The new emergency room chief of staff at Eureka Springs Hospital said he and his team are excited about the facility moving forward in a “new direction” and giving the community the care it “deserves.”
At the regular monthly meeting of the Eureka Springs Hospital Commission held Monday, Feb. 17, Dr. Jacob Roberts, the new chief of staff at the hospital through its agreement with staffing company 360 Degree Medicine to run its ER, gave a positive outlook about recent changes and the future.
“We really truly look forward to helping the hospital kind of move forward into the new direction and provide care for this community in a way that the community deserves,” Roberts told commissioners. “… We are a group of emergency medicine physicians. We’re based in Northwest Arkansas and Southwest Missouri. We operate in many of these hospitals similar in size and geographic location to what Eureka Springs is. Many of our doctors live in this area as well. None of our physicians are from really anywhere outside of Missouri or Arkansas.
“This is our home base, our geographical area. We’ve been in this area since 2008 and we’ve got quite a few physicians who work with us.”
Roberts and 360 Degree Medicine replace Emergency Staffing Solutions and Dr. Gary Parkhurst, who had been running the ER until the hospital ended the agreement in late January.
Parkhurst had worked at the hospital for 10 years before learning on Wednesday, Jan. 29, he was barred from entering the hospital, he recently told the Times-Echo.
“So as you’re aware, we recently made the difficult decision to terminate our staffing agreement with ESS,” Lana Mills, the hospital’s new director of nursing and clinical services, appeared to read from a prepared statement at the Feb. 17 meeting. “ESS was a physician contract company and we did not fire any physicians individually. ESS had been made aware in writing of issues beginning back in April of ’24. Since that time, there had been many attempts to work with ESS to correct the issues. This move was made to provide the best care for the community, the families and the patients that visit the Eureka Springs Hospital.
“360 Degree Medicine immediately came in and ensured that there was never one minute that a physician was not on site. The group of physicians is a local group that provides high-quality care and is familiar with Eureka Springs in that area, as Dr. Roberts has said. On Jan. 31, at [7:30 p.m.], we were completely off trauma divert for blood products. Our blood products were back inhouse and this is a testament to the hard work of our staff… We have many things changing in our hospital. Our trauma survey is now scheduled for June. … It was supposed to be scheduled for February. I had to apply for an extension after finding that there were a lot of things that had not been previously completed, but we are now getting them done. Stroke is being updated. The database from the Arkansas Stroke Registry, they have been given access to our electronic reporting system, and so that is being updated and that is actually now complete.
“We’re getting back on track.”
Roberts said the goal is for his team at 360 Degree Medicine to partner with ESH for the foreseeable future.
“We really feel like this is a hospital we can have a long-term relationship with,” Roberts said. “Most of the places we work we’ve been there for years, and that’s our ultimate goal, to have a good relationship that is good for the hospital and good for the community.”
Commissioners seemed supportive of recent hospital changes, according to comments made at the end of the 23-minute meeting.
“I’m just pleased at the direction we’re going in and the way changes are developing, that are things that need to be done,” commissioner David Carlisle said. “They’re being done in kind of a reasonable fashion and I’m really pleased.”
Commission vice chair Brian Beyler agreed, mentioning all the “new things and great things that are happening in the hospital.”
“I think it’s going to be great moving forward,” Beyler said, speaking to Mills, acting CEO Jodi Edmondson and Cynthia Asbury, the hospital’s chief financial officer. “So, thank you for everything you’ve done lately.”
Chair Sandy Martin praised the new staff and employees keeping a “positive attitude.”
“I just want to underscore what all they’ve said,” Martin said of her fellow commissioners. “I’m extremely pleased with the staff and the collaboration and the teamwork that you’re all doing. It really is coming together. You keep adding good people. You keep your care. You keep your positive attitude. And that is greatly appreciated.
“It’s been tough, but we’ll get through it. And a huge thank you for getting us through state and getting us compliant with CMS. That was a huge mountain to climb and a lot of work. So, bravo to you all.
