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

A 300-bed community hospital boasting its best-ever clinical scores and a strong track record community health investment sought a certificate of need (CON) for a second hospital in a neighboring community. Larger, well-known systems from the nearby metropolitan area were vying for the same CON. Suddenly, dissatisfied patients began to make noise, and local physicians and politicians offered no support.

The hospital needed to rally internal and external advocates to share its story of community commitment with local influencers and ultimately gain the CON.


The hospital had two issues: Despite massive improvements in clinical scores, past quality problems shadowed its reputation. On top of that, misconceptions persisted, and it had never told its story in a deliberate way.

We built a grassroots team of employees, physicians and community members to spearhead a pride effort. The campaign to change the perception of the hospital was anchored by a compelling, central narrative from patient and employee stories, fortified by concrete data. Once influencers were identified and developed, we ran a significant campaign internally and in the community to garner advocates for the CON.

Lawn signs popped up. Community leaders were cultivated. Leadership spoke to civic groups. The team held letter drives inside and outside the hospital, setting up tables at big box retailers and eateries.


The campaign took on a fevered pitch, ultimately resulting in more than 5,000 letters of support filed with state regulators within several months. This included endorsements from a majority of local physicians. Although competitors launched a countereffort to thwart the mounting support, the hospital eventually won the CON. With new allies and new understanding of the hospital’s mission and goals, the organization has expanded and enjoys widespread community support.

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Advocacy Team

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Political Campaign


A community hospital competing against two well-funded, respected systems for a CON was challenged by a troubled reputation. We developed a grassroots campaign, harnessing the power of storytelling, to change mindsets and win the CON.


members of grassroots group


letters of support to CON board


CON won; hospital built

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