Hospital posts September operating gain but warns of slow cash collections and rising payables
October 17, 2025 | Weston County, Wyoming
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The hospital reported a net operating gain for September but finance leaders warned the board that cash collections lag behind recorded revenue, leaving the organization with higher accounts receivable and accounts payable balances.
Tish, the finance presenter, told the board the hospital posted a $118,000 gain in September and that gross patient revenue was strong for the month, but much of that revenue had not yet been collected. “We made lots of money, we just haven't collected it,” Tish said, explaining that cash collections lag revenue and that Medicare and other payers can take up to 60 days to pay claims.
Tish said deductions for contractual allowances were slightly better than budget and total expenses for the month were lower than budget, which helped the bottom line. She and others noted accounts payable ranged “between 45 and 61 days” and rose after booking large state invoices that must be paid so the hospital can remain eligible for quarterly payments. “We have to pay that by November,” she said when explaining the increase in payables.
Board members asked about work to improve collections. Carrie and other participants said the new collections vendor (started activity in late September) began by working older claims and moved to more recent accounts on Oct. 1; finance leaders said the earliest collection improvements should appear in mid- to late October, with clearer results by the end of the month or the start of November.
The finance report also itemized non-operating items and one-time receipts: CT project donations (noted in finance documents), a refund and a sale of older injectors for the new CT, interest and bond interest expense, and a BARATA loan payment related to pharmacy equipment. Tish said daily cash outflows declined modestly and that days cash on hand increased by three days because expenses were down in September.
The board discussed next steps: accelerate claim submissions and collections work, monitor accounts payable deadlines tied to state programs, and continue implementing Epic and charge-master corrections that finance said are underway.
Tish, the finance presenter, told the board the hospital posted a $118,000 gain in September and that gross patient revenue was strong for the month, but much of that revenue had not yet been collected. “We made lots of money, we just haven't collected it,” Tish said, explaining that cash collections lag revenue and that Medicare and other payers can take up to 60 days to pay claims.
Tish said deductions for contractual allowances were slightly better than budget and total expenses for the month were lower than budget, which helped the bottom line. She and others noted accounts payable ranged “between 45 and 61 days” and rose after booking large state invoices that must be paid so the hospital can remain eligible for quarterly payments. “We have to pay that by November,” she said when explaining the increase in payables.
Board members asked about work to improve collections. Carrie and other participants said the new collections vendor (started activity in late September) began by working older claims and moved to more recent accounts on Oct. 1; finance leaders said the earliest collection improvements should appear in mid- to late October, with clearer results by the end of the month or the start of November.
The finance report also itemized non-operating items and one-time receipts: CT project donations (noted in finance documents), a refund and a sale of older injectors for the new CT, interest and bond interest expense, and a BARATA loan payment related to pharmacy equipment. Tish said daily cash outflows declined modestly and that days cash on hand increased by three days because expenses were down in September.
The board discussed next steps: accelerate claim submissions and collections work, monitor accounts payable deadlines tied to state programs, and continue implementing Epic and charge-master corrections that finance said are underway.
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