[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6552705,"mediaKeyId","5108009-f4bf2a685f2b71ee8fc019bca87da86f","parentId",5108009,"title","KPMG finds inconsistent accruals, invoicing and revenue-reconciliation issues; committee hears 30/60/90-day ‘quick wins’","audioSeconds",382,"startMs",2723000,"endMs",3105000,"viewUrl","/Search/View?dp=1&key=5108009-f4bf2a685f2b71ee8fc019bca87da86f&start=2723&end=3105","thumbnailUrl","https://assets.pipeline.soar.com/5108009-f4bf2a685f2b71ee8fc019bca87da86f/thumbnail_2723000.jpg","articleUrl","/articles/6552705/Tennessee/KPMG-finds-inconsistent-accruals-invoicing-and-revenue-reconciliation-issues-committee-hears-306090-day-quick-wins","mediaUrl","https://secure.pipeline.soar.com/6552705-1af14a36a5a496b233ed6b4c6305b423/orig.mp4?Expires=1776031976&Signature=cVQDGgBT4YqREn2ZB-CvnTq8zwfmlHzhWjZjdewwHifdiZyOfLBzbNp9N2lzNxZGOl5LvI8ZcJhb4dzHSkqYR8TasTTXtkDDDotgq39Y4TxCzrpIebH9ePsyyRqCqVSMq6WC6rbW8uxcjJ9jy51bCgNauivOknOOeexASrC9fd73bTD5IgmIuG5jcG0~QYj0fOal3-~zFkMNgHHBKLbPL-6pE9bpUxR-K2NdqK0FScUylrgslkOpl7kgc4nHOfGnZDeA0ZTwj1M3DNczWyci9YwGDbKumfWvSnmsDuddUCDhds89IKC2wQc-Vd3OY2iVIA5stZSr5KLd7vDZRSM9yA__&Key-Pair-Id=KUT5TJCACFTXG","author","Metro Nashville Network","date","2025-06-27T09:07:39Z","article","KPMG told the Hospital Authority finance committee that its review of the hospital’s accounting and financial-reporting processes found multiple areas needing improvement, including inconsistent accruals, invoice-recording gaps, discrepancies in patient-revenue reporting and an allowance-for-doubtful-accounts methodology that auditors have flagged.

Hillary Simic, a partner with KPMG, said the firm began on-site work in May and focused on quick wins that could be implemented immediately, followed by longer-term process changes and year-end audit support. \"We've come out and have been on-site for a few weeks, really working closely with the team to understand what the current state process is,\" Simic said.

KPMG director Chris Dixon outlined what the team described as \"symptoms of an underlying problem\": accruals recorded with different methods by different people, invoices entering the accounting process inconsistently and patient-revenue and accounts-receivable reconciliations that lack hospital-side controls over data provided by the revenue-cycle manager. Dixon said the allowance for doubtful accounts is being estimated in multiple ways and sometimes underestimates the hospital's exposure.

Dixon also flagged an example of lease accounting that went unrecorded: a sanitization-equipment lease entered into and received, but not recorded on the books for roughly 18 months. \"That long gap, as you can imagine, causes issues in tracking your financials and measuring your net assets accurately,\" Dixon said.

KPMG described a set of quick wins already under way. Staff and consultants prioritized outreach to the 62 vendors that make up roughly 85% of expenses so accounting can obtain statements and better estimate accruals at month end. The KPMG team said it is tracking about 80 observations across accounts payable, accruals, revenue, leases and fixed assets and will measure improvements month to month using the month-end close and year-end processes.

Doctor Blackledge, who said he was appointed to the CFO role in February, welcomed KPMG’s work and said the improvements and the new finance hire introduced at the meeting will help stabilize reporting. KPMG said it will deliver an implementation roadmap with longer-term recommendations and will focus on June and August closes and year-end audit preparation.

