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Rachel Davis Takes Director Position at TCMH

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Rachel Davis, Director of Public Relations, Marketing & Physician Recruiting

Rachel Davis of Plato is the new director of public relations, marketing, and physician recruiting at Texas County Memorial Hospital.

Davis most recently worked as the executive director of operations for a chief operating officer at Mercy Hospital in Joplin.  She has a bachelor’s degree in business with a marketing concentration from Missouri Valley College in Marshall, MO and a master’s degree in health administration from Missouri State University in Springfield.

In her time at Mercy, Davis was responsible for working with and overseeing numerous physicians, clinics, and service lines.

“I am thrilled to be back home, and I’m looking forward to the opportunity to use my healthcare knowledge to benefit the local hospital and clinics,” Davis said.

Davis and her family made the decision to return to Texas County in 2017 after buying a farm in Northeast Wright County where they are building a home.

“It’s not often that we have the opportunity to hire someone with the knowledge, experience, and local ties that Rachel has,” Wes Murray, chief executive officer at TCMH, said.

Murray noted that Davis presented a “key opportunity” for the hospital to match abilities and skills to the hospital’s personnel needs.

“We don’t always have the luxury of finding people to work here that can meet our current needs and bring additional skills we can use,” Murray said.

Murray noted that the role requires a calm demeanor, the ability to wear multiple hats, and the ability to shift gears drastically without much notice—all traits he believes Davis holds.

“Rachel can help us with our current needs and with the future healthcare needs of our hospital,” Murray said.

Davis and her husband, John, have three children, Callie, Tucker and Marlee.  Davis is an award-winning barrel-racer, and enjoys riding horses and other outdoor activities in her free time.

Ladies…New Year Brings New Focus on You and Your Cervical Health

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Tracey Arwood, CNM

By Tracey Arwood, CNM

January is Cervical Health Awareness Month and a time to focus on what you can do to prevent cervical cancer.  Each year, more than 11,000 women in the United States are diagnosed with cervical cancer.

Human papilloma virus (HPV) is a very common infection that spreads through sexual activity, and it causes almost all cases of cervical cancer.  About 79 million Americans currently have HPV, but many people with HPV do not know they are infected.

The good news is that cervical cancer can be prevented.

The HPV vaccine is recommended by the CDC for girls and young women age 11 to 26 for the prevention of cervical cancer.  The vaccine is most effective if given before the onset of sexual activity, and it is a part of the routine vaccination schedule for both boys and girls around the ages of 11 or 12.

Cervical cancer can also be prevented through regular screening tests and follow up care. Cervical cancer screenings, such as pap smears, can help detect abnormal cells early, before they turn into cancer.  If abnormal cells are detected, simple treatment options are available to remove the abnormal cells.

Routine pap smears are recommended every 3 years after the age of 21, and more often if the tests come back with abnormal results.

It is important to continue getting routine pap smears until age 64, even if previous pap smears have all been normal.  HPV may stay dormant for many years before causing cellular changes that turn into cervical cancer.

Most women can receive routine cervical cancer screenings at no charge, either as a prevention visit through their insurance or through state funded programs.  Show-Me Healthy Women is a Missouri wide program offered through the health department that covers cervical and breast cancer screenings for women who have no insurance and meet certain income guidelines.

Cervical cancer risk is also reduced by using latex condoms consistently to prevent HPV transmission.  Smoking also increases the risk of HPV developing into cervical cancer.

Tracey Arwood, CNM provides complete women’s healthcare.  Tracey sees teenagers after their first period, and she has HPV vaccines available.

To make an appointment with Arwood, contact the TCMH Medical Complex in Houston at (417)967-5637 or the TCMH Mountain Grove Clinic at (417)926-1770.


TCMH is a Testing Ground for New Wound Therapy Technology

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Ellen Willis, wound therapist at Texas County Memorial Hospital, uses Mirragen to treat a wound on the foot of Jerry Rader. Willis saw more closure in two weeks of therapy using Mirragen on Rader’s foot than the previous two months of treating the foot with traditional methods.

