said. “They have led us through an exhaustive process that helped us determine that our value and potential interest from larger healthcare organizations may never be higher than it is today.”

Any acquisition would include all of Williamson Health’s assets. This includes Williamson Medical Center, Bone and Joint Institute of Tennessee, Williamson Health Medical Group and other services throughout the county.

Proposals will likely be reviewed by the Board in the late fall. If a satisfactory offer is identified that is deemed a good fit for the community – and a sustainable path to remaining independent is not a viable option – Williamson Health may present to the Williamson County Board of Commissioners (County Commission) for approval a recommendation to sell to the system.

If the County Commission approves a recommended proposal, it must then be presented to and approved by the Tennessee Attorney General and reviewed by the Federal Trade Commission (FTC). This process, along with detailed negotiations, could take 12 to 36 months.

Butler presented the comprehensive strategic plan, as well as a heartfelt letter addressed to the community from the Board, to the County Commission at its July 14 meeting.

“It is important to emphasize that no decision has been made. This is the beginning of a thoughtful, deliberate process,” said Williamson Health Chief Executive Officer Phil Mazzuca. “There are multiple variables that could allow us to remain independent, and one thing is for sure: for nearly seven decades, Williamson Health has provided compassionate, high-quality care to this community, and our commitment to strengthening that legacy remains unchanged. Our focus is not just on surviving the challenge ahead, but on building a stronger, more resilient future.”

By law, any proceeds from a potential transaction must be used exclusively for healthcare-related purposes in Williamson County. After debts are paid, including all grants and loans, the remaining funds would likely be placed in a trust to be managed by an independent foundation established by the Williamson Health Board of Trustees and responsible for allocating the proceeds in alignment with community health priorities.

“One of the most rewarding aspects of this process would be gaining the ability to bring entirely new healthcare initiatives to the community that were previously beyond our financial reach,” added Mazzuca. “If new ownership is determined to be the best path forward, the anticipated proceeds will empower a newly formed independent foundation to invest in programs and services that could transform the health and well-being of our community in ways we never thought possible.”

Williamson Health has created a page on its website that provides more information about this process, as well as answers to frequently asked questions. This page will be updated as needed. 

ABOUT WILLIAMSON HEALTH | Williamson Health is a regional healthcare system based in Williamson County, Tennessee, with more than 2,300 employees across more than 30 locations and more than 860 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 new Boyer-Bryan West Tower in 2024, offers extensive women’s services, state-of-the-art cardiology services, advanced surgical technologies, an 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 the Bone and Joint Institute of Tennessee, The 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.