Mayor Barry slammed over handling of Nashville General Hospital plans

Less than 48 hours after the Metro Council last week signed off on Nashville Mayor Megan Barry’s $275 million Major League Soccer stadium, many African-American council members say they were blindsided by the next big proposal.

With no warning, Barry announced plans to end inpatient care at Nashville General Hospital, a longtime symbol in the city’s black community, which has fought for years to keep the safety-net hospital in operation. The mayor cited the facility’s long-standing fiscal instability.

Members of the council’s Minority Caucus are now questioning the openness of an administration that has promised better transparency.  

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► More:Nashville General to end inpatient care, Mayor Megan Barry announces

They’re also criticizing the timing of last Thursday’s announcement, which came two days after African-American council members gave overwhelming support for the mayor’s MLS stadium project. The stadium was approved on a 31-6 vote.

Tanaka Vercher, chair of the council’s Budget and Finance Committee and a minority caucus member, said her Veteran’s Day weekend was spent responding to emails and phone calls from people she said are scared and confused about the impact of the hospital plans.  

“Fundamentally, we’ve had a breakdown in the process,” Vercher said. “I still have just a lot of questions. This is something that you can’t just do a haphazard announcement without due diligence and informing those critical stakeholders — the board, the council, myself, SEIU.

“Just the whole process of it, the optics of it, doesn’t look well in the community, specifically the black community,” she said. “People are afraid, and they don’t know what the announcement means.”

Transparency under fire with hospital plans

Barry’s push to end inpatient care at Nashville General Hospital — a facility that she says has relied on more than $500 million in Metro dollars since 2005 to stay afloat — comes after its future has been debated for the past decade.

The hospital exceeded its annual $35 million subsidy from Metro each of the past two years, requiring $26 million in emergency funding from the council.

► More:Nashville General Hospital seeks $20M boost to annual city subsidy

Despite that history, many of the hospital’s biggest advocates on the council say they didn’t foresee a complete departure of inpatient services happening right now.

“I did not know it was coming,” said At-large Councilwoman Sharon Hurt, adding that many people in the community are confused by the implications. “It’s being presented in a way that is not transparent.”

Hurt, who said she doesn't see the hospital as a "black-and-white issue," suggested the mayor’s office waited to roll out the Nashville General Hospital news until the MLS stadium financing was secure earlier in the week.

“I think that it was not by happenstance that the (stadium) vote on Tuesday night occurred and this issue came two days afterwards,” Hurt said. “I wouldn't necessarily describe it as being upset, but I do believe that it was premeditated.

“(The soccer stadium) was the priority and they didn’t want to have anything interfere. And had this announcement been made prior to, I think that the results of that vote on Tuesday would have been different.”

Barry proposed the hospital overhaul immediately after Meharry Medical College announced a new partnership with HCA to send some of its medical students to train at TriStar Southern Hills Medical Center instead of Nashville General.

The mayor followed with a letter to the council that referenced the work of health care restructuring specialist Kevin Crumbo, who recommended a new model for the hospital. In the letter, Barry said she remains "committed to safety-net care in our community."

Mayor's office commits to working with council for final hospital plans

Barry spokesman Sean Braisted said the timing of the announcement was the result of the Meharry-HCA news.

“This news, while great for Meharry and HCA, raised obvious questions about the future of Nashville General Hospital, which Mayor Barry tried to address in her remarks and letter to the Metro Council,” Braisted said. “We certainly regret that council members did not feel they had adequate notice of the announcement, and we will be working closely with them over the coming weeks and months as a plan is fully developed that will result in better healthcare outcomes for the population served by Nashville General Hospital.”

► More:Barry's Nashville General proposal raises questions about where care is given and how it's funded

Under Barry’s hospital plan, her administration intends to submit a “substantial request” to the council for funds to stabilize the facility until the end of the fiscal year. Barry said she wants to then refocus efforts on transforming the facility into an ambulatory surgical care center, which would provide only outpatient services.

The city-run hospital, housed in a building owned by Meharry in historically black North Nashville, has long struggled to pay its bills.

Only about 40 of its 120 beds are being used on an average day and 20 percent of those are part of an inmate care contract, according to the mayor's office. Barry said outpatient visits account for more than 90 percent of all visits to the hospital.

The transition to an outpatient-only facility would require approval from the council, the Nashville Hospital Authority and Meharry.

Metro councilman Ed Kindall of North Nashville said he didn’t feel blindsided like some of his colleagues because he had caught wind of preliminary talks. He said he wants to learn more about the mayor's new model and potential consequences.

But like others, he said the proposal should have been delivered prior to consideration of the MLS stadium.

► More:Nashville Metro Council approves financing for $275M MLS stadium project

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“We should have had some of this discussion before we got into funding such a huge project as soccer. Because in my mind, obviously health for people who need it the most in this city to me is more important than having a soccer team," he said.

“It’s not that I’m against a soccer team, but if I had a priority, and it came down to money for one versus the other, my money would be on the health.”

Councilman: future MLS stadium votes could get caught in hospital controversy

In past moves to reduce Metro’s role in providing health care, former Mayor Karl Dean oversaw the privatization of two other facilities owned by the Nashville Hospital Authority — the former Bordeaux Long-Term Care facility and Knowles Home assisted living facility.

The privatization was led by then-Finance Director Rich Riebeling, who is today Barry’s chief operating officer.

Minority Caucus chairman Councilman Scott Davis said he and others were caught off guard by the hospital announcement. He's requested a meeting with Barry and her administration about the issue.

“Right now, it’s kind of shocking,” he said. “It’s something that at this time, I don’t think I can support. It's tough. This thing is bothering a lot of people.

"Our worlds are rocked," he added.

African-American support was a key reason Barry, a progressive Democrat, put together a winning coalition in the 2015 mayor’s race. But Nashville General Hospital is the latest issue that has shown some pushback from that constituency.

Multiple black council members last week criticized the percentage of minority-owned companies that have received contracts for government work, noting it has remained below benchmarks set by the city, according to a new Metro report.

The Nashville chapter of the NAACP has opposed the mayor’s plan to redevelop the site of Greer Stadium, pointing to the African-American history at Fort Negley, a Civil War historic landmark that sits next door.

Moving forward, Barry needs support from black voters for approval of a May 1 referendum on increases to four taxes, including the sales tax, to pay for a $5.2 billion transit plan that includes with light rail. There are also future council votes tied to the MLS stadium project.

Davis said he hopes the Nashville General Hospital announcement wasn’t deliberately made after the MLS stadium vote. But he said future legislation needed for the stadium project — including approval from 27 council members to raze old buildings at the fairgrounds — could now face a more difficult road to passage as a result of the hospital talks.

“This isn’t a threat or anything, but we still have a 27-vote coming up soon,” he said. He called the hospital announcement "bad timing" that was caused by the Meharry-HCA development, not a desire by the mayor to raise the hospital issue now. "It put us in this position: soccer stadium or hospital? And frankly, the hospital is more important.”

“If we’re going to work this hard to get a stadium built, we should be able to work just as hard to save a hospital."

Reach Joey Garrison at 615-259-8236, jgarrison@tennessena.com and on Twitter @joeygarrison.