Megan Barry's resignation as Nashville's mayor basically ends months of debate about whether to close General Hospital. David Briley pushed back against the mayor's plans, even before he took over her job.
"I'm committed to the city having a public hospital — period," Briley said in his first press conference. "So I'm committed to General Hospital. At the same time, we have to make sure every penny there is spent in the most efficient way."
The Metro Council named a working group to discuss new operating models that might wean the hospital off of $50 million a year it's been getting from the city. The panel has not yet met, even though Barry had given them until the end of the year to hatch a plan in lieu of closure.
Now there's no rush, says budget chair Tanaka Vercher.
"I think the discussion is going to be tremendously different," she says, noting that the hospital management should be seen as the experts. They weren't consulted before the closure announcement in November.
Vercher adds that she wants the Hospital Authority to decide quickly whether to stick with CEO Joseph Webb, who has been widely supported by the panel. There were some unanswered questions about his performance review, but the Hospital Authority opted for a short-term extension in January primarily because of the impending closure.
The city may end up spending more money in the coming year, rather than less, Vercher says. The uncertainty of recent months has made it more expensive to run the hospital, forcing the facility to offer bonuses for nurses to stay and pay vendors worried about the hospital going out of business.
"We have to get them to a place where they can recover from that announcement that created additional uncertainty and instability within the hospital ... before we can even begin to talk about what sustainability looks like," she says.
It's become increasingly clear that the hospital has the support of the city. A Vanderbilt poll from February found nearly two-thirds of Nashville voters wanted more investment in the facility and more than 90 percent thought funding should at least stay the same. Even Conservatives on the Metro Council opposed closure. The new vice mayor, Sheri Weiner, says she'd like to slow the "constant churn" of outside ideas and collaborate with management to improve the business operation.
The Hospital Authority is conducting its own strategic review, and Councilwoman Erica Gilmore says that will be an important starting point.
"For so long, they haven't really had the opportunity or a platform where we really listened to them because we've just kind of been taking the role as a city and just saying, 'cut, cut, cut.' So I just think the report that they have to offer will really be insightful."
Meharry Medical College has its own panel tasked with reimagining indigent care in Nashville. And that work continues. But Patrick Johnson, who oversees institutional advancement at Meharry, says stability benefits the process.
"Nashville General is still our index hospital. So the more secure they are, the more secure Meharry is," he said. "We welcome that."
The talks of closure came just as Meharry decided to move its medical students to an HCA hospital across town, citing a slowdown in patient volume at General Hospital. However, Meharry owns the building and leases it to the city. It's also the primary location for Meharry's resident physicians.