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Finance update: hospital reports month loss, metro subsidy and payer mix central to operations; Midtown clinic lease likely not renewed
Summary
Hospital finance staff reported a $1.1 million loss in April and said a $60.7 million Metro subsidy remains a central revenue source; leadership recommended not renewing the Midtown Clinic lease amid multi-year operating losses and the board approved a wind-down through June 30.
Keith Moran and Dr. Blackledge presented the April financials and a payer-mix analysis and told the board the hospital continues to operate at a loss while the Metro subsidy remains a major funding source.
Moran reported April net loss of $1,100,000 and a year-to-date net loss of $19,900,000. He said inpatient admissions, outpatient visits and case-mix index had mixed performance against budget and the cath lab remains an underperforming revenue source. Dr. Blackledge and finance staff said a Metro subsidy of $60,700,000 is a key component of the hospital's revenue mix; the presentation tied that subsidy to the hospital's charter to serve uninsured patients and county inmates, and staff said uninsured care plus Davidson County inmate care together accounted for about 32.8% of patient volume in the displayed snapshot.
On service consolidation, Dr. Elders told the board the Midtown Clinic at 1919 Charlotte Avenue has produced operating losses (roughly $1.5 million to $2.5 million in recent years and about $1.7 million through April 30, 2025) and hospital leadership intends not to renew the five-year lease. The board approved a short extension to June 30 to wind down operations and to move two primary-care providers and several specialty providers to Bordeaux and Metro Center locations; leadership said the receiving clinics have capacity to absorb the providers.
Why it matters: Financial performance and the interplay between insured revenue, Medicare/state funding and a large Metro subsidy shape operational decisions including clinic consolidation and service locations. Leadership said efforts to increase insured patients, pursue state hospital reinvestment funds and clean up patient contact data for surveys are part of the funding plan.
Provenance: Financials and the Midtown Clinic discussion were presented during the finance committee and CEO reports; the board discussed payer mix, state funding programs and the planned clinic closure.
