Inside MMH: The One-Quarter-Cent

Inside MMH: The Sales Tax

As we continue our series on taking the community inside our walls and our operations, today we discuss the one-quarter-cent sales tax speculation.

Few subjects involving McCurtain Memorial Hospital have created more confusion than the one-quarter-cent county sales tax. For years, people have repeated claims that the hospital receives millions of dollars in taxpayer money, that the hospital controls those funds, or that receiving the sales tax makes the hospital a public hospital.

The facts are much simpler.

McCurtain Memorial Hospital is operated by McCurtain Memorial Medical Management, Inc., a private, not-for-profit 501(c)(3) corporation. The corporation leases the hospital facility through an agreement with the McCurtain County Hospital Authority, which is a public body. The Hospital Authority and the hospital corporation are separate organizations with separate boards and different legal responsibilities.

The hospital recognizes that we are accountable to the community we serve. We believe people should be able to ask reasonable questions about their hospital, and when information can appropriately be shared, we will continue sharing it. That commitment comes from our belief that public confidence must be earned through honesty, accuracy and transparency.

How the Sales Tax Began

In 2002, McCurtain County voters approved a one-quarter-cent county sales tax to support the hospital. A one-quarter-cent tax means that 25 cents is collected on every $100 of taxable purchases.

The original tax included a 10-year expiration date. The ballot also placed an important restriction on the money: it could not be used to pay salaries, wages or employee benefits.

Ten years later, in 2012, the issue went back before the people. McCurtain County voters overwhelmingly approved making the one-quarter-cent hospital sales tax permanent. That vote did not create a new tax. It continued the tax the voters had originally approved in 2002 and removed its expiration date.

The hospital is deeply grateful for that support. There have been difficult years when these funds helped pay essential bills and kept the hospital operating. There have also been times when, without this support, the hospital could have faced closure. We do not take the community’s support for granted.

The Hospital Does Not Receive a Sales-Tax Check

One of the most important facts about this tax is that the money is not deposited into the hospital’s bank account.

Sales tax is collected from customers by businesses and sent to the Oklahoma Tax Commission. After the state processes the collections, the county’s portion is returned to McCurtain County and held by the McCurtain County Treasurer.

The hospital never takes possession of those tax dollars. The money remains in county accounts until approved expenses are paid.

Each month, the hospital’s Chief Financial Officer prepares a list of eligible expenses. Those expenses commonly include items such as blood products purchased from the Oklahoma Blood Institute, medical supplies, insurance and other necessary operating costs. These are generally the same types of expenses that have been submitted for payment for decades.

The expense list is presented to the McCurtain County Hospital Authority. Authority members review the invoices and purchase orders and must approve them. After that approval process is completed, the paperwork is returned to the county. The county then prints checks payable directly to the approved vendors.

The hospital does not receive the money and then decide how to spend it. The county pays the approved vendors directly.

This process also means that neither the Hospital Authority nor the county sales tax paid for the hospital’s recent renovations. Those renovations were paid from hospital operating revenue—not from the one-quarter-cent sales tax.

How Much Does the Hospital Receive?

The amount varies from month to month because sales-tax collections rise and fall with local spending. In many months, eligible hospital expenses paid through the fund total approximately $135,000 to $140,000. Based on recent annual figures, the benefit has been approximately $1.8 million per year, or an average of roughly $150,000 per month over an entire year.

That is a significant amount of help, and we are grateful for every dollar. However, it is important to place that amount in context.

The Oklahoma Tax Commission’s August 2026 report shows that McCurtain County has a total county sales-tax rate of 1.75%, or one and three-quarter cents. The Commission reported a total county distribution of approximately $1.42 million for that reporting month. That is the total for all county sales-tax purposes combined. It is not the amount designated for the hospital.

The hospital’s portion is only one-quarter of one cent. McCurtain County also collects sales taxes for other voter-approved county purposes and entities. The Oklahoma Tax Commission’s public monthly report combines the county’s collections into one countywide total; it does not provide a separate recipient-by-recipient breakdown showing how much was ultimately spent for the hospital or each other local purpose.

For that reason, it would be inaccurate to look at the county’s entire sales-tax distribution and claim that the full amount went to McCurtain Memorial Hospital. It did not.

It is also important to understand the delay in the process. Tax collected by a business during one month is generally reported and remitted later, processed by the Oklahoma Tax Commission, and then returned to the county in a following distribution cycle. The amount reported during a particular month does not necessarily represent purchases made during that same month.

