HCA Healthcare
October 27, 2024

*NOT FOR EXTERNAL DISTRIBUTION*

Source: Nashville Business Journal
Author: Nikki Ross
Date: October 27, 2024

Middle Tennessee is about to get two freestanding emergency departments. 

HCA Healthcare’s TriStar Division and Highpoint Health — Sumner with Ascension Saint Thomas were both approved by the Tennessee Health Facilities Commission Wednesday to build proposed freestanding ERs in White House, a city that sits in both Sumner and Robertson counties.

“Today's decision was a huge win for the people of White House and surrounding communities when it comes to their health care access,” said David Whelan, senior vice president of strategy and development for HCA TriStar, in a LinkedIn post. 

TriStar’s $17.8 million freestanding ER will be at the intersection of Raymond Hirsch Parkway and Highway 31W in White House and is expected to open in the summer of 2025. Highpoint Health’s $20.6 million Highpoint Health White House — ER  with Ascension Saint Thomas will be built on the northwest corner of North Sage Road and Maiden Lane, a half mile from Exit 108 off Interstate 65 and is expected to open in the spring of 2025. 

TriStar's ER is yet another addition to HCA’s (NYSE: HCA) massive family tree. The hospital system is Nashville’s largest publicly traded company by revenue, generating $64.9 billion in 2023, according to Business Journal research. The hospital system operates 186 hospitals and 2,400 ambulatory sites of care across 20 states and the United Kingdom. HCA’s TriStar Division oversees 17 hospitals, 89 physician offices and 18 urgent care centers in Tennessee and Kentucky, including TriStar Hendersonville Medical Center. 

Highpoint Health is owned by Brentwood-based Lifepoint Health and Ascension Saint Thomas under a joint venture. This will be the first new freestanding ER jointly owned by the two health care entities. Ascension Saint Thomas is one of Nashville’s largest employers, with 8,900 employees locally in 2023, according to Business Journal research. The hospital system operates three of Nashville’s largest hospitals: West, Midtown and Rutherford.

While a massive overhaul of the certificate of need process was passed earlier this year, the changes for freestanding emergency departments won’t go into effect until July 2025. Which means until next summer, hospitals still need to file for a certificate of need. 

“Even before it was passed, we were already working on this,” said Mitch Edgeworth, president of HCA’s TriStar Division. “I’m still encumbered by the bureaucracy and the red tape that is the certificate of need process.” 

Starting next year, hospital systems will be able to build a freestanding ER within 10 miles of their hospital without a certificate of need. Competitors will be able to build a freestanding ER outside of that 10-mile radius without a certificate.