Med Center Health has won the latest battle in the continuing war over health care supremacy in Bowling Green.

Franklin County Circuit Court Judge Thomas D. Wingate ruled on Monday that the Kentucky Cabinet for Health and Family Services must approve Med Center’s certificate of need to establish a hybrid freestanding emergency department and urgent care facility on a 10-acre lot it owns in The Hub development along Lovers Lane.

That ruling reverses the February denial of Med Center’s CON application in which hearing officer Kris M. Carlton wrote that Med Center had “failed to prove that an additional freestanding emergency department in the identified geographical service area is needed.”

Carlton’s ruling came after a hearing during which rival TriStar Greenview Regional Hospital argued that the Med Center facility wasn’t needed because Greenview had already won CON approval for both a second hospital and a freestanding emergency department in the Lovers Lane corridor.

Greenview, in fact, has started construction on its 11,131-square-foot freestanding (not attached to a hospital) emergency department that will have 11 patient rooms and is located almost directly across Lovers Lane from the Med Center property.

The presence of that freestanding ER was a big factor in the denial of Med Center’s CON application; but the not-for-profit hospital’s lawyers convinced Judge Wingate that there are holes in the ruling against them.

Wingate wrote that “inaccurate findings of fact” related to projected patient volumes supported reversal of the hearing officer’s decision.

The judge also cited the fact that Med Center is proposing a hybrid model that will see both emergency department and urgent care patients as a factor in his reversal.

According to Wingate’s ruling, “The hearing officer erred in finding that Greenview’s present and yet-to-be-constructed facilities are proper alternates for the type of care proposed in petitioner’s (Med Center Health) application.”

Wingate, in his ruling, said: “The court holds that the record clearly supports that Greenview has failed to rebut the presumption of need for a hybrid freestanding emergency department by clear and convincing evidence.

“Rather, substantial evidence in the record supports a need for a hybrid FSED in the service area.”

Med Center Health leadership welcomed Wingate’s ruling and released a statement saying that the hospital, in partnership with Texas-based Intuitive Health, “will bring the region’s first and only hybrid FSED and urgent care facility to Warren County.

“This innovative model will increase access to care while improving the patient experience by delivering the right level of care at a reduced cost.”

That is a similar argument to the language in Med Center Health’s application for a CON to build the hybrid facility.

The hospital proposed, through a partnership with Intuitive Health, to build the 12,500-square-foot, $14.5 million hybrid facility on a portion of a 10-acre parcel it owns in The Hub.

In applying to the CHFS to build the emergency department/urgent care facility, Med Center Health argued that it would be a unique concept with the potential to make health care more efficient, and in some cases, less costly for patients.

According to the CON application, the planned facility would eliminate the need for patients to choose between going to the emergency room or to an urgent care clinic.

“There should be a number of benefits (with the hybrid facility),” Wade Stone, Med Center Health’s executive vice president, said in December. “The key one is efficiency.

“Patients won’t have to guess if they need to go to the emergency room or urgent care. Both services will be under one roof.”

If built, the hybrid facility will continue the transformation of the Lovers Lane corridor into a health care hub.

In addition to the freestanding emergency department it is building, Greenview has plans to build a 72-bed, 238,405-square-foot TriStar Greenview Regional East Hospital on a 30-acre site near the existing Greenview Surgery Center at 484 Golden Autumn Way.

In April of 2023, Greenview was awarded a certificate of need for the 72-bed Greenview East hospital. That CON application called for Greenview, an affiliate of Nashville’s HCA Healthcare, to invest $350 million to build a facility that would itself have a 12,500-square-foot emergency department with 12 spaces for patients.

Its 72 beds would be transferred from the 211-bed Greenview hospital on Ashley Circle, meaning there would be no initial increase in the total number of beds operated by Greenview.

Despite the CON approval, ground hasn’t been broken for Greenview East and Greenview CEO Mike Sherrod has said he isn’t sure when that project will start. As with the freestanding ER, Med Center Health has opposed Greenview East and delayed its construction.

“From what I understand, we’re still tied up in court,” Sherrod said.

Another Greenview expansion project, establishment of an ambulance service on its Ashley Circle campus, is also on hold.

As for Med Center Health, the statement released by management said “construction is expected to begin soon” on the Lovers Lane hybrid facility.

Franklin County Circuit Court documents indicate that Judge Wingate’s ruling is “appealable,” but Greenview administrators haven’t yet responded to questions from the Daily News about plans to appeal.