The Review Happens in Public

The McCurtain County Hospital Authority is the public body responsible for overseeing these tax dollars. The Authority’s consideration of hospital invoices takes place during a public meeting.

The Authority normally meets on the last Monday of each month at 5:30 p.m. at the McCurtain County Board of County Commissioners Office in Idabel. Meeting notices and agendas are posted in advance. Members of the community may attend and observe the Authority’s consideration of the invoices and purchase orders presented for payment.

Because the tax proceeds remain under county and Authority control, requests specifically seeking records of the collection, custody, approval or payment of those tax dollars should be directed to the McCurtain County Hospital Authority or the appropriate county office. Those public bodies possess the official governmental records concerning the tax fund and payments made from it.

Where the Hospital’s Money Actually Comes From

Another common rumor is that McCurtain Memorial Hospital is “raking in millions” from county taxpayers. That statement leaves out nearly all of the hospital’s financial picture.

Based on the hospital’s payer mix, roughly 90% of the hospital’s patient-service revenue is connected to Medicare and Medicaid. A small portion comes from patients who have no insurance and must pay for their own care. The remainder generally comes from commercial health-insurance companies.

Medicare and Medicaid reimbursements are not the one-quarter-cent county sales tax. They are payments for healthcare services provided to eligible patients, much like a commercial insurance company pays a hospital after one of its members receives care.

This distinction matters in McCurtain County. The U.S. Census Bureau estimated the county’s median household income at $50,467 in 2024. “Median” means half of the county’s households earned more than that amount and half earned less. Census-based estimates also show that approximately 21.2% of McCurtain County residents lived below the poverty line during the 2020–2024 period.

Those economic realities help explain why Medicare and Medicaid make up such a large portion of the hospital’s business. We serve an older, rural and economically vulnerable population. Many patients are covered by Medicare, Medicaid or both, while others have no insurance at all.

Medicare and Medicaid Do Not Determine Ownership

Participating in Medicare and Medicaid does not, by itself, turn a private hospital into a county hospital, public trust or governmental agency.

Federal regulations describe the Medicare relationship as a “provider agreement.” In simple terms, a qualified hospital agrees to follow Medicare’s conditions, provides covered healthcare services and receives reimbursement for those services. That payment arrangement does not decide who owns or operates the hospital.

Oklahoma’s Open Records Act also recognizes a difference between a governmental body and a nongovernmental organization that receives public money as payment for goods or services. Whether an organization is subject to the Open Records Act depends upon its legal creation, structure, control and relationship with government—not simply whether it accepts Medicare, Medicaid or another form of government reimbursement.

McCurtain Memorial Medical Management, Inc.’s position is that it is a private, not-for-profit corporation operating the hospital under a lease arrangement with the McCurtain County Hospital Authority. The Authority is the public body, while the corporation operating McCurtain Memorial Hospital is a separate private organization.

That position does not lessen our responsibility to the community. We will continue answering appropriate questions and sharing information when doing so is lawful, responsible and consistent with patient privacy, employee privacy, contracts and other legal obligations.

The Bottom Line

The one-quarter-cent hospital sales tax is important, but it is often misunderstood.

The hospital does not receive the tax directly. The tax is collected through the Oklahoma Tax Commission, returned to McCurtain County and held by the County Treasurer. The hospital submits eligible expenses to the McCurtain County Hospital Authority. The Authority reviews those expenses during a public meeting, and after approval, the county pays vendors directly.

The tax cannot be used for salaries, wages or employee benefits. It did not pay for the hospital’s recent renovations. The hospital is also not the only entity or purpose supported by McCurtain County sales taxes.

The approximately $1.8 million in annual assistance is meaningful, and it has helped this hospital survive some extremely difficult years. But it is not an unrestricted pot of money, it is not deposited into the hospital’s bank account, and it does not represent most of the hospital’s revenue.

The overwhelming majority of the hospital’s patient-service revenue comes from caring for people covered by Medicare and Medicaid. The hospital earns that reimbursement by providing emergency care, inpatient care, outpatient services, diagnostic testing, therapy, surgery, clinic visits and other healthcare services.

For more than two decades, the people of McCurtain County have helped support their local hospital through this one-quarter-cent sales tax. We are grateful for that trust. The best way we can honor it is by using the established process, respecting the restrictions approved by voters and continuing to provide the healthcare services this community depends upon.

That is the truth about the sales tax.