Cookeville Regional Medical Center, a not-for-profit hospital in Tennessee, has sued more than 2,000 patients for unpaid medical debt since 2021, with lawsuits rising each year (232 in 2023, 523 in 2024, and 545 in 2025). It is the second hospital in Middle Tennessee identified by WSMV4 Investigates for pursuing legal action against patients on this scale.

Patients who receive emergency care at the facility risk lawsuits and wage garnishment if they cannot pay their bills. One patient, Shannon Langley, who has a seizure disorder and has been treated multiple times at the hospital, was sued twice and is now having her wages garnished to cover more than $9,000 in debt. Shocked by a process server appearing at her home, she now fears returning to the nearest hospital for future seizures and worries her family would need to transport her to Nashville, about 90 minutes away.

The hospital states it only pursues legal action as a last resort after more than 180 days of repeated outreach attempts on a case-by-case basis. It emphasizes its commitment to community care, noting that it provides more than $30 million in charity care annually, including discounts for eligible patients, and works with individuals on payment plans and financial assistance. Patients facing medical debt are encouraged to inquire about charity care programs that may help reduce or eliminate their bills.