For the past several months some patients at Texas County Memorial Hospital have had the opportunity to test Mirragen, a new wound therapy product from ETS Wound Care in Rolla.

Mirragen, developed by Missouri Science and Technology student and ceramic engineer, Steve Jung, is a bioactive resorbable glass fiber technology that has been found to help wounds heal faster.  As a glass fiber, Mirragen can also be used for wounds with challenging geometries.

Bioactive glass has been used since the 1960’s to grow bone tissue.  The silica used in bioactive glass was not a suitable product for growing soft tissue, but Jung used boron in a glass fiber that was found to help heal soft tissue.  The borate-based fiber is sturdy and durable for a period of time, but it also breaks down and dissolves as soft tissue heals.

Mirragen was tested on patients for almost 10 years and received approval from the Food and Drug Administration in 2017.  It is the only product of its kind in the world, and it’s slated for release to the broader domestic market later this year.

As part of a controlled domestic release, Ellen Willis, board certified wound therapist at TCMH, received a donation of Mirragen product to use on some difficult wound cases at TCMH.

About half of Willis’s work as a therapist involves wound care.  She provides wound care to TCMH inpatients, outpatients and TCMH Home Health of the Ozarks patients.

“With the use of Mirragen, I was able to see positive improvement on chronic wounds within one to two weeks,” Willis said.

Willis considers a “chronic” wound to be a wound that has been open for more than a month.  Some of Willis’s chronic wound patients have wounds that have not healed for a year or more.

Because Mirragen is a fiber made up of layers, it can be placed on all areas of the wound—bone, tendon, and facia.  Mirragen can also be used on wounds that cannot be treated with negative pressure wound therapy—a traditional treatment for large wounds or wounds that are not healing.

The borate-based fiber resembles the microstructure of a clot, which might help a wound heal on its own.  Mirragen also absorbs up to 400 percent of the wound’s moisture, another important factor in wound therapy.

With one difficult wound in a patient at TCMH, Willis saw more closure in a month of treatment with Mirragen than she had seen in nine months of traditional wound therapy.

“I used Mirragen on this patient when all of my normal wound therapies had not worked,” Willis said.  She noted that in trials Mirragen had “incredible success” with diabetic and pressure ulcers, common wounds that Willis treats at TCMH.

Mirragen has also been tested and proven effective on venous ulcers, burns, surgical incisions and donor/recipient graft sites.

Currently, Willis has only treated patients with donated Mirragen product because it’s “very expensive”.  Due to the newness of Mirragen to the market, it’s not a reimbursable product for Willis to use on most of her patients.

Mirragen is sold in small packets of four-inch by four-inch, two-inch by two-inch or one-inch by six-inch devices.

ETS Wound Care has a mission to help to serve patient in underserved areas like the Ozarks where the product was developed.  ETS committed to working with Willis and a few TCMH patients so Willis could try the product.

“There are always variables in treating wounds,” Willis said. “Different body chemistries respond to treatment in different ways, but overall Mirragen will be a great tool in the wound therapy toolbox.”

ETS hopes to continue to grow borate-based bioactive technology to develop and commercialize a broad range of breakthrough solutions for the wound care market.

“We appreciate the mission of ETS to minimize the cost of treatment and improve patient outcomes,” Wes Murray, TCMH chief executive officer, said.  “We were honored to be asked to be part of their continuing studies and receive donated product to use with some of our patients.”

Murray explained that ETS hopes that the Ozark region can become known as a place where some of the best wound care in the world is available.

“Wound therapy is a growing need in our area, and we hope we can continue to use Mirragen and help ETS achieve their mission,” Murray said.

TCMH has grown wound therapy services at the hospital over the past few years, and Jason Loden, DO, a general surgeon joining the hospital in the summer of 2018, has hopes of making wound care a portion of his practice.

“With Dr. Loden’s and Ellen’s interest and skills in wound care we should be able to provide more wound therapy services in to our patients in the upcoming year,” Murray said.

Currently Willis is limited in the scope of wound therapy services she’s able to provide without a physician working alongside her.

“When Dr. Loden gets here, he will be able to oversee some new wound therapies for our patients,” Willis said.  “It will be a great benefit for our area patients.”

