Attorney set to look into hospital

Gabriel Mallard, a Little Rock attorney specializing in healthcare, is expected to lead an investigation into the recent controversies at Eureka Springs Hospital.

Kent Turner, chair of the hospital commission, announced at the commission’s regular meeting Monday, Nov. 18, that an attorney will begin looking at “all aspects of the hospital.”

“As a result of many of the things that have been going on with the hospital, I have been in contact with our independent attorney in Little Rock, who we have on staff,” Turner said. “They are an attorney, a law firm, that deals in medical matters.”

However, Eureka Springs Mayor Butch Berry said Wednesday, Nov. 20, that Mallard had not yet been hired.

“The hospital has not formally hired Gabriel Mallard yet,” Berry said via email. “Kent Turner, chair, upon my recommendations has been in communication with Mr. Mallard about conducting an investigation into the Hospital management and procedures. Because of their expertise in compliance programs, bylaws, and organizational structures, we anticipate the commission hiring this firm in the near future.

“Because of Mr. Mallard’s court commitments, nothing has been finalized at this time.”

Mallard is an attorney with the firm Mallard Gardner, whose website says the firm “serves as both healthcare counsel and general counsel for several hospitals throughout the state of Arkansas.”

“In that role, we advise clients in matters ranging from governmental compliance to litigation to mergers and acquisitions,” the firm’s website states. “Other matters upon which we advise include physician relations and medical staff bylaws, contract negotiations, and audit responses. We also serve as counsel to physicians, clinics, hospices, nursing homes, non-profit entities, and governmental hospitals.”

Mallard was expected to arrive in Eureka Springs next week, Turner said at the Nov. 18 meeting, but Berry’s statement on Nov. 20 put that date into question.

“Starting next week … they are going to come in and do a complete investigation of all aspects of the hospital,” Turner said at the Nov. 18 commission meeting. “They agreed to do that as of this morning.”

The announcement drew applause from the audience, which included current and former hospital staff members, many of whom spoke during public comments voicing displeasure about recent actions by the commission.

Turner said he was looking forward to hearing the attorney’s findings.

“It’s my hope, and I think the hope of all of us, that this attorney will come back with some hard facts as to what’s going wrong, what’s going right, what we need to change, what we don’t need to change,” he said, later adding, “…I am very interested in getting moving on this independent investigation that we’re going to have at the hospital just to see if we can figure out exactly what’s going on.”

The controversies at the hospital were brought to light after the commission held a series of recent special meetings to make personnel changes that have not been explained publicly. Former CEO Angie Shaw was terminated Friday, Nov. 1, in a move that has been sharply criticized by many current and former employees.

During three special meetings held Monday, Nov. 4, the commission then terminated Jessica Petrino, the hospital’s former chief nursing officer, put chief financial officer Cynthia Asbury on a 60-day Performance Improvement Plan “to be monitored by the commission,” and named HR director Jodi Edmondson acting CEO.

All decisions were made effective immediately and with no explanation from commissioners, who went into executive session to discuss each position before returning to announce their decisions.

Fifteen people spoke about the hospital during the public comments segment of a Nov. 11 city council meeting, while five additional letters were read into the record on the topic. In addition, nine people spoke at the Nov. 18 hospital commission meeting.

Most of those who spoke at the Nov. 11 council meeting called for the removal of Turner and former vice chair Barbara Dicks, with additional requests for the dismissal of Asbury and Edmondson at the Nov. 18 commission meeting.

Dicks resigned from the hospital commission on Friday, Nov. 15, at Berry’s request.

The current and former staff members who have spoken or submitted letters at the two meetings alleged that they’ve experienced a “toxic” and “hostile” work environment at the hands of the current administration, along with members of the hospital commission — including allegations of illegal activity, including violating the Freedom of Information Act and the Health Insurance Portability and Accountability Act (HIPAA).

“I’ve been exposed to a hostile and toxic work environment for some time now,” Joy Kennedy, former emergency room director who worked at the hospital for 10 years before resigning on Nov. 5, told city council members at the Nov. 11 meeting. “Cynthia Asbury, CFO, has had a negative impact on the hospital since her employment. We’ve had an unbelievably high staff turnover. Her unwelcoming behaviors have affected me mentally, emotionally, physically and spiritually. Her lack of respect, communication and transparency has caused me great stress.”

HEALTH DEPARTMENT AUDIT

On Nov. 4 — the same day the commission fired Petrino, placed Asbury on a Performance Improvement Plan and elevated Edmondson to acting CEO — the Arkansas Department of Health conducted an audit on the hospital.

