THE PATIENT IS GETTING HEALTHIER
After four years of slogging through the dreary fiscal trenches, Andrea Mossman was able to report some good news Wednesday.
At the Aug. 19 Northern Inyo Hospital District (NIHD) board meeting, Chief Financial Officer Mossman delivered an upbeat report on the district’s overall financial health. She literally said “good news” multiple times during her presentation.
In the recently completed 2026 fiscal year, the district saw increased revenue, higher investment income, fairly stable expenses and a very helpful $10 million shot in the arm from the federal government ($2 million from a Medicare settlement and $8 million from an IRS refund). That translated into a better-looking balance sheet than Mossman has presented in the four years since she took the CFO job.
While the majority of services and care delivered to patients saw a slight increase, the bottom line was boosted by a solid increase in surgeries at the hospital. The numbers: General Surgery: 108 cases above budget (13%); Orthopedics: 79 cases above budget (38%, thanks to a partnership with the Mammoth Orthopedic Institute); Urology: 31 cases above budget (21%).
The concise general summary from Mossman stated, “Growth in admissions, surgical services, diagnostic imaging, and outpatient clinics generated revenue above budget while ongoing … initiatives improved cash flow and liquidity. … The organization successfully exceeded budget through sustained volume growth, disciplined financial management, and favorable non-operating income.”
The investment report was positive.
“We’re growing cash for the first time ever,” Mossman said, adding that four years ago the district was “depleting” its cash. The district investment accounts started FY 2026 with about $10 million and ended the year with about $36 million invested. Mossman noted the $8 million from the IRS helped beef up that total, as did moving money to garner higher interest rates in the 4-6% range. Investment income came in at about $774,000. Operating income for the year hit $116.4 million, about $8 million higher than budgeted. Expenses ate up that additional income, rising by about $8.6 million to $124 million. That left a fairly modest $551,000 slice of red ink in the operating budget.
The “good news” Mossman highlighted was that NIHD actually turned an operating profit (oops, nonprofits don’t do profits, “revenue exceeded expenses”) in the last two quarters of 2026 totaling $2.7 million.
The nadir of the operating budget hit in the fourth quarter of 2025 when the operating budget was about $14 million in the red.
The biggest increase in expenses came from a 5% yearly raise for NIHD employees, which was not budgeted, she noted. Total salaries and benefits were $64.5 million, or 52% of total costs.
On the bright side of the payroll ledger, employee benefits were only 35% of total wages, while last year they were 49% and four years ago hit 70% of payroll expenses. The district has now funded about 45% of its pension liability, she said, a big improvement from 7% four years ago.
“Days of Cash on Hand” is a common financial benchmark, and NIHD ended 2026 with enough cash to cover 122 days operations. Again, a big change from the low point of just 84 days of cash in 2024.
Bond holders like to see at least 75 days of cash, Mossman said. That 122-day figure could be misleading on the low end. The district has about $40 million of unrestricted cash, Mossman reported, and $30 million of accounts receivable on the books, she added.
A new AI billing and collection system, innocently named Jorie, has led to “record cash collections” and a big drop in write-offs, she said.
“Overall,” Mossman concluded, “NIHD enters Fiscal Year 2027 from a position of improved financial strength.”
