Your taxes support Nashville General Hospital. Weigh in on its future.

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12-03-2025

Nashville General Hospital turns a new page when CEO Dr. Joseph Webb ends his 10-year tenure on Friday.
The hospital now has the opportunity to redefine itself and its role in a city where healthcare is one of the dominant industry players, ironically in a community where health outcomes are generally poor.
This is also a chance to move past financial and leadership controversies that have plagued General, the only public hospital in town.
Most important, this a moment for all Nashville-Davidson County citizens to realize that they have a stake in the hospital's future.
Over the last 11 years, city taxpayers have subsidized the hospital by an average of nearly $50 million a year. In the 2024-25 fiscal year, that subsidy rose to $59.5 million − or about 40% of the total budget.
The hospital historically has served a large number of patients who cannot afford to pay for treatment. In 2016, the hospital, under Webb's watch, asked for two $10 million emergency city subsidies to pay the bills. The year prior, General's patient mix included 46% who could not pay.
General cannot survive without the public's support. It must answer some tough questions. What is the mission of the hospital in 2025 and beyond? Is it sustainable? If so, how might the community gear it for success?
The Hospital Authority Board lost confidence in Webb after a late February internal audit report revealed millions of dollars in contracts not authorized by the board, falsified contracts and overpayments.
Board members began to push him out, and at a time where the outgoing leader was seeking a contract renewal, they clipped his wings.
On Monday, even before Webb left his post, board members named Chief Nursing Officer Veronica Elders as interim manager while they seek and hire a new CEO.
Over the last decade, governance has been at times tumultuous. Board seats in the 11-seat authority have not always been filled. In 2018, the board voted 5-1 to extend Webb's contract without an evaluation or setting any terms for his leadership. Seven years later, here we are.
Webb's supporters say he was passionate about serving underrepresented communities. He touted his success in a news release after the audit.
"Together, we have transformed Nashville General from a hospital of last resort to a hospital of choice for thousands of Davidson County citizens," Webb said.
The hospital, which originally opened in 1890, has leased space at Meharry Medical College, one of Nashville's four historically Black colleges and universities, since 1998.
However, the relationship between Webb and Meharry President James Hildreth has soured.
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Meharry officials said the hospital owes it $7 million and would not finalize a physician's services agreement. Plus, the hospital's lease is up in 2027.
Before the internal audit's release, Webb worked to rally the community to support building a new hospital funded by the city. With his departure, another question that the board will have to resolve is what happens after the Meharry lease ends.
Year
Taxpayer subsidy
2014-15
$45,000,000
2015-16
$45,000,000
2016-17
$51,000,000
2017-18
$52,141,100
2018-19
$46,112,100
2019-20
$43,112,100
2020-21
$43,112,100
2021-22
$49,560,000
2022-23
$54,038,000
2023-24
$57,820,700
2024-25
$59,555,300
Community input is vital.
In 2017, former Nashville Mayor Megan Barry recommended Nashville General end its in-patient care, a controversial proposal that died very quickly.
The recommendation drew an unusual alliance between then At-Large Council Member Erica Gilmore (now Trustee) and former Council Member Steve Glover to keep the hospital open. Gilmore, a Black Democrat, and Glover, a white conservative Republican, expressed concerns about lack of transparency by Metro Government and the impact on the Black community's access to health care options.
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"We understand the important role of Nashville General Hospital, and the role it plays in our city, and we have committed to securing its future," Gilmore said at a news conference in 2018.
Nashville's Black community makes up 26% of the population of the city, which for decades prior to the Civil Rights movement maintained racial segregation laws. Even today, the lingering effect of the unequal treatment affects health outcomes and access to opportunities for marginalized residents.
Current Mayor Freddie O'Connell expressed his support for Nashville General.
"I'm very, very excited to work with both the board of Nashville General Hospital on establishing new leadership," O'Connell said in February. "This is to me the clearest opportunity we've had to look forward to a future for NGH in quite some time.
Now is the time to amplify the public conversation on the role and future of Nashville General Hospital for the benefit of all citizens.
David Plazas is the director of opinion and engagement for the USA TODAY Network Tennessee. Call him at [phone], email him at [e-mail] or find him on X at @davidplazas or BlueSky at davidplazas.bsky.social.
This article originally appeared on Nashville Tennessean: Nashville General Hospital only survives with public support | Opinion