Tennessee approves Regional One Health’s certificate of need for new hospital on Union Avenue campus

State authorization advances long-planned replacement facility in Downtown-Medical District corridor

Regional One Health has received state approval to move forward with plans for a new hospital in Memphis, clearing a central regulatory step for a project intended to replace and modernize the county-owned health system’s main facility. The Tennessee Health Facilities Commission granted a Certificate of Need (CON) for a new hospital on the former Commercial Appeal property on Union Avenue.

The planned hospital site is at 495 Union Ave., with adjacent land at 492 Union Ave. acquired for a combined $23.9 million in a transaction that closed in January 2025. The location sits between Downtown Memphis and the Medical District, an area that includes major healthcare and academic institutions.

What the approval means—and what it does not

A Certificate of Need is a state review and approval process required for certain healthcare projects, including new hospital construction. The approval authorizes Regional One’s hospital plan for the specific location and scope reviewed by the state, but it does not by itself complete design, financing, procurement, permitting, or construction steps that must still follow.

Regional One has indicated demolition of the former newspaper building is expected to begin in spring 2026, a milestone that would prepare the site for the next phases of development.

Funding and timeline: major work remains

Local funding actions have already been taken in parallel with the state review. Shelby County Commission approval includes $500 million described as part of the foundational phase of the hospital funding plan.

Regional One’s publicly stated schedule anticipates an 18- to 24-month design phase followed by about four years of construction. Under that framework, the health system is targeting completion in 2031.

Project delivery team and planned clinical focus

Regional One and county leaders previously announced a project team for the new facility, including program management by a joint venture between Covalus and Allworld Project Management. Design and construction roles were also identified, including HDR for architecture and interior design and a joint venture branded as Memphis Healthcare Builders for construction management, alongside specialized engineering firms.

The planned facility has been described as an academic medical center campus, with clinical components expected to include a bed tower and expanded services in key areas. Regional One has outlined the following as major elements of the future hospital program:

• Trauma and burn services
• Women and infants care
• Expanded emergency department capacity
• Post-acute services
• Oncology
• Modernized ancillary service suites

With state approval in place, the project now shifts from regulatory review toward detailed design, site preparation, and construction sequencing.

Regional One’s existing campus provides specialized services that are integral to emergency and complex care delivery in the region. The new-build initiative is structured to modernize facilities while maintaining those capabilities in Memphis as planning transitions into implementation.