Hospital Board Approves 2026 Capital and Operating Budgets

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 for an Omnicell medication management system upgrade and the replacement of plain film x-ray equipment.

Linda Pamperien, TCMH chief financial officer, presented the proposed 2026 capital budget, noting that the largest projects, along with a $70,000 contingency fund, account for 74.4 percent of the total budget.

The Omnicell upgrade is estimated at $288,000. Omnicell is an automated medication management system used in the emergency room and medical-surgical departments to reduce medication errors and waste, improve accuracy, and save staff time. In addition, the pharmacy will purchase a unit dose packaging system for $25,000, allowing bulk medication purchases to be repackaged for use with Omnicell, resulting in cost savings for the hospital.

The replacement of plain film x-ray equipment in the radiology department is projected to cost $201,370.

“We are anticipating that the Omnicell upgrade will be covered by grants, if possible, in 2026,” Pamperien said.

Other significant expenses in the capital budget were $54,000 to purchase a new roof top air conditioner unit for the dietary department; $26,329 for a new pediatric colonoscope and $30,000 for central sterile instruments for the surgery department; $26,534 for Vapotherm and $28,993 for a BiPap machine for the respiratory department, and $11,739 for two recliners for the intensive care unit, $20,690 to purchase two new stretchers for the emergency department and $22,000 for two new stretchers for the operating room; $50,000 for an ultrasound machine for the Medical Office Complex; $19,046 for an infant warmer for the obstetrics department; $22,522 for card reader system access; $15,000 for generator grant matching funds; $15,500 for a blood bank interface and $17,000 for a Class 2 Biosafety Cabinet for the laboratory department; $12,500 for stationary face shield for mammography; $13,000 for sleep lab software interface; and $125,000 for technology updates.

For the 2026 operating budget, the board approved projections showing an overall increase in gross operating revenues of 7.8 percent and an increase in operating expenses of 5.1 percent.

The budget anticipates a 13.2 percent increase in inpatient revenue, a 7.1 percent increase in outpatient revenue, and a 6.6 percent increase in emergency department revenue. Additional projected revenues include a 4 percent increase from Hutcheson Pharmacy, $32,000 from the sale of replaced generators, and a 10 percent increase in 340B income.

Pamperien reported that TCMH will incur additional expenses in 2026, including salaries associated with a new hospitalist model beginning in January and compensation for Charlie Rasmussen, DO, who will begin a part-time family medicine and obstetrics practice in January at the Medical Office Complex in Houston. The budget also reflects a $950,000 increase in salary expenses due to the rise in the minimum wage.

“We are being conservative on our capital and operating budgets this year, and our goal is to break even in 2026,” Pamperien stated.

The board of trustees approved both the 2026 capital and operating budgets as presented.

In other business, Bill Bridges, TCMH chief executive officer, shared updates on several recently awarded grants.

The Delta Regional Authority (DRA), in partnership with the State of Missouri, invested approximately $4.2 million in 10 statewide projects through its States’ Economic Development Assistance Program (SEDAP). Bridges announced that TCMH received approximately $432,000 to upgrade essential equipment and systems in the medical-surgical, intensive care, and emergency room units.

“We are grateful to the DRA and SEDAP for this funding,” Bridges said. “The new telemetry monitoring equipment and intravenous pumps are critical to preventing patient transfers, reducing medication errors, retaining full-time local jobs, and maintaining lifesaving care here in Texas County.”

TCMH also received a $16,818 grant from Missouri One Start, the state’s workforce recruitment and training division. The funding will allow twelve nurses to attend the Critical Care Registered Nurse Program and thirteen nurses to participate in the Certified Emergency Nurse Program.

“This training will enhance the quality of care we provide to our patients,” Bridges said.

Additionally, the hospital secured a $3,600 grant through the Rural Citizens Access to Telehealth project, a collaboration between the Missouri Telehealth Network and the Missouri Department of Social Services, MO HealthNet Division.

“We are thankful for this funding to upgrade our existing RapidAI operating system,” Bridges said. “RapidAI has significantly improved stroke care at TCMH, and this enhancement will ensure we remain at the forefront of AI technology.”

Bridges announced that Ray Bruno, family nurse practitioner in the Medical Office Complex in Houston, has submitted his resignation effective January 7.

“We extend our heartfelt gratitude to Ray for his 16 years of dedication to TCMH and the countless patients he has served,” Bridges said.

Pamperien reported that Melissa Carter has been hired as the new laboratory director, beginning January 23. Carter will replace Kora Dowden, who will remain with the hospital in a part-time laboratory role.

“We are thrilled to welcome Melissa to TCMH,” Pamperien said. “With her extensive experience and expertise, we are confident that she will excel in her role as our laboratory director.”

Pamperien also presented the financial report for November. Overall revenues decreased by $1,465,970, or 16.1 percent, compared to budgeted expectations. Inpatient revenue declined by $566,663, and outpatient revenue decreased by $888,073.

The hospital recorded 59 admissions in November, down 44 from the same period in 2024, bringing year-to-date admissions to 898.

The hospital’s profit/loss report showed a net operating loss of $941,817 for November, with a year-to-date loss of $3,027,885. The earnings before interest, depreciation, and amortization (EBIDA) for the respective month were negative at $678,603, and the year-to-date EBIDA was negative at $131,782.

Present at the meeting were Pamperien; Bridges; Courtney Owens, chief nursing officer; Helania Wulff, public relations and marketing director; April Crites, quality and risk director; and board members Jim Perry, OD; Ross Richardson; Joleen Durham; and Jerri Crump. Jennifer Hugenot, board member, and Kristina Grant, DO, Vice-Chief of Staff, were not present at the meeting.

The next meeting of the TCMH board of trustees is Tuesday, January 27, at noon in the hospital board room.