Ending

KPMG and hospital finance staff characterized the immediate changes as measurable steps to improve the month-end close and the reliability of financial statements. The firm will return with follow-up reports and an implementation plan covering both quick wins and multi-quarter process changes.","mediaType","Video","parentTitle","06/26/25 Hospital Authority Board: Finance Committee","oneSentenceSummary","KPMG told the Hospital Authority finance committee it found inconsistent accrual and invoicing practices, gaps in patient-revenue reconciliation with the outsourced revenue-cycle manager and lease recording errors; KPMG and hospital finance staff described short-term fixes and a roadmap for longer-term improvements.","taxTitle","Hospital Authority Board Meetings, Nashville, Davidson County, Tennessee","taxId",69306,"location","Tennessee","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6552709,"Finance committee approves suite of IT, software and telecom contracts and forwards FY26 budget to full board",319,1986000,2305000,"/Search/View?dp=1&key=5108009-f4bf2a685f2b71ee8fc019bca87da86f&start=1986&end=2305","https://assets.pipeline.soar.com/5108009-f4bf2a685f2b71ee8fc019bca87da86f/thumbnail_1986000.jpg","/articles/6552709/Tennessee/Finance-committee-approves-suite-of-IT-software-and-telecom-contracts-and-forwards-FY26-budget-to-full-board","https://secure.pipeline.soar.com/6552709-780aeec69b877e6479b8493f5fc283a2/orig.mp4?Expires=1776031976&Signature=U8whP4hnjgZCL4ganV0R9Y6yXDBD9lqRlSIFlILh6grIpbcT3UdU3Ekdex7LnJyzgARR23pJnbE7zmDPx7xCZ1SfzXNT7HWZItWkn7auif-FOJsx6H-R8Hn1HUScMbfzrJmnRAv6jj6FRxnYNfn11N6301H3yZhwpl75rbqejHKpEJ2wL1Li2-iQs2NzsD6o2jbtzX-3URDF8UPbksa1qK1ZxBDBxmQesoZFZ5vqPtiafrMfWB4SOubZyEr4H5M5wtSgxq1l08nhv5Wmf07SGJl-0K2vYmh5JK5qEtbw3mH8WzH2W7F~5QijjHX7zft4pVq4~yS2cigUyUwqcuOv9Q__&Key-Pair-Id=KUT5TJCACFTXG","The Hospital Authority finance committee on an evening meeting approved a series of contracts for workforce software, clinical decision support, cloud and infrastructure services and carrier connectivity and voted to forward a proposed fiscal year 2026 budget to the full board.

The committee approved two phases of a UKG implementation for payroll/timekeeping and human-resources functions, a three-year subscription to MCG clinical criteria, network and internet circuits with Comcast, AT&T and Lumen, software and licensing agreements with Dell and Microsoft, and renewals for Liquidware Labs and other IT tools. Committee members then voted to advance the FY26 budget, which staff said reflects a $6 million reduction in the Metro subsidy compared with the authority’s initial request.

The contracts are intended to consolidate multiple systems, reduce manual effort and improve clinical and administrative workflows. Diana Wofford, staff member, presented the UKG contracts, saying they replace unsupported payroll software and combine timekeeping, scheduling and HR functions into a single suite. \"Before you have the UKG workforce pro timekeeping and HR system, they're 2 separate contracts, and we respectfully request that you approve these contracts,\" Wofford said.

K. (chair) moved and the committee approved each contract by voice vote with no recorded roll-call votes in the transcript. For the UKG work, Wofford said the combined platform will support recruitment, onboarding, scheduling, pay-for-performance, learning management and offboarding and is expected to improve data access for leaders and staff.

The committee approved a three-year agreement with MCG, a nationally recognized clinical-criteria vendor. A hospital presenter said the MCG subscription is embedded in the hospital's Cerner electronic health record and helps determine medical necessity and reduce payer denials. The presenter said the three-year cost is $28,311 with a 5% annual increase.

