A Nashville General Hospital board committee overseeing the safety-net medical facility for indigent patients voted unanimously Tuesday not to renew the contract of its controversial CEO Joseph Webb.
The committee voted 3-0 to recommend that the full Metro Nashville Hospital Authority Board replace Webb when his contract expires June 30. The 11-member board, which currently has two vacancies, is expected to vote on whether to extend Webb’s contract during its meeting Thursday.
Webb did not attend the committee meeting.
This is Webb’s 10th year at the helm of the hospital, which is located in a building leased by Meharry Medical College and on the college’s campus — a lease that expires in two years.
“I have concerns about whether Dr. Webb is the right person to advance the hospital,” said David Esquivel, an attorney and committee member. He also stated concerns about a lack of details on the proposed new hospital and the “disfunctional” relationship between the hospital and Meharry.
Only one resident, Laura Cantrell, spoke during time allotted for public comments, and she lobbied to remove Webb.
Cantrell is a former department manager in the Patient Access department, and said Webb often promoted his friends and relatives to hospital positions regardless of qualifications.
Cantrell, who lost her job last year due to a restructuring, described a “pervasive toxic work environment that has been fostered during this CEO’s tenure.”
“I witnessed employee morale reach an all-time low with employees feeling undervalued, overworked and underappreciated,” she said.
Only one person spoke in favor of keeping Webb.
Dr. Shindana Feagins, a longtime member of the Hospital Authority Board, said she has seen Webb accomplish many things with limited resources over the years. Feagins is a Meharry graduate who performed her residency at Nashville General. She abstained from voting Tuesday but will have the opportunity to vote when the full board decides whether to keep Webb.
Committee member Craig Lesser listed several concerns, including the strained relationship between the hospital and Meharry, before saying he didn’t want to renew Webb’s contract.
“It’s time for a reset,” Lesser said.
Christy Smith, the committee chair, noted concerns about nepotism and the fractured relationship between Webb and Meharry.
“I don’t know that that wound can be healed quickly,” she said.
Smith also said she felt it was time for new hospital leadership.
Mayor Freddie O’Connell, who appoints Hospital Authority Board members — excluding those serving terms that began before O’Connell took office — has publicly stated his support for Nashville General Hospital on numerous occasions. He doesn’t get a vote on Webb’s fate.
In response to Tuesday’s vote, O’Connell said he supports the committee’s decision to find “the best possible leadership for the hospital.”
“I’ve maintained for months that a brighter future begins with the execution of a successful professional services agreement with Meharry Medical College as part of a renewed and restored partnership,” O’Connell said. “From there, we can pursue a process (with many strong templates in Metro) to conduct a thorough review of what is needed to provide quality healthcare for our community through our safety net hospital.”
I’m confident that the Hospital Authority Board will act in the best interest of Nashville and the community that NGH serves. I support their process, and I remain as steadfast today as when I took office in my commitment to a strong Nashville General that serves Nashvillians for generations into the future.”
But Metro officials got involved publicly earlier this month as long-standing tensions between Nashville General Hospital and Meharry came to the forefront.
Dispute escalates between Meharry, Nashville hospital
Disagreements have intensified recently between Webb and Dr. James Hildreth, the president and CEO of Meharry, one of the nation’s oldest and largest historically Black academic health science centers.
Meharry’s provost, Dr. Jeannette E. South-Paul told The Tennessean last month that the hospital owes the college $7 million and isn’t allowing its staff to fill enough leadership roles at the teaching hospital. Webb and his then-CFO Bruce Naremore told a reporter that the hospital does not owe that much money and Webb accused the college of being a derelict landlord that hasn’t taken care of an aging 11-story building. With Webb on the conference call, Naremore, who has since retired, said: “Meharry can say whatever they like, I call it often times ‘fiction.’ “
Webb sought common ground in a Jan. 30 letter to Hildreth saying “the community is crying out” for the two of them to sit down and discuss the partnership between the hospital and college. He wrote: “Together Meharry Medical College and Nashville General Hospital can positively impact the healthcare outcomes of Nashvillians in a major way.”
He also sent a copy of the letter to religious officials, more than 20 elected leaders including O’Connell, Metro Nashville Council members and hospital board members.
