Centennial Medical Center’s proposal to create a satellite emergency department in Spring Hill has received state approval.

After more than two hours of questioning and debate, the Tennessee Health Services and Development Agency this morning denied opposition from a host of nearby hospitals and physicians to narrowly grant the HCA hospital’s application to build the $9.1 million facility at Saturn Parkway and Kedron Road.

The agency voted 4-to-3 in favor of the project, with HSDA Chairman Carl Koella abstaining.

Project plans call for a full-service, 24-hour emergency department that will operate under Centennial’s license as an extension of the Nashville facility. It will be part of a larger, 34,000-square-foot medical office building that will be constructed on land HCA purchased in 2006 to build a 56-bed hospital.

“This is a great victory for the City of Spring Hill,” said Larry Kloess, president of TriStar Health System. “We are honored that the citizens and leadership of Spring Hill asked us to serve their growing health care needs and look forward to providing the quality emergency medical services this community so clearly wants and deserves.”

Centennial argued that population growth in Spring Hill, coupled with its distance to Maury Regional Medical Center in Maury County and Williamson Medical Center in Williamson County, created the need for additional health care services in that community that neither Maury Regional or Williamson Medical adequately address.

Similar reasoning helped HCA receive HSDA approval in 2006 to build its Spring Hill Hospital. But appeals from Williamson Medical, Maury Regional and others led to years of back-and-forth battling that ultimately resulted in a court ruling blocking the new hospital.

Those same opponents spoke out today against Centennial’s ED plan. Their main argument was that patients may suffer from delays in care if they visit the satellite ED because individuals with higher-acuity issues will need to be transferred to a hospital. Centennial will transfer those patients to the Nashville facility instead of Williamson Medical or Maury Regional, unless the patient specifically requests it.

Williamson Medical and Maury Regional had hoped to convince TriStar instead to open an urgent care center in Spring Hill, asserting that such a facility could provide the same level of care at a lower price point. Centennial countered that an urgent care facility does not provide the same level of services, but the parties delayed the CON hearing from September in order to continue discussions.

Currently, Maury Regional operates an urgent care center in Spring Hill, but it is only open for 12 hours a day. Representatives from Maury Regional and Williamson Medical told the HSDA board today that they have begun talks to extend the hours of that facility. But Centennial attorney Jerry Taylor said those efforts are too little, too late.

“They have spent hundreds of thousands of dollars and years defeating the earlier hospital,” Taylor said. “And when that was done, did they do anything? Did they come to this community and say, 'We know you have these needs, and we’ll put an emergency department there?' They did not.”

HSDA board member Lynne Johnson, who voted in favor of HCA, said Williamson Medical and Maury Regional have been “asleep at the switch for several years, at least since the last one was denied, and they’ve not been serving the community like they should.”

Maury Regional CEO Robert Otwell issued a statement saying the hospital, while disappointed, will not appeal the agency's decision. "We remain concerned about this project and its impact on the community in regards to quality of care, high patient charges and preservation of patient choice. It is our hope that the public will understand that this facility, in fact, is a 24-hour urgent care center and that those with true emergencies who visit this facility will be transported to Centennial Medical Center in Nashville."

Dennis Miller, CEO of Williamson Medical, said his facility also does not plan to appeal the decision. The hospital's strategic planning team instead "will continue reviewing and analyzing services — which may include providing expanded, 24-hour urgent care services to Spring Hill residents in conjunction with Vanderbilt University Medical Center and Maury Regional Medical Center — to meet the needs of these communities."

Centennial plans open its ED in 2013.