The TCMH campus on South Sam Houston Blvd. in Houston.

Despite decreased revenue challenges in both inpatient and outpatient departments, Texas County Memorial Hospital was able to produce a positive bottom line in April, hospital board members and administration heard at last week’s monthly meeting.

TCMH ended April with a positive bottom line of $68,128 and a reduced year-to-date loss of $266,341. Linda Pamperien, TCMH chief financial officer, reported overall revenues were down $314,870 from budgeted expectations. Inpatient volumes were down $157,581, and outpatient revenue was down $41,977.

“Hospital volumes so far this year have not taken off like we would have liked, but we are still hopeful that our numbers will pick up in the coming months,” Pamperien said. 

Gross operating revenues year-to-date are off 5.45 percent from budgeted expectations.  Net revenues after reductions and contractuals are off 11.8 percent from budgeted expectations.

“The number of patients admitted is down in comparison to 2018,” said Wes Murray, TCMH chief executive officer. “Many factors influence our admission numbers, but the light cold and flu season early in the year definitely made a negative impact to our bottom line that we are still catching up from.”

Murray said the nationwide reduction in births has hit the rural areas hard. He said TCMH has felt it.

“Nationwide, birth rates have decreased for four consecutive years,” Murray said. “Birth rates in 2018 marked a 32-year low, the lowest reported since 1986.”

Murray said birth rates at TCMH were 260 in 2013 and have significantly dropped since then to 170 births in 2018.

“We have an excellent group of obstetrical physicians and our nurses in the obstetrics department are seasoned in their field,” Murray said. “Our hospital provides a safe and convenient place for area moms to deliver their babies and receive very personalized care close to home.”

TCMH plans to expand and remodel the obstetrics department in the next few years once the new surgery area is complete.

“Updating the existing obstetrical department is just one of the many steps we are taking to stay current with other area hospitals,” Murray said. “It is just the right thing to do.”


Murray said the 2013 Rural Health Clinic settlement due to TCMH from Missouri Medicaid has been made final. The anticipated check will be more than $413,000. It has been delayed for many years. 

“Missouri Medicaid still owes us funds from 2014-2017 that total over $1.9 million,” Murray said. “For whatever reason, the state is severely behind on processing our funds. They just need to catch up and pay us what we are owed.”

A joint venture between the Houston School District and TCMH is making progress in the right direction. Murray updated the board of trustees on the latest news regarding bringing back the health occupations class for area Houston High School students.

“I’m pleased to report that we now have one nurse who has received her instructor certification to teach in the program,” Murray said. “We have received a verbal approval for an additional instructor, and we have one more nurse who is currently in the application process.”

The health occupations class will allow the students who complete the program to graduate high school with their CNA (certified nursing assistant) certificate. TCMH employs CNAs and for many students, obtaining a CNA certificate is a stepping stone to helping them decide to go ahead and work toward a degree in nursing.

Currently, Houston High School students are transported to West Plains daily to be a part of the health occupations class offered there. The students lose a tremendous amount of class time due to the commute distance every day.

“We couldn’t be more excited to be a part of this program with the school,” Murray said. “It will be a huge asset for the students, the community and TCMH to be able to offer this right here in Houston once again.”

The hope is that the program will be ready to go for the start of the 2019-’20 school year if everything goes according to plan.


Murray told the board of trustees a 3D mammography unit has been purchased in accordance with the 2019 capital budget.

“Our physicians are genuinely grateful for the upgrade to the existing mammography unit,” Murray said. “They are anxious to be able to offer the new technology to their patients right away.”

Pamperien said they expect the new mammography unit to be installed in late June or early July and that during the installment process, there will be a two-week downtime where screenings will not be available.

“We are hopeful that the removal of the existing equipment and the installation of the new equipment will go quickly and smoothly so we can get right back to providing patients with the services that they need,” Pamperien said. “We are very pleased to be able to offer this upgraded service to our patients, we just want to make sure that it performs like it should right out of the gate.”


Physician recruiting efforts have ramped up once again to find additional family medicine and internal medicine physicians. TCMH has been presented with a few potential candidates this year and is anticipating a few in-person interviews in the coming months. The focus continues to be on finding a physician who is community minded and has a desire to live and work in a rural area.

For the past month, TCMH has had a third-year general surgery resident working under Jason Loden, DO. The resident has not yet decided where he wants to practice once he wraps up next year, but he does have a desire to work in a rural area.

TCMH has also committed to allow first-year medical students from A.T. Still University the opportunity to complete two-week rotations under TCMH physicians.

“First-year medical students are not always sure what path they want to pursue, so the time they spend with our physicians can be extremely valuable for them and for us, long-term,” Murray said.

Murray said opening the door for medical students to spend time at TCMH and in our community offers them a first-hand experience to what practicing medicine in a rural community is like.

“Some of the students might know right away that rural healthcare is not for them while others fall in love with it,” Murray said. “We’re hopeful that through their experiences here that they may decide to come back again during their second or third-year and may decide to join us permanently once they are finished with their residency program.”

Murray said the medical student route is slow, but that it offers great potential for future recruiting efforts.

“We have been very successful with recruiting great physicians who want to live here and raise their families in our community,” Murray said. “We continue to need the help of our community to retain them.”

Present at the meeting were Murray; Pamperien; Doretta Todd-Willis, chief nursing officer; Rachel Davis, public relations; Amanda Turpin, quality director; Linda Milholen, MD; board members, Jim Perry, OD, Allan Branstetter, Omanez Fockler, Janet Wiseman and Jay Loveland; and guest, William Mahoney, CoxHealth representative.

The next meeting of the TCMH board of trustees is noon Tuesday, June 25, in the hospital board room.

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