The future of Nashville General Hospital will be up for discussion on Nov.27 at the monthly meeting of the Metro Nashville Hospital Authority. It’s the next step in a process that has involved much public input and scrutiny, a formal review and much concern and worry about the livelihood of the 122-year-old hospital.
The seven-member board will review the opinions shared in a trio of public meetings and the findings from a report that shows the hospital losing money every day it opens for business.
“We were very pleased that people chose to participate. It was helpful to hear the concerns. They will certainly be considered by the board and shared by the board. That is part of the info we will use to make a decision,” said Waverly Crenshaw, Jr, chairman of the Metro Nashville Hospital Authority.
The round of public meetings followed a very dismal, 26-page report from Alvarez & Marsal, a firm that specializes in corporate turnarounds.
The Hospital Authority Board, which oversees NGH along with Bordeaux Long-term Care and Knowles Home Assisted Living & Adult Day Services facilities, ordered the report after struggling to find ways to remedy problems at the long-time community hospital that treats nearly one-fourth of Davidson County’s patients who cannot pay for their doctor’s appointments.
Metro issues $43 million annually to the board to manage the care centers. Despite the allocation, NGH loses a reported $2,400 a day according to the report.
“During this economic climate, most cities are evaluating their budgets and looking for ways to control or eliminate costs – Nashville is no different. But this city has a history of supporting those in need since 1890 and we would expect that the city will continue this support,” said Dr. Wayne Riley, president of Meharry Medical College.
Financial strain isn’t the only issue plaguing the hospital. The vitality and viability of the hospital is in question. The report claims the hospital’s issues are “more structural than functional”. Despite having 150 beds, the study found that the hospital only admits 11 patients a day and treats just 47 acute patients daily. That’s possibly due to several neighboring hospitals that account for a total of 2,300 beds, presenting more choices.The study findings suggest that even if NGH filled nearly all of its beds, it would still come up with a financial loss.
“That’s a good thing. People should have choices. The thing is how can we make sure the resources at (NGH) are where they want them. The study is helpful for identifying what the community needs and what services they will use. That’s what we want to focus on. What do they want from General Hospital that will make us better servants to their medical needs and the money we spend,” said Crenshaw.
Based on its findings, Alvarez & Marsal made recommendations on how to fix the troubles it found. Those choices range from the hospital continuing to function as is, reducing its inpatient services and functioning as an ambulatory center only, or changing its function to outpatient and clinical. Taking on any of the recommendations would not only impact the patients coming to the hospital for services, but the nearly 800 Meharry students who train and learn at the hospital.
When the Hospital Authority considers the input that has been given, one of the options discussed will be the consideration of partnering with other hospitals. Regardless what the next chapter holds, Riley says change is inevitable.
“We believe that through collaboration and honest dialogue with all stakeholders, including the Mayor, the Hospital Authority, health systems experts, the community and Meharry Medical College, a viable solution can be developed that meets the comprehensive health care needs of the patients who rely on NGH and does not destabilize the teaching mission of Meharry Medical College,” said Riley.