For additional information about wound therapy at TCMH, contact Willis at (417) 967-1270.  Additional information about Mirragen is available at

CBCO Blood Drive Planned at TCMH

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Texas County Memorial Hospital is hosting a blood drive on Fri., Jan. 26th from 9 a.m. to 3 p.m. Community Blood Center of the Ozarks (CBCO) will collect blood donations in the Jayson Gentry Community Safe Room on the TCMH campus.

Currently there is a critical need for blood type “O negative”, which is known as the “universal blood type” because it can be transfused into recipients of all blood types.

TCMH receives 100 percent of their blood supply from CBCO. All blood collected by CBCO stays in the area to be utilized by Ozark communities, neighbors and families.

TCMH and 36 other hospitals in this area are served by the CBCO. Approximately 250 units of blood are needed each day. TCMH uses approximately 500 units of blood each year.

Eligible donors can be anyone 16 years old or older who weighs at least 110 pounds and has not given blood in the last 56 days.   All donors must provide identification when registering to donate.

For more information about the blood drive contact Connie Brooks, education director at TCMH, (417) 967-1340 or 1-866-967-3311. For questions regarding donor eligibility contact the CBCO at 1-800-280-5337.

Ambrea Reyes is December Employee of the Month

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Texas County Memorial Hospital has named Ambrea Reyes of Rolla the December employee of the month.

Reyes is a respiratory therapist in the cardiopulmonary department at TCMH.  She has been employed at TCMH for over two years.  Reyes was nominated for the award by her supervisor, Lauren Toman, cardiopulmonary department director.

“Ambrea embodies the TCMH spirit and values,” Toman said. She explained that Reyes often receives compliments from physicians and other hospital staff about the compassionate care she provides to her patients.

“Ambrea is also very organized in the way she works, and she helps out with department quality assurance,” Toman said.

Toman described Reyes as “vibrant”, always smiling and bringing a positive attitude to work.

As employee of the month,  Reyes received a certificate honoring her achievement; a pin; a special parking place in the TCMH lot; one day of paid vacation; a $50 gift card, and gift certificates to Paws N Claws, D&L Florist; Blissful Nirvana Massage, Wehr Motors, Savor Grill and Big Red Car Wash.  A reception will be held at the hospital in honor of Reyes.

Reyes is eligible for the 2018 TCMH employee of the year award.

Ambrea Reyes (left) with her supervisor, Lauren Toman.

First Baby of the Year Arrives

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It’s a boy!

Cain Ray Kirkwood took the honors as the first baby born at Texas County Memorial Hospital in 2018, arriving at 12 p.m. on Tuesday, January 2nd.

Baby Cain is the first child of Stormy Ford and Philip Kirkwood of Houston.  Dr. Tricia Benoist of Mercy Clinic in Houston, delivered baby Cain, and he was six pounds, three ounces and 20 inches long.

Roma Hollenbeck and Julia Bryant, representatives of the TCMH Auxiliary,  and Wes Murray, TCMH chief executive officer, presented gifts and gift certificates to Cain and his parents after his birth.  Businesses throughout the county donated the gifts to celebrate the arrival of the first child born at TCMH in 2018.

Baby Cain is being held by his mother, Stormy Ford, left to right at Philip Kirkwood, the baby’s father, Wes Murray, TCMH CEO, and TCMH Auxiliary members Julia Bryant and Roma Hollenbeck.

Tree Contest Benefits Hospice of Care

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Shari McCallister of D&L Florist presented the funds raised from the Christmas tree voting in her shop to TCMH Hospice of Care. Shown here, left to right, are Melanie Evans, Hospice of Care; McCallister; Courtney Owens, Hospice of Care, and Jay Gentry, TCMH Healthcare Foundation.

Texas County Memorial Hospital Hospice of Care is the beneficiary of $358.41 following this year’s Christmas tree contest hosted by D & L Florist in Houston.

Shari McCallister of D&L Florist hosts the contest annually by decorating numerous trees in her shop with various themes for Christmas.  Visitors to the store are asked to vote on their favorite tree with money.  One penny counts for one vote, and all of the funds collected go to TCMH Hospice of Care.

