Annual Audit Report Shows TCMH in Strong Financial Position

Texas County Memorial Hospital had $43.2 million in operating revenue in 2025 but recorded a $1.52 million decrease in net position following the annual audit report presented at the board of trustees meeting Tuesday.

David Taylor, senior manager at Forvis Mazars in Springfield, MO, presented the annual financial audit report and emphasized the hospital’s strong underlying financial health despite the reported loss.

“The hospital’s days cash on hand of just over 100 reflects a strong financial position,” Taylor said. “Even with Medicaid Disproportionate Share Hospital (DSH) adjustments impacting the bottom line, operational performance actually improved year over year when those factors are excluded.”

Taylor explained that approximately $1.1 million of the reported loss was tied to Medicaid DSH-related liabilities, which are influenced by a three-year federal reimbursement lag. Without those adjustments, the hospital’s operations would have improved by roughly $471,000 compared to the prior year.

He also highlighted the hospital’s balance sheet, noting $12.1 million in cash and investments compared to $12.5 million in debt.

“This level of cash relative to debt is uncommon among similarly sized organizations,” Taylor said. “The hospital is in a conservative and stable financial position, supported further by favorable USDA financing terms.”

Taylor also discussed the potential impact of recent federal legislation, including the One Big Beautiful Bill, which proposes approximately $1 trillion in Medicaid cuts over the next decade, representing roughly 15 percent of federal Medicaid spending. He noted that such reductions could lead to decreased Medicaid enrollment and a rise in uninsured patients, placing additional financial strain on rural hospitals.

In addition, Taylor reviewed the proposed Rural Health Transformation Plan, which would allocate $10 billion nationally over five years, with Missouri expected to receive approximately $216 million. While the plan presents funding opportunities, he noted the dollars will be distributed competitively and are modest compared to the scale of the proposed Medicaid reductions. TCMH officials and healthcare leaders around the state are still waiting to hear how the funds will be dispersed so they can plan accordingly.

“Despite industry headwinds, this hospital continues to demonstrate stability, strong reserves, and disciplined financial management,” he said. “That positions TCMH well to navigate whatever comes next.”

Taylor praised TCMH for its outstanding financial management as a rural hospital. “As a rural hospital, you face many challenges, but your position is strong enough to face them,” he said.

In other business, Joleen Durham was sworn in for a five-year term on the TCMH Board of Trustees.  Jim Perry, OD, TCMH Board of Trustees chairperson, administered the oath of office to Durham.

The TCMH Board of Trustees unanimously approved officer positions for the upcoming year, with Perry serving as chairperson, Ross Richardson as vice-chairperson, and Durham as secretary.

April Crites, TCMH quality and risk management director, reported continued improvements in patient satisfaction and quality performance across departments.

“Inpatient satisfaction scores showed meaningful gains, with both overall and top-box scores increasing significantly,” Crites said. “These results reflect the dedication of our staff to providing high-quality, patient-centered care.”

Crites also presented the first quarter Quality Assurance and Performance Improvement (QAPI) report, noting progress in emergency department interpreter services, radiology quality assurance compliance, and obstetrics safety initiatives.

“Our OB team continues to focus on critical maternal health initiatives, including postpartum hemorrhage risk assessments and depression screenings,” she said. “These efforts are especially important given Missouri’s maternal health challenges, and we are committed to reaching 100 percent compliance.”

She added that overall QAPI results demonstrate steady, positive progress across service lines.

Bill Bridges, TCMH chief executive officer, announced the addition of Mark Peebles, physician assistant, of Mansfield, who has signed a three-year contract and will begin practicing at the Medical Office Complex in Houston beginning July 1. Peebles will see patients that need urgent care through the TCMH same day clinic.

“We are excited to welcome Mark, who brings more than 19 years of experience to our medical staff,” Bridges said. “His expertise and dedication to quality care will enhance access to timely services for patients across our community.”

Linda Pamperien, TCMH chief financial officer, presented the March financials, which reflected an increase of $951,698 in overall revenues from budgeted monthly expectations.

“Our inpatient revenue increased $169,696, a 12.2 percent increase and our outpatient revenue was $819,317, a 10.2 percent increase from our budgeted monthly expectations,” Pamperien said.

According to Pamperien, the hospital had 105 admissions in March, down 39 admissions from the same time frame in 2025, with 291 admissions year-to-date.

“Our overall expenses were up one percent for the month,” Pamperien shared. “A contributing factor was increased central supply expenses due to the return of cataract surgeries at the hospital, which is a positive for the community.”

The financial report reflected a positive bottom line for March, with an increase of $582,792 and a year-to-date loss of $12,372. Earnings before interest, depreciation, and amortization (EBIDA) for the month were positive at $850,433.

Present at the meeting were Taylor; Crites; Bridges; Pamperien; Courtney Owens, chief nursing officer; Helania Wulff, public relations and marketing; Christopher Baldwin, MD, chief of staff; and board members Durham; Perry; and Jennifer Hugenot. Not present were board members Jerri Crump and Ross Richardson.

The next meeting of the TCMH board of trustees is scheduled for Tuesday, May 26, at noon in the hospital board room.