Hospital posts positive FY24 margin and mixed start to FY25; board reviews utilization and clinical-trial plans

Hospital finance leadership told the board the system finished fiscal year 2024 with an unaudited operating surplus (approximately $8 million positive margin), aided by one-time Medicaid/MCO payments in June. Monthly highlights: May showed strong inpatient activity and higher outpatient revenue but a $540,000 monthly loss; June benefitted from one-time TennCare/MCO payments producing a net margin of roughly $2.9 million for the month; July (the first month of FY25) returned to elevated expenses tied to raises and start-up costs, producing a month loss of about $820,000.

The finance presenter urged caution in interpreting one-time other revenues but noted a positive year-to-date operating position relative to budget. Board members asked about the cath lab, noting a lost interventional cardiologist and resulting referral of catheterizations when needed; presenters said the cath lab is currently in construction and referrals are handled externally.

On operations, Miss Poole reported steady increases in emergency-department volumes since launching the no-wait ED in March (quarterly averages rising from roughly 2,100 to a projected 2,300) and noted rising Metro employee registrations for services. Staff said they are working with Metro HR and state agencies to incorporate state employees into hospital coverage arrangements and are coordinating highway signage for consistent Nashville General Hospital branding at key exits.

Finance and operations also presented clinical-trials infrastructure investments (an Oracle CTMS implementation and related hardware) intended to scale the hospital's clinical-research capacity; staff said the CTMS integrates with Cerner and would reduce per-trial administration as study volume grows. Presenters noted the CTMS has a one-time implementation cost and a tiered fee schedule tied to trial volume.

The board approved the three months of financials (May, June, July) and asked leadership to report back with implementation timelines on capital projects and vendor transitions affecting clinical capacity.