Here are two recent certificate-of-need applications that were first denied and later awarded on appeal:
1. In October 2023, Nashville, Tenn.-based HCA Healthcare submitted its first of what would later become three CON applications to build a $234 million hospital in Hanover County, Va. The state denied the initial application on the grounds that HCA had not "demonstrated an institutional need for its proposed project," said Vanessa MacLeod, an adjudication officer for the state health department, in October.
Rival nearby health systems, Marriottsville, Md.-based Bon Secours and Richmond, Va.-based VCU Health also objected to the project, arguing that it would eat into their market share. HCA appealed the decision with a second application for a freestanding emergency room, which was also denied.
The third and final application outlined plans for the $21 million Middle Virginia Surgicenter, which will be the first phase of a plan to develop a larger hospital in Hanover County.
2. In November 2023, Healthcare Resources and the Hoover Health Care Authority purchased a campus in Hoover, Ala., that they planned to convert into a mixed-use center anchored by an ASC and physician medical offices. After initial approval by the Hoover City Council, the project began facing opposition from Forest Park Group, which argued that it already planned to offer similar services in the same area.
Forest Park also claimed the Health Care Authority did not have proper numerical breakdowns for the types of surgeries that would be performed at the ASC. A public hearing was held in May and months of deliberation followed, resulting in CON approval for the center on Aug. 27.