Texas County Memorial Hospital board members approved a $1.2 million capital budget at their monthly meeting Tuesday.  Most of the funds are allocated for new surgery equipment needs and the purchase of a new ambulance.

Linda Pamperien, TCMH chief financial officer, presented the budget data for 2023. The larger ticket items make up 67 percent of the total capital budget.

The new surgery equipment needed for the department will be $356,876.  The sum includes a colonoscope at $43,453; an Olympus laparoscopic tower at $199,482; and vital sign monitors at $113,941.

“We are updating our surgery equipment with the anticipated opening of the surgery center in 2023,” Pamperien said. “Dr. Hollis Tidmore, the general surgeon that joined TCMH in 2022, will use the equipment daily.”

Also, included in the 2023 capital budget is $196,000 to replace an ambulance for the emergency medical services department.  Due to the number of miles TCMH puts on ambulances each year, the hospital tries to replace the oldest ambulance in the fleet annually.

Other major expenditures in the capital budget were $53,046 to purchase a new fetal monitor and infant warmer for the obstetrics department; $17,076 for two new vital sign monitors for the medical-surgical department; $35,559 to purchase four new stretchers for the emergency department; $27,939 for a new treadmill for stress tests; $34,753 for a new storage building; $40,000 to purchase a new coagulation analyzer for the laboratory department; and $30,000 for 30 computer replacements. 

For the 2023 operating budget, board members approved an operating budget that projects an overall increase in gross operating revenues of 9.4 percent and an overall increase in operating expenses of 7.2 percent.

The 2023 operating budget anticipates a 12.2 percent increase in inpatient revenue, a 7.1 percent increase in outpatient revenue, a 10.8 percent increase in emergency department revenue, and an 11.3 percent increase in swing bed revenue. In other revenues, a 69.3 percent increase is forecasted for $3 million in grants for the new surgery center, the Licking clinic and the Medivan transportation program.

Pamperien noted that provider changes in 2022 affected the planned budget, and 2023 will fluctuate depending upon providers that begin work at TCMH as well as nursing positions that may or may not be filled in 2023. 

“Cash flow continues to be very good as we look ahead into the new fiscal year,” Pamperien said.

“With our budget for the upcoming year, we can drill down into the numbers that we need to reach monthly and daily with our patient services,” Stace Holland, TCMH chief executive officer, said.

Holland discussed increasing swing-bed numbers by reaching out to case managers at larger hospitals providing services where patients are receiving services that require rehabilitation following surgery.  An orthopedic surgeon from Rolla has also spoken with Holland and the TCMH medical staff about seeing patients and possibly doing some procedures at TCMH.

“We want to be actively thanking our physicians for the patients they are sending for additional services at TCMH as well as communicating with our physicians about our inpatient and outpatient needs,” Holland said.


Dr. Tricia Benoist, TCMH chief of staff, spoke highly of the emergency department services and the nighttime hospitalist services provided by the new 360 Degree Medicine group.  “We have worked out glitches in communication, and we are working with them so they know the types of patients we can keep at TCMH,” Benoist said.

Benoist noted that during the height of Covid patient care protocols changed due to the number of patients needing care. 

“Now that our patient numbers are back at normal levels, it’s important that we return to regular standards of care which includes more hospital inpatient care where we can more closely monitor patients,” Benoist said.

She said the data compiled reflects that inpatient nurse and doctor communication scores were very high and communication about medication scored exceptionally high at the hospital.   

April crites, tcmh quality and risk management director, on a recent survey

April Crites, TCMH quality and risk management director, presented the recent Press Ganey patient satisfaction scores for September through November. She said the data compiled reflects that inpatient nurse and doctor communication scores were very high and communication about medication scored exceptionally high at the hospital.   

According to Crites, patient rounding and one-on-one pharmacy consults with patients are garnering very good results for patient satisfaction.  “Hopefully we can continue these trends,” Crites said.

Pamperien presented the financial report for November highlighting an increase in outpatient revenues of $140,596 over budgeted expectations.  The outpatient revenues were primarily through the emergency, radiology and laboratory departments.

“Our inpatient volumes did take another hard hit this month and were down $1,009,732, a 55.8 percent decrease from our budgeted expectations,” Pamperien reported.

Hospital expenses were up for November by $47,943, and TCMH ended November with a negative bottom line of $555,057 and a year-to-date loss of $4,478,605.

Board members agreed to extend the current Texas County jail contract for another month until Jan. 24 while Sheriff Scott Lindsey reviews options and plans the department’s budget for the upcoming year.   

Present at the meeting were Pamperien; Holland; Benoist; Crites; Courtney Owens, chief nursing officer; Helania Wulff, director of public relations, marketing and physician recruiting; board members Joleen Durham, Jim Perry, OD, Steve Pierce and Allan Branstetter.

The next meeting of the TCMH board of trustees is noon Tuesday, Jan. 24, in the hospital board room.

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