In candid and impassioned remarks during the Eureka Springs Hospital Commission’s regular meeting on Monday, Dec. 16, longtime local physician Dr. John House outlined the urgent challenges facing the hospital and presented a proposal to potentially ensure its survival.
House’s comments highlighted the complex interplay between local healthcare management, national trends and the unique needs of rural communities like Eureka Springs.
House began by framing the hospital’s current struggles within a broader context.
“Health care in this nation is in crisis,” he said. “… This is just a local manifestation of the current state of health care in the U.S.”
He pointed to a national trend of rural hospitals closing, noting that Eureka Springs Hospital had been able to resist this trend until recently.
“Of course, it was only a matter of time before the health care crisis finally hit home,” he said, referencing the hospital’s transition from a full-service facility to one offering only emergency and outpatient services.
House attributed many of the hospital’s challenges to systemic issues, including the marginalization of healthcare providers in decision- making processes.
“We have pushed out doctors and other health care providers from managing hospitals,” House said, leaving decisions to “people who know nothing about taking care of sick people.”
This disconnect, House said, is at the root of the broader health care crisis.
House’s assessment wasn’t limited to national issues. He described specific instances of mismanagement at the hospital, citing declining patient trust and the erosion of collaboration between the administration and medical staff.
House, a former chair of the hospital commission, said Mayor Butch Berry recently offered to reappoint him to the commission.
“I declined because I felt like it’s too late for that, that the only way forward to save the hospital was for a complete reset,” House said.
Proposal
In a move he described as the third of three options for the hospital — the first two being closing the facility or allowing it to “limp along,” which he predicted would result in closure in “less than a year” — House proposed that the commission allow his or another management company to take over operations of the hospital.
He presented a letter of intent to the commission, detailing his qualifications and vision for the hospital’s future.
House currently runs two clinics that he said are financially stable. Last year alone, his clinics handled more than 15,000 patient encounters, House said.
“I’ve worked extremely hard to earn the trust and respect of my patients,” he said, noting that his reputation extends to colleagues and the broader community.
His proposal emphasized restoring trust between the hospital and the community, improving operational efficiency and expanding services.
Hospital’s Decline
House provided a detailed timeline of the hospital’s decline, beginning with mismanagement under a Louisiana- based company more than a decade ago. He recalled that the company — Allegiance Health Management of Bossier City, which House did not identify by name — allowed the hospital building to deteriorate and failed to pay bills. Despite these issues, House said the clinical staff continued to deliver quality care.
After the Louisiana company’s departure, the hospital was managed by a new organization with a dynamic CEO who temporarily revived morale and operations. Again House did not identify the company ny name but he was apparently referring to Alliance Management Group of Broken Arrow, Okla.
“Unfortunately, his tenure was cut short,” House said, “due in large part to being undermined by some of the very same people involved with this current little controversy that we’ve been discussing for the last several months.”
The hospital’s reputation has suffered dramatically, House said, with many residents now choosing to seek care elsewhere, and the hospital’s patient base has dwindled.
“I can tell you, I refer patients out every day that I work,” he said. “Ninety percent of them will tell me: ‘Oh, I don’t want to go to the Eureka hospital.’ They don’t even know why. They just know that (Eureka Springs Hospital) has a bad reputation and they don’t want to have anything to do with it.”
House was unequivocal about his preference for the hospital’s path moving forward.
“I don’t want to see it go away,” he said. “I have a passion for it, and I feel confident that if you put your trust in me that we’ll make it work, one way or another.”
Commission Response
The commission agreed to review House’s proposal in detail and discuss it further at future meetings.
“We certainly want to entertain this,” commission chair Kent Turner said, adding that the hospital first needs to get approval for its plan to correct deficiencies noted in recent reports based on surveys conducted by the Department of Health and Human Services Centers for Medicare & Medicaid Services.
“In our opinion, you need a license to move forward,” Turner said to House.
In a Nov. 26 letter, an Arkansas Department of Health official said a lack of regulatory compliance could result in “termination of your Medicare agreement.”
The hospital has submitted “several drafts” of a plan for corrective action regarding the survey findings to the health department, Turner said.
Executives Absent
Acting chief executive officer Jodi Edmondson and chief financial officer Cynthia Asbury, who regularly attend commission meetings, were absent from Monday night’s meeting, with Turner explaining that health department personnel were “on site” and that Edmondson and Asbury were “working on some changes” to the plan for corrective action.
Turner said Edmondson had asked him to relay the news that the hospital has hired a director of nursing and clinical services. He said the hospital also has a new lab manager.
On Tuesday, Dec. 17, Turner said by email that Edmondson had hired the new director of nursing. He also acknowledged that he and Edmondson have had brief telephone conversations with “consultants that may be able to assist us on a short term basis.”
Commissioner Sandy Martin, who will become chair on Jan. 1, said by email that she received one resume for the CEO’s position, had a brief telephone conversation with that candidate and forwarded the resume to Edmondson.
Public Comments
During the portion of the meeting designated for public comments, the commission heard from several former and current hospital employees who spoke about what they described as an unfavorable working environment. Also speaking during public comments was a stroke survivor who emphasized the need for the hospital to maintain its occupational and physical therapy services, calling them “invaluable” in his recovery.
Bradley Tate-Greene, who sits on the city’s advertising and promotion commission, pointed out that Turner had said — in response to a question from city council member Harry Meyer at the council’s Dec. 9 meeting — that he would resign.
Both Turner and Mayor Butch Berry said on Dec. 10, the day after the council meeting, that Turner had not resigned from the commission.
“Legally resigning at the last city council meeting, Kent Turner, as the chair in a public meeting means I don’t know why you’re here tonight,” Tate-Greene said.
Current and former hospital employees have repeatedly complained about what they describe as bullying and favoritism by hospital administration. Tate-Greene admonished the commission to take those complaints seriously.
“Here’s a suggestion for you,” he said. “Next time you want to get the employee’s side of the story, ask them to write a statement and send it to all of you and not one of you, so that way you can have all the facts and all the informaiton and that way you can make a decision instead of coming to a meeting (and) hearing one side of the story, or he said, she said, or political motive or favoritism.”
Tate-Greene also chastised commissioners for repeatedly violating the Arkansas Freedom of Information Act, including a recent incident at which the commission adjourned a special meeting and continued discussing hospital business. That discussion — captured on an audio recording — included Turner commenting that he “wouldn’t have a colonoscopy,” in an apparent reference to a surveyor finding that there was no record detailing required cleaning of endoscopes.
