Cash-strapped Nashville hospital struggles with basic bookkeeping, city seeks to halt inpatient services: 7 things to know

An audit of financially struggling Nashville (Tenn.) General Hospital found the city's safety-net facility has been grappling with bookkeeping and accounting issues, although improvements have been made in more recent months, according to The Tennessean.

Here are seven things to know.

1. Auditors from Crosslin reviewed Nashville General's finances for the fiscal year ended June 30.

2.They ultimately determined hospital management did not have proper oversight of transactions or activity of hospital accounts, according to the report.  

3. The Tennessean reports auditors said that issue resulted "material misstatements" in financial numbers for accounts such as patient payments and lease payments.

4. The auditors stated, "Without continued improvements in the processes and controls around the hospital's financial statements, management will be unable to provide accurate and appropriate financial statements for the hospital on a timely basis."

5. The audit released Wednesday revealed similar issues found in an audit released Jan. 12. That audit determined the hospital did not accurately monitor finances during fiscal year 2016. At the time, Nashville General CFO Geoff Blomeley placed partial blame on his decision to require management to generate monthly reports, which moved focus to managing cash rather than annual accounting practices. Mr. Blomeley has since left, and Bruce Naremore now serves as CFO.

6. Although audits of fiscal year 2016 and fiscal year 2017 revealed similar bookkeeping and accounting issues, auditors acknowledged the hospital has made some basic improvements to accounting so far in fiscal year 2018. They noted in the report any improvements won't be completely reflected until the next audit.

7. In the meantime, the future of the hospital remains unclear. The Tennessean reports Nashville Mayor Megan Barry and leaders at Nashville-based Meharry Medical College are considering a proposal to stop inpatient services at Nashville General.

Read the full report here.

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