Nashville General Hospital audit reveals contract discrepancies and financial control weaknesses

Concerns over financial oversight and contract management took center stage at the Nashville Hospital Authority Board meeting on February 27, 2025. Board members expressed urgency in addressing significant issues raised during an audit, which revealed material weaknesses in internal controls and discrepancies in contract approvals.

Katie Farris, an audit director from Crossland PLLC, presented the findings of the fiscal year 2024 audit, highlighting two material weaknesses and two significant deficiencies in financial reporting. Farris emphasized that these issues could lead to material misstatements in financial statements, complicating the board's ability to make informed decisions. "The implementation of sufficient controls allows management to provide accurate monthly financial statements," she stated, underscoring the need for immediate corrective actions.

The audit also uncovered troubling patterns regarding contract management. Lauren Riley, the Metropolitan Auditor, detailed five allegations related to Nashville General Hospital, including overbilling by a valet service and contracts that bypassed board approval, totaling approximately $4.6 million. "We substantiated that there were contracts that did not go to the board appropriately," Riley confirmed, raising alarms about the hospital's financial governance.

Board members reacted strongly to the findings, with calls for a thorough review of the contracts in question. One member noted, "We need to understand agreements that should have been presented to us, that were not presented to us," emphasizing the potential implications of these oversights on the hospital's budget and operations.

The meeting concluded with a commitment to further investigate these issues and ensure that corrective measures are implemented. The board plans to revisit the audit findings in their next meeting, aiming to restore confidence in the hospital's financial practices and governance.