Cookeville Regional Medical Center budgets $487M in expenses, plans expansions and new electronic health record

Cookeville — Cookeville Regional Medical Center presented its fiscal year 2026 budget and capital plan to the city council during a public hearing on June 5, 2025, describing anticipated revenue increases, major capital purchases and planned facility expansions.

Why it matters: CRMC’s budget and capital projects affect regional health care capacity, staffing and local hospital finances. The hospital’s plans were presented to the council because the city reviews and adopts the facility’s annual budget on first reading.

Most important details - Hospital presentation: Summer Day introduced the CRMC budget. The facility expects $4,000,000 in net income for FY2026 versus a projected $1,000,000 for FY2025; budgeted operating margin is 3.9% versus a projected 4.1% for FY2025. - Revenue and uncompensated care: CRMC budgets a large uncompensated care line ($31,000,000) and forecasts revenue growth driven by higher volumes, new physicians, shorter length of stay and improved collections. - Expense and capital totals: The facility budgeted approximately $487,000,000 in operational expenses for FY2026 versus $459,000,000 projected for FY2025. The capital plan includes $48,000,000 in departmental capital and $37,000,000 in expansion and renovation projects; combined departmental plus expansion capital was described in the presentation. - Notable capital items: planned purchases include Epic (a new electronic health record system), a Varian TrueBeam linear accelerator for radiation oncology, a 4 West renovation adding 20 beds, endoscopy expansion adding four suites, and a rehabilitation expansion in partnership with Encompass that would add 40 inpatient rehab beds.

Questions from the public and CEO responses Resident Trenton Stroh asked how the budget would address ER wait times, staffing shortages and access to outpatient behavioral health care; he also asked about exposure to potential federal Medicaid cuts and the continuation of the 340B/340B‑type prescription assistance program.

Buffy Key, identified in the meeting as CRMC’s CEO, said the hospital has a five‑to‑seven‑year growth and expansion plan, is implementing a new electronic medical record (Epic), and is planning a new emergency department on the south side and a south‑tower expansion. Key said the hospital is concerned about proposed Medicaid cuts at the federal level and noted CRMC’s ongoing participation in the 340B program, which the hospital said lowers prescription costs for local patients.

Key also described efforts to relieve ER volume pressure, including an urgent care open seven days a week until 11 p.m., recruitment efforts and capital investments. On Epic, Key said the system was selected after review and that integration with other health systems would improve safety and continuity of care.

Council action The council opened and closed the public hearing and voted 5‑0 to move the hospital budget forward on first reading; council members expressed support and appreciation for CRMC leadership and the information provided.

Ending CRMC’s FY2026 budget and capital plan will continue through the city’s ordinance process. Hospital officials said they expect to continue planning and recruiting to implement the expansion and EHR projects described in the presentation.