“Voting for a tree has become a family tradition for many,” McCallister said, explaining that grandchildren are brought in by their grandparents, mothers and daughters and groups of friends come in together.

The majority of the funds collected are small change, but many people vote with paper money, too.

“There are quite a few one and five dollar bills, and some tens and twenties,” McCallister said.

McCallister noted that the fundraising effort is a giving opportunity for many people that might not be asked to give to a local charity on a regular basis.

“The Hospice of Care team took care of my father, Doyle Sillyman, and it’s an honor to be able to give back to them through this contest each year,” McCallister said.

McCallister said the “love tree”, a white tree decorated with red berries and red Cardinals, was the winner of the 2017 contest, garnering the most votes.

The funds collected will go into the Hospice of Care Fund managed by the TCMH Healthcare Foundation.  The funds will be utilized locally to help provide end of life care for Hospice of Care patients and their families.

According to Jay Gentry, director of the TCMH Healthcare Foundation, the Christmas tree contest has raised $2,624 for Hospice of Care since the contest began.


Hospital Board Approves 2018 Capital and Operating Budgets, Plans for the Arrival of Three New Physicians

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Texas County Memorial Hospital board members approved a $1.4 million capital budget at their monthly meeting on Tuesday.  The majority of the funds are allocated to to complete the new surgery department infill and equipment needs and to make major upgrades to the hospital’s electronic medical records system.

Linda Pamperien, TCMH chief financial officer, presented the budget data for 2018.

The capital budget—the largest in recent history—is a 49 percent increase over the 2017 capital budget.  Pamperien noted that depending upon how the infill of the surgery department goes, some of the funds might not be needed.

The surgery infill is being completed in-house by the hospital’s plant operations staff.  Funds of $814,000 are available through the TCMH Healthcare Foundation and a Delta Region Authority grant to help with the cost of the infill and the equipment purchases.

According to Pamperien, the TCMH plant operations department estimates the surgery infill will cost another $500,000 to complete.

The new surgery equipment needed for the department will be $439,407.  The sum includes items such as an endoscope reprocessor at $33,174; an endoscope and tower at $114,574; surgical lights and booms at $170,855 and cleaning and sterilization equipment at $101,260.

“With the addition of Dr. Jason Loden next summer, we need to have the necessary equipment available for he and our current surgeon to do as much as they can,” Wes Murray, TCMH chief executive officer, said.

Also in the 2018 capital budget is $375,500 in equipment for computer hardware and upgrades to the hospital’s electronic medical records (EMR) systems.   The upgrades include a new server and software and hardware to integrate all of the hospital and clinic EMR.

“Currently, we have two different EMR systems—one in the hospital and one in the clinic,” Murray said.  “That was what we had to do 10 years ago when we were just beginning to use EMR.”

As some of these early EMR systems are “reaching the end of their life”, Murray explained that all of the area hospitals are working on integrating their EMR systems so that clinic and hospital information are readily available and to save money on service fees and upgrades in the future.

“We have different fees for licenses and support, and integration will allow us to have one fee for support and a global license,” Pamperien said.

TCMH plans to integrate the EMR under CPSI, the system they currently use for EMR in the hospital.  CPSI, based in Alabama, has been working with TCMH for technology services since 2000.  Their EMR is designed for smaller hospitals and healthcare systems like TCMH.

“These types of changes in our EMR are always a difficult process, but it’s what we have to do,” Murray said.

Jonathan Beers, DO, TCMH chief of staff, noted that the integration process will allow patients receiving care at TCMH clinics and at the hospital to have easily shareable information.  Hospital staff can see what’s happened with a TCMH clinic patient prior to receiving care at the hospital and vice versa.

“This is going to be so much better for our nursing staff,” Beers said.

Physicians had access to both hospital and clinic EMR for patients, but it was not available in one program nor was it available for ancillary staff.  Clinic staff could only see the clinic portion, and hospital staff could only see the hospital portion.  Clinic staff would have to scan in documents from the hospital as part of the clinic record.

