Maury Regional Medical Center and Williamson Medical Center on Tuesday formally announced their opposition to Centennial Medical Center’s plan to open a satellite emergency department in Spring Hill.

According to a statement from Maury Regional, the hospitals filed a joint opposition letter with the Tennessee Health Services and Development Agency because they are concerned about patient care, costs and choice. They also argue there are “superior alternatives” to the ED plan.

“We fully understand the desire of the Spring Hill community to have access to more health care services and we are committed to being part of the solution,” said Maury Regional CEO Robert Otwell. “However, we believe that labeling the scope of care proposed by Centennial as an emergency department gives the public a false impression that life-saving services and physician specialists would be readily available in the case of a true emergency.”

Centennial, part of HCA’s TriStar Health System, in June filed a Certificate of Need application to build a freestanding emergency department on the site where it had planned a 56-bed acute-care hospital several years ago. The department would operate as an extension of Centennial under the Nashville hospital’s license.

Williamson Medical’s board of directors voted in August to oppose the project, but Maury Regional had been mum on its intentions until Tuesday. Pushback from the two hospitals was instrumental in blocking the Spring Hill Hospital, which HCA stopped pursuing late last year.

Otwell and Williamson Medical CEO Dennis Miller argue in separate statements that the lack of capabilities like an on-site surgical suites and cardiac-catheterization labs at the ED could delay urgent care for patients who, unable to get necessary care at the satellite ED, would be transferred to Centennial Medical Center instead of nearby Maury Regional in Columbia or Williamson Medical in Franklin.

“This type of facility could unintentionally cause delay in the provision of definitive care for acutely ill or injured patients whose outcome is affected by the timeliness of care in the hospital setting, not just timely Emergency Department care,” says Ronald Hagen, medical director of Williamson Medical’s emergency department. “Such patients would be better served by simply proceeding directly to a hospital-based emergency department or, if necessary, by calling 911 and being transported by EMS to the nearest appropriate facility.”

An automatic transfer to the Nashville hospital may also interfere with patient choice, the hospitals argue, given that some patients may want to stay closer to their Spring Hill homes.

Finally, the hospitals contend that an urgent care center could provide the same level of care as proposed in the Centennial ED at significantly lower cost. Maury Regional estimates the average charge for comparable non-emergent services in an emergency department would be 500 percent to 600 percent higher than if they were provided in an urgent care center.

“Centennial seems to believe erroneously that an urgent care center cannot have the same level of service as the facility they have proposed. There is no reason an urgent care center cannot have the same imaging, laboratory and staffing, with significantly less patient expense and more patient choice,” Otwell said. “We remain hopeful that Centennial will engage in a productive discussion about an urgent care center. However, if Centennial remains determined to build the facility that is proposed, we intend to express our concerns to the Agency.”

The hospital CEOs both said they expect other facilities, such as Vanderbilt University Medical Center, to oppose the CON. VUMC officials could not be reached for comment Tuesday afternoon.

The HSDA will hold a hearing on the CON on Sept. 22.