UMC expenses explained

The number of days patients spend in the hospital isn't driving the enormous deficit racked up by University Medical Center.

According to preliminary audit findings presented to the Clark County Commission on Tuesday, the professional fees charged by physicians and other costs have been larger contributors to UMC's skyrocketing operations expenses during the past two years.

George Stevens, the county's chief financial officer, said the deficit at UMC has snowballed from $9.3 million in fiscal year 2005 to $56.5 million in fiscal year 2007. During the same time period, the medical center has seen patient days increase only slightly, from 176,104 in 2005 to 177,051 in 2007.

"The volume of business at the hospital has not increased significantly," Stevens said.

However, data gathered for the ongoing financial audit show that professional fees charged to the hospital have shot up by 52 percent in the past two years. In fiscal year 2005, Stevens said professional fees amounted to $22.4 million. That increased to $34.1 million in fiscal year 2007.

"Will we get a breakout of the professional fees?" Commissioner Chris Giunchigliani asked at one point.

Stevens told her that professional fees were basically physician costs.

Other big ticket items driving up the cost of doing business for UMC were supplies and purchased services, which includes patient transportation. The cost of supplies rose 23 percent over two years, from $96.7 million in 2005 to $119.2 million in 2007. Purchased services were up by 22 percent, from $42 million in 2005, to $51.3 million in 2007.

The annual audit is not complete, Stevens said, but preliminary findings will give commissioners a taste of what's coming. The biggest issue is going to be the quality of the medical center's accounts receivable, Stevens said.

"I'm hoping we won't have any major surprises," Stevens said. "I don't think we will."

The medical center has been beset by financial troubles and mismanagement, ailments that forced Clark County commissioners to authorize a $60-million bailout in March.

That action wiped out more than half of the Clark County's budget to build parks, community centers and other discretionary projects.

Commissioner Chip Maxfield said he would like auditors to look at UMC's ability to collect more of the money owed it. He's received many complaints from people about bills that are miscoded and subsequently aren't paid by the proper entities.

"We want to make sure that we're receiving 100 percent of what we're eligible to receive," Maxfield said. "Are you looking at that as well?"

Stevens said the billing system at the hospital is not a good one because it was designed for a much smaller institution. However, replacing it would be a $100 million proposition, he told the commissioners.

Maxfield stressed that there needs to be a way to track caseload and cost accurately at the hospital.

"We have to have a long-range plan for how to make the hospital well," Maxfield said.