Hildreth responded a day later in a letter to Webb that was more direct, highlighting several “real” issues that won’t be helped by merely talking, he said. He cited Webb’s refusal to finalize a standard “physicians services agreement,” often called a professional services agreement, that would outline physicians’ services and compensation.
Metro Legal officials noted concerns about the lack of a formalized agreement because it creates a risk of violating federal fraud and abuse laws. The last agreement between the two expired nearly two years ago.
Hildreth also pointed out that the hospital is supported by the city and is the designated training site for Meharry students and residents. Yet, the hospital’s daily census, or patient population, ranges from 30 to 50 patients despite being licenses for 150 beds. Webb has said that the current hospital only has room for 83 patients.
The city paid the hospital $59.5 million last fiscal year to help offset costs of caring for indigent residents. But city leaders have long been concerned that it’s not fulfilling its role as the safety-net hospital, with many indigent patients admitted daily to other hospitals, including Vanderbilt University Medical Center and Ascension Saint Thomas.
Webb also has been criticized for missing the December deadline to turn in all documents related to the hospital’s fiscal-year 2024 budget.
Webb and Naremore, who retired last month, insisted the hospital — often called NGH — turned in all records in a timely manner to the city’s external auditors. Not so, according to an email sent to the men from Kevin Crumbo, the city’s former interim finance director.
Crumbo cautioned Webb and Naremore in a sternly-worded Jan. 6 email: “Bluntly put, NGH’s failure to timely complete its audit has caused the delay referenced below, a remarkable inconvenience and setback for Metro’s financing cadence.”
Nashville General Hospital expansion plans scrutinized
Webb has publicly touted his vision for a new, state-of-the-art hospital, which he said shouldn’t be built vertically.
“Hospitals are not built straight up and down anymore,” he said.
Webb told The Tennessean last month that he envisions building a teaching hospital on 20 to 25 acres, costing between $500 million and $700 million, and said he’s waiting on the city to find the land, claiming “that is the only hold up.”
“We can’t move forward with putting final documents in place, nor can we pursue financing until we have the land,” the hospital CEO said, noting that Meharry’s campus doesn’t have the room to expand.
Webb said consultants suggested building in North Nashville, taking over part of the Ted Rhodes Golf Course and nearby soccer fields. Neither the hospital oversight board nor Metro Council has approved this plan.
Some Hospital Authority Board members have heard concerns that the price to build Webb’s proposed hospital, wherever it might be located, would likely cost closer to $1 billion.
Dr. Raymond Martin, acting chair of the Hospital Authority Board, sent an email last month to a reporter expressing his personal views, not that of the entire board, reading, in part: “It would be desirable for Nashville to study the projected healthcare needs of the city over the next couple of decades.”
Some city officials and board members have said they want to see a services analysis to identify overlaps and gaps in health care coverage to guide them on mapping out future plans for the hospital.
Hildreth’s letter to Webb on Jan. 31 said: “The vision for Nashville General is only yours, without regard to the impact it will have on Meharry’s programs and services, without regard to the city’s expectation of a partnership and, most importantly, without regard to the healthcare needs of the residents who rely on us to provide the highest level of care.”
Hildreth also claimed in his letter than Nashville General has spent taxpayer dollars to establish “an alternate clinical enterprise that caters to patients with private insurance.”
The majority of the hospital’s patients can pay for medical services, which Webb said is by design to help offset the costs of caring for those without it.
Webb has pointed to several improvements during his decade-long tenure, to include creating a touted Food Pharmacy, a clinical program where doctors prescribe certain food and offers that food to patients in need. This can range from low-carb foods for diabetics to high-caloric foods for cancer patients to give them strength to withstand chemotherapy.
Also, Webb was the first to branch out and expand beyond the main campus with three community clinics in Midtown, Bordeaux and MetroCenter.
In late January, about 50 people attended a OneNashville community meeting to discuss the hospital’s future. Several people spoke at Corinthian Missionary Baptist Church, expressing support for Webb and his vision for a new hospital and underscoring the need for quality medical care for all Nashvillians.
Reporter Beth Warren covers health care and can be reached at [email protected].
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