Metro General Hospital

Metro General Hospital

Metro General Hospital, formerly serving many of the underprivileged in Nashville, Tennessee, merged with George W. Hubbard Hospital due to a major glut of patient rooms in the region. Today, the former hospital site is undergoing revitalization. While much of the campus was demolished, three primary and historic buildings were spared the wrecking ball and are being gutted for repurposing. The Rolling Hill Mill development, so named for the corn mills that were once located in the area, will convert the former hospital site into a mixed use community on the banks of the Cumberland River. With the land being very close to downtown Nashville, it is hoped that this once landmark institution can continue to serve the city well into the 21st century.

History

The hospital first admitted its first patients as the ‘City Hospital’ on April 23, 1890. The land that it resided on was donated by the state of Tennessee in 1840s (5), to never be used as anything but a ‘hospital’. When it opened, it was the city’s first full-fledged medical facility, constructed at a cost of $30,000 (5), and had one physician, seven nurses, and a total capacity of 60 beds (1). Each room featured an iron bed and a chair; dumb-waiters hoisted supplies and food from floor-to-floor, while laundry chutes took away soiled sheets and garments to the laundry building. It was considered ‘state-of-the-art’ for its time.

The hospital flourished, producing much revenue that was boosted by the local medical schools – the University of Nashville and the University of Tennessee. The first administrator saw the need for more qualified nurses, and as a result, in 1891 a training school for nurses was constructed. It was the first such school between the Ohio River and New Orleans (5). A new addition to the hospital was constructed in 1913, followed by a pediatric ward in 1914. In 1932, a large art-deco expansion was constructed, increasing the average number of patients to 188 by 1934.

The tide turned after World war II when admissions began declining. Meharry Medical School began to handle many of the city’s African-Americans. By 1954, the physical plant was in poor condition. Vanderbilt University, which operated the hospital under contract, was overextended as the Vanderbilt Hospital patient numbers declined (5). In May, a proposal was floated around to merge Metro General with Vanderbilt for economic reasons but this idea failed.

The nursing school closed in 1970 due to declining enrollment.

Buildings on the campus:

1. City Hospital is the northern-most building and also the oldest. In 1998, it included the original 1890 section, the 1911 copper-roofed East Wing addition that overlooked the Cumberland River, and the 1932 brick addition that fronted Hermitage Avenue (8). The 1932 addition was considered one of Nashville’s ‘best examples of Art Deco architecture’. Several post-World War II brick additions were considered ‘not historic’ or ‘architecturally significant’.
2. The Howse Wilson Hall was constructed in 1922 as a school for the nurses and enlarged in 1931 when the original City Hospital was expanded (8).
3. The boiler house and smokestack (power plant) was located adjacent to the original hospital structures and were constructed in 1927 (8).
4. The site also included a one-story brick car barn constructed in the early 1920s to service and repair Nashville’s electric streetcars (8).

Meharry Medical College and Hospital

Samuel Meharry, an African-American, founded a predominately-black medical college and hospital in Nashville in 1876 with a starting pledge of $10,000 (2). Legend has it that on a lonely Kentucky road in 1826, Samuel’s wagon was stuck in mud; a family of free blacks had taken him in for the night and helped him get on his way the next day. From that act of charity, Samuel vowed to someday repay them by doing something to help blacks. The first class of just 13 at the new Medical Department of Central Tennessee College of Nashville was held in a dank basement, an institution that was established ten years prior by the Freedman’s Aid Society of the Methodist Episcopal Church. In 1900, in honor of the Meharry brothers, the department was renamed in honor of them. Fifteen years later, it became an independent medical college. The Meharry-Hubbard Hospital was dedicated in 1912 (7).

The Meharry Medical College prospered throughout the 20th century, graduating thousands from its ranks every year, and becoming well known as its alumni practice medicine and health services across the country and worldwide. Nearly 40% of black physicians and dentists were Meharry trained, according to a 1980 Princeton University study (2)(4). On the other side of the coin, the Meharry-Hubbard Hospital teetered on financial ruin numerous times due to the excess supply of patient beds in the Nashville region. For instance, the $30 million patient tower, constructed in 1973, was ‘never full’ and was a ‘huge money drain’ (4); the college eventually defaulted on the loan (7). Licensed to hold 405 but staffed for only 110, students from the college found that they could not receive adequate student training at the facility. These lack of patients eventually led to the college losing accreditation in two key medical programs since 1988 (2). Metro General was much the same way, licensed to hold 213 beds, its average patient load was about 100 (4). In the same year, Meharry proposed moving the ‘City Hospital’ to Hubbard. Under this plan, the city would own and operate the facility, but Meharry doctors would staff it (7).

