Hospital Authority Board expects finalized PSA with Meharry; hears finance, contracts and foundation updates

The Hospital Authority Board on July 1 heard that a public service agreement (PSA) between the authority and Meharry Medical College is in final legal review and is expected to come back to the board for approval at its August meeting.

The board meeting at Nashville General Hospital also included a financial review showing improved month-end results tied to timing of subsidies and a Meharry lease, approval of two vendor contracts, updates on quality and regulatory surveys, a foundation fundraising report, and progress on a CEO search and KPMG operational review.

Board Chair Christie (listed in the meeting as Christie) and staff described the PSA update as a legal finalization step. "The short story is that the lawyers are looking at it more carefully," said the staff presenter updating the board on the PSA. "We are very confident that at our meeting in August we will have a final agreement that the lawyers have all signed off on and that will be acceptable to both Meharry and to the hospital." The presenter said revisions under review were mostly language and clarity items and not expected to change the agreement's thrust.

Why it matters: the PSA frames the working relationship between the hospital authority and Meharry Medical College. Board members asked to receive the final draft at least 10 days before the August meeting and requested an executive summary of the agreement's principal elements when the draft is circulated.

Finance and budget

The finance overview showed a sharper year-end than prior months, driven largely by receipt-timing of Metro subsidies and recognition of a Meharry lease. The finance presenter, identified in the meeting as Ray (finance presenter), said the timing of subsidy receipts and lease accounting improved the operating margin in the most recent month. "We received 6,400,000 of subsidy in the current month," the presenter said, adding that timing and operational cost reductions were factors in the improved result.

Board members pressed for clarity on an $8 million lease tied to Meharry and why it had not been included in the prior budget. The finance presenter said the lease was recognized at month end and that the team is implementing accruals so similar items will be spread across 12 months going forward. The board was also told that accounts payable totaled about $17,000,002 (as reported for the period) and remains a major operational challenge.

KPMG is working on operational and finance infrastructure projects. Interim Chief Executive Officer Dr. Elders said the KPMG operational optimization work stream 1 and workplace efficiency work stream 2 are on schedule for August deliverables. "They are working on tools and deliverables," Dr. Elders said, and the hospital will present further actions to the board after KPMG completes its work.

Quality, medical staff and safety

Dr. Bullock, reporting for the medical staff bylaws committee, said the committee submitted a final bylaws draft to legal two days before the meeting; the plan is to seek Medical Executive Committee (MEC) approval and then a medical staff vote at the annual dinner in September.

Quality leaders reported three safety wins: three consecutive months without a fall with injury, improved C-section utilization metrics, and clearance of deficiencies following an emergency department survey and an unannounced security-related survey July 22. The quality report also listed ongoing opportunities including hand-hygiene adherence, falls prevention work, and renewed emphasis on workplace violence prevention. "We are escalating findings to our leaders and care teams," said the quality presenter, who described an active multidisciplinary workplace violence committee and other interventions.

Foundation and community outreach

Kate, speaking for the Nashville General Hospital Foundation, said the foundation raised about $300,015 last year and reported that the food pharmacy program has provided more than 1 million meals since inception and about 167,000 meals this year. She also said the foundation logged roughly 2,500 patient rides with its golf cart service and cited new grant applications and donor partnerships under development.

Marketing and PR

Kathy Poole, director of marketing, said outreach and engagement activity covers the city broadly and noted new public relations help engaged on an interim basis with FIN Partners and exploratory discussions with another firm, Gerard. She cited a recent media mention tied to U.S. News coverage and highlighted upcoming events including a School of Health Sciences graduation in September.

Contracts and procurement

The board approved two contracts after committee review:

- A two-year maintenance agreement with Fujifilm for imaging equipment at the Bordeaux facility, costing about $36,000 annually; and

- A one-year contract with auto-renewal for GEBBS Healthcare Solutions, which finance said will reduce expenses by approximately $44,000 per month (roughly $500,000 annually) through a mix of onshoring and other comparative changes.

CEO search and governance

The CEO search committee reported that Metro procurement received 10 proposals from executive search firms by a July 24 deadline and that an evaluation committee drawn from hospital leadership will review and score proposals; the board representative on that evaluation is board member Dr. Esquivel. The board also approved updates to CEO performance review criteria and committee consolidation to align with a coming permanent CEO hire.

Votes at a glance

- Approval of minutes from June 26 — approved (motion passed; roll-call tally not specified). - Committee assignments for fiscal year 2026 — approved (motion passed; roll-call tally not specified). - Approval of quality report — approved (motion passed; roll-call tally not specified). - Fujifilm maintenance contract (Bordeaux imaging) — approved (motion passed; roll-call tally not specified). - GEBBS Healthcare Solutions contract — approved (motion passed; roll-call tally not specified). - CEO performance review committee recommendations — approved (motion passed; roll-call tally not specified).

Discussion, next steps and closing

Board members reiterated a request that the PSA draft and an executive summary be circulated in advance of the August meeting to allow time for review and, if necessary, committee deliberation. Interim CEO Dr. Elders and board leadership said they are working with Metro Finance and Metro Procurement on urgent capital needs estimated in the report and on steps to repair finance processes. The board set its next meeting for August 28, 2025.

The meeting included routine governance items — an annual conflict-of-interest submission was requested for 2025–26, and committee rosters were approved — and closed after expressions of appreciation for staff and volunteers and acknowledgment of recent operational improvements.