Carson Tahoe improves net worth in 2010

Carson Tahoe Regional Medical Center improved its net worth by $25.6 million during the year, driven by about $13 million in net operating income and the $6 million in donated funds to the Carson Tahoe Cancer Center, which the hospital acquired last year.

Downtown Reno's two big hospitals - Renown Regional Medical Center and Saint Mary's Regional Medical Center - lost a combined total of more than $68 million last year.

The gusher of red ink at the two big hospitals more than offset profits at Northern Nevada Medical Center, the fourth other acute-care hospitals in the Reno, Sparks and Carson City region. The six hospitals posted a combined loss of nearly $27 million during 2010.

Analysts and hospital executives said the financial performance indicates that hospitals continue to struggle as high unemployment leaves many workers without a way to pay for health care.

At the same time, they said, some hard-pressed employers have reduced health benefits and some consumers have decided to put off elective medical procedures because they don't want to pay their out-of-pocket costs.

Most of the hospitals showed marked improvement in their financial performance during the final quarter of the year.

Saint Mary's Regional Medical Center lost more than $44.5 million during the year, although the rate at which the hospital lost money slowed during the fourth quarter.

Renown Regional Medical Center, meanwhile, reported a loss of $24.1 million for the full year despite a fourth-quarter turnaround that led to net income of $7.65 million in the last 90 days of the year.

The data is collected by the Center for Health Information Analysis at the University of Nevada, Las Vegas.

The financial reports made public last week also show:

• Northern Nevada Medical Center in Sparks recorded net income of $5.37 million, including income of nearly $4.2 million during the fourth quarter.

• Renown South Meadows was profitable through the year, recording net income of $6.1 million during 2010.

• Sierra Surgery and Imaging LLC, a physician-owned specialty hospital in Carson City, recorded net income of $4.6 million during the year.

The combined loss of $27 million last year for the six hospitals in Reno, Sparks and Carson City compares with a combined loss of about $100,000 in 2009.

In 2009, Renown Medical Center earned $12.8 million, Saint Mary's lost $40 million, Northern Nevada Medical Center lost $2.2 million, Carson Tahoe Regional Medical Center earned $21.9 million, Renown South Meadows earned $3.1 million and Sierra Surgery and Imaging earned nearly $4.3 million.

While the two biggest hospitals in Reno struggled financially last year, small hospitals in the rural - largely gold-rich - counties of northern Nevada thrived last year.

Rural hospitals in the region posted net income of nearly $55 million, with Northeast Nevada Regional Hospital in Elko accounting for $30 million of the rural total.

Mike Uboldi, president and chief executive officer of Saint Mary's, noted that the hospital cut its loss during the fourth quarter to $8.3 million, down more than $6 million from the previous quarter.

"Even though we saw our financials improve in the fourth quarter of last year due to the excellent medical management by our hospital physicians, we continue to struggle financially like most of Nevada's hospitals due to the economic recession," Uboldi said.

John Packham, director of health policy research at the University of Nevada School of Medicine, says hospitals nationwide have struggled during the downturn.

"It continues to be a tough year for hospitals, and an extremely tough year for hospitals in Nevada," Packham said.

He said the safety net of health insurance continues to erode across the state - high jobless rates and employer cutbacks of benefits both play a role - and consumers continue to stall on some medical care if they can put it off for a while.

Here's one indication of that trend:

At the two Renown hospitals in Reno - Renown Regional Medical Center and Renown South Meadows - outpatient operations generated $175.6 million in 2009. Last year, that revenue fell by about 6.8 percent and totaled $163 million at the two hospitals.

Even hospitals that did well during 2010 required close management.

Ed Epperson, president and CEO of Carson Tahoe Regional Healthcare, said managers have been keeping a close eye on costs while encouraging an organization-wide focus on generating and collecting revenue.

He said, too, the hospital has been working with physicians and others in the community to develop new programs to meet healthcare needs.

Mark Crawford, chief executive of Northern Nevada Medical Center, said the hospital stayed close to a strategic plan it developed four years ago.

"Despite the regional outlook, we knew that we had effectively charted our course and made sure that we did not stray," Crawford said.

Northern Nevada Medical Center, like other hospitals in the region, saw a sharp upturn in income during the fourth quarter. Nearly 80 percent of its net income came during the last quarter of the year.

At Renown Regional Medical Center, meanwhile, the fourth quarter's net income of $7.6 million was a $15 million turnaround from the third quarter.

Hospital financial analysts say the fourth-quarter boom probably reflects some combination of an improving local economy, rising rates of illness with the onset of winter and a rush by patients to use medical benefits that expire at the end of the calendar year.