One-hundred-and-fifteen years after it was founded, Mcharry Medical College was facing dire financial situations again (2). In mid-October 1991, Nashville officials approved of a plan to merge the financially-ailing private institution’s hospital with the city’s physically deteriorating taxpayer-financed Metropolitan General Hospital. The merger would phase out services at the current Metro General Hospital over the time period of two years and relocate them to Meharry-Hubbard. During this time, the city would be responsible for the services at the merged facility. The merger, if it was not approved, might have sent the final notice to the medical college; it had proposed several months earlier of moving out to another, more supportive city (4)

In early 1998, the hospital relocated from its Hermitage Avenue location to the renovated George W. Hubbard Hospital on the Meharry Medical College campus (1). It operates today as a 127 bed facility, now named the Nashville General Hospital at Meharry (6). The former emergency room was utilized for a brief period for the Metro Primary Care Center but was closed by 2000 (5).

Redevelopment

On July 19, 2000, Nashville received $900,000 of a $1.5 million grant as part of a federal brownfields program. The money was spent preparing the riverfront along the Cumberland River for redevelopment with ‘an amphasis on the Rolling Hill Mill site.’ (6) $200,000 of the money would be spent to clean up petroleum-related and minor barium and lead contamination; $200,000 on hazardous-waste assessment of the riverfront; $200,000 on petroleum contamination assessment of the riverfront; and $300,000 on the revolving-loan cleanup fund.

In February 2003, the city of Nashville received a $1.35 million federal grant to prepare the Rolling Mill Hill site for redevelopment (3); the name is derived from the mills that were once located in the area that processed corn shipped to Nashville for flour (5). This included the Metro General Hospital site and was placed on the ‘fast-track’ as a prime redevelopment zone as it offered expanse views of the Cumberland River and the downtown skyline (5). In July, a site plan was completed by RTKL Associates Incorporated. The plan, which included mixed residential, retail, entertainment and office development, was determined to be a feasible project along Hermitage Avenue. It would also include a greenway project that would connect to other hiking trails and parks along the Cumberland River and other various streams throughout the city.

Infrastructure work began in the summer of 2004 (5). Under the agreement, some of the older hospital structures would be saved and reused under the 10-acre Phase One development. Other non-notable or non-historic structures would be demolished. One of those being saved is the oldest building on the former hospital’s campus. Opened in 1890, it featured articulate brick and stone facades and a green copper roof, however, numerous additions built during the 20th century marred the beauty of the hospital. As part of Phase One, the additions would be demolished and the hospital renovated to its former site plan. In addition, the Art Dec-era hospital structure, constructed around 1931, the power plant, constructed in the 1920s and the WPA-era trolley barn from the 1930s would be saved.

According to the plan (8), 333 conventional apartments would be constructed, along with 255 loft apartments, 63 loft condominiums, 65 fee simple townhouses, 98,630 sq. ft. of office space, 104,020 sq. ft. of retail space and 150,000 sq. ft. of ‘community space’, such as a community center, greenways or parks and art facilities.

Did the merger save the hospital?

In December 2005, the Nashville General Hospital at Meharry reported that it could ‘be broke in a month’ and could face ‘possible shutdown in two months’ (7). The hospital quickly tried to find $8 million to $10 million in ‘safety-net cash’ so that the hospital could continue to operate but failed to do so. The facility, dependent on patients who do not have health insurance, wanted to depend less on public funds as it tries to shift towards patients who do carry insurance; such patients would help the hospital offset the cost of caring those who do not have any (insurance). The financial issue was not nearly as dire until 2005, when the state of Tennessee cut TennCare, the state’s version of Medicare, by 190,000 patients to save money. As a result, the share of TennCare patients fell from 42.9% to 36.1% in fiscal-year 2005; during the same period, the number of uninsured patients rose from 24.2% to 30.7%.

Links

1. Rolling Mill Hill background
   1a. Feasibility study
2. Rolling Mill Hill

Sources

1. “General Hospital.” Nashville.gov. 18 July 2006 Article.
2. Christion, Cornell. “Merger may extend Meharry’s rich history of training, healing.” Commercial Appeal (Nashville) 1991 Oct. 30. 19 Feb. 2007.
3. “City hires planning firm for Rolling Mill Hill site.” Tennessean (Nashville) 26 March, 2003. 19 Feb. 2007.
4. Ajanaku, Karanja A. “Meharry pushes hospital merger, may leave Nashville if plan fails.” Commericial Appeal (Nashville) 1991 March 31. 19 Feb. 2007.
5. Zeppstaff, George. “Old General Hospital site can be developed, city says.” Tennessean (Nashville) 19 May 2004. 19 Feb. 2007.
6. Mayor, Evan. “Metro’s $900,000 brownfields grant means end for old General Hospital.” Tennessean (Nashville) 20 July 2004. 19 Feb. 2007.
7. Packstaff, Todd. “Cash-strapped General needs a savior, a plan.” Tennessean (Nashville) 19 Feb. 2006. 19 Feb. 2007.
8. “Market Feasibility Study for Rolling Mill Hill.” Economics Research Associates (Washington) and Walker Collaborative (Nashville) June 2003. 19 Feb. 2007 Feasibility study.