“The EMR technology claims to communicate with each other, but it’s actually all very proprietary,” Dr. Jim Perry, OD, chairperson of the TCMH board of trustees and ophthalmologist in Cabool, said regarding his personal experience with EMRs.

Pamperien noted that TCMH will save $43,000 in annual support fees and receive much better customer service from CPSI than they have received through one of the current EMR vendors.

“This is a big investment, but it will pay off quickly,” Pamperien said.

The other major expenditures in the capital budget were $84,000 to purchase 35 new intravenous pumps and $63,832 to purchase a new fetal monitoring system for the obstetrics department.  The new, computerized fetal monitoring system will also seamlessly interface with the new EMR when both are in place.

For the 2017 operating budget, board members approved a net operating budget of $32,652,730 that projects excess revenue over expenses of $118,183.

“With this year’s budget we are accounting for the arrival of three new physicians,” Pamperien said, referring to the addition of Jason Loden, DO, a general surgeon; Teresa Loden, DO, a pediatrician, and Doug Crase, MD, a family medicine physician.  All three physicians are slated begin work at TCMH in the summer of 2018.

According to Pamperien, there are additional costs with the start of new physicians, but when a physician practice is established, the return on the investment is good for the hospital.

“Currently each of our top four primary care physicians are generating an average of $2.9 million in inpatient revenue and $1.7 million in outpatient revenue,” Pamperien said.

The 2018 operating budget anticipates a 4.8 percent increase in inpatient revenue, a 6.3 percent increase in outpatient revenue, an 5.9 percent increase in emergency department revenue and a 5.75 percent increase in swing bed revenue.

Pamperien anticipates the “contractual adjustment”—the difference between the hospital charge and the portion of the charge covered by insurance—will increase in 2018.  The 2018 operating budget anticipates a contractual adjustment of 63.2 percent.

In addition to the three new physicians joining TCMH in 2018, two full-time positions are budgeted additions to two departments in 2018.  The budget reflects a merit raise for employees in late 2018 and an overall increase in operating expenses of 6.2 percent.

“We are budgeting again to ‘break even’, and our accounts receivable and cash flow continue to be very good as we look ahead in to the new fiscal year,” Pamperien said.

Also at the meeting, board members heard that TCMH has received funds totaling about $500,000 from the state of Missouri for the 2012 Medicaid cost report settlement.

In November, Pamperien reported that TCMH had requested help from the Missouri Hospital Association (MHA) to collect $1.2 million from the state of Missouri. The funds were owed to the hospital following Medicaid cost settlements completed for fiscal years 2012, 2013, and 2014.

The funds being held are for services provided by TCMH to Missouri Medicaid patients.  The funds are not dispersed by the state until final cost reports are completed for each fiscal year.  The funds that would typically be paid by the state following the cost report settlements were frozen by the Governor’s office.

With help from the MHA, TCMH and other hospitals were able to get some of the state funding owed to them.  Funds from the 2013 and 2014 Medicaid cost report settlements are still owed to TCMH.

Inpatient and outpatient revenues were down in the month of November resulting in a negative bottom line of $262,219.26 and a negative year-to-date balance of $844,099.32.

Present at the meeting were Murray; Pamperien; Beers; Doretta Todd-Willis, chief nursing officer; Joleen Senter Durham, director of public relations; and board members, Perry; Omanez Fockler; Janet Wiseman, and Jay Loveland.

Board member, Mark Hampton, was not present at the meeting.


The next meeting of the TCMH board of trustees is Tue., Jan. 23 at 12 p.m. in the hospital board room.

Brick Pavers Installed as Part of TCMH Healthcare Foundation Project

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A section of bricks in the first installation.

The Texas County Memorial Hospital Healthcare Foundation has completed the first installation of bricks from a paver project that began earlier this year at the county hospital.

The pavers are installed at the hospital’s front entrance canopy.  Funds raised from the brick paver project support the ongoing fundraising efforts of the Healthcare Foundation and benefit the new surgery department construction at TCMH.

“The first round of brick paver installation only completed a portion of the area for the pavers, so we are seeking donations toward additional pavers to be installed in the spring of 2018,” Jay Gentry, TCMH Healthcare Foundation director, said.

