Metro hospital authority to explore options to fix financial instability

Tuesday, September 18, 2012 at 5:31pm

Recognizing its “unsustainable” business model, the Metro Nashville Hospital Authority board announced Tuesday it had launched a strategic planning process for the city’s health care facilities that serve the indigent.

The hospital authority — which oversees Nashville General Hospital, Bordeaux Long-term Care and Knowles Home Assisted Living & Adult Day Services — received a final strategic assessment at its Tuesday board meeting that outlines potential options to create a more sustainable operation.

“Our initial challenge was to identify near-term opportunities for financial improvement of the facilities and assess the long-term implications of the rapidly changing health care environment,” the authority’s board chair Waverly Crenshaw said in a statement.

“As the process has evolved, however, it is clear to the board that the current operational model is financially unsustainable and the ultimate goal must be to redesign the business model of the MNHA facilities to better meet the community’s changing health care needs.”

According to a hospital authority news release, the options range from “maintaining the status quo to re-purposing the hospital as an ambulatory care facility with reduced inpatient services to a full scale re-design of the business model focused entirely on outpatient and clinical services.”

The consulting firm Alvarez & Marsal produced the assessment, which the board plans on further reviewing before deciding on a course of action. The hospital authority says it also intends on working with other Metro agencies, patients, staff and other community stakeholders before taking action. Community “listening sessions” are also in store.

The hospital authority announced two options aren’t on the table: doing nothing or closing Metro General Hospital.

“With the elimination of those two extremes, however, all options to preserve and enhance access to primary health care services and create a sustainable operational model will be considered,” the press release reads.

According to hospital authority figures, Nashville General Hospital’s emergency room and clinic provided approximately 76,000 patient encounters but the hospital encountered only 4,000 hospital admissions. Although the facility has 150 beds, the hospital admits only 11 patients per day and cared for only 47 acute patients per day last year.

The hospital required more than $46 million in subsidies and extraordinary payments last year. Another $10.5 million were required collectively for the Bordeaux and Knowles center.

The hospital authority anticipates the new federal health care law will drive greater health care competition as more people are insured service — and perhaps destabilize an already depleting enterprise.

Despite 2,300 licensed beds within a 2.5-mile radius, Nashville General Hospital captured only 6 percent of that audience, the hospital authority says.

“With the expectation that more patients will become insured in the changing health care environment, it is anticipated that individual choice will increase and drive even greater competition in the marketplace,” the authority says.

4 Comments on this post:

By: govskeptic on 9/19/12 at 5:42

Most would state a 56.5 million dollar subsidy to this authority on a
yearly basis certainly is not sustainable and hasn't been for some
years now. As long as there's individual choice available, the hospital
has an image problem, rightly or wrongly, that must be improved
upon. An extensive exam into that problem and possible solutions
from a "truthful" firm should be the first order of business.

By: TGL on 9/20/12 at 10:36

I daresay many people have never crossed the thresholds of General Hospital, Bordeaux or Knowles Home--not even some of the Metro Council Members who represent these facilities. You are the fortunate people who have "individual choice". Image problems, you bet! How does one overcome years of press sensationalism, years of being used as a political object to dangle to sway voters, years of just being barely funded to cover the basic needs of a hospital, a nursing home and an assisted living home, years of having different city leaders impose consultants upon consultant as the last one did not give the answer they wanted to hear. No other hospital faces these obstacles, no other hospital has patients quit coming to their clinic visits or their surgery appointments as they heard the hospital is or may be closing through the news, no other hospital has to explain to a city council of why they advertise or purchased a billboard, no other hospital in this city has to continually fight to care for people who deserve to be cared for just like those of you who have "individual choice", no other hospital has physicians and nurses who have to be social workers in order to help their patients be able to get their medicines, their home health and even something like a toilet chair. General and their partner, Meharry Medical College, continue to provide quality care to all who come through the door even with all these hurdles. Bordeaux continues to care for our most vulnerable elders and those with serious injuries and or fighting to overcome serious injuries, providing them with a safe home, yet with closure this often leads to confusion and further illness, just think of leaving the comfort of your home of years and the safety of knowing where you are living. Knowles offers a place to transition our elders from an active home life, yet with closure the uncertainity of being alone and unable to function unassisted leaves these elders frightened. 56.5 million dollars compared to the millions spent on sports, convention centers, parks, salaries and healthcare benefits for elected leaders, and other numerous budgetary fluff is a bargain for the quality of care provided at these facilities. The board is correct in trying to find the right solution, but the solution is not to further delete services at these facilities. Be a part of the solution to destroy the negative images, these facilities belong to the people of Nashville, Davidson County, take a tour, talk to their leaders and pray for their sustainability. And yes, the lights are still on and doors are still open, there are committed physicians, nurses and staff waiting and ready to care for anyone, regardless of your status in life and regardless of your ability to pay, they are there not because of being an IMAGE, but because they are proud of the quality of life and care they give the citizens of Nashville, and yes, even to those of you who have "individual choice", you never know when your CHOICE is no longer available.

By: Blanketnazi2 on 9/21/12 at 8:09

TGL, great post! General scores higher than a lot of other hospitals in the Nashville area when it comes to safety and quality of care. I used to volunteer at JB Knowles in Bordeaux and the staff always took good care of the residents and showed true concern for them. Too bad there is an "image" problem.

By: thetruthbetold on 11/30/12 at 7:31

It.s more than just "image". You have a mafia type atmosphere there and they do harm to patients and employees! It's a dangerous place to be. They need to close or fire the entire administration and then some and bring in new, honest, law abiding citizens!