Nashville General Hospital is trying to keep a negative audit from being used to justify shutting down the facility. The Metro Hospital Authority has been fighting a proposal from Mayor Megan Barry to downsize the city's struggling safety-net hospital, and some board members are worried about how an audit might look to the casual observer.
This outside audit, conducted by Crosslin, shows Nashville General in a much better position than the prior year with less debt and more revenue from paying patients. There are still nearly two-dozen deficiencies cited, though that's down from 30. And the auditors still raise the same serious concerns about whether the hospital can remain a "going concern" and even afford to stay in business.
Hospital authority board member Fredia Outlaw pressed auditors late Friday to revise their language before sharing the financials with the Metro Council this week.
"We want to make sure that we first put it in context of what we are and who we are and who we serve," she said. "I think a lot of people don't understand that."
Nashville General is the city's hospital of last resort for those who can't pay, which means it typically handles medically complex patients. But the mission also has made it difficult to attract insured patients, though there has been a slight uptick according to the new draft audit.
"This is where we were, and we may have been performing not to standard, but we are correcting all of that," Outlaw said. "We're putting some things in place and we're trending upward."
Board member Richard Manson described a potential reaction for city leaders reading their audit without the proper context.
"I look at this and say, 'Oh my God. What are they doing over there?" he said.
Manson expressed frustration that the city didn't fully fund General Hospital's budget request for the year. That made the facility's outlook even more uncertain, even though the Metro Council is likely to approve an additional subsidy again this year.
In order to not run out of operating cash Jan. 30, General Hospital has requested nearly $20 million on top of the $35 million it already received — totaling roughly what the hospital requested during the budget process but was denied.