METROPOLITAN GOVERNMENT/OF NASHVILLE AND DAVIDSON COUNTY ‘4 ~ OFFICE OF THE MAYOR MEGAN BARRY a 4 METROPOLITAN COURTHOUSE MAVOR, vi (NASHVILLE, TENNESSEE 720 PHONE: 2-00 EMAIL: myeriinaeie oe November 9, 2017 ‘The Honorable David Briley, Viee Mayor ‘Members of the Metropolitan Council The Metropolitan Government cf Nashville ‘and Davidson County ‘Nashville, Tennessee 37201 Dear Vice Mayor Briley and Members ofthe Council, | want to let you know about animportant change inthe relationship between Nashville General Hospital and Mehuery Medical College and plans for reconfiguring the hospital's operating model to make it more financially stable. Mebury, a historically black medical college, has trained doctors to provide care throughout our nation, inchuding in many underserved areas, for more than 140 years, Nashville General has served as the index teaching hospital for Ncharry since 1992, giving medical students invaluable experience ‘working with patients from across our community. However, Nashville Generals curent daily census {is about one-third ofits licensed capacity, Only about 40 ofits 120 beds are being used on an average: day, and 20 percent of those are pat ofan inmate care contract. Meharry currently has to pay to send students to other sates in order to get the experience necessary to enter the medical profession ‘Asa result, Meharry, which owas the building in which Nashville General operates, needs access to & local hospital serving a greater rumber of patients in order to make its educational program the bes it can be. Today Mehaery announced tha it will partner with Nashville-based HCA’s TriStar Southern Hills Medical Center, giving the nation’s premier hospital company access to some of the best and ‘brightest young minds the medieal community has to otter. This is also an opportune time to revisit Nashville General's operating model, which has proven fiscally unsustainable, and restructure it in a way that will promote better health care outcomes for residents in North Nashville and across our city. Sine 2005, Metro has provided more than hall a billion dollars to support the operations of Nashville General, while the numberof patients being served has decreased, I believe we can invest our resources more strategically to provide for the health ‘are needs of our city's indigent population, while maintaining operations at Nashville General Hospital.‘Vive Mayor David Briley and Members of Councit November 9, 2017 Page Two With the help of restructuring specialist Kevin Crumbo, who has donated hundreds of hours of his ‘ime, the Metro Hospital Authority and my administration have been exploring ways to improve Nashville Generals long-term oatlook. 1s time for a new model, one that will be Focused on preventing people from needing in-patient services while ensuring that the patients curently using Nashville General for their outpatient health care needs, which amounts to more than 90% of the total patient visits, wil stil receive the same or better ~ care at this facility Later this year, my administration will submit tothe Council a substantial request for supplemental funds to stabilize Nashville Generals fiscal situation so the hospital ean continue to provide services and meet its financial obligations forte rest of this budget yeat. Meanvsile, we will work with stakeholders throughout the upcoming budget cycle toward a goal of refocusing Nashville General Hospitals operations to an ambulatory care model that provides high-quality clinie and other ‘outpatient care services. We also will eeate an indigent care fund to ensure that ll patients who are curently using Nash General will still have their healthcare needs met either at Nashville General or at other area hospitals, ‘This wil result in better health care outcomes for the patient population being served. Asa city, we are financially committed to promoting better health results and healthcare operations. ‘We can restructure that commitment in a way that results inthe best health eare outeomies for residents ‘while providing a more stable finding model tht won't require Metro to sacific services in other areas of government, or possibly ‘order to provide that quality care As I’ve said many times, Tam ccmmitted to safety-net care in our community. This will ake all of us, ‘working in good faith and with good intentions, to create a successful new model for Nashville General Hospital. My administrtion and Meharry Medical College are absolutely committed to ‘working with community stakeholders to do just that. I know we're up tothe task, and I appreciate {Yur partnership as we take on this important work. ec: Dr. Jan Brandes & Members of the Hospital Authority