University Medical Center is shown last month. Clark County commissioners have scheduled a hearing Tuesday for CEO Lacy Thomas to explain the hospital's lack of financial disclosure. Photo by John Locher.

How much money has University Medical Center lost this year?

Don't ask Clark County commissioners, who make up the public hospital's board of directors. They don't know.

Why?

UMC administrators stopped filing monthly financial reports with the county six months ago, even though they are required to do so at least quarterly by creditors.

And that most recent report, submitted in May by hospital CEO Lacy Thomas, was the monthly fiscal snapshot for January, meaning no one outside UMC has been able to take the money-bleeding hospital's pulse for the past 10 months.

This has triggered concerns among commissioners, who have scheduled a hearing Tuesday for Thomas to explain the lack of disclosure.

"I want to know what specific difficulties exist out there in providing timely financial reports," Commissioner Yvonne Atkinson Gates said at the board's Nov. 8 meeting.

Without regular reports, commissioners cannot ensure adequate oversight of a taxpayer-supported facility that lost $78 million between 2001 and 2005.

Veteran Commissioner Bruce Woodbury said he wants the reports to make sure there is not a repeat of the shock commissioners suffered four years ago.

In November 2002, commissioners scolded then-UMC Director Bill Hale for surprising them with a massive deficit months after the hospital learned of financial problems, forcing commissioners to quickly approve a $38.4 million bailout, slash the struggling hospital's budget and close two of UMC's QuickCare clinics.

"We were told all of a sudden that we had serious financial problems," Woodbury said. "We don't want that to happen again."

UMC's Thomas reports directly to County Manager Virginia Valentine, who said Thursday that Thomas has not offered her an explanation of the reporting delay.

"I am very concerned," said Valentine, the county's chief executive since August. She said she has a meeting Monday with Thomas to discuss what he plans to tell the board at the next day's hearing.

Valentine added that she promotes open government and believes the finances of a hospital supported by the public should be made public.

"We would like to provide as much public information as we can about the hospital," she said. "Transparency is a priority for the county in all its operations."

The disclosure that UMC has not filed the financial reports came two days after the Review-Journal submitted a records request seeking the past 18 months' worth of those documents. The hospital has traditionally filed such reports monthly and is required to submit them at least quarterly as part of the agreement that led to the issuance of bonds for new construction projects.

Thomas was unavailable for interviews Thursday and Friday, UMC spokeswoman Cheryl Persinger said.

Relaying information he provided her, Persinger said the financial reports have been delayed by a new financial management computer system implemented county-wide in October 2005.

"It was a conversion process to a new system," Persinger said. "That's been very difficult because it (the software) is not geared toward hospitals and health care."

Multiple county officials were skeptical of this explanation.

In separate interviews, three county officials pointed out that UMC has submitted financial reports to the county this year, months after the new software was put into place.

"That explanation's not going to wash," said one official, who spoke on condition of anonymity. "It doesn't make sense."

Another official said even if there are technical problems, Thomas should be qualified to sift through UMC's operating figures and compile a basic finance report. Then-Clark County Manager Thom Reilly boasted of Thomas' background in finance when he petitioned the County Commission to hire him in 2003. Reilly's written request identified Thomas as a certified public accountant and the former vice chancellor for finance and chief financial officer for City Colleges of Chicago.

"It's a basic financial management tool to monitor a budget," the official said. "How do you know whether you need to make corrections if you're not looking at monthly numbers?"

The nonprofit hospital was budgeted to lose $15 million in the fiscal year that ended June 30, with much of its deficit stemming from its obligation, unlike private hospitals, to treat indigent and uninsured patients.

However, part of UMC's mission is to become self-sustaining without taxpayer subsidies. But commissioners have no way of knowing where it's falling within those goals without regular finance reports.

County officials' apprehension about UMC's finances comes in the wake of Clark County Auditor Jerry Carroll's report in September that blasted the hospital's decision to outsource patient admitting, billing and other revenue-generating functions to a private company.

Carroll found the contract Thomas recommended with ACS Consulting -- designed to bolster the hospital's bottom line -- actually led to a $6 million fall in revenues during its first year in place.

Carroll's staff also found flaws in the ACS agreement that allowed the company to collect more than $1 million in fees even though the firm was supposedly working on a pay-for-performance basis.

The hospital bungled a transaction to sell its bad debt, the audit found. UMC inadvertently sold for 1.25 cents on the dollar 3,900 accounts on which patients were actually paying.