Members of the Eureka Springs City Council peppered the hospital commission for more than two hours during a workshop held Monday, April 1 at The Auditorium, with most continuing to call for change in the facility’s administration.

The hospital commission, meanwhile, presented the council with a stack of documents aimed to lay out a better picture of the controversies that have arisen since early November and started with the sudden firings of chief executive officer Angie Shaw and nursing director Jessica Petrino.

“If I were on your side of the the table, I would read every one of those documents,” hospital commission chair Sandy Martin said after council member David Avanzino asked for each commissioner to tell the council what they would do about the situation if they were sitting on the council’s side of the table. “… I think you’ll find a different side of the story in there, and I think you’ll find out how it progressed, and who progressed it, and I think the other side of the story is in that.”

After the firings of Shaw and Petrino in early November, with no public explanation from the commission, many former and current employees voiced outrage at the commission and hospital administration, accusing hospital chief financial officer Cynthia Asbury and Jodi Edmondson, the human resources director who is currently serving as acting CEO, of fostering a hostile work environment. Allegations of episodes of harassment and bullying led to some employees resigning, former employees have said during commission and council meetings since Shaw and Petrino were let go.

“I want to be clear about this: We all take those complaints seriously,” Martin told council members. “Some of them are extremely valid, others are not. But, we still stand by our staff.”

Each council member voiced opinions and asked questions of commissioners. Most talked about the amount of phone calls and complaints from current and former employees of the hospital and constituents about the ongoing issues.

Martin gave a timeline of the hospital’s journey from being designated as a Rural Emergency Hospital in 2023 to where things stand today. She said commissioners first heard about possible employee issues last August, approximately two months before the terminations of Shaw and Petrino.

“In August we started getting feedback and rumbles of some disgruntled employees and some situations going on,” Martin said. “The commission, specifically the chair at that time, started looking into it. We were continuing with the REH model.

“… September 4th, the previous CEO submitted her resignation letter to to the chair, but rescinded it and never acted on it. On the10th of September, she sent a memo to the commissioners saying that we should not have any contact with staff without going through her, which we found interesting. On September 12th, she sent a memo to staff stating, rather lengthy memo, stating the hostile environment and that changes were going to be made that obviously were not immediately. In November, we had the surprise visit from the state. They were in for a week. We had a massive audit, 53 pages, plus a secondary, seven page that was a clarifying. It’s kind of what they do. They do a mass one and then they’ll send out others. We spent a lot of time getting that corrected. And as you know, we got that acceptance that we were clear and back in CMS compliance and we had one seven-pager left to do. We just received clearance that that plan of correction was accepted as well.”

Financial woes were also examined at the workshop along with suggestions of getting an outside company or another hospital to take over management of the facility.

All options are on the table, Martin said, while commissioner Kate Dryer said two finalists are being interviewed for the CEO position.

Hospital commissioners, meanwhile, said only hearing one side of the story from past employees, and in newspaper and social media reports, has led to much of the negativity, and that the hospital is in a positive place and headed in the right direction.

“… The commission did do a lot of investigation into the environment,” Martin said during her introduction and the hospital timeline. “We’ve made some corrections. Right now, we think our environment is really good. Seems like most people are happy. We had our second employee appreciation luncheon today….”

‘THE ADMINISTRATION IS AN ISSUE’ Council member Rachael Moyer, who originally requested the stack of documents from the commission, said she had spent the previous two days reading through them. It hasn’t changed her mind that Asbury and Edmondson should be removed, she said, while pointing out the 24 hospital staff members who have left or been fired since early November.

“…Ultimately what I’m trying to do is just try to get a systematic understanding of what’s happening and we need an explanation for why our turnover is so high,” Moyer said. “And to me, it seems as though it might be tied to the current administration. But, what I hear you guys saying is, it’s maybe primarily tied to news coverage or something else. You know, can you see why I’m asking this question? I’m not placing blame on anyone. I just want to understand what is happening.”

Martin said she understood why the question was being asked, but said she doesn’t feel as if the administration is leading to the high turnover. Instead, she urged council members to communicate their negative feelings with commissioners, whom she said need to know what is being alleged.

“… When you hear these things, have them contact one of the commissioners,” Martin said . “And have them let us know so that we’re aware of some of these things. But yes, I think your take is correct. We do not feel that [turnover] is higher or due to this particular administration. We do acknowledge that it is due to a lot of changes in disruption at the hospital itself. But to tag it onto this administration, I don’t think that’s accurate.”

