Llano County takes over hospital management
Llano Hospital has been owned by Llano County for decades, and it will now be operated by it. The county recently inked a deal to separate from the facility’s former operator, Mid Coast Health System, leaving the hospital’s management in its hands. Photo by Brittany Osbourn
Llano County will now manage Llano Hospital following a recently inked separation agreement with the facility’s former operator, Mid Coast Health System.
The Llano County Commissioners Court signed the agreement with Mid Coast during its regular meeting Monday, March 10, after over three months of negotiations. Mid Coast wanted out of its management deal due to “the challenge to maintain profitability” at the hospital.
Now, the county-owned hospital will be operated by the Llano County Hospital Authority Board, a group of seven appointed volunteers who formerly served in an oversight capacity for the hospital’s operations on the county’s behalf.
“It’s daunting, the amount of work we’ve got to do, but we’re excited,” board President Pat McDowell told the Commissioners Court on Monday. “Now that we’ve gotten over that big hump, we’ve got a program to manage.”
The hospital, 200 W. Ollie St. in Llano, has been managed by private entities for the past 15 years, with Mid Coast in the driver’s seat since 2020 and Baylor Scott & White running things prior to that.
One of the first moves the Hospital Authority Board made was to bring in Hatch Smith as the facility’s head administrator. Smith served as Llano Hospital’s CEO with Mid Coast, but the healthcare provider furloughed him along with 11 other employees in December 2024 to save on staff costs. He volunteered to continue working for free after the furlough but will now receive a partial salary as the transition of operations takes place. Most of the other furloughed employees also will be brought back, according to McDowell.
“The Hospital Authority Board has taken the hospital back. We are going to operate it independently. We are going to try and restore as much of the services we’ve had in the past,” said County Judge Ron Cunningham said at Monday’s meeting. “It’s been a struggle to get this done, but we’re grateful for the work that the Hospital Authority Board has done on this and the attorneys have done on this.”
According to Cunningham, the exact cost of operating the hospital is still unknown, but it will now be a budgeted item moving forward. He explained that the county never got a clear picture of what it took to run the hospital from Mid Coast, which played a part in the separation.
“We don’t know what that number (cost) is right now, but that is one of the things that we’re looking at,” he told DailyTrib.com. “One of the reasons we wanted to get separated was to see the true financial impact of the hospital.”
While no comprehensive budget for Llano Hospital has been developed, the county did approve spending up to $450,000 on Jan. 27 exclusively for its operations in the current fiscal year.
The facility will maintain its federal “critical access hospital” designation, which makes it eligible for reimbursements for treatment of Medicare patients. This designation comes with the requirement of providing 24-hour emergency care services and serving as a primary care facility in rural communities with limited access to hospitals, including Llano, Mason, and San Saba counties.
“I know it’s been a difficult task and lots of sleepless nights for people,” Precinct 2 Commissioner Linda Raschke said Monday, addressing the members of the Hospital Authority Board, county attorneys, and Judge Cunningham. “Thank you. The hospital needed to stay open. I appreciate the work that you all have done.”