Update, 1:28 p.m.: Both hospital proposals were approved in separate 8-0 votes, to loud applause from the chambers.
Update, 1:25 p.m.: During Commission discussion, Chair Rick Chinn said, “I think if both of these new hospitals are approved, then the (Tennova CON) relocation is in question. I don’t think we should have two hospitals that are 1,000 feet apart.”
Member Barbara Brennan asked about Vanderbilt Health, which is a 20% owner of Tennova, and said she was struck that no one from Vanderbilt appeared at the hearing to support Tennova. “Where are they?” She also said she heard a lot about Tennova’s “intention” to do things to better serve the community, but, “Why hasn’t it been done proactively before?”
Commission member Dr. Steven Flatt asked why one of these health systems isn’t pushing to provide much-higher-specialty services in Clarksville, beyond what’s proposed. He said a city the size of Clarksville should have had such services long ago.
Commission member Melanie Keller said having all three hospitals will drive competition, which should compel each to provide more specialty services.
Multiple members agreed that BACH should not be a factor in any of this, as they aren’t open to the public.
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Update, 1:10 p.m.: During closing comments, Tennova took aim particular aim at AST, saying that if the commission is willing to deny only one of the hospitals, they ask that it be AST’s, as it is only 1,000 feet from the Tennova Sango ER.
Update, 1 p.m.: During questions from commission members, several asked about the status of Tennova’s request to move their 2021 CON from Trenton Road to Exit 11. Commission Executive Director Logan Grant said the relocation request is still in a review period. After review, the approval could get administrative approval or referral to the board.
Tennova representatives said COVID-era expenses caused them to rethink the location, and the commission agreed that Tennova began asking about the relocation several months before the AST announcement.
Tennova makes case against new hospitals
Update, 12:30 p.m.: Attorney Travis Swearingen, representing Tennova Healthcare-Clarksville, said they are not afraid of competition. However, they are concerned that the investment of a half-billion dollars into unneeded healthcare will damage healthcare in Clarksville because of lower volumes. “There are not enough nurses, doctors and patients to support what will become five hospitals in the Clarksville-Montgomery County area,” Swearingen said.
He also showed data that indicated that for community level discharges, Tennova has handled 68%, with TriStar handling 12%, Ascension Saint Thomas 8% and Vanderbilt 12%. He said 65% of the time, people are out-migrating to seek tertiary care that’s not provided in Montgomery County and won’t be provided by the new hospitals.
Swearingen said that if the additional hospitals open, he projected that by 2030, each hospital will only be able to operate at 43% occupancy, which will have a “devastating fragmentation of care.” “There are simply not enough patients to go around for all these hospitals,” he said.
“The services they are proposing are the exact same services Tennova is already providing, at best,” Swearingen said. “What they are planning to offer is duplicative.” He said that the outmigration from communities that TriStar is already serving is actually worse than Montgomery County’s.
Tennova CEO Drew Emery said Tennova began working on relocating its CON for a satellite hospital late last year, long before the AST hospital announcement.
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Dr. Alan Werner, chair of the Tennova board, said he was saddened to hear all the public comment complaints about Tennova and said these problems have not been brought to the board’s attention. However, he said there’s been an aura of complacency in Clarksville for far too long. “We are committed to correcting wrongs and making it right. It hurts me to hear that Clarksville or Tennova is a bad institution.” Werner showed information that from 2021 to 2025, Tennova’s patient satisfaction rating improved from 3.5 out to 4.4 out of 5.
Werner also announced that Tennova is looking to establish Level III trauma certification.
There was no applause – only silence – from the 300 people in attendance following each Tennova speaker.
Previously:
NASHVILLE, TN (CLARKSVILLE NOW) – Clarksville’s healthcare future was on the line Wednesday morning as two hospitals went before the Tennessee Health Facilities Commission requesting permission to build here, amid objections from Clarksville’s only existing hospital, Tennova-Healthcare. Ascension Saint Thomas (AST) and TriStar are both applying to build full-service hospitals with ERs.
The Tennessee Health Facilities Commission was filled with attendees looking to advocate for the hospitals, oppose them, or see the outcome. The 200-some seats in the commission chambers were filled, with about 75 people, most of them wearing blue AST and light blue TriStar T-shirts, standing in the back and along the sides of the chambers. Over 40 people were standing outside in the lobby, watching the hearing on a livestream.
