Conflicts of interest plague Williamson County Medical Center

Conflicts of interest plague Williamson County Medical Center

Williamson County needs about half a billion dollars to pay for planned growth, and selling the Williamson County Medical Center to a private company could be one way to start raising that money. But most county commissioners say the hospital isn’t for sale.

As reported, the county has owned the hospital since the 1950s.

The only alternative to selling the hospital, other commissioners say, would be to increase property taxes — year after year.

Last month, most commissioners wouldn’t even consent to a study into whether it’s in taxpayers’ best interests to sell the hospital.

Todd Kaestner (photo courtesy of Facebook)

Seven elected county officials have ties to the medical center.

• Four of the 24 commissioners — Bert Chalfant, Dana Ausbrooks, Matthew Williams, and Jack Walton — serve on the hospital’s board of trustees.

County Mayor Rogers Anderson also serves on the hospital’s board of trustees.

• Another commissioner, Thomas Little, has a brother who serves on the board of trustees.

• County Commissioner Steve Smith directs the Williamson Medical Center Foundation.

These examples reek of conflict, Commissioner Sherri Clark said.

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“If there is a direct conflict of interest, then I do believe that they need to recuse themselves,” Clark said.

“I could not myself vote on an issue if I had a direct conflict of interest.”

Commissioner Todd Kaestner also supports studying a sale. The hospital is worth about $400 million, he said.

County Commissioner Gregg Lawrence said the hospital costs county taxpayers $1.5 million each year; the county borrowed money for it in 2002. Other commissioners, such as Chalfant and Walton, said Lawrence is wrong. The county spends nothing.

Jack Walton (photo courtesy of Facebook)

Legally, if county officials sell the hospital they could use the proceeds only for health-care expenses, Little told Tennessee Watchdog last year.

Kaestner said commissioners don’t know that for a fact, and the county attorney should investigate. But the attorney, Kaestner said, can’t investigate without a directive from the county commission.

“It’s clearly a confused topic,” Kaestner said.

“They repeatedly vote to not understand that, which means they are unwilling to have an adult conversation about it, which I find to be a breach of fiduciary duty.”

The county’s education department spends about $38 million a year on health-care expenses, Kaestner said.

“Could we use it for that? Nobody knows. That’s the point,” Kaestner said.

“Nobody currently knows the answers to these questions.”

Another day older and deeper in debt

The county is about $500 million in debt and has about $500 million in funding requests for 10 new schools in the next decade, Kaestner said.

“Operating expenses will be higher than the capital costs.”

Anderson, Smith and Ausbrooks did not return repeated requests for comment. Officials at Williamson Medical also failed to return repeated requests for comment.

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Walton and Chalfant said, per county law, four commissioners and the county mayor must serve on the hospital’s board of trustees.

“I receive no compensation for serving on the hospital board — nothing at all,” said Chalfant, who was just re-elected by commissioners to another three-year term on the board of trustees.

“My take on this is it’s a conflict of interest for Lawrence, who is in the insurance business. It’s also a conflict of interest for Kaestner, because the business he works for was created by the founders of HCA. Give me a break.”

HCA is a private medical company based out of Nashville.

Lawrence failed to return a follow-up request for comment.

Kaestner, in an emailed statement, said the following:

“That’s one of the most hilarious comments I’ve ever heard. Yes, I work for a publicly traded company that was founded by Jack Massey, Dr. Thomas Frist, Sr. and some other notable successful Nashville executives, in March of 1978, over 39 years ago,” Kaestner wrote.

“A significantly more direct and real conflict of interest is that Bert Chalfant has and currently sits on the board of trustees of Williamson Medical Center.”

Clark, meanwhile, said it’s OK for one county commissioner to serve on the hospital’s board of trustees — but no more.

“The current number we have is something I do not support,” Clark said.

UPDATE: After the original publication of this story, in an emailed statement, Lawrence responded to what Chalfont said about Lawrence having a conflict of interest:

“Mr. Chalfant’s statement is completely unfounded.  Whether the county owns and maintains Williamson Medical Center or not has absolutely no impact on my business.”

In our next story, we will examine what might happen if commissioners sell the hospital to a private company and how it might affect medical care in not just Williamson County but Middle Tennessee.

Contact Christopher Butler at

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