Taos Health Systems: one-time HDAA payment masks year-long revenue shortfall, CEO says

James Geiser, chief executive officer of Taos Health Systems, told the Taos County Board of County Commissioners on June 3 that the hospital’s gross revenue through April was about $152,000,000, roughly $4,663,000 under the budgeted $156,000,000.

“Before [the HDAA payment], we've been running all year long in a loss,” Geiser said in his presentation. He explained that the system received a Health Care Delivery and Access Act payment of about $6.35 million and, after a hospital tax of roughly $763,000, netted about $5.6 million that materially improved the year‑to‑date bottom line. Geiser also highlighted operational pressures: inpatient admissions and orthopedic surgeries — a high average‑charge area for the hospital — are down, and the hospital is paying more for locum coverage for surgical call.

Commissioners asked about liquidity and reserves. Geiser said days of cash were about 49.3 for April and discussed reserve targets for critical‑access hospitals, noting a typical goal of 80–100 days and that some peer hospitals aim for 180 days. “There’s a quality and patient safety category… only 25% of those HDAA funds can go toward building those reserves,” he said, describing constraints on how the supplemental funds may be used.

The presentation also listed capital purchases funded through mill levy allocations (about $4,045,867 to date) and noted ongoing purchases tied to GRT transparency reporting. Commissioners said they would continue monitoring the hospital’s financial plan and the effect of potential future HDAA payments on service expansion and reserves.