Hospital officials say Meharry roster delays cost Nashville General $1.1M in GME funding; talks ongoing

Bruce Naramore, chief financial officer of Nashville General Hospital, told the Hospital Authority Board that the hospital missed out on about $1,100,000 in state graduate medical education (GME) funds in 2024 because Meharry Medical College did not provide required resident rosters in time.

"We were unable to get the resident rosters that we needed from the Meharry Medical College in time to qualify," Naramore said, describing a submission deadline the state enforces for primary-care residency rosters. He said the roster was later provided in December but the state had already distributed the 2024 funds to other programs and would not revisit the prior distribution.

Naramore said he now has the roster dated July 1, 2024, and that the hospital will submit it to the state; Tennessee Hospital Association and state contacts believe the hospital is in a position to receive GME funding again, though Naramore said he cannot guarantee it will equal the previous $1.1 million.

The hospital repeatedly described the working relationship with Meharry as an ongoing priority: Webb said leaders have scheduled biweekly meetings with Meharry’s provost and senior vice presidents and are working through inaccuracies reported publicly. "We have since met with the leadership at Meharry, and we have scheduled a biweekly every other week meeting to continue working through issues with them," Webb said.

Council members asked about hiring responsibilities, payment routines and whether the provider services agreement (PSA) requires updating to share future GME funds. Naramore said any revenue sharing with Meharry would require an amendment to the PSA and that modifying that agreement has proven more difficult than expected.

The board discussed payment cycles and late payments to partner hospitals, with Webb saying cash-flow management and routine pay cycles — 30, 60 or 90 days — are factors in when partner invoices are paid and that hospital leadership had opened talks with Vanderbilt about a proposed payment cycle.

No formal decisions were taken at the hearing; Webb and Naramore said they will continue meetings with Meharry and pursue submission of required rosters to the state.