TCMH photo
Texas County Memorial Hospital Credit: Houston Herald

Linda Pamperien, chief financial officer at TCMH, presented the monthly financial report.

Overall revenues were down $404,467 from our budgeted expectations, she said. Inpatient volumes were up $520,164 and outpatient revenue was down $943,556.

Pamperien reported 80 increased admissions for the year compared to same period a year ago.

Bad debt for November was $408,542 with 63 percent of the dollars written off coming from the emergency department.

The hospital incurred $175,735 in unbudgeted COVID expenses.

She reported that no additional federal CARES Act funds were booked for November, as recommended by BKD, the hospital’s accounting firm.

Pamperien mentioned that the contractual adjustments for the month were lower than budgeted, coming in at 59.4 percent. The contractual adjustments year-to-date are 66.3 percent.

TCMH ended November with a positive bottom line of $360,541 and a reduced, year-to-date loss of about $1.3 million.

“The decrease in our contractual adjustments helped give us a positive bottom line this month,” Pamperien explained.


During his administrative report, CEO Wes Murray said the hospital’s ShoMeVax application was approved. TCMH is looking at all options to receive the COVID vaccine as soon as possible.

Amanda Turpin, quality director, reported that an announcement made earlier in the day suggested that the current shipments of Moderna’s vaccine will be allocated to patients in long-term care and their healthcare team first.

“Hospitals should begin receiving Moderna shipments again in January,” Turpin said.

Murray mentioned that the East Wing COVID unit conversion project is nearly complete, but further construction is halted until the central monitoring system arrives.

“We are putting in every effort to get it as close to completion as we can without the central monitoring system in place,” Murray said. “Our hospital has been very full, and we continue to get new COVID patients, so we really need a larger dedicated area just for them.”

Murray noted area nursing homes are seeing a surge in COVID-related deaths and many of the patients are requiring inpatient care.


Hospital board members, Jim Perry, OD and Allan Branstetter recently met with hospital administration to go over the details of the next fiscal year’s expectations.

During their meeting the TCMH board members approved the 2021 operating and capital budgets for the hospital.

The majority of the funds are allocated to purchase a new ambulance, two additional Omnicells for pharmacy, a new sterilizer, four additional cardiac monitors, a new bed for the intensive care unit, 52 new replacement computers and will include a new mobile MRI machine as well as the site construction needed to place it.

The capital budget is a decrease of $71,104 from 2020.

Included in the capital budget is $75,382 to be used to purchase new endoscopy equipment for the surgery department.

According to Pamperien, the new equipment is critical to continue to do colonoscopies and esophagogastroduodenoscopies (EGD’s), something the TCMH physicians do frequently.

“This year has not gone as well as we had hoped, but much of that is to be expected due to COVID,” Murray said. “We have budgeted 2021 to be as neutral as possible.”

Murray explained that the capital items outlined in the 2021 budget will not be purchased unless they become absolutely necessary.

“Quality and safety are two things that we will never jeopardize when it comes to patient care,” Murray said. “Everything else will have to be looked at as a case by case situation so we can maintain our fiscal responsibility and turn things around next year.”


Bennie Cook, member-elect, Missouri House of Representatives, District 142, was a guest speaker at the meeting.

“Healthcare for our community is important to me,” Cook said. “My wife is a pharmacist and I have a great respect for what she does and what still needs to be done for Missourians right here in our district and throughout the state.”

Cook explained that TCMH is great for Texas County and that having the hospital here means a lot to the community.

“I always want to be accessible to you, and just know that I am hear for you and to fight for this hospital to make sure that it is around for years to come,” Cook said.

“It is a breath of fresh air to be represented to Jeff City instead of Jeff City being represented to us,” Jim Perry, OD, said.

The board members expressed their sincere appreciation to Cook for his willingness to come and meet with them to discuss healthcare in rural Missouri.

Present at the meeting were Murray; Pamperien; Turpin; Doretta Todd-Willis, chief nursing officer; Rachel Davis, public relations; Linda Milholen, MD; board members Perry, Omanez Fockler, Jay Loveland, Allan Branstetter and Steve Pierce and guest, Cook.

The next meeting of the TCMH board of trustees is noon, Tuesday, Jan. 26. Due to current social distancing restrictions in place as a result of COVID-19, the meeting will take place via teleconference. To attend the meeting, call 417-967-1236 to be placed into the meeting.