Nashville General Hospital has requested nearly $20 million to get through the rest of the fiscal year that ends in June.
Without a cash infusion — which has become a regular mid-year request — the hospital says it will run out of operating funds Jan. 30. But the administration of Mayor Megan Barry is intensely scrutinizing the request, especially amid a looming proposal to dramatically restructure the public hospital.
The $19.7 million doubles the mid-year request from 2016. In a letter to the Hospital Authority, Metro finance director Talia Lomax-O'dneal points out that this infusion, combined with its annual $35 million subsidy, would add up to the most money spent on the hospital since 2010 when the city wrote off $31 million in hospital debt.
She notes that the Hospital Authority no longer operates a nursing home or assisted living facility, and it's taking care of almost half the number of patients compared to 2010, with a daily average of 34 patients staying overnight.
"My primary obligation is to the taxpayers and to make sure the finite resources of this government are managed responsibly," Lomax-O'dneal writes.
The Metro Department of Finance is questioning bonuses that are part of the supplemental request, as well as staffing costs that are going up despite fewer patients being cared for.
For their part, the hospital's management has aired concerns about retaining nurses and doctors with such an uncertain future, following Barry's proposal to convert the hospital into an outpatient-only facility. As recently as 60 days ago, the hospital projected a need for $13 million, but the management says the prospect of closure will increase staff attrition and may even drive paying patients elsewhere.
Finance officials also want more information about $300,000 budgeted for legal expenses related to any restructuring. City leaders want to know whether that means the hospital plans to go along with changes to the operating model.
Barry has said she will provide the hospital with enough funding to get through the year, though she did not say how much. The total $55-million subsidy — $35 million at the beginning of the fiscal year, plus $20 million now — would be in line with what General Hospital CEO Joseph Webb requested from Barry in May after he was encouraged to be honest about how much he really needed to run the chronically cash-strapped facility.