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Dean calls for changes at General Hospital
With the Metro Hospital Authority expected to present grim news at its mid-year budget review on Thursday, Mayor Karl Dean has drawn a line in the sand, saying that changes are coming in the way Metro provides indigent care.
A letter from Dean was sent to the Hospital Authority board and CEO Dr. Reginald Coopwood on Jan. 9, stating that Metro has no additional revenues to offer the hospital authority. The mayor finished the letter by stating he has charged Metro Finance Director Richard Riebeling to “begin looking at options that would continue health care delivery for our indigent and underserved citizens, but at a lower cost to [Metro].”
Dean said all options should be on the table and that Riebeling will present his recommendations in time for the start of the next fiscal year.
Last year, the Hospital Authority, which includes Nashville General Hospital at Meharry, Bordeaux Long Term Care and Knowles Home Assisted Living facilities, was forced to ask for an additional $11.5 million line of credit from Metro. Dean gave support to the additional line of credit, but then proceeded to reduce the Hospital Authority’s budget by about $2 million.
According to Dean’s letter, the outlook is bleak for the Hospital Authority again this fiscal year. One source told The City Paper the authority’s deficit is anticipated to be millions of dollars at just the midway point of this fiscal year.
“As revenue growth continues to fall below projections, in all likelihood this means reducing expenses,” Dean’s letter stated. “The Authority must be willing to take these steps because the City cannot provide additional revenues (either through a supplemental appropriation or an increase in the line of credit) this fiscal year to bail out the anticipated deficit.”
A draft report of an internal audit on General Hospital’s progress in meeting recommendations made by an independent 2005 performance study, showed the hospital had followed through on most of the suggestions made in order to improve its financial standing.
Despite the progress, the first quarter operating deficit for General Hospital alone this year was $4.86 million.
In his letter to the Hospital Authority, Dean pointed out that bond-rating agencies have taken note of the drain that supporting the authority has been on Metro.
“The negative outlook reflects our concern that continued open-ended subsidization of Metro General Hospital by Metro’s general fund, absent new revenue sources or additional expenditure controls, will exacerbate the structural instability of Metro’s budget,” rating agency Standard and Poor wrote about Metro bonds issued last year.
Coopwood could not be reached for comment late Monday. The Hospital Authority mid-year budget review will take place at 4:30 p.m. Thursday in the Metro Council chambers.
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Metro out to buy every indigent person in the city health insurance and point them toward Vanderbilt, Baptist, Southern Hills etc...We would save MILLIONS! General Should be shut down.
Anna, as usual, you have no idea what you're talking about.Vanderbilt already provides some healthcare services for free to poor people, but they won't step up and provide all the services that are needed to help. If they could, they'd already be doing it. That's what General's role in the community is - to provide healthcare to people who cannot afford it. That's always going to put General in some kind of deficit and, frankly, we should be amazed that their deficits aren't higher.There's no money to be made from serving poor people and it's arrogant for Karl Dean to think that there's some kind of new way of doing it. If he has ideas, he should be putting them out on the table before he threatens General's money. My guess is that he doesn't have a plan and that he's trying to pressure Vandy and the other local hospitals to "do the right thing" and accept more indigent care patients. That's a losing bet and he's a fool to make it.
Morpheus, correct with one change. Vanderbilt does not provide helthcare services for free, those costs are transferred to the patients who do pay for services. That is one reason the services are very overpriced.
What happened to the idea that Metro employees should have to use General? Why doesn't Dean and all elected officials use General only?
In a declining economy, we'll see more use of General, not less. It is patently rediculous of Mayor Dean to beat on General Hospital to cut costs. Instead, he should be seeking more funds for General, not threatening to cut it's funding.I agree, Anna 3 doesn't know what she's talking about. Morpheus 120 appears to understand General's role and mission. He also appears to understand that Dean is being a butthead by sending this letter and threatening the indigent: Hard to get blood from a rock. And Dragon is right on as well, services are never free but are paid for by those who do not have health insurance, since insurance companies negotiate lesser fees for health services.Metro employees are encouraged to use General through a waiver of their deductibles, but they will never required to do so.
Metro emeployees used to have to use General, but they have a new plan that allows them to see Drs within the network, often these are their same Drs they see for every thing.
Dean:I know !Instead of Morhpine, we can have the patients bite down on a stick. That'll save money for us to spend on our own overpriced healthplan.Sue Cain:And they can't sue us for over or under dosing, 'cause it's just a stick !Pure genius Dean :)