Meharry Medical College and Nashville General Hospital sign two-year service contract

Meharry Medical College and Nashville General Hospital signed a new operating agreement — defining the relationship between the city’s oldest medical school and the city-owned teaching hospital for the next two years.

The two institutions reaffirmed their shared mission of serving Nashville’s underserved communities, correcting racial health disparities and training the next generation of health providers.

“I want people in Nashville to know that — like other teaching hospitals around the country — NGH will be one of the best hospitals in the city, if not the state,” said Dr. James Hildreth, Meharry Medical College’s CEO.

Unity was the message at the signing event on Wednesday. That’s a major departure from earlier this year. In February, contentious board meetings, an unflattering audit and derisive media comments culminated in Nashville General’s Dr. Joseph Webb leaving the CEO post he held for a decade.

Although the relationship has seen a fair amount of tension since its start in the 1990s, a large part of recent conflict hinged on the old professional services agreement. It expired in 2023, and the two sides were operating under the outdated contract. City government officials were ringing alarm bells, saying the lapse opened each of the organizations up to lawsuits. But negotiations continued to stall.

Nashville General’s new CEO, Veronica Elders, joined Hildreth to talk with reporters after the event. They both said the new agreement was possible because of the change in leadership at the hospital.

“Now we have a very transparent administration, which we have not had in the past,” Elders said.

“And that makes all the difference,” Hildreth added. “If the leadership is not buying into this, it’s just not gonna happen.”

Meharry faculty treat patients in the hospital and medical students use it for clinical experience. The professional services agreement — nicknamed the PSA — spans 40 pages and lays out the nitty gritty details. For example, lays out which institution has to do upkeep on infrastructure, like outpatient clinic space, and clarifies billing processes. It also lists the kinds of issues where each side has to keep the other in the loop — like if the hospital wants to drop a service, or if Meharry wants to put a new building on campus.

Campus concerns were another major source of tension over the past few years.

“Today, National General’s operating in this facility right behind us,” Mayor Freddie O’Connell said at the signing event. “I think everybody recognizes that it’s old.”

The building has several infrastructure problems. Administrators told WPLN earlier this year that HVAC issues had led to canceled surgeries, for example.

The lease ends at the end of 2027, and for years, Nashville General administrators have discussed finding a new home. As the tensions that led to Webb’s resignation were coming to a head, O’Connell was publicly stating a new location wouldn’t be possible until a new PSA was in place.

“Now that we have this restored partnership, we can start defining what that new hospital looks like, where it might be,” O’Connell told reporters on Wednesday. “We will probably help convene a working group that includes multiple stakeholders to make that possible.”

Hildreth and Elders said they were hopeful the new agreement would solve other ongoing issues. For example, there had been complaints about hiring. Specifically, Meharry officials had criticized Nashville General for hiring doctors unaffiliated with the medical school and without consulting Meharry officials.

Now, each institution gets to weigh in on hiring at the other.

“It is a joint hiring committee, where Meharry has a voice in the positions that we hire, as well as we have a voice and decisions that they’re making as well,” Elders said.

The Nashville General CEO answers to a Metro Government hospital board. Until recently, Hildreth said, Meharry didn’t have much access to it.

“Meharry Medical College was relegated to the public comment section of the board meetings,” he said. “If we’re your partner, why would we have to wait until the public section of a meeting to express our thoughts and make our contributions? That has totally changed. We now have a seat on the board of hospital authority.”