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Nashville General reports May shortfall; board approves financials and TeamHealth contract amendment
Summary
Finance staff told the board May showed a $4 million unfavorable operating margin driven by a $1.9M revenue shortfall and expense pressures; the board approved May financial statements and a $205,379 TeamHealth hospital medicine amendment. Staff described an 11-month recovery and growth plan and said Metro approved $74.8 in operating funding for 2027 components.
Nashville General leadership on Tuesday told the Hospital Authority board that May 2026 was an unfavorable month financially and laid out steps to recover while the board approved the month’s financial statements and a physician-services contract amendment.
Dr. Insley, finance committee chair, and finance staff reported that gross revenue in May was $1.9 million below budget — largely driven by a roughly $2 million outpatient shortfall — and that net revenue missed budget by about $1.8 million. Expenses were roughly $2.1 million over budget for the month. Combined, staff described an unfavorable operating margin of about $4 million for May; year-to-date the board was told the operating margin was $4.8 million unfavorable to budget.
Finance staff identified several drivers: a lease methodology change that increased year-to-date expense recognition, an unbudgeted professional services amount tied to the Meharry partnership (reported at about $1.6 million year-to-date), an increase in employee benefits and higher contract and utilities costs. Dr. Blackledge (finance staff) said the organization has moved to a weekly reporting cadence and described a recovery plan and a seven-track growth plan to address volume and expense trends; staff said preliminary June results were stronger than May.
The board approved the May financial statements by motion.
Contract: The board also approved an amendment to TeamHealth’s hospital-medicine agreement to account for a cost adjustment of $205,379; the board discussed holding the contractor accountable through quantity and quality metrics, and Dr. Elders said she was working on those measures.
Metro funding: In questions about the city budget, finance staff said the hospital was "fully funded" for 2027 operating components and reported a total of "74.8" (described in the meeting as three components of roughly 67.8, 3.5, and 4.3). Staff said budgets will be locked July 7 and that additional capital-budget details will be presented later.
What happens next: Staff will continue weekly financial reporting, implement the recovery and growth plans and return with updates; contract accountability measures for hospital medicine will be developed.
