Success Story: The Power of Grassroots: Leveraging Support for a CON Battle of the Ages


A 300-bed community hospital boasted a stellar new women’s center, the best clinical scores in the hospital’s history and a track record of investing millions of dollars in community health initiatives.

The board of directors identified a critical need: they wanted to build a new hospital in a neighboring community but the movement faced stiff headwinds. Building this new facility was critical to the success of the organization because of changes in market share and growth. The hospital needed to win a CON, but large, well-known systems in the neighboring big city were opposing it on legal grounds.

Dissatisfied patients began to appear and make noise, while local officials and politicians stood at arm’s length, offering no support.

The hospital needed to rally its employees and find external champions willing to speak on its be-half. They needed their story of community commitment to be firmly planted in the minds of local officials, community leaders and other stakeholders.


In understanding how to move forward, the hospital had to recognize that past quality problems shadowed its reputation despite massive improvements in clinical scores. For years, it had neglected to tell its story in a deliberate way with key audiences and was being defined publicly through a narrow, and even misleading, lens.

To regain confidence and support, we helped the hospital:

  • Build a grassroots advocacy team comprised of employees, physicians and community members.
  • Create its own compelling and central narrative from patient stories, employee advocates, concrete clinical data and national recognition on quality patient care.
  • Identify and develop influential community leaders who would recognize and appreciate their mission and success, and serve as allies in sharing their story.
  • Increase visibility and communication from hospital leaders about their goals and how the new hospital would help the community.
  • Quickly develop a PR campaign to reach every corner of the community during the CON process, raising awareness and interest and giving supporters a chance to lend support.

Lawn signs popped up around town. Sympathetic community leaders were cultivated, became active allies and deliberately worked the new narrative into their day-to-day conversations with influential peers, enlisting more advocates and supporters. Leadership spoke to civic groups with even five minutes to spare on their next agenda. A grassroots team held letter drives inside and outside the hospital, even setting up tables at big box retailers and eateries.


In less than two months, more than 1,000 letters of support were filed with state regulators. The next several months would bring that total to more than 5,000.

The campaign reached such a fever pitch that competitors had no choice but to awaken their well-resourced PR teams with efforts to thwart mounting support.

While the hospital didn’t win its certificate of need immediately, they did eventually through the appeals process. The momentum built through the campaign took root and grew into new and sustaining community support.

With new allies, and new understanding of the hospital’s mission and goals among key leaders, the organization has expanded and developed services that helped secure its future in delivering quality healthcare for their community.


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