Texas County Memorial Hospital ended the year with increased inpatient and outpatient revenue for the fourth year in a row, board members heard at last week’s monthly meeting.

Wes Murray, TCMH chief executive officer, and Linda Pamperien, TCMH chief financial officer, presented a positive picture of growth for the hospital at the end of 2018.

“We have progressively made improvements over the past four years with growth in inpatient and outpatient revenues,” Pamperien said.

TCMH was down 131 inpatient admissions in 2018, compared to 2017. Outpatient volumes were up nearly 10 percent over budget. 

Pamperien explained that key departments with decreased revenues over budgeted expectations in 2018 were swing bed utilization, home health and hospice.

“The additions of our five new providers in 2018 has helped us to increase our outpatient volumes in the clinics, and has produced a lot of downstream revenue to the hospital in areas of surgery, laboratory and imaging,” Pamperien said.

Pamperien said hospital expenses rose only 3.24 percent in 2018. 

“Our staff did an excellent job managing our expenses as we grow, but there are extra costs associated with bringing on new physicians that cannot be avoided,” Pamperien said.

Pamperien said the implementation of the new electronic medical record in the clinics last fall was an expensive project. It proved to be a tough transition for all of the medical staff, Pamperien said, but most of them have developed workflows to be able to see patients smoothly. 

“Most of our physicians are now back up to their normal productivity standards,” Pamperien said.

With depreciation on the hospital addition, expenses related to new physicians and fewer hospital admits, TCMH will end 2018 in the red. The final financial picture for the year will be complete after the 2018 financial audit. Auditors will be on site in March, and audit results will be presented at the April board meeting.

“Our physicians continue to do an excellent job managing their inpatients and referring outpatient services to TCMH whenever possible,” Murray said. “Times are tough for rural hospitals, but we are managing to keep moving forward despite the forces working against us.”


Murray reported that a search has begun to recruit two, full-time, CRNAs (certified registered nurse anesthetists) due to positions that will become open in the spring.

Murray said TCMH recently received notice that Jim Spantgos, CRNA, who has been serving the community at TCMH since 2009, plans to retire. Chris Huckstep, CRNA, who joined Spantgos in providing anesthesia services at TCMH, will be relocating in the coming months due to family obligations. 

“I commend Jim and Chris for their support of TCMH and their service to our community,” Murray said.  “They have been large contributors to the success of our rural community hospital.”


Amanda Turpin, quality management director at TCMH, presented finalized quality assurance and process improvement reports for all TCMH departments involved in quarterly reporting.

“I’m pleased to say that every department has completed their reports for the past year, so we are compliant with CMS [Center for Medicare Services] regulations,” Turpin said.

Turpin also provided the 2019 quality assurance reporting plans and goals for each hospital department.  Turpin said that some of the plans and/or goals remain the same because the affected department continues to gather data about the same thing as in the past and every piece is very important to patient care.

New quality work in 2019 includes the stroke coordinator monitoring air transport times, the emergency department evaluating triage and overall time spent in the ER. Also, the medical surgical floor will be performing chart reviews for all inpatients to ensure documentation is completed timely.

Inpatient volumes were down and outpatient volumes were up at the hospital in December, according to Pamperien’s financial report. TCMH ended December with a negative bottom line of $250,961 and negative year-to-date balance of $707,837.

Present at the meeting were Murray; Pamperien; Turpin; Doretta Todd-Willis, chief nursing officer; Dr. Jonathan Beers, chief of staff; Rachel Davis, director of public relations; board members, Dr. Jim Perry, OD, Omanez Fockler and Jay Loveland; and guest, William Mahoney, CoxHealth representative.

Board members Janet Wiseman and Mark Hampton were absent. 

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