Miami public hospital's financial picture getting worse

While some health systems were slowly, painfully beginning to regain their footing as 2009 drew to a close, they may be the lucky ones. In the case of one badly-needed public health system serving Miami's poorest residents, the picture appears to be getting grimmer by the minute.

At the 1,550-bed flagship hospital for Jackson Health System, a sprawling facility which provides ongoing care for some of the city's poorest neighborhoods and operates the region's only Level I trauma care center, things are going from bad to worse. Board members for Jackson Health System, which runs the much-needed public hospital, are already looking at an $88 million loss this fiscal year.

With patient volume dropping by 6.5 percent recently, that number is likely to get worse. In fact, though unaudited statements from the county's Public Health Trust suggest a $56 million loss for the last fiscal year, that number could hit $150 million, some observers suggest. And as if that weren't bad enough news, the hospital is likely to be hit harder by state budget cutbacks as Tallahassee deals with its own budget crunch.

Board members with the Public Health Trust seem most concerned over the executive leadership's inability to get a good handle on the actual volume of accounts receivable owed to the system. As of Nov. 30, Jackson listed accounts receivable at $431.8 million, but that number seems quite uncertain, board members say.

Some execs there say that the problem lies with a faulty computer system that has been listing uncollectable bad debts as accounts receivable; others say that the hospital has been estimating collections on 29 percent of gross charges, where the number could really sit at 24 to 26 percent. All told, it all sounds pretty slippery for an institution with $1.9 billion in annual revenues and 10,000 employees. One has to wonder how managers could let this much slip.

This apparently isn't the first time Jackson has had issues with the value of its oustanding accounts; in 2007, it was sued by collector International Portfolio Inc., which claimed that the $1.9 billion in accounts receivable it bought were worth nowhere near what the system had claimed.

To learn more about Jackson's woes:
- read this Miami Herald piece

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