HCA Healthcare Inc-owned TriStar Health has applied for a certificate of need with the Tennessee Health Services and Development Agency to build a freestanding emergency department in Antioch. – Nashville Business Journal

TriStar Health couldn’t get approval to build a freestanding emergency department in the affluent Brentwood area, so it’s setting its sights on neighboring Antioch.

Last month, the HCA Healthcare Inc.-owned health system filed a certificate of need application with the Tennessee Health Services and Development Agency to build a $14 million facility off exit 60 of Interstate 24 in the Century Farms development.

The 10,860-square-foot freestanding emergency department would be an extension of the TriStar Southern Hills hospital, which is approximately 7.3 miles southeast, according to the application. The facility would house 11 beds, a trauma room and behavioral health capabilities.

HCA has 71 freestanding emergency departments in operation, with 32 more approved for construction nationally, according to its application. Locally, the company has similar facilities in Dickson, Portland and Spring Hill, with one planned in Mount Juliet.

The request comes on the heels of a nearly three-year effort to build a similar facility near the Old Hickory Boulevard exit on Interstate 65 in Brentwood. HCA had purchased that property, the former home of AIG, in 2014 for $65 million.

Williamson Medical Center and Vanderbilt University Medical Center opposed that project, arguing it was a tactic to lure away the wealthy, insurance card-carrying patients who live in Williamson County. HCA (NYSE: HCA) has used freestanding emergency departments as proving grounds for potential hospitals in the past, and opponents alleged the company planned to do the same in Brentwood.

Saint Thomas Health also applied to build a similar facility about a mile away. Both applications were denied.

TriStar, the Nashville-area division of HCA, continued to appeal the decision until it was ultimately struck down by an administrative law judge in October.

At the time, a TriStar spokeswoman said, "We are committed to serving the needs of the fast-growing community in South Nashville. To that end, we will continue to identify additional ways in which we can provide access to care for patients…”

A facility a few miles east in Antioch could be a way to meet those needs.

In its March application, the health system says its Southern Hills emergency department is overcapacity and Antioch’s population growth necessitates the construction of a freestanding emergency department. TriStar says it has received 27 letters of support from residents of Antioch and points to a previous Tennessee Health Services and Development Agency ruling that stated Antioch is “currently underserved from a health care perspective.”

In an email, TriStar Director of Marketing and Public Relations Katie Radel said, “Over 35 percent of residents in Antioch choose TriStar Southern Hills Medical Center for their emergency care needs. The freestanding emergency department would provide high-quality emergency care with easy access to the Antioch community.”

The application will be reviewed at a THSDA meeting on June 27.

It’s not clear if the Antioch freestanding emergency department will face the same challenge from competing health systems as the Brentwood proposal did. The deadline to file such opposition is June 12.

A spokesperson for Williamson County Medical Center declined comment; Vanderbilt did not respond to a request for comment.

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