“Thank you to the commissioners … because the commission has been steadfastly supportive of this and in lockstep. That makes all the difference in the world, so thank you for that.”
NEW COMMISSIONER
Vivian Smith, whose appointment was recently approved by the city council, took part in her first meeting as part of the commission.
When asked to tell a little about herself, Smith said she has “over 50 years of healthcare experience.”
“I started as a [licensed vocational nurse] and then got my master’s in public administration,” Smith said. “I’ve been in both the public and private sector in hospital administration and healthcare administration.
“I’ve been through more audits than I care to be through and have conducted some, so I’m kind of familiar with what you went through.”
The hospital commission still has one vacancy remaining.
CFO REPORT
In her finance report, Asbury said the hospital was down “about 3 percent” for the month of January.
“That is ultimately due to we have had less volume through the month of December, which mean less income, less payments being paid in from insurance through the month, and a decrease in services as well in January,” she said. “So, not to be surprised by that, given the volume of statistics, but we have already seen an increase in the month of February for our stats going back up, trending in a good direction.”
In a revenue and usage summary, the hospital is down 53 percent compared with last year, Asbury said.
“Compared to last year, we are significantly down 53 percent,” she said. “Again, we don’t have any operating room or anesthesia services. I mean, that’s about a $75,000 amount there just in that. Overall, our ER again was down for the month. We were still on divert until the end of the month, on the trauma divert … kind of this time of year with no tourists and stuff as well there is a decrease in the volume through the ER.
“So, we’ve already again seen an increase. In January we did have some observation stays already, which was significant. We hadn’t had that income coming in in a bit, and we’ve had an increase in that as well through already the month of February.”
In the income statement report, Asbury said the total loss for [January] was “about $87,000.”
“I mean, again, when you have a decrease in the revenue … our expenses are going to remain about constant,” she said. “But I think we’re definitely moving in the right direction with the new partnership we have with 360, the patient volume … we’ve had an increase in EMS services.”
Asbury told commissioners that she sees things improving beginning in March.
“I think getting through February is going to be the last struggle month,” she said. “Tourists pick back up in March, so we’ll see the increase of the influx coming back that’s there usually from March through October.”
WEATHER PREPAREDNESS
Martin asked Roberts if winter weather, and being prepared for difficult traveling conditions, provide any special challenges for his team and the ER staff.
“As far as the operations, we’re primarily making sure that we have staff that’s prepared to stay here through inclement weather in those regards,” Roberts said “When it comes to actual operations, probably the biggest challenge we may have is transfers out depending on what the weather looks like and the patients we have. So, we have to be prepared to maybe keep some patients for longer periods of time than what we may otherwise. But, those are all kind of bridges you cross when you get to them.”
Martin asked if keeping patients longer than what is expected under the rules of being a Rural Emergency Hospital, is justified based on weather challenges.
“I assume that because it’s weather-related that it’s not a violation of REH,” Martin said.
“No, and according to that, we can keep patients for up to 48 hours on an observation stay,” Roberts responded. “But, that doesn’t really include a patient that is in the ER in an ER status, not an observation status, but an ER status. That’s there because they’re receiving treatment or you can’t transfer out.
“Unfortunately, sometimes patients will stay in ERs, in that status, for days because of either transport type issues, say with weather or something like that, or sometimes because there’s not an appropriate receiving facility. Primarily, you see that with psychiatric patients. Sometimes there won’t be availability for that.”
BANK SIGNATURES
The commission approved taking former commissioner Kent Turner off the list of authorized banking signatures.
The current list of approved signatures includes Martin, Beyler, commissioner Kate Dryer and Mayor Butch Berry.
MEETING DAY CHANGES
The commission voted to change the day and time of its monthly meetings, voting to have meetings starting in March at 2 p.m. on the third Monday of each month. The change is to help accommodate the schedules of staff who attend meetings, Martin said.
