Auditors present UMC El Paso Hospital District financials; commissioners accept report

Auditors from Forvis Mazars presented the El Paso County Hospital District's audited financial statements for the year ended Sept. 30, 2025, to the Commissioners Court on Jan. 12. Danielle Zimmerman, partner, explained the audit scope, significant judgment areas and benchmark comparisons with other large Texas public hospital districts.

Zimmerman flagged material areas of audit focus: patient accounts receivable and allowance for contractual adjustments, supplemental Medicaid funding settlements that flow through the district's statements, and pension-related assumptions affecting the net pension liability. The auditors also assisted the district with adopting GASB 101 (compensated absences), which required a true-up to accrued expenses during the audit process.

Officials discussed the district’s debt profile. Commissioners asked whether the district’s roughly 48% debt-to-asset ratio should raise concern; the auditors and the district CFO explained much of the debt is general obligation debt approved by voters and tied to capital projects. Auditors noted peer comparisons and said that, given the capital nature of much of the debt and upcoming tax revenues and bond proceeds, the ratio is within industry norms for capital-expanding districts.

Audit highlights presented to the court included approximately $145 million in property-tax revenue for the district and Medicaid supplemental funding recognized at around $149 million, both material to operating results. The district reported an increase in net position of about $16.4 million in 2025 compared with a decrease the previous year.

Commissioners voted to accept the audit presentation; the motion carried. The court recorded that follow-up work will include ongoing grant compliance and the completion of a federal single audit for expenditures exceeding the single-audit threshold.