The series was initially going to be titled Time Heals before being renamed Hawthorne by June 6, 2009.

Jada Pinkett Smith had previously promised never to work in television again, but changed her mind after reading the pilot script, which her manager insisted she read because he believed it was fantastic.

Pinkett Smith had her husband Will Smith read the pilot script as well, and he encouraged her to take the meeting after seeing it.

In the original pilot, the role of Dr. Tom Wakefield was played by Jeffrey Nordling, but in February 2009 Michael Vartan was cast to co-star as the character instead.

Series creator John Masius served as executive producer for the first season and then stepped back from that role in the second season, naming Glen Mazzara as showrunner so he could focus more on writing.

The show received largely negative reviews from critics, with outlets like The Washington Post, USA Today, and the Boston Herald criticizing it as clichéd and unfocused, and comparing it unfavorably to Showtime's Nurse Jackie.

Despite mixed critical reception, Jada Pinkett Smith won the NAACP Image Award for Outstanding Actress in a Drama Series in 2010 for her role in the series.

The series was cancelled by TNT after its third season, leaving the season 3 finale's cliffhanger as an unresolved series finale.