Board approves KPMG advisory contract and multiple renewals as finance committee flags volume declines and cash steps

The Nashville General Hospital Authority Board approved a short‑term advisory contract with KPMG and several contract renewals April 24 after the finance committee recommended the agreements.

KPMG advisory contract: The board approved a KPMG engagement described as accounting, financial reporting and operational efficiency assistance from May 1 through July 31, with an expectation of deliverables into August. The contract price reported to the board was $910,000. Board members stated the work is to strengthen accounting infrastructure, speed up month‑end/year‑end close processes, improve reporting, and help produce an actionable plan for operating efficiencies. A board member stated the contract will be funded in part from a Metro subsidy provided earlier in the year.

Other contracts approved: The board also approved renewals or reauthorizations for Health Catalyst (cancer data abstraction and reporting), Registry Partners (presentation of cancer registry information), EnerSource Mid South Satellite (security/cable signal protection) and Gallagher (directors & officers, cyber, umbrella and crime insurance). The Gallagher renewal was discussed as time‑sensitive and the committee recommended increasing umbrella coverage; the committee identified funds to cover the added cost. The Health Catalyst and Registry Partners contracts were presented as necessary for compliance and accreditation related to cancer reporting.

Finance report highlights: Finance staff told the board the hospital’s March volumes were mixed: inpatient admissions fell from 296 in February to 232 in March but remained above a budgeted 220; emergency department visits increased month‑to‑month (2,252 in March) but were below budget by 83 visits; outpatient clinic visits rose to 4,645 and were 26% above budget year‑to‑date. Deliveries decreased from 40 to 32.

Financial results: Net patient revenue for March was reported at about $4.45 million, approximately $924,000 below the month’s budget. The hospital reported a monthly net loss of roughly $1.4 million and a year‑to‑date loss of about $19.8 million; cash at month‑end remained positive after Metro subsidy draws and capital funds. Finance staff noted seasonality and extra days in March affected comparisons.

Cath lab status: The board discussed that there was no cath lab volume in the period reported. Clinical leaders and finance staff said the hospital has equipment and staff capacity but lacks interventional cardiologists; Vanderbilt was cited as a potential partner to cover interventional procedures while the hospital stabilizes staffing.

Why it matters: The KPMG engagement and contract approvals are intended to shore up accounting and operational processes during a period of negative operating results and leadership transition. The finance report showed the hospital remains operational but financially stressed and using temporary Metro subsidy and capital funds to maintain cash.

Quotations: “I believe, to me, I’m excited that we'll have a financial infrastructure that will be a little more transparent, a little more accurate,” said a finance‑committee speaker describing KPMG’s expected contribution. Hospital staff reported the KPMG work is intended to produce faster, more reliable financial reporting and actionable operating recommendations.

Board procedure: Each contract was taken up after review in the finance committee and approved by voice vote; the meeting record shows committee discussion of alternatives and pricing but no roll‑call vote tallies in the transcript.