That might sound like some unremarkable business news. Something that would show up at the bottom of a newsletter like this.
There are about 200 hospitals in the state. Why should you care about this one?
Well, if you live in Nashville, you’re paying for the doors to remain open — even if you’re never a patient. The city budget includes tens of millions of dollars in subsidies for Nashville General every year. For fiscal 2027, it’s almost $70 million. That’s about $90 per person in Nashville for the year.
The hospital offers care to some of the most vulnerable people in the city. It’s in the 37208 zip code in North Nashville. That’s a historically Black neighborhood that has been economically marginalized since 1960s. That’s when city officials destroyed 100 square blocks of Black-owned homes and businesses to build Interstate 40.
That zip code fares among the worst in the metro for health indicators like how often people are diagnosed with chronic diseases like diabetes and how often people use the emergency room because they don’t have access to a doctor. These are structural problems that the city can use the hospital to address.
But to do that, the hospital has to succeed. And that’s not a given.
WHAT TO KNOW
The lease is up at the end of 2027.The CEO will be guiding the hospital through severe financial strain, and the person will oversee one of the most transformative times in the hospital’s history.
Nashville General has always struggled; caring for very sick people who can’t pay is inherently difficult. But hospital leaders have said the hospital’s budget is in worse shape than safety net facilities in comparable cities.
As of May, the hospital was running at a loss of $4.6 million for the year. That’s largely because admissions are down, and revenue from those admissions has come in $15 million short of expected so far this year.
Its severely outdated building is the cause of expensive, systemic problems. For example, HVAC issues got so bad the hospital had to cancel scheduled surgeries. Nashville General leases the facility from Meharry Medical College; that’s just one of the ways the two institutions are tightly knit. The lease on that building ends soon, and it’s unclear whether the plan is to stay or go. In a recent meeting, hospital staff said updating the building would likely cost at least $400 million. And leadership said last year that a new facility would cost at least $500 million.
The debate over fixing the building or getting a new one has been heated for years. Stephen Elliott at the Nashville Banner has covered that pretty extensively.
The CEO will be tasked with preventing big budget shortfalls, and guiding the hospital through choosing a location plan. And then either an expensive renovation, or an even more expensive site planning, design and construction process.
This newsletter story is a condensed version of this article I wrote. And that is a condensed version of a story that former health reporter (and current This Is Nashville host) Blake Farmer and I have together been covering for more than a decade. If you want to dive in, there’s plenty to sink your teeth into in our archives.
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The most recent drought monitor categorizes 93% of Tennessee as dryer than it should be. Nearly 75% of the state is in some degree of drought. And almost a third of the state is in severe or extreme drought. That could hurt Tennessee farmers — and everyone who is trying to buy food.
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MORE TO KNOW
- The Nashville Electric Service commissioned a major internal investigation after its Winter Storm Fern response left hundreds of thousands without power. The report is out. It spans 133 pages. It confirmed several accusations, like NES failed to ask for help soon enough, that its customer communication infrastructure hadn’t kept up with Nashville’s population explosion, and the utility failed to communicate timelines and other important information early on. Mayor Freddie O’Connell’s statement reads in part, “The NES review is a critical piece of data for my Winter Storm Commission as they consider the public testimony and information gathered in recent weeks from Metro agencies and partners about the broader government response for their forthcoming report. This is how accountability works: identify the gaps, commit to solutions, execute with transparency, and report progress. Nashville is doing that together.”
- Metro Nashville Public Schools Board passed its budget Tuesday after tense debate.The Nashville Banner reports the board passed raises and cost of living adjustments for teachers, additional funding for before- and after-school programs, and an extended work calendar for support staff.
- More than 12,000 people in Nashville experienced homelessness over the last year. That’s according to new data presented at Nashville’s 2026 Homelessness Symposium. Among those who lived without stable housing were 500 children, according to conference speakers. Experts point to a lack of affordable housing as a driving force behind homelessness. According to data at the symposium, there are only 39 affordable units for every 100 extremely low-income renters in Tennessee. Leaders worry federal changes could reduce future funding for homeless services.
FROM THIS IS NASHVILLE
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