The purpose of the audit was an initial clinical review after the hospital’s re-designation as Rural Emergency Hospital late last year, Turner told commissioners, later adding that it’s a “Medicare-based audit.”

“…They still have about six or seven days before they get the actual report back to us,” Turner said at the Nov. 18 meeting. “My conclusion is that the report is not going to be very favorable on the hospital. Primarily, they found a lot of discrepancies in the clinical workmanship of the hospital over the last six months. But, I don’t know the details of that and don’t have any idea what specifically they’re talking about.”

Turner said the report will be available to the public when it’s released so “everybody will be able to see what’s included in it,” and the hospital has 10 calendar days to respond.

“We have 10 calendar days to get our plan back to them, how we intend to correct any deficiencies that they have found,” Turner said. “We will probably be having multiple workshops to develop that plan during that time period … some workshops just as soon as we get that report and understand what it’s about.”

During the CEO’s report, Edmondson said she looked forward to hearing the results of the audit.

“The survey will represent how we’ve performed in the last 12 months,” she said. “We anticipate their letter this week and we’re excited about the opportunity for improvements moving forward.”

‘IS THERE A REASON THEIR BACKS ARE TURNED?’

Nine people spoke during public comments at the Nov. 18 hospital commission meeting, with many calling for resignations or removals.

The comments came as Asbury and Edmondson sat at the table a few feet away, with Asbury noticeably looking toward her right side, with her head turned away from each speaker.

Heather Wilson, a member of the city advertising and promotion commission, stopped in the middle of her comments to address the issue.

“Is there a reason that their backs are turned…?” Wilson said. “Just wondering if there’s a reason that your back is turned?”

Wilson’s questions drew silence in the room, with no response from Asbury or commissioners.

Other speakers mentioned recent reports of potential HIPAA violations, including allegations of Dicks accessing the hospital’s camera system remotely and commissioners having access to patient records. Issues are ongoing, according to former employee Charlotte Bunyar.

“I’m here to urge the commission to take action to maintain the dignity of the hospital commission by voting to remove Kent Turner from his position,” Bunyar said. “This action is necessary due to his unethical and inappropriate behavior, as highlighted in previous articles and public comments.

“Secondly, I urge the current hospital commission to hold an executive session, or whatever the process is, to discuss the immediate termination of the CFO and interim CEO.”

Bunyar voiced concerns over HIPAA violations, saying there are “allegations that the current CFO has been secretly recording conversations with employees using an image recording advice.”

“A current employee who wishes to remain anonymous reported Cynthia wearing meta glasses, pressing a button on her meta glasses and recording the conversation that was had,” Bunyar told commissioners. “It’s reasonable to assume that private health information, along with personal data such as Social Security numbers, could be unintentionally recorded. … This unethical practice should warrant immediate termination due to a potential HIPAA breach, and it is inherently inappropriate for a hospital CFO to be doing this or to have access to sensitive patient information.”

Orin Shaw, Angie Shaw’s husband, asked commissioners: “Do you truly care about the employees of Eureka Springs Hospital?”

“Do you know that there’s been three people that’s put in their resignation for fear of retaliation and not one person on this board, or these people here [Asbury and Edmondson], have talked to those people about that? Not one.

“No one has talked to these people … citizens of Eureka Springs, about why they’re putting in their resignation, why they feel that they would be retaliated against. Not one of you people. You’re too worried about covering your own butts, writing up stuff and making sure that you guys are covered. You’re not taking care of those employees that are still at the hospital. … If you’re not going to take care of the people that you still have, you’re not going to take care of the next ones either.”

Since the terminations of Angie Shaw and Petrino, communication among staff at the hospital has been lacking, Tina Adams, currently laboratory director and infection control officer, told commissioners.

“There has not been any communication or organizational chart for us to follow,” said Adams, who said she submitted her five-week notice of resignation on Nov. 6. “The nurses have no contacts to call in case of an emergency. Our nurses have no clinical leader to support and help them. This is putting their license on the line and patients at risk.”

Another employee, Terry Moore, didn’t mince words when describing his personal uncertainty with the current environment at the hospital.

“I’ve got four great-grandbabies at the house right now, and they’re in my custody. They’re in my care,” Moore said. “And you know, y’all got the s**t scared out of me. I don’t know whether I’m coming or going. There’s a lot of stuff going right and there’s a lot of stiff going wrong with that little hospital on the hill up there, but I’m asking you today: Either shoot the damn thing or let’s fix it, because this is getting us nowhere.”

Moore also called for Turner to resign from the commission.

