Llano County has officially regained control of its hospital after County Judge Ron Cunningham signed a Memorandum of Understanding (MOU) with Mid Coast Central at Monday’s County Commissioners Court meeting. The agreement, presented by David Willmann and Pat McDowell of the Hospital Authority Board, finalizes the separation after Mid Coast had already signed off on the terms.
"The Hospital Authority Board has taken the hospital back, and we are going to operate it independently while working to restore as many services as possible," Cunningham stated.
Located at 200 W. Ollie St., the hospital has been under private management since 2010—first by Baylor Scott & White, then by Mid Coast in 2020.
Keeping a Critical Access Hospital
McDowell addressed the court, emphasizing the board’s goal of running the facility as a Critical Access Hospital, a designation that allows for Medicaid reimbursements and requires the hospital to provide 24-hour emergency care for underserved rural communities.
"This has been a long process, and while we've put in a lot of work to reach this point, even more lies ahead," McDowell said. "This is essentially a start-up, and the workload is daunting—but we're excited. We now have a program to manage, and we’re ready to get started."
The hospital’s services will benefit residents in Llano, Mason, and San Saba counties by ensuring continued access to emergency and primary care.
Leadership & Staffing Updates
McDowell also announced that Hatch Smith will serve as the hospital’s new administrator. Smith, who was previously the hospital’s CEO under Mid Coast, was furloughed in December along with 11 other employees. Since then, he has worked without pay, though plans are in place to provide him with an abbreviated salary due to limited funds.
Despite the transition, McDowell reported that the hospital has retained most of its staff and will bring back the majority of furloughed employees.
Funding & Budget Planning
While a full budget for hospital operations has yet to be determined, Cunningham confirmed it will be factored into county financial planning moving forward. Although Mid Coast did not disclose exact operating costs during negotiations, Llano County has committed up to $450,000 to support the transition, with an additional $400,000 from the Llano Economic Development Council.
Next Steps & Transition Timeline
The County Commissioners Court unanimously approved the MOU and separation agreement, with a motion by Cunningham and a second by Commissioner Peter Jones. While Mid Coast will continue limited operations during the transition period, full control of the hospital is expected to be completely transferred by May 31.
