Brittney Lofthouse – Staff Writer

Late Wednesday, Mission Health Systems announced that they have signed a Letter of Intent to join Hospital Corporation of America, (HCA Healthcare Inc.) based in Nashville, Tenn. Mission said its board voted unanimously to execute the letter of intent with the Nashville-based for-profit health care company, which operates 177 hospitals and 119 surgery centers in the United States as well as the United Kingdom. The nonprofit community hospital group said the decision is based on its “long-term vision and commitment to preserve and expand” the organization’s quality of care in what it calls “a rapidly consolidating healthcare industry.”

While the news of the Letter of Intent, like most that comes from Mission Health Systems, caught local officials by surprise, leaders say it’s too soon to speculate on the effects.

“I met with some officials from Mission this morning,” said Franklin Mayor Bob Scott. “At this stage, it would be premature to speculate on the merger.  However, I did express my concern about moving Angel to a new facility rather than renovating the current hospital.  Angel Medical Center, is in many ways, the core of Franklin and there is room for expansion nearby.  The community has a kinship with Angel and many of the people I have spoken with feel they too would prefer keeping the current hospital, renovating it and expanding it at the current location. However, I have heard some positive things about HCA which could mean a plus for Franklin.  Time will tell as all the requirements for a merger are met. I do not expect anything to happen anytime in the near future. I believe it will be months away.”

The deal is subject to to the negotiation of a definitive agreement and applicable regulatory approval, Mission said. Mission launched a website — — with the announcement to provide updates on the merger as they become available.

While details of the Letter of Intent are limited, the one thing that would be for certain that if it does go through, the move would place Mission under the umbrella of the for-profit HCA company, which has 240,000 employees throughout its system and navigates more than 27 million annual patient encounters, a fact sheet provided by the company shows. Mission Health System and its affiliates, such as Angel Medical Center and Highlands-Cashiers Hospital, will also be HCA and will be considered for-profit facilities.

“It is very early to tell what the Mission and HCA healthcare acquisition talks will produce,” said Highlands Mayor Patrick Taylor. “It appears the region is on the verge of a major change in the delivery of healthcare.  My concern is that small markets and facilities, such as the Highlands/Cashiers Hospital, will be lost in the discussions, and that the community will have no input.”

A letter to employees sent by Mission Health System told employees that while nothing is set in stone, if the merger is approved, it is likely the transition would start this calendar year. Mayor Taylor said that options for the Highlands-Cashiers Hospital are still on the table and that it may break away from Mission Health System before anything is final.

“I believe all options should be on the table, even realignment with other providers like C. K Harris/Duke Life Point,” said Mayor Taylor.

The Letter of Intent does say that current projects already in works within Mission Health Systems, such as the relocation of Angel Medical Center, will be honored and continued under HCA.

“It is important to us that HCA Healthcare expresses a commitment to supporting our clinical best practices and our communities’ values,” Paulus was quoted as saying in a news release. “The recognition HCA Healthcare continues to earn for being one of the world’s most ethical companies is compelling.”

Macon County Commission Chairman Jim Tate said now that the news has settled, county leaders will have to wait for more information to see what lasting impact it will have for residents.

“My initial reaction was a sense of utter surprise, as once again, the county was caught with some unexpected news in regards to Mission’s objective, but now that the potential reality of the situation has started to settle, I have to ask myself, will this potential take-over help or hurt our local health care system?  I am sure that this question is being pondered by many people, but from the county’s perspective, the ultimate goal is to help ensure that our constituents receive the best possible healthcare.  And, the county will be monitoring this situation very closely to see if, when and how we can help,” said Tate.