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Hospital leaders spent $400K on acclaim cards but receipts missing for best Michael Schwab/USA TODAY NEWTWORK – TENNESSEE

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Dr. Joseph Webb, CEO of Nashville General Hospital, speaks during “Conscious Conversation,” a association affair to altercate the approaching of Nashville General Hospital captivated at First Baptist Church Capitol Hill, Thursday, January 11, 2018.(Photo: Alan Poizner / For The Tennessean)Buy Photo

Nashville General Hospital has no affidavit to abutment 85 percent of the acclaim agenda purchases fabricated by three top hospital admiral over a two-year period, according to a new Metro centralized audit.  

The audit, anachronous Aug. 28, found that affairs from the three credit-card holders at the cash-strapped safety-net hospital totaled $401,419 in 2016 and 2017.

The better costs accommodate about $32,000 spent on airfare, $22,000 spent at a cafeteria sandwich alternation and $20,000 spent at cine theaters.

Related: Briley: Nashville General Hospital CEO deserves ‘a chance,’ but charge be scrutinized closely

Hospital leaders are accustomed to use government acclaim cards to accomplish baby purchases of beneath than $1,000 on account of the hospital, but burghal auditors say they can’t verify that these purchases benefited the hospital due to a abridgement of receipts kept by officials.

The hospital could not aftermath abstracts for 40 out of 47 of the affairs to auditors. That includes no acclaim agenda statements and transaction receipts for any purchases fabricated above-mentioned to April 2017.

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The three officials who accept acclaim cards are hospital CEO Joseph Webb, Controlling Abettor Dawn Thomas and Director of Marketing Cathy Poole.

The ysis — a absolute ysis of the accretion processes for the hospital — comes as the hospital’s affairs accept been beneath acute ysis afterwards the ability has required millions in emergency added allotment in contempo years.

Although auditors, by reviewing the website of J.P. Morgan Chase Acclaim Card, were able to actuate which vendors accustomed the payments — and how abundant was spent —they were clumsy to actuate whether it was to abutment the mission of the hospital because of the abridgement of documentation.

In an Aug. 21 letter to Metro Accountant Mark Swann, Webb said the hospital administering has advised the audit’s allegation and accepts the ysis staff’s recommendations. 

Poole, the hospital’s backer and one of the three credit-card holders, said the abridgement of receipts in the accounts payable files for the acclaim cards was due to aerial about-face aural the accounts administering of the hospital.

“We are acquainted that some of the cancellation files were confused during agents transition,” Poole said. “Our new access will ensure this will no best be an issue.”

The ysis says the hospital lacks behavior and procedures account the hospital management’s ambition on the use of acclaim cards, ysis and approval, and adaptation with acclaim agenda statements. 

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But at the audit’s recommendation, Poole said the hospital has now developed a antidotal activity plan that includes rerouting acclaim agenda acceptance to Webb’s controlling assistant. Poole said the hospital is additionally developing “a absolute policy” on acclaim agenda usage.

More: Nashville General Hospital paid ex-councilman in secret, says addition ex-board member

Poole said none of the costs were articular as inappropriate. She additionally said the hospital’s “process was actuality aesthetic during a ytical time” during the findings, acquainted the administering was alive to defended a abiding arch banking officer.

Poole said the hospital’s ambition is to abide “being good admiral of aborigine dollars.”

The Metro Analysis Lath is set to altercate the ysis at its account affair Tuesday.

At-large Councilman Bob Mendes, who sits on the six-member committee, said he wants to assets acumen until he gets added advice about the sample admeasurement of the ysis and an account for the biking and added spending.

“But acutely accepting affidavit is what should happen,” Mendes said. “Without alive added about what the sample admeasurement was and whether there was any aftereffect to amount out the purpose of the expenses, it’s adamantine to apperceive whether to be a little agitated or a lot bothered.”

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Top credit-card spending includes:

Other acclaim agenda spending during the two-year aeon includes $12,609 to the National Lath for Quality Assurance; $10,533 to Pista Print for press services; $7,970 to Liberty Affair Rental for artefact renting for events; $7,626 to Indeed for recruiting; and $7,280 to The Tennessean for bi-weekly advertisements.

More: In aberration decision, Nashville General Hospital extends CEO’s arrangement with no terms

Poole said anniversary of the items were “related to hospital expenses.”

She said the Regal Cinemas accuse were acclimated for full-time employees, who accustomed altogether cards with two cine tickets enclosed. The Vista Print accuse went against invitations for contest hosted by the hospital.

She said Jason’s Cafeteria was acclimated to baby breakfast and cafeteria meetings, an agent acclimatization and added continuing hospital meetings. The affair rentals were for an anniversary association bloom fair, a Doctor’s Day, a blight survivorship event event and a radiological technology academy graduation. The Tennessean ads were for recruiting nurses, she said. 

For the accepted 2018-19 budgetary year, Mayor David Briley and the Metro Lath provided a $46.1 actor hospital subsidy — $11.1 actor again the $35 actor subsidy accustomed in contempo years. Hospital leaders had been clumsy to accomplish within the $35 actor from the city, banishment assorted mid-year added allotment requests to the council.

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In all, the hospital paid $120.7 actor to vendors in 2016 and 2017, according to the audit.

Purchases aloft $10,000 charge be through aggressive closed bids beneath the hospital policy. Purchases amid $4,000 and $10,000 can be fabricated in the accessible with three accounting quotations, while purchases amid $1,000 and $4,000 need only exact quotations. Purchases below $1,000 can booty abode on the accessible market.

The ysis begin that the hospital’s payments are “generally” admiring of the hospital’s mission, excluding the acclaim agenda purchases, accustomed the abridgement of documentation. 

But it additionally begin the hospital authority’s purchasing policy was not consistently accomplished aural departments. 

Out of 60 sampled purchases, the ysis says, 27 did not chase the authority’s behest policy. Thirteen of the 27 examples were instances area proposals and aggressive closed bids should accept been required.

More: Fifth lath affiliate quits Nashville General Hospital, citation ‘grave concerns’

“The accretion functions of anecdotic vendors, accepting bids, and advancement bid affidavit are responsibilities of hospital departments with little blank from a centralized accretion function,” the ysis reads. “There are no abundant procedures to adviser departments on how to accomplish these accretion functions.”

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The hospital’s management, in its acknowledgment to the auditor, committed to establishing a activity to bid out food and accessories that are not covered by their apprenticed accumulation purchasing organization. 

“We will authorize bid processes, communications and record-keeping to accommodated the accomplished standards of accountability,” the hospital’s acknowledgment says.

Among added findings, the ysis additionally says the hospital’s payments to vendors accept not been fabricated by accustomed agreement and appraisement of their contracts — a abiding affair for the hospital, which has struggled to pay invoices on time. 

Out of 60 sampled invoices over the two-year period, 50 invoices — 83 percent — were not paid aural acquittal terms. 

While the ysis begin able accretion controls are “generally in place” — and that beyond vendors were paid on boilerplate aural 60 canicule — it begin an barring for payments to Meharry Medical College, the hospital’s accomplice school.

The hospital, for example, fabricated a $4.4 actor acquittal to Meharry this accomplished February for invoices that anachronous aback to 2014.

 Reach Joey Garrison at 615-259-8236, [email protected] and on Twitter @joeygarrison.

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