Auditors give University Medical Center of El Paso district an unmodified opinion; commissioners accept 2024 audit

The El Paso County Commissioners Court on Jan. 13 accepted the audited financial statements for the El Paso County Hospital District (University Medical Center and related entities) for the year ended Sept. 30, 2024, after a presentation from auditors who issued an unmodified opinion.

Chris Clark, managing partner with Forvis Mazars, told the court the audit provides reasonable assurance that the district’s financial statements and footnotes are accurate and complete. "We have issued an unmodified opinion on the financial statements," Clark said.

Why it matters: An unmodified opinion indicates auditors found no material misstatements in the district’s year-end financial statements. Commissioners and hospital officials used the presentation to review operating trends and to discuss how growth in services has affected revenue, accounts receivable and reserves.

Key findings presented

- Unmodified audit opinion: auditors reported no material exceptions. - Balance-sheet growth: total assets rose from about $764 million in 2020 to $935 million in 2024. - Net position: the hospital district’s net position rose from about $125 million (2020) to $213 million (2024), a roughly 70% increase across five years. - Revenue and expenses: net patient service revenue increased from approximately $392 million in 2020 to about $725 million in 2024 (an 85% increase by the district’s reporting), driven in part by new facilities that opened in 2024. - Accounts receivable: days-revenue-in-AR rose slightly, with patient accounts receivable at about $118 million this year, up from $92 million last year — a trend auditors tied to ramping activity at a new micro-hospital and surgical hospital. - 2024 net position decline: the combined district reported a decline in net position of about $18 million for the year; auditors and staff explained two principal drivers behind the year-over-year change: lower health-plan support (about $20 million) and a redistribution of previously recorded supplemental Medicaid settlement payments to other participating hospitals (about $18–30 million as discussed during Q&A).

Commissioner and staff discussion

Commissioners questioned whether the drop in net position reflected a one-time adjustment or recurring pressures. Auditors pointed to specific items that affected 2024 results, including the health plan enrollment normalization following the COVID public-health emergency and a settlement redistribution that was recognized in 2023 and adjusted in 2024.

Action and next steps

The court voted to accept the audited financial statements on a motion by Commissioner Olguin and a second from Commissioner Butler. County and hospital leaders said the team would continue to monitor accounts receivable and to report on grant-compliance audits scheduled for spring. Auditors noted an upcoming single-audit (grant compliance) due under federal rules for entities receiving more than $750,000 in federal funds.

Speakers (as identified in the meeting)

- Chris Clark, managing partner, Forvis Mazars (auditor) - Jacob (UMC/El Paso Hospital District leadership; first name used in meeting) - Michael Nunez (hospital district official) - Omar Garza, El Paso Children (accounting lead referenced) - Gus Gonzales, El Paso Health (accounting lead referenced)

Authorities

- policy/regulation: Federal Single Audit requirement (for entities receiving >$750,000 in federal awards) — referenced by auditors in discussion of upcoming compliance work.

Actions

[{ "kind":"other", "identifiers":{"agenda_item_id":"6a"}, "motion":"Accept the audited financial statements for the El Paso County Hospital District as of Sept. 30, 2024.", "mover":"Commissioner Olguin", "second":"Commissioner Butler", "tally":{"yes":5,"no":0,"abstain":0}, "outcome":"approved", "notes":"Auditors issued an unmodified opinion; staff to proceed with grant-compliance audit work in spring." }]

Clarifying details

- "Patient accounts receivable": Approximately $118,000,000 at year end; auditors attributed increase to ramp-up of newly opened micro-hospital and surgical hospital. - "Net position change": A decline of about $18,000,000 in 2024 driven by a drop in health plan support (~$20,000,000) and redistribution of supplemental Medicaid settlement payments (discussed figures approximating $18–30 million during Q&A).

Proper names

[{"name":"University Medical Center of El Paso","type":"organization"},{"name":"Forvis Mazars","type":"organization"},{"name":"El Paso County Hospital District","type":"organization"}]

Community relevance

- geographies: ["El Paso County"] - impact_groups: ["patients","taxpayers","health-plan members"]

Meeting context

- engagement_level: {"speakers_count":5,"duration_minutes":45,"items_count":1} - implementation_risk: "low" - history: [{"date":"2024-10-01","note":"New micro-hospital and surgical hospital opened, driving AR increase."}]

searchable_tags:["UMC audit","Forvis Mazars","accounts receivable","net position"],

salience:{"overall":0.62,"overall_justification":"Financial audit affects fiscal oversight and bond confidence; unmodified opinion is important for bond markets.","impact_scope":"local","impact_scope_justification":"Affects county hospital finances and local health services.","attention_level":"medium","attention_level_justification":"Primarily of interest to finance and health-care stakeholders."},

engagement_forecast:{"newsworthiness":{"national":0.05,"regional":0.20,"local":0.75,"justification":"Local fiscal oversight and hospital operations are mostly locally relevant."},"notify_recommendation":{"audience":"city","reason":"Local stakeholders and health reporters will track fiscal health and bond implications.","justification":"Unmodified audit opinion is routine but notable."},"predicted_read_time_minutes":3.0}