Visiting Nurses warn fund balance shrinking as charity care rises

Douglas County Visiting Nurses executives told the County Commission that charity care has risen sharply and that ongoing declines in reimbursement have eroded operating margins, requiring the use of reserves in coming years.

Cynthia Lewis, CEO, and Pam Morgan, the finance director, said charity care increased about 40% over three years and that changes in Medicare reimbursement have made operating profits difficult amid rising inflation. Morgan said the organization has been drawing on fund balance; between 2023 and 2025 projections the organization expects a significant decline in reserves if current trends continue. She said the in‑kind value of their facility in the county health building is approximately $315,000 and must be recorded on financial statements.

Commissioners asked for clearer, internally consistent budget documents; staff noted partner budget sheets are sometimes updated late and asked partners to ensure year‑to‑date and adopted figures are clearly labeled. The commission did not take formal action on the request in this session and asked for additional financial detail.