Finance committee reviews March variance report, flags locum and overtime costs and calls for deeper revenue reconciliation

The Del Memorial Clinic Finance Committee spent substantial time April 21 reviewing the March variance report and operational metrics to understand revenue timing and recent cost pressures.

Executive Director Albert Wall told the committee primary-care revenue is lagging and that staff absences in January–March reduced collections. He said the clinic moved $300,000 from the locum-tenant line into salary during a prior budget cycle for an employed medical doctor; after that provider’s departure in March, the money had to be moved back and the locum-tenant line is still projected to be overspent. Wall said the committee has options including buying out Wilderness Staffing contracts or renegotiating them.

Wall explained Wilderness providers are paid a guaranteed week on day rates plus callback at about $149 an hour, which creates fixed costs and unpredictable callback expenses tied to weather and seasonal demand. He said one contractual change — moving certain providers off call — could cut an estimated $4,500 a week in costs for each shift reclassified.

On revenue, Wall cautioned that Athena-sourced month-to-month figures are approximations and revenue historically did not appear on variance reports until June; he intends to seek exact transfer numbers from municipal staff. He also said Medicaid reimbursements increased revenue in March and noted an item showing a quarterly HRSA drawdown amount.

The committee discussed accounts receivable and collections; Wall said hiring an accounting clerk has increased the volume of accounts being sent to collections as staff clean up historic debt, and he framed this as a deliberate accounting cleanup ahead of grant or organizational changes. Committee members asked for clearer, month-to-month comparisons and for updated estimates to be provided to the board.