MOSES LAKE — While bad debt and charity care expenses at Samaritan Hospital were lower than anticipated in September, they’re higher than projected for the first three quarters of the year. Chief Administrative Officer Alex Town said that’s a reflection of the way people are paying their bills, and that trend may continue in 2026. Town said Samaritan administrators have increased the amount of anticipated uncompensated care from the original 2026 budget projections.  

“As I’ve mentioned previously, in 2023 we were at $6 million (in uncompensated care expense), in 2024 at $8 million, and this year we’ll be at nearly $13 million,” Town said.  

Some low-income patients qualify for reductions or elimination of their bill, referred to as charity care. That’s in addition to money owed to the hospital that’s written off as uncollectible. Town said the way people are paying for medical care delivered by Samaritan, referred to as payor mix, is changing, and the number of people who don’t have insurance of any kind, referred to as self-pay, is increasing. 

“What’s concerning to me is our self-pay payor mix. (In August) we were at 3%, which is the highest I’ve ever seen. In September, our self-pay payor mix jumped up to 3.5%,” Town said. “And with all the regulation changes to Medicaid eligibility, it’s going to be more difficult to get those patients enrolled.” 

Town said he expects that to have a significant impact on bad debt and charity care expenses, and the 2026 budget projections reflect that. The preliminary budget will be presented to the hospital board at its Nov. 11 meeting.  

Hospitals typically are paid for their services through a mix of publicly funded insurance, private insurance and self-pay patients. For the year through the end of the third quarter, the percentage of private insurance and publicly funded insurance customers increased slightly when compared to the 2025 budget. 

Even with increased bad debt and charity care, Samaritan is projected to finish 2025 in a good financial position.

“Unless something dramatic happens, we’re going to finish this year off very well,” Town said.

The number of surgeries is below the budget projection, Town said, and so is the number of people who stay in the hospital overnight or longer for treatment, referred to as medical admissions. The obstetrics department is above budget projections, however. Town said the loss of an orthopedic surgeon contributed to the decrease in surgeries.

Outpatient revenue – for people who are treated and discharged the same day – is above the budget projection, however. Town said some treatments that used to require an overnight stay now can be done in a day.

Revenue from the two Samaritan Clinics is well below the budget projection; the clinic has some open family medicine physician positions, which is a contributing factor, he said.

Expenses are slightly lower than projected through the first three quarters of the year. Samaritan has hired more permanent staff, which has allowed the hospital to reduce its temporary staff. Town said he expects the need for temporary manpower to keep decreasing in 2026. But Chief Executive Officer Theresa Sullivan said temporary employee expenses will go up in the spring, while Samaritan is moving to its new hospital.

Even with the revenue challenges, Samaritan is about $10.6 million in the black for 2025 to date and ahead of the budget projection, Town said.