Members of the Texas County Memorial Hospital board of trustees learned this week that an update of a strategic plan for the institution is under way.

Strategic planning efforts are underway at Texas County Memorial Hospital, according to Wes Murray, chief executive officer at TCMH. He reported on current planning efforts at the county hospital to members of the hospital’s board of trustees at their monthly meeting.

“We have completed many things in our strategic plan over the past few years,” Murray said. “But it’s time to pick up this plan again and move forward.”

The largest construction project in the history of the hospital is nearly complete.  Additional construction for a tornado safe room and a new surgery department is underway.

“There is still work to be done to our facility to enhance all of our patient care areas and make them ready to best serve the patients in our service area,” Murray said.  “Re-focusing on our strategic plan will also give us the opportunity to address the changing healthcare environment.”

A consultant from the Ozarks Independent Health Network, the independent hospital consortium that TCMH has joined, will be on site in late October working with the hospital’s administrative team.

Murray presented a sample strategic plan that uses color coding on a detailed spreadsheet to list the goals and objectives of the portions of the plan and those responsible for each portion on a single sheet.

“The traditional strategic plan is put together in a binder and goes on a shelf to be pulled out and referred to as needed,” Murray said. “This spreadsheet style is something that I see sitting on our desks to be referred to daily if needed. It will keep us focused.”

Murray noted that the consultant facilitating the strategic planning meeting works at no charge to TCMH because the hospital is a member of the independent hospital network. 

“We will feed information to him, and he will put it into a decipherable format,” Murray said about the upcoming meetings.

In addition to strategic planning with the consultant and the TCMH administrative team, Murray, Linda Pamperien, chief financial officer; Doretta Todd-Willis, chief nursing officer, and members of the TCMH board of trustees met recently with most members of the hospital’s active medical staff to discuss strategic planning for the hospital.

“The meeting was generally very positive,” said Dr. Jim Perry, OD, TCMH board member. “The physicians are seeking additional education and training so they can best help the hospital financially.”


A new healthcare coding system known as ICD-10 will soon be required of all healthcare providers.  Perry explained that “what used to be 1,000 codes is going to over 100,000 codes.” According to Perry, billing for healthcare services will become much more complex with ICD-10.

“Our physicians want to know what they can do to help the hospital,” Murray said, “and there are some professional resources we have available that can help all of our providers in the hospital and in the clinics.”

Training will be provided to all clinic staff and billers as well as the physicians and mid-level providers.

“ICD-10 is much more complicated,” Perry said. “Healthcare providers can’t afford to leave money on the table, and they can’t afford to over code.”

Murray hopes that the plan of action for the area healthcare providers will “get everyone on the same page.”

Todd-Willis explained the TCMH utilization review nurse, case manager and social worker are trying to be more proactive in “roaming the halls” and working with the physicians, keeping them informed about the status of their patients and specific issues faced by each patient based on their payor status and their healthcare needs.

“By spending more time in the halls talking with the physicians, we have already seen a difference,” Murray said.

Murray noted that discussion about referrals was also an important component to the meeting with the physicians.

“We are asking our medical staff to help address the challenges we face when patients are asked to seek additional healthcare services by specialists that are not part of TCMH that do not want to accept TCMH’s diagnostic services,” Murray said. 

It’s not uncommon for area patients that have to see a specialist at another healthcare facility to be asked by the other healthcare provider to have new diagnostic services provided at the facility. An MRI or other service obtained at TCMH will be invalidated by the specialist who then orders additional diagnostic services—sometimes repeating those services that have already been obtained at TCMH—at additional cost to the patient or the patient’s insurance provider.

“This is a challenge we face,” Murray said. “A majority of these additional tests are not necessary.”

Murray explained that with the recent expansion and renovation project at TCMH, many diagnostic tools available at TCMH are state of the art and the latest in healthcare technology.

“We appreciate and need our patients to get their diagnostic services here,” Murray said. “When our patients see a specialist that questions the validity of a test done at TCMH, a disservice is done to the patient.”

Murray has “his opinions” about specialists that do not want to accept test results from TCMH.

“Our patients should be aware that imaging, blood work or other test results done at their local hospital are of the same quality as the same services available at larger hospitals or clinics located outside of the area,” Murray said.

Members of the medical staff are also looking at any services being sent elsewhere that could be done at TCMH.

“We want our patients and our physicians to choose TCMH services whenever we can,” Murray said. “Utilizing the local healthcare facility is not only more convenient and timely for the patient,  but it helps our hospital and supports our local economy.”

TCMH will offer monthly education to all of the active medical staff at the monthly TCMH medical staff meetings. At the medical staff’s request, hospital administration and board members will meet again with the medical staff early in 2014.


Murray reported that certified application counselor specialists with Connections CoxHealth have been at TCMH providing informational sessions about the new healthcare exchange to area residents.  CoxHealth and other healthcare entities around the state received funding to train counselors to work with area residents needing help with the new exchanges.

“They have agreed to come back and provide additional information, especially after the technological difficulties get worked out that have prevented enrollment this week,” Murray said.  He noted that there were attendees at each session on Monday, and additional sessions were offered on Saturday.

Marketing materials will be made available to TCMH for patients that are uninsured.  Plans are also underway to provide training sessions in the Mountain Grove area, too.

“It’s very nice of the certified counselors to come out to address our community members,” Murray said.  “We can’t offer this service, but it’s something that’s needed in more rural locations, too.”

In her financial report, Pamperien reported that TCMH had a $123,349 loss for September, with a loss for the year at $826,229.

Contractual adjustments and expenses for the month were lower, but inpatient and outpatient volumes, including the emergency department, were also down for the month.

Present at the meeting were Murray; Pamperien; Todd-Willis; Joleen Senter Durham, director of public relations; Dr. John Duff; and board members Perry, Omanez Fockler, Janet Wiseman, Mark Hampton and Russell Gaither.

The next meeting of the TCMH board of trustees is noon Tuesday, Nov. 26, in the downstairs meeting room of the hospital.

Leave a comment

Leave a Reply