The pavers range in size from 4-inch by 8-inch bricks with three lines of text to 8-inch by 8-inch bricks that can accommodate six lines of text or a business logo.  Donations from $100 to $350 will purchase a brick.

Multiple 8-inch by 8-inch arrangements of pavers can also be ordered to make specific, larger designs.  Quotations for these individual arrangements are available from the Healthcare Foundation, and pricing is based on the project.

The surgery department shell at TCMH has been completed, but interior work—operating rooms, recovery rooms, a waiting area, staff dressing rooms, and other related spaces are currently in the process of being built.  TCMH has received donations from private donors, and a grant from the Delta Regional Authority to help with the project. Funds are still being raised for specialized equipment the department will need, and the brick paver donations benefit the department.

Bricks are placed in the front entrance island at TCMH.

“The pavers are a great way to recognize or memorialize someone or a significant date,” Gentry said.  He suggested that the pavers can be engraved with the name and birthdate of a child, with the names and anniversary date of a marriage or with family or business names.

In the new installation are the names of all the TCMH employees that participated in raising funds for the hospital’s capital campaign.  Organizations and businesses have also participated in donating funds to have bricks engraved with logos or other details related to the group.

All bricks are laser engraved to create the most durable and permanent engraving.

“Donations received as part of the brick paver project are tax deductible,” Gentry said.

The Healthcare Foundation has a printable mail order form for bricks or an online ordering and payment form available here.

For additional information about the paver project or the TCMH Healthcare Foundation, contact Gentry at or 1-866-967-3311.

Nurses Honored at DAISY Award Ceremony

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Stephanie Tabor (far right) winner of a DAISY award with Doretta Todd-Willis, TCMH chief nursing officer, and Karen Williams, one of the two people that nominated Tabor for a DAISY award.

Texas County Memorial Hospital honored Stephanie Tabor of Cabool with a DAISY award at cinnamon roll breakfast open to all TCMH staff on Friday morning.

Tabor is a registered nurse (RN) in the medical surgical department at TCMH.   The DAISY (Diseases Attacking the Immune System) Award is the highest recognition award for TCMH licensed practical nurses and RNs.

The DAISY Award is part of the non-profit DAISY Foundation of Glen Ellen, CA.  The Foundation was established by the family of J. Patrick Barnes.  Patrick died at the age of 33 in late 1999 from complications of idiopathic thrombocytopenic purpura, a little known but not uncommon auto-immune disease.

The care Patrick and his family received from nurses while Patrick was ill and hospitalized inspired the DAISY Award as a way of thanking nurses for making a profound difference in the lives of their patients and patient families.

The DAISY award recipient must be nominated for a specific act of extraordinary care that was experienced by the person making the nomination.  Tabor received two different nominations for the DAISY award from Karen Williams and from Nate Beard.

Williams described the care provided by Tabor as “standing out”.

“Stephanie always went above and beyond,” Williams wrote in her nomination of Tabor.

Beard, a patient of Tabor’s has experienced many hospitalizations; he has been paralyzed for the past eight years.

“Stephanie had empathy and sympathy for me,” Beard wrote in his nomination.

Beard explained that even when he wasn’t in Tabor’s direct care, she would check in on him during his hospitalization.

Nominees for DAISY awards with Doretta Todd-Willis and Delinda Lansdown.

“She’s one of the best nurses I’ve ever had,” Beard said.

Tabor received a special DAISY Award pin; a recognition certificate, a bouquet of fresh flowers, and a hand-carved stone sculpture called “A Healer’s Touch”.  Cinnamon rolls were served at the breakfast because Cinnabon cinnamon rolls were a personal favorite food of Patrick Barnes during his hospitalization, and he always shared the cinnamon rolls with the nursing staff.

Brittany Walter, Paul Fockler, Cody Rogers, Tony Young, Ashley Russell, Courtney Stewart, Stephanie Gingerich and Nancy Branson, nurses at TCMH, also received special recognition and a DAISY pin for also being nominated for DAISY awards.

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