Davidson County's Sheriff says closing Nashville General Hospital's inpatient services could quadruple the amount his agency has to spend on securing inmates while they receive medical care.
Right now, prisoners recover from surgery and other inpatient procedures in a special secured wing at Nashville General. Speaking during a Metro Council hearing on a proposed restructuring of the city's public hospital, Sheriff Daron Hall said it's safe for one officer to guard multiple inmates.
But at a private hospital, prisoners would have to be spread out in regular unsecured rooms requiring two guards per person. That would add about $3 million to their annual price tag, Hall said.
"If you have five inmates there today, you’re paying one officer 24 hours a day to do that," he said. "If you shut that down and take those five inmates, you’d require 10 officers to supervise them in individual rooms in some other hospital."
That is, unless another hospital is willing to work out the same type of deal and let them have their own area.
But even if they did, Hall said that would mean more spending, as the area would need to be modified and secured.
Another possible cost, he said: more vehicles, since inmates would likely be sent wherever beds are open at the time. That could also result in having to dispatch officers to more than one hospital on a daily basis.
Nashville's mayor proposed the dramatic changes to the hospital in part because of the cost of operations. Last year, for example, they needed $10 million mid-year to stay afloat, and the hospital board says they will need another infusion of cash this year.
Cost Of Fragmented Care
Joseph Webb, the CEO of Nashville General Hospital, also argued for the hospital's survival during Monday's meeting, laying out why he thinks it's unwise to get rid of the emergency room and turn the facility into a clinic.
He told the committee that eliminating inpatient services, as the mayor has recommended, would make it harder to manage care for uninsured patients because they would bounce from one medical center to another.
"If you eliminate the ability to stabilize them and to capture them at the ER level, then you've destroyed the whole system, and it doesn't work," he said.
He pointed out that Nashville General has been able to reduce the number of re-admissions — how many people return to the hospital — in part by offering more preventative care and educating patients about their diseases. He also said they would lose state and federal funding if they were reduced to clinic status.