Metro Atlanta hospital chiefs offered a short and not-so-sweet response to Grady Memorial Hospital’s request for $30 million cash to help care for poor patients.

No.

Not only did they refuse to help, they heaped on some scolding advice:

“Grady Health System must dramatically revamp its approach and processes to meet its mission of ‘providing quality health care to Atlanta’s poor.’”

Grady officials are now threatening to ask the state Legislature to impose a tax on metro hospitals that would go toward supporting indigent care.

“We’re not afraid of a fight,” said Pete Correll, head of the nonprofit board that oversees Grady.

The tough stand on both sides reflects an escalating tension between Grady, a hospital suffering under the financial burden of indigent and trauma care, and other metro hospitals, which say they’re having their own tough times.

In December, Grady officials met with the leaders of about a half-dozen area hospitals to request a combined contribution of $50 million over about five years to support the safety-net hospital.

Emory responded with some help: It eliminated $20 million of the approximately $62 million in debt owed by Grady, officials said. Emory medical school provides many doctors who work at Grady, which has not been able to pay them.

That led to Grady’s request of $30 million from other metro hospitals.

In a letter dated Jan. 6, obtained by The Atlanta Journal-Constitution, the leaders of the other hospitals rejected the idea. They said they all are treating more people who cannot pay, and “we simply are unable to comply with Grady’s cash request.”

In their letter to Grady, the hospital chiefs suggested creating a “community indigent care consortium that would direct funds and other forms of assistance to major Grady cost centers.”

Correll, the Grady board chairman, responded, “I don’t know what that means. I’m a South Georgia boy. I understand we need some money.”

Those at the December meeting included representatives from WellStar Health System, Atlanta Medical Center, Emory Healthcare, Southern Regional Health System, Gwinnett Medical Center, Piedmont Healthcare and DeKalb Medical.

Grady is suffering financially because it handles so many more nonpaying patients than other hospitals, said Grady CEO Michael Young.

If Grady closes down, he said, these hospitals would be flooded with poor people needing care, resulting in a far higher financial burden than Grady’s current request.

Correll, the former head of Georgia-Pacific, said that Grady has embarked on a $100 million community fund-raising effort, and that many businesses that are contributing are also facing hard times.

“We’re shocked and disappointed,” Grady officials said in a letter responding to the hospital leaders’ rejection, sent Thursday. “We find it impossible to understand how so many major businesses and citizens in metro Atlanta are responding positively to help Grady through this tough time, but the hospital community cannot commit any monetary support.”

The hospitals are willing to help in other ways, said Joe Parker, whose Georgia Hospital Association hosted the December meeting. They offered to help support legislation that would add funding and to lend financial and medical management expertise.