E. Thomas Chaney, former HAI executive, along with former HCA execs Charles Miller and Richard Ragsdale, spin away from Republic Health Corp., to create Community Health Systems. Its focus is solely on rural and community hospitals.

The creation of CHS is an early indicator of what’s to come: leaders from HCA and HAI will create a countless number of new, competitive companies that transform Nashville into the vibrant health care hub it is today. Multiple mergers, acquisitions and IPOs become hallmarks of CHS, as well as Nashville health care generally.

The company goes public for the first time in 1990 and again in 2000. Led by Wayne T. Smith, who becomes CEO in 1997, CHS will eventually become the largest operator of hospitals in the United States (by facility count) and the largest non-urban provider of health care services in the nation.