Home Evidence record Starr County Memorial Hospital

Agency record · emergency department

Two people a day arrive in crisis. The hospital has no psychiatric bed to admit any of them.

Starr County Memorial Hospital gave us three reporting periods of behavioral health emergency department data — volume, payer mix, and where each patient went next. This is that dataset in full, with what we calculated from it and every place it does not yet reconcile.

1,094

Behavioral health emergency department encounters across three reporting periods.

734

Encounters a year, annualized from the most recent six months. Two a day.

350

Of those 1,094 left in police custody or on a transfer out of the county — 32%.

0

Psychiatric beds in the county to admit any of them to.

Figure H1 · Disposition

Where 1,094 encounters ended.

Six in ten went home. The other four in ten did not: they left in police custody, on a transfer out of the county, or against medical advice. The width of each ribbon is the count.

1,094 encounters 682Discharged home · 62.3%196Transferred out of county · 17.9%154Left in law enforcement custody · 14.1%62Left against advice / eloped · 5.7%
See this figure as a table
Behavioral health emergency department dispositions, three periods combined.
 EncountersShare
Discharged home68262.3%
Transferred out of county19617.9%
Left in law enforcement custody15414.1%
Left against advice / eloped625.7%
Total1,094100%

Source: Starr County Memorial Hospital, provided to Starr County Behavioral Health Center. Three reporting periods, FY2023–2024 through April 2026. Percentages calculated by SCBHC.

Figure H2 · Trend

The share going home is falling. Every other outcome is rising.

Each bar is one reporting period at 100%. Going home fell from 66.9% to 58.0%. Leaving in custody rose from 11.9% to 17.4%; transfers out of the county rose from 16.4% to 20.4%. Three periods is a short series — but every line moves the same way in each of them.

100% 50% 0% FY2023–2024 FY2024–2025 FY2025–Apr 2026 487 240 367
Discharged home Transferred out of county Left in law enforcement custody Left against advice / eloped
See this figure as a table
Disposition as a share of encounters, by reporting period.
Reporting periodEncounters InsuredUninsured HomeTo law enf. Psych transferAMA / eloped
2023–2024487329158326588023
2024–202524017169143324124
2025–2026 (6 mo.)367251116213647515
Total1,09475134368215419662

Source: Starr County Memorial Hospital. Shares calculated by SCBHC from the encounter counts. The FY2024–2025 total of 240 sits oddly between 487 and an annualized 734 — see what we're unsure of.

Figure H3 · Capacity

Fourteen people a week. Zero beds.

At the current annualized rate, about fourteen people arrive at the emergency department in behavioral health crisis every week. The county has no inpatient psychiatric bed, no crisis stabilization unit and no diversion center to admit a single one of them.

≈14 people a week in behavioral health crisis 0 psychiatric beds in Starr County

Source: encounter volume from Starr County Memorial Hospital, annualized by SCBHC from the most recent six months (367 encounters → ≈734 a year → ≈14 a week). The absence of local psychiatric capacity is stated on The Need.

Figure H5 · Payer mix

Roughly a third of these encounters are uninsured.

751 insured, 343 uninsured. That share is why reimbursement alone cannot fund a local crisis center — and why the uncompensated cost currently lands on the hospital district.

Source: Starr County Memorial Hospital payer mix, three periods combined.

Figure H4 · Interactive

What the uninsured third costs, at your assumption.

The hospital gave us volume and payer mix but not cost. So we will not print a cost — we will print a range and let you set the input. 343 of 1,094 encounters were uninsured; that is about 232 a year.

232 uninsured encounters a year
Annual uncompensated exposure $278,400

Calculated by SCBHC. Uninsured share (343 of 1,094) from the hospital's payer mix; the annual figure of 232 is the uninsured share applied to the annualized 734. Cost per encounter is YOUR assumption — the hospital has not provided cost data. This is the input we have asked the District for.

What we're unsure of

Two things in this dataset we cannot yet explain.

We publish these before a reviewer finds them. Both are being reconciled with the hospital.

Under review The FY2024–2025 encounter count

240 encounters sits between the 487 of the prior year and an annualized 734 for the current period. That is a large swing in both directions within three years. Either the counting method changed, or the reporting window did — we need to know which before this row can carry weight.

Open question The two agencies' fiscal years may not align

The hospital's fiscal year and the Sheriff's Office fiscal year have not been confirmed to cover the same months. Until they are, treat any hospital-to-Sheriff comparison in the briefing as indicative rather than exact.

Prepared by

Johnny Gonzalez, MBA

Co-Founder & Organizer, Starr County Behavioral Health Center USA, Retired

While you have been reading

$0.00

This is the uncompensated emergency care line alone — at the midpoint assumption, and only the share that falls on the hospital district. It is running right now, and the share of patients leaving in custody has risen in every period we have data for.