UNMH Accountability

$90 million – the amount Bernalillo County taxpayers send to the University of New Mexico Hospital each year. $146 million – the cash on hand UNMH plans use to build the first phase of a 5.2 million square foot mega-hospital. Zero – the amount of accountability the hospital has for the use of 6.4 mils ($90 million) of Bernalillo County taxing authority.
Last June, the University of New Mexico Hospital made public its plans to build the first phase of its master plan – a 96 bed elective care hospital. The justification for the expansion was and is to reduce emergency room wait times by moving elective or scheduled care to the new facility thereby freeing up beds in the old hospital for patients coming from the ER – which would in turn free up exam rooms currently occupied by ER patients waiting for a bed “upstairs.” 
Let’s assume for a moment that there are not questions about the hospital’s occupancy rates and that it is currently operating at 91% to 95% of capacity not the 63% to 71% provided by the Hospital Association and the Department of Health. Let’s also assume that the UNMH has done everything within its power to schedule elective care during non-peak hours and has implemented policies that use current resources in the most efficient manner. If we accept those assumptions, then UNMH may have made its case that they need to build a new 96 bed facility.
However, there would still remain serious questions about how UNMH managed to squirrel away $146 million in order to build a new 185,000 sq. ft. facility out of cash on hand. Remember, UNMH is a public hospital and receives substantial public funding particularly from Bernalillo County.  Those county tax dollars are treated as “direct revenue to offset uncompensated care.” In other words, dumped in to a single pot where they are co-mingled with the hospital’s other revenue sources without any requirement to account for the specific uses of those tax dollars.
So how did we get here? Back in 1978, Bernalillo County entered into an agreement with the University to take over operation of the Bernalillo County Medical Center – later to become UNMH. In 1992, the Commission placed on the ballot a 4.3 mill per year levy for the “continued operation and maintenance of the Hospital.” The voters approved the levy that year but the Commission retained some authority over how those dollars were used – that is until 1999.
In 1999, the County entered into an agreement with the University that transferred “exclusive responsibility” to “control and manage the Hospital” and made the UNM Regents the “ultimate governing body.” The County agreed to continue to provide “Mill Levy support,” and to “use its best efforts to obtain approval” for continued support from the voters.
At that time, the agreement provided roughly 2/3rds of the current $90 million. In 2004, UNMH needed the County to extend the lease to a 50 year term in order to secure financing for the Bill and Barbara Richardson pavilion. 
Four years later in 2008, claiming inadequate indigent care funding, UNMH asked the Commission to place on the ballot a 50% increase in Mill Levy support that was approved by the voters and added roughly $30 million to existing funding. At about the same time according to UNMH CEO, Steve McKernan, the Hospital had already begun putting away “savings” in order to fund the new $146 million facility. How can UNMH claim poverty while at the same time run a surplus sufficient to put away over $146 million?
It’s clear that the taxpayers of Bernalillo County have contributed a significant amount of their tax dollars to this project without their knowledge. It’s also clear that the hospital’s 2008 claims of poverty were somewhat exaggerated. 
As County Commissioners, we have a fiduciary responsibility to the people of Bernalillo County. But the fact is, through a series of ill-advised leases the Commission no longer has the ability to live up to that responsibility. 
In the end, UNMH may build its new facility – and it may even be justified. But that doesn’t change the fact that taxpayers are providing $90 million a year to UNMH with little oversight and no accountability. It’s a situation that needs to change in order to provide the public with the representation, stewardship and health services that they deserve.
—— Note —–
This article was published by the Albuquerque Journal under the title “Increase Oversight on UNMH Tax Money” on Monday January 14th, 2013. Read it here (subscription required).