Hospital Authority finance panel hears budget and revenue-cycle updates after public comment

The Hospital Authority finance committee received updates March 28 on the hospital's audit, budget and January financial results, and voted to approve the minutes and the financial report before adjourning.

Christie, the hospital's chief financial officer, told the committee that the audit partner (Crossland) will present the 2023 audit at the full board meeting and that the audit for 2023 carries a clean, unmodified opinion. She asked committee members to reserve audit questions for the full board presentation so the audit partner can respond.

Christie gave a budget update, saying the budget the board approved in February was also presented to Metro Finance and the mayor's office and that the administration expects feedback in about 60 days. She said month-to-month year-to-date figures will be updated and that a final budget will return to the board for approval.

On operational metrics for January, the presenter reported 244 inpatient admissions, about 165 observation visits, patient-days near budget and an average length of stay of 4.0 days, which is below the budgeted level. Deliveries were 23 for the month versus a budget of 38. Christie said the hospital's case mix is down about 7% year to date and staff are reviewing documentation for possible opportunities.

Financial results for January showed total revenue roughly $3.4 million below budget for the month, driven primarily by lower inpatient gross revenue (approximately 18% below) and reduced outpatient/elective activity following canceled clinic days. Collected revenue for the month was about $4.8 million versus a budgeted $5.2 million (an approximately 8% shortfall). The hospital recorded a negative margin of about $750,000 for January, while year-to-date the hospital showed a $4.4 million surplus that puts it roughly $8 million ahead of budget through seven months.

Christie said contract labor expenses contributed materially to the month's unfavorable variance; the hospital has several open director-level positions and has reclassified some security costs into contract labor for accounting purposes. She said most other expenses were near budget and supply costs were better than budget.

Mr. Block presented the revenue-cycle report for January 2024 and highlighted improved collections and reduced days in accounts receivable: January's days-in-A/R were about 4.93 days, a low for the measured period. He said net revenue collections improved (January 2024 finished at about 114% relative to a prior period benchmark) and that denial rates have trended down, crediting new staff hires in utilization management and clinic outreach (including Faith Reed and Jessica Crabtree). Block cautioned that regulatory and payer changes require continuous engagement with clinics to sustain improvements.

A member moved to approve the financial report and a second was recorded; the motion passed by voice vote. The committee then moved to close the meeting and adjourned.