As Clarksville continues to grow as one of Tennessee’s fastest-expanding communities, healthcare access has become a critical issue for our families and neighbors. The community’s rapid growth has attracted the attention of major healthcare organizations, including both HCA Healthcare (operating through its TriStar brand) and Ascension Saint Thomas, both of whom have demonstrated interest in expanding healthcare services in Middle Tennessee.

As of now, both hospitals have submitted letters of intent and are working on their applications, to be considered at a state Certificate of Need (CON) hearing on July 23 in Nashville.

What is Certificate of Need?

A Certificate of Need (CON) is a state-level permit required before establishing or modifying any healthcare facility in Tennessee. The Tennessee Health Facilities Commission oversees this approval process to ensure new hospitals truly benefit the communities they serve.

The CON process serves three key purposes:

  • Community Need Assessment: Evaluating population needs, existing services, and access for vulnerable groups.
  • Quality and Cost Control: Ensuring high-quality care while preventing oversupply that drives up costs.
  • Financial Viability: Reviewing whether projects are sustainable and protect both patients and the healthcare system.

This system prevents unnecessary duplication of services while ensuring new facilities actually improve healthcare access for residents.

How CON process works

When any healthcare organization wants to build a new hospital or expand services, they must follow this process:

  1. Letter of Intent: Filed between the first and 10th day of any month, with the full application and filing fee due within five days of publication.
  2. Public Notice: The Letter of Intent must be published in local newspapers to inform the community.
  3. Application Review: Tennessee’s review cycle lasts 60 days, though applications with no opposition can be considered for a 30-day review.
  4. Public Input Period: Any party wishing to contest or oppose a CON application may file written letters or appear before the agency within specific timeframes.
  5. Public Hearing: Applications typically include public hearings where local residents can share their input.
  6. Commission Decision: A CON is granted through the approval or denial of an 11-member board, with members appointed by the governor and representing different healthcare sectors.
  7. Appeal: Only unsuccessful CON applicants, not opposing parties, have the right to appeal the Commission’s decision. Upon appeal, the losing party is liable for costs, including the other side’s attorney’s fees.

How you can participate

As Clarksville residents, you have several important ways to participate in any CON process:

  • Stay Informed: Follow local news coverage and attend community information sessions that applicants may host.
  • Submit Written Comments: Residents can submit written testimony to the Commission during review periods.
  • Attend Public Hearings: When applications are filed, public hearings provide opportunities to voice support, concerns, or questions directly to the Tennessee Health Facilities Commission.
  • Contact Your Representatives: Share your views with local and state officials about healthcare needs in Montgomery County.

Each type of organization brings different strengths, priorities, and community commitments that should be evaluated as part of any CON application.

Important upcoming CON hearing

The CON hearing will be Wednesday, July 23, at 9 a.m. at 425 N. Representative John Lewis Way, Senate Hearing Room I, Cordell Hull State Legislative Building, Nashville. The meeting is open to the public.

As the CON processes unfold in Clarksville, remember that your participation as a community member is not just welcomed – it’s essential. The commissioners making these decisions need to hear from the people who will be affected by them: Clarksville families, workers, and long-term residents who understand our community’s unique healthcare needs.

Whether specific proposals move forward or not, engaging in these processes helps ensure that future healthcare decisions in Montgomery County truly serve the best interests of the people who call Clarksville home. The goal isn’t to support or oppose any particular organization, but to ensure that whatever healthcare development occurs genuinely improves access, quality, and affordability for our growing community.

For more information about the Certificate of Need process, contact the Tennessee Health Facilities Commission at (615) 741-2364 or visit their website at tn.gov/hfc. To stay informed about any hospital development proposals in Montgomery County, follow local news sources.

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