The strong support the commission is giving Asbury and Edmondson, and the fact that nothing she read in the documents changed her mind on that issue, is concerning, Moyer said.

“I’m left with three kind of primary concerns or conclusions,” Moyer said. “The confidence of the commission in the current hospital administration has resulted in, I see this as contributing to staff turnover, unless there’s a better explanation, which I haven’t heard yet or read in there. It seems to me that it’s tied to administrative issues. Not because I made that up, but because that’s what’s being told to me by folks who worked in the hospital and who have connections to the hospital through contract labor. That’s why I’ve come to that conclusion. I didn’t see anything presented that substantially changes that trajectory. So that’s concerning to me.

“The community’s trust in the commission and the administration, this is the second thing, has almost completely deteriorated for whatever the reasons are, not placing blame on anyone, but that’s where we are right now. And I think that’s what my colleagues have been trying to point out. There is no trust. I’ve spent the last week systematically talking, not just people who contact me, I reached out and talked to people, people who chose to not get treatment here because of the lack of trust, people who have worked there previously, people who currently work in the hospital, medical professionals in the community that refer people to the hospital and everyone agrees that the administration is an issue in the trust factor. Whether there’s an actual basis for it or not, that is the perception.”

Nothing will change opinions on the hospital, or the recent controversies, until something is done, Moyer added.

“What do you do about the perception? You have do something. They’re not going to read all of this,” she said, referring to the stack of documents provided by the commission. “It’s not going to change their mind. They’re going to read the paper. … There’s no trust and there’s nothing that’s been presented here that would convince me that that’s going to change. I think we’re down the same road still with that. Both of these concerns seem to have a huge financial impact on what’s reflected in these income statements. Patient revenue’s down, half of what’s budgeted, staff expenses are up, double what’s budgeted. The commission and the current administration, in my opinion, are completely, dangerously off track with the operating budget for 2025. By my calculations, several million dollars. If that goes through $6 million in reserves really quickly, again, I’m concerned that the council is going to be expected to reallocate money to help make up the difference. If so, at what point does that happen? The $6 million isn’t going to last forever.

“In my mind, that money could possibly be used to make improvements needed to the hospital and get a management company in to take it, administration to outpatient services, managing the whole thing by professionals, if that’s possible. Do I have one in my pocket? No. But I think strongly that that’s the direction that we should be going. Finding a professional management company to manage this, take this out of your hands so you don’t have to be dealing with it, you guys are volunteers. Make it more financially feasible for the future. I would urge the commission to revisit the budget immediately and report back so that we can have a better idea of where we’re actually standing financially.

“And in conclusion, I’m firmly in favor of securing a full service management contract for the hospital operation. And I urge the commission to expedite that process and find a viable candidate as soon as possible. And I’m not in support of commissioners who refuse to look at that option…” That led to Moyer being invited to the next hospital commission meeting where she could ask more specific budget questions to Asbury.

“I appreciate that,” Moyer responded. “I appreciate transparency and openness to work together. I think that’s the only way that we’re going to be successful in keeping the hospital open. I think everybody feels the same way. But, I stand by my statement.”

‘LOOK AT THE POSITIVE THINGS’ Each hospital commissioner got their opportunity to address the council early in the meeting when asked what they would do if their roles were reversed.

“I’m going to speak to this side of the table and say, you know, we really don’t know what happened that caused this event, this major event in Eureka Springs, but we do know one side of this story and that side of the story is the, the personal side of the story,” Avanzino said. “And it’s been very, I don’t want to say frustrating, but it’s gut-wrenching to hear some of the stories about what has been lost in the way of a paycheck, insurance, so forth and so on. So at least for myself, it’s been a lot. I’m going to say probably since November, over 200 phone calls and emails, and they still keep coming.

“So I would like to know from each one of you individually, if you were in our shoes, what would you do?”

Commissioner Sharon Deramus said new staff coming on board are making a difference moving forward.

“…I’m pretty pumped about some of the new staff that’s come on board in the emergency room, the trauma nurse that was hired,” she said. “As a nurse to a nurse, I was really impressed. And it is essentially an emergency room. That’s what it is.

