At the end of 2026, Middle Tennessee School of Anesthesia (MTSA) will celebrate the retirement of Larry Hornsby, BS, BSN, CRNA, FAANA, a nationally respected leader, educator, entrepreneur, and advocate whose influence has helped shape the CRNA profession for decades.

Hornsby joined MTSA three years ago after an already distinguished career that included serving as President of the American Association of Nurse Anesthesiology (AANA), helping lead national advocacy efforts for CRNA practice advancement, and founding one of the country’s most successful CRNA-owned anesthesia management companies.

Over the course of his career, Hornsby became widely recognized in the nurse anesthesia profession for his expertise in the business of anesthesia, an area largely absent from CRNA education when he entered the field.

“I didn’t know what I didn’t know when I started,” Hornsby said. “There isn’t a book on the business of anesthesia. There wasn’t someone you could call and ask how to do it. I made mistakes, a lot of them, but I learned from everyone.”

After founding his first anesthesia company in 1991, Hornsby grew the organization from a single practice location into a nationally recognized enterprise spanning multiple states. Along the way, he began lecturing at state association meetings, schools, webinars, and conferences, sharing practical lessons learned from years spent building and managing anesthesia practices.

That passion for education ultimately led him to MTSA.

In a story Hornsby strongly remembers today, MTSA President Dr. Chris Hulin invited him to lunch at a Cracker Barrel to discuss an idea: building a formal business education program for nurse anesthesia students.

At the time, Hornsby was nearing retirement from a successful corporate leadership role and had no plans to enter academia.

“I thought I was done,” Hornsby said. “I had a great job, great benefits, and I could have retired comfortably. But I couldn’t stop thinking about the opportunity to teach the business of anesthesia from a much larger platform.”

That conversation would eventually lead to the creation of the Hornsby Business Institute (HBI), a groundbreaking program dedicated to preparing CRNAs to better understand contracts, reimbursement, independent practice, compensation models, and the evolving healthcare business landscape.

The program was named in Hornsby’s honor, something he says he never expected.

“To have the Hornsby name attached to something that will continue helping future generations of CRNAs… that’s one of the greatest honors of my life,” he said.

While Hornsby’s professional accomplishments are significant, he says the relationships he built at MTSA became one of the most meaningful parts of this chapter of his career.

“MTSA became family to me,” he said. “I’ve never been more welcomed anywhere. Everybody embraced me. Nobody ever treated me like I was anything less than a peer, and that meant more to me than I can explain.”

Hornsby often reflects on the culture of support he experienced at MTSA and the opportunity the institution gave him to bring real-world business experience into the classroom in a way many traditional university settings may not have allowed.

“I knew I could teach the business of anesthesia,” he said. “But MTSA gave me an opportunity I would not have had anywhere else.”

Dr. Chris Hulin says Hornsby’s impact on MTSA and the profession will continue long after his retirement.

“Larry brought an incredible depth of knowledge, leadership, and experience to MTSA, but more importantly, he brought a genuine passion for helping students succeed,” Hulin said. “His influence can be seen not only through the Hornsby Business Institute, but through the countless CRNAs he has mentored throughout his career.”

As he reflects on his career, Hornsby says the advice he hopes future CRNAs carry forward is simple: take the time to understand not only the clinical side of anesthesia, but the business side as well.

“We do a great job teaching clinical anesthesia,” he said. “But understanding the business side of the profession matters too. Understand your worth. Understand where the money comes from, how contracts work, and how to protect yourself professionally. That knowledge matters.”

As retirement approaches, Hornsby plans to spend more time with his wife, four young grandsons, fishing trips, cruises, and life on his cattle farm.

Hornsby says his connection to MTSA and the profession will not end with retirement.

“The Hornsby Business Institute will continue,” he said. “I may not drive the bus anymore, but I’ll always help keep it fueled up however I can.”

While his daily presence on campus will be deeply missed, Hornsby’s legacy at MTSA, and throughout the CRNA profession, will continue for generations through the students he mentored, the leaders he inspired, and the institution that proudly carries his name forward through the Hornsby Business Institute.