Speaking for new hospitals
State Sen. Bill Powers was first to address the Commission, pointing out that Clarksville is soon to surpass Chattanooga in population to become the fourth largest city in the state, yet it has only one hospital. He spoke on our growth in school enrollment and industrial activity. “Clarksville-Montgomery County is accelerating in evert measurable sector in progress, yet our healthcare system remains stalled.” Powers advocated for all three hospitals, letting them thrive in competition.
State Rep. Jeff Burkhart, who has many years of experience as an emergency responder, spoke on the increasing traffic issues, and the difficulty of getting to only one hospital from various areas of the county. Having two additional hospitals on each end of town, with one in the middle would make a big difference. “There would have been a lot of lives saved if we had had that option years ago,” Burkhart said.
State Rep. Ronnie Glynn pointed out that the young man shot in the parking lot of the Montgomery County Fair drove past the site of the proposed TriStar hospital to get to Tennova. He speculated on whether that teenager would have lived if he had gotten to a hospital within 10 minutes, instead of taking a 20-minute drive.
Several other current and former officials spoke up for the hospitals, including State Rep. Aron Maberry, City Mayor Joe Pitts, County Mayor Wes Golden, Maj. Gen. (retired) Brian Winski (former commanding general of Fort Campbell).
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Hospital leaders make their pitch
AST CEO Fahad Tahir pointed out that since 2010, Clarksville has added 74,000 new residents, 34,000 homes, 10 schools, 800 new businesses but no new hospitals.
Attorney Clark Spoden, representing TriStar, pointed out that the Bed Need Formula is not in the CON Statue. It is merely a guideline, and it can be disregarded, as it has been in recent hospital decisions in Rutherford County and in Spring Hill.
TriStar President Mitch Edgeworth addressed the issue of almost 50% of people leaving Montgomery County, or “out-migrating,” for hospital care. He said 88% of that hospital outmigration is for non-tertiary services, meaning they could be cared for at a community hospital. He also said that outmigration has gotten worse – growing 79% from 2010 to 2023.
Public comments for new hospitals
Fifty-four members of the public came forward to speak, all given one minute each and all speaking in favor of opening the new hospitals. Several brought up difficulties with care they received at Tennova, including having to see specialists through telehealth instead of in-person, faulty diagnoses, understaffing and long wait times for emergency care. Many spoke of receiving far better care after seeking care at TriStar and Saint Thomas facilities.
Among those speaking were Jack Turner, EMS Director Chris Proctor, Pastor Stephanie Jenkins, Dr. Kevin Kennedy Jr., Maj. Gen. (retired) Walt Lord, County Commissioners Rashidah Leverett, Joe Smith, Ryan Gallant and Walker Woodruff, Customs House Director Frank Lott, City Council member Brian Zacharias, Leo Millan and LifePoint Pastor Mike Burnette.
Also speaking were representatives from the Catholic Church, the local Economic Development Council, Centerstone, Bikers Who Care, Tennessee Orthopaedic Alliance, Nashville Kats, the local Veterans Coalition, Tennessee Oncology, the local Korean American Association and several nurses, doctors and other health care workers.
The meeting is being livestreamed at this site.
This article will be updated.
What hospitals have planned
TriStar Health, part of Brentwood-based HCA Healthcare, plans to bring a 68-bed hospital, expandable to 224 beds, on a site on the south side of Tiny Town Road, about 1.5 miles west of Exit 1 of Interstate 24. The $286 million investment would create more than 200 healthcare jobs and serve both Montgomery and Stewart counties.
Ascension Saint Thomas, a Nashville faith-based, nonprofit hospital system, plans a 44-bed hospital, expandable to 132 beds, on a 96-acre site northeast of Exit 11, the current site of Boyd’s Pumpkin Patch. The $148.5 million investment would create approximately 250 healthcare jobs. Both Tennessee Oncology and Tennessee Orthopaedic Alliance have announced plans to build facilities on the AST campus, and Montgomery County plans to build an EMS station there.
Tennova-Healthcare Clarksville, part of Franklin-based Community Health Systems, was granted a CON in 2021 to build a 12-bed satellite hospital with a 14-bay ER on Trenton Road. That hospital was never built. On June 4, Tennova announced it would ask to modify its Trenton Road CON to build instead at Exit 11, next to its existing Sango ER and the planned AST hospital. That request remains pending before the Health Facilities Commission.
Christian Brown and Jordan Renfro contributed to this report.
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