Adam Bertram, IT director, described the Comcast proposal as providing clinic Internet and a redundant circuit for Nashville General as part of business-continuity planning. Bertram said the hospital solicited three quotes for the data circuits and selected vendors for service and carrier diversity.

On software licensing, staff said they completed a software assessment and solicited quotes from multiple vendors; Dell was selected as the lowest-priced bidder on both the cloud services provider (CSP) and the Microsoft product-support agreement (MPSA) bids. Staff told the committee the combined licensing changes equal a $38,000 reduction compared with prior pricing after moving some licenses between contract types.

Doctor Blackledge, who identified himself as having been appointed to the CFO role earlier in the year, presented the FY26 budget slides and said the authority originally requested a $66 million Metro subsidy; the returned budget included $60 million, prompting staff to increase patient revenue assumptions and trim expense categories such as contract labor, supplies and pharmacy. \"I do respectfully ask the board's approval for the budget presented,\" Blackledge said. The committee approved advancing the budget to the full board.

Votes at a glance

- Minutes: Accepted (motion made and seconded; voice vote)
- UKG — Phase 1 (payroll/timekeeping): Approved (voice vote). Presenter: Diana Wofford; staff said the current payroll platform is no longer supported.
- UKG — Phase 2 (HR suite): Approved (voice vote). Presenter: Diana Wofford; described as the HR module to integrate with Phase 1.
- MCG clinical-criteria subscription (3 years): Approved (voice vote). Cost presented: $28,311 with 5% annual increase; staff said switching criteria now would require significant rework after embedding MCG in Cerner.
- Comcast data circuits (clinic internet and redundant circuit): Approved (voice vote). Presenter: Adam Bertram; three quotes solicited.
- Liquidware Labs (virtual desktop infrastructure analytics/monitoring): Approved (voice vote). Presenter: IT staff; three bids obtained; three-year pricing offered a year free.
- Dell CSP (Microsoft cloud licensing): Approved (voice vote). Presenter: IT staff; Dell quoted lowest price.
- Dell MPSA (on-premises Microsoft licensing): Approved (voice vote). Presenter: IT staff; staff explained Windows 11 licenses moved between contract types but combined pricing is reduced.
- Microsoft enterprise support (3 years): Approved (voice vote). Presenter: IT staff; described as broad support for Microsoft products.
- AT&T (site interconnectivity): Approved (voice vote). Presenter: IT staff; selected for price and diversity among carriers.
- Lumen (hospital internet renewal): Approved (voice vote). Presenter: IT staff; renewal for existing service.
- FY26 budget: Approved to be forwarded to the full board (voice vote). Presenter: Doctor Blackledge.

What the committee said about vendor selection and procurement

Committee members asked about formal RFP thresholds and why some items were not run through a formal RFP; Christy Lewis, staff member, said a quick-reference guide was created to clarify how to complete contract information sheets and asked presenters to include quotes and vendor comparisons when no formal RFP is used. Staff repeatedly reported that three quotes were gathered for the data-circuit and licensing procurements even when no formal RFP was issued.

Next steps and context

Most approvals were by voice vote during the finance committee meeting; the budget will return at the full board for final action. Staff said they will provide a written summary showing which contracts were anticipated in the FY26 budget and which are outside it. Several presenters described the changes as part of multi-year efforts to consolidate systems, contain costs and make administrative processes more efficient.

Ending

The committee then heard a KPMG presentation on accounting and financial-reporting improvements (separately reported) and welcomed a newly introduced finance hire. The committee adjourned to prepare for the full board session.","The Hospital Authority finance committee approved a set of IT, software licensing and telecommunications contracts and voted to forward the proposed fiscal year 2026 budget to the full board after staff outlined changes to a reduced Metro subsidy.","actionData","errors"]

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KPMG finds inconsistent accruals, invoicing and revenue-reconciliation issues; committee hears 30/60/90-day ‘quick wins’

Finance committee approves suite of IT, software and telecom contracts and forwards FY26 budget to full board