“Sir, I think you do need to do just what they said,” he said. “You need to step down and get out of the way because it’s already gone too far for anything to spread out and be smoothed over with the peanut butter and jelly. We’re past that point on the hill, but I’m asking y’all tonight to fix the thing.

“Fix it or kill it. Whatever it takes.”

Wilson and fellow CAPC member Bradley Tate-Greene, both with healthcare backgrounds, spoke about the importance of leadership in situations like the one the hospital faces.

“I hope you all can take away valuable lessons from this experience that has been going on over the last couple of months,” Wilson said, adding that she has been involved in health care for the past 30 years, including overseeing case management for three longterm acute care hospitals in Tampa, Fla., and currently helps “a rural health system build rural health clinics across the United States.”

She currently wants to focus on Eureka Springs Hospital for her doctoral dissertation in organizational leadership and development “with a specific focus on rural health care systems,” Wilson said, adding that she recently reached out to Turner with a more detailed overview, but got no reply.

“Perhaps the email didn’t reach him,” she said. “So, I’d like to invite you to engage with me on this topic. After reviewing my proposal in more detail, I kindly ask that you share any insights and thoughts with me that you might have. Together, perhaps we can learn, and I would encourage any person before me who cannot ethically rise to meet the role of leader or commissioner, or your oath as a commissioner, to step down and put in place those who can.”

Tate-Greene, meanwhile, didn’t hold back, often raising his voice, when addressing commissioners on an array of topics, saying “there are great concerns of things that have happened that have been published.”

“Number one, you have violated commissioner Arkansas state ethics,” he said, addressing Turner. “You need to resign immediately. If not, there needs to be a vote of confidence tonight. Otherwise, the commission has a right to dissolve the whole commission. It is totally different than the CAPC, of which I serve.

“So, yes, I am a commissioner and I know you should not be texting each other about commission things. You’re not even allowed to meet another commissioner, as indicated in the paper. I mean, you should have already resigned.”

The Times-Echo reported Nov. 14 that Turner and Dicks exchanged text messages about firing Shaw as early as Aug. 15, and also discussed other personnel matters by text, as well as meeting privately with Asbury, all violations of the Arkansas Freedom of Information Act.

Tate-Greene questioned the recent decisions of the commission and how it has affected the hospital.

“The question, however, remains, can this boat be turned around that has basically put on a sinking level that is the hospital,” he said. “Or, are we continually going to plug holes with leadership who continue to create more leaks, or who are only patching the holes with fake actions, volatile actions, and concerning plots that just fill the holes with dynamite awaiting for this ship to explode and downward it goes into the area of legal fines, closure, even worse, bankruptcy for the city … due to laws being broken, policies being violated, and regulations and protection of staff being disregarded.

“I’m not taking this lightly. Many of the employees have noticed discrimination, retaliation, violations of law, health and safety policies and practices both for themselves and patients, even some to the degree of losing licensure. It’s worth noting that whistleblowing and how an individual has a right to report corruption, criminal and unethical business practices in a workplace to appropriate government authorities. It can take place and it needs to take place and it has taken place.”

Tate-Greene noted recent allegations that Asbury has refused to sign off on things employees needed for patient care.

“But also note this, according to public policy exception, an employer or commission may not rely on the atwill doctrine as a basis for escaping the liability to discharge an employee for refusing to perform an illegal act,” he said. “You cannot discharge an employee who is protecting the safety of patients. You can’t tell somebody that they filled out a form incorrectly when you need ventilators for a hospital. … There are charges of possible murder, manslaughter, prison time for a neglect to provide respiratory services. There is a law that protects that.”

NEW CHAIR FOR 2025

No commissioner can hold the same officer’s seat for more than two consecutive years, so a new chair and vice chair were unanimously approved at the Nov. 18 meeting.

Sandy Martin was unanimously approved to replace Turner as chair and Brian Beyler was picked to be the new vice chair.

Martin and Beyler will assume their new roles effective Jan. 1.

While not one comment was addressed specifically, some commissioners did mention the public concerns at the end of the meeting.

“I just want to thank the public for coming out and sharing your concerns,” Martin said. “We have concerns, too. We’re working on it. And I hope you’ve heard what our actions so far that we’re taking. I’m looking forward to the investigation and I’m looking forward to chairing the [commission] because I’m proud of the hospital and I’m proud of this commission and I’m proud of the staff. You’ve done a good job. So, thank you.

“I think we’re moving forward and Kent, thank you for your service and your dedication. It’s been hard and you’ve been wonderful.”

Turner also thanked the public who attended the meeting.

“I also thank the public for your comments tonight,” he said. “I very much appreciate them and very much appreciate the fact that you feel so sincerely about the hospital.”