Vanderbilt Hits Snag Over Plan To Build Hospital in Murfreesboro

By Anita Wadhwani, Tennessee Lookout

December 14, 2021

A plan by Vanderbilt University Medical Center to expand its Rutherford County footprint with a new 42-bed, $144 million hospital is once again facing opposition from major hospitals already serving patients in the fast-growing region.

Officials with Williamson Medical Center, TriStar Stonecrest Medical Center and Ascension St. Thomas, in formal opposition notices filed with state regulators, are seeking to block efforts to establish the proposed Vanderbilt Rutherford Hospital on property the hospital already owns in Murfreesboro. Williamson Medical Center cited Vanderbilt projections that 18% of patients would come from outside of Rutherford County, including adjacent Williamson County.

Vanderbilt officials say a new hospital is necessary to keep up with demand in rapidly growing Rutherford County — and to alleviate the patient load in its main campus in Nashville, which operated at more than 96% of capacity in the last fiscal year, according to an application submitted to the state. Vanderbilt projects that 62% of patients who could receive services at the new facility would otherwise be traveling to Vanderbilt’s Nashville hospital.

Vanderbilt officials also pointed to the large network of Vanderbilt-affiliated doctors and nurses already working at clinics in Rutherford County; it has more than 140 doctors and other practitioners seeing patients in the county, the hospital said.

But Vanderbilt’s competitors argue they are already meeting the need for hospital services in Rutherford County, a suburban area with a population that skews younger and healthier than populations in major urban centers. A new Vanderbilt hospital would also target competitors that already have a fragile financial footing, St. Thomas argued in its formal opposition filing.

Vanderbilt officials cite the need for their facility with claims the St. Thomas Rutherford ER leaves patients languishing in hallways while waiting for free beds. State filings show Vanderbilt’s competitors accuse the medical center of using “deceptive bed need data.”

The battle over Vanderbilt’s plans have grown increasingly contentious, with accusations that Vanderbilt is using “deceptive bed need data” to establish a hospital it knows will siphon patients away from already established hospitals then charge them higher rates, state filings show.

Vanderbilt officials in their own filings have quoted local doctors who claim that St. Thomas ER is frequently full of patients languishing in hallways for multiple days while waiting for a hospital bed to free up.

“Clearly there is a disconnect between the occupancy data reported by Saint Thomas Rutherford, and the experiences of local physicians, and their patients in obtaining timely access to hospital care,” Vanderbilt’s application said.

It is Vanderbilt’s second attempt to establish a hospital in Rutherford County. Last year, state regulators with Tennessee’s Health Services and Development Agency denied the safety net hospital’s plans to build a 48-bed facility in Murfreesboro — a proposal that was also actively opposed by hospitals in Rutherford County.

Vanderbilt voluntarily dismissed its appeal of that decision in October. Earlier this month, Vanderbilt was ordered to to pay more than $382,000 in appeal related costs.

The dispute over Vanderbilt’s latest attempt to establish a Rutherford County hospital has already spilled into court. On Friday, Tristar Stonecrest, Williamson Medical Center and all three St. Thomas hospitals in Rutherford County filed suit against Vanderbilt in Davidson County Chancery Court.

The hospitals are asking the court to prevent Vanderbilt from destroying documents filed as part of its appeal of the state’s rejection of its plans last year. The hospitals contend that the mounds of confidential information Vanderbilt submitted in court as part of its appeal will likely be necessary in an inevitable legal fight over its latest attempt to build a new hospital.

In the meantime, lawmakers approved a new state law that revised the criteria for granting certificates of needs — which function as a state permit — to build a new hospital in Tennessee. The law went into effect on October 1.

Vanderbilt submitted its new application for a certificate of need for the Rutherford County facility on the same day.

Previously, the state could grant a certificate of need if the proposed health care facility met four criteria: that it met a demonstrated need, was developed in an orderly fashion, was economically feasible and met quality measures.

The new criteria has three benchmarks: the facility must be necessary to provide needed healthcare in the area served, meet quality standards and that the “effects attributed to competition or duplication would be positive for the consumers.”

The Health Services and Development Agency meets Wednesday to consider Vanderbilt’s application.

Tennessee Lookout is part of States Newsroom, a nonprofit network of state government news sites supported by grants and a coalition of donors.