We use a qualitative, explorative study to examine the role played by board members’ cognitive frames in the adaptation of governance models in U.S. and Dutch not-for-profit hospitals. Relying on frame analysis, we identify four frameworks that influenced how board members perceived their role in the adaptation of governance models. We then describe how these frameworks shaped how board members perceive three areas of governance: conception of board, interaction between the teams, and relationship with other stakeholders. We contribute to literature on the adaptation of governance models by revealing cognitive frameworks that influence how board members perceive the role of boards in the adaptation process. We also find that studying board members in two countries provides additional information on how “taken-for-granted realities” can constrain the individuals’ acts of framing while applying governance principles.