Texas County Memorial Hospital

Texas County Memorial Hospital recently received minor citations in seven areas following a three-day, comprehensive facility survey.

Hospital board members heard at their monthly meeting in September that seven surveyors from the Missouri Department of Health and Senior Services arrived Aug. 24 to survey for compliance with federal, state, swing bed and patient safety initiative condition of participation regulations. The surveyors arrived unannounced, the custom for DHSS surveys and most site visits.

“We had three days of intense scrutiny of policies, operational procedures and patient care,” said Wes Murray, TCMH chief executive officer at TCMH. “Surveyors also interviewed staff and patients before exiting the hospital on Aug. 27.”

Written citations were delivered to the hospital on Sept. 10 and included:

•Providing pricing on the list of items not covered by Medicare for swing bed patients.

•Updating policies in medical records and environmental services.

•Scheduling fire drills annually and testing off campus building emergency lighting annually.

•Updating credentialing and medical staff bylaws.

•Addressing patient care plans, hand hygiene and registered nurse supervision of patients in nursing departments.

•Increasing quality assurance reporting for some departments and including that information in the monthly board of trustees report.

•Updating menus, manuals and sanitation procedures in dietary.

Murray, who said TCMH submitted a plan of corrections for the citations on Sept. 18, noted that the number of surveyors on site during the survey was challenging for the hospital and small departments where many of the department managers also provide patient care in addition to managing their departments.

“While it was a challenge, our staff again rose to the occasion and did their best in providing the information the surveyors needed as quickly as possible,” Murray said.

DHSS surveyors have not fully surveyed the hospital in a few years and since the new construction was completed.

“We continually ask our department managers to stay on top of their policies and procedures so we are prepared when surveyors arrive at our hospital,” Murray said.  “A big thank you to Doretta Willis and our department managers for stepping up to the task when we needed them during the survey process.”

TCMH officials said they expect DHSS surveyors will be back on site in the near future to assess how the hospital has responded to citations.


TCMH has not been successful in recruiting additional physicians to the hospital medical staff during recent site visits, but recruiting for additional full-time physicians is underway.

Murray reported that Kim Kemnitzer, FNP, has been seeing patients at the TCMH walk-in clinic.

“With the addition of Kim, we’ve been able to free up additional appointment space for patients to get in to see Holly Atterberry,” Murray said.

Sara Openshaw, of Mountain Grove, has passed the board certification exam for family nurse practitioners and will begin seeing patients at the TCMH Mountain Grove Medical Complex when her license arrives.

“We are very excited about having Sara join our team,” Murray said.  “Sara and her family live in Mountain Grove and have ties in the community.  She will be a great asset in our clinic.”

Dr. William Wright, family medicine physician at TCMH, will collaborate with Openshaw and continue to see patients one day a week at the Mountain Grove Clinic. Tracey Arwood, CNM, sees women and provides obstetrical care at the clinic two days a week.

Dr. Cory Offutt, a third-year family medicine resident, will join TCMH next summer after completing residency. He recently contacted TCMH about doing his final surgical and clinical rotations at TCMH under members of the TCMH medical staff.

“Dr. Offutt is very enthusiastic about getting to TCMH and learning our electronic medical records system and getting his clinic set up in advance,” Murray said. “And we are all looking forward to helping him get off to a strong start in his new practice.”


Murray reported that with the relocation of the Wri-Tex 911 office from the hospital’s campus, the vacated space is being renovated into a biomedical engineering shop and office. 

Murray also explained that TCMH is looking at self-funded options for employee health insurance.

“We are the only hospital in our Ozarks Independent Health Alliance that has a fully insured health insurance plan,” Murray said.

Murray and Jennifer Hugenot, human resources director at TCMH, are looking at health insurance options.

“With a self-funded plan we could possibly provide insurance that more of our employees and their families could afford,” Murray said. “And we can make TCMH the healthcare provider of choice for services that we are able to offer.”


Murray told board members that he and other TCMH directors attended at the Houston Area Chamber of Commerce’s September luncheon where Sen. Mike Cunningham spoke.

“Sen. Cunningham specifically asked me for questions, and again, we asked him to support Medicaid reform and expansion to benefit the rural hospitals in his district,” Murray said.

According to Cunningham’s report to the chamber, Medicaid expansion is not an agenda item for the State Senate. 

“Sen. Cunningham told us that our hospital’s fate was to be bought out by a larger healthcare system because that’s what happens to small businesses,” Murray said, explaining that all of the TCMH directors present engaged Cunningham, challenging his position on Medicaid expansion in the state.

“Again, we asked Sen. Cunningham to please represent the people and businesses in his district in Jefferson City,” Murray said.


Linda Pamperien, TCMH chief financial officer, presented the August financial report. Overall revenues were down during August. Expenditures for the month were down, too.

 TCMH ended August with a negative bottom line of $153,956 and a negative year-to-date balance of $1,339,354.

Present at the meeting were Murray; Pamperien; Dr. Jonathan Beers; Amanda Turpin, quality assurance nurse manager; April Steele, administrative secretary; and board members Dr. Jim Perry, OD, Mark Hampton, Janet Wiseman and Omanez Fockler. Board member Russell Gaither was absent.

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