“I think we just need to get the word out that we’re hiring. Looking at some of the resumes for the CEOs, I’m very impressed. … We’re just going to have to gain their confidence. You know, I mean we’ve all heard the bad press too, and that that concerns me as a nurse. But, it’s got to be principles before personalities.”

Commissioner Brian Beyler also attributed much of the controversy surrounding the hospital to newspaper and social media reports.

“…The negative press,” he said. “I know there’s concerned employees that are no longer with us. I understand that. I also believe that a lot of the stories that have been shared need to be heard from both sides. I believe there’s a lot things there that our press has not helped at all.

“ … My concern is that it’s time to turn it around and start looking at the positive things. And I encourage all of you to go up and take a tour of the hospital, see what’s going on up there and get a feel for it. From my perspective, we’ve got a great place. We don’t need to lose this hospital. We need to stay strong and be strong. … I’m telling you, until that press turns it around, these people are going to continue to want to go to Berryville because they’re reading that newspaper going, ‘oh, there’s a lot of problems over there.’ And that’s a concern of mine. It’s time to put some positive stuff out there from not only us as a commission, you guys as the council start to look hard at what is the hospital doing right now. And the things of the past, we’ll sort those out…” Commissioner David Carlisle agreed.

“I think if I were on your side of the table, I would try to maintain my awareness of the environment that we live in, that information is not what it used to be, that the information available to the consumer of Facebook and the press in our town is faced with the same thing that we’re faced in the world at large,” he said. “A lot of information, difficult to parse. What we do know is that negative information is mother’s milk. It just makes us happy to hear that and we feast on it. And so do our citizens. It’s hard not to, and once you get a drum beat going, all I have to do is repeat it and repeat it. Now it’s by mouth.

“So, I’ll just try to remember that there is a source of information here that’s kind of dry and really cruddy and hard to acquire and assimilate and balance off against the hideous stories that are being told of dismembered bodies in the violent hospital. There is a truth probably somewhere in the middle, but the fact is, it’s human beings. I read some of the reports and it sounds like it was high school in there at some time, and an administration that wasn’t seeing it, and we’re a little distant, and we couldn’t pick it up and it escalated and the people that were in charge were over their head. They couldn’t control the fact that communication hadn’t been kept clean and that personalities had been allowed to flower and it became untenable and then exploded. And now it’s viral and all those sad stories probably have an element of, I mean, if I’m getting fired, by golly, I am being trampled on, of course, and I’m sure there was some unfairness. There’s no way it couldn’t be just statistically, but we’ve got to remember that there is a body of evidence that can be looked at and balanced off and that isn’t as cut and dry as I read in the gossip columns, pardon me…” Carlisle said “it’s definitely clear that things are better now than they were,” at the hospital.

“… It was the assumption that the team, the administration was doing their job,” he said of the past. “They did until some minor discrepancies just oscillated and became a driving force and disrupted the hospital. The disruption is over. The rebuilding is what’s happening at this time. That’s what we’re doing. That’s what we’re seeing. And the attitude amongst the employees over there, the people that work over there, they’re glad to be there.

“I’m sure there’s somebody that’s not, but most of them are, and that’s kind of where it is, I think.”

Dryer also praised new staff, specifically mentioning Lana Mills, the hospital’s director of nursing and clinical services. She also thanked the council for agreeing to hold the workshop and encouraged having regular sessions with the two bodies.

“Our new group of emergency room physicians are smart, young, eager, talented physicians,” Dryer said. “I can’t really talk about the prior group of folks who were there and the events that led up to their departure. I don’t believe I can talk about that. … But, I can promise you that the individuals, whether it was a group … or if it was an individual that was asked to no longer be with us, none of these decisions were willy- nilly. I can promise you that.”

The hospital commission’s newest member, Vivian Smith, said she was still learning the background of the events discussed at the workshop and urged open communication moving forward.

“You have a lot of angry and hurt people that come to you all the time,” Smith said to the council. “I think I was disheartened by what I heard at the meeting because there has to be mutual respect. We have to keep the conversation going. There has to be no name-calling. We have to believe in each other. You have the belief in this commission. We all want the same thing.

“I want this hospital to remain open. I visited the hospital, and I was so impressed the first time I walked in there. I went and had a procedure done there, and I was impressed with the staff, with the physical look of the facility, and I just want to encourage us. I’ll talk to any of you. I don’t know anything right now, and I’m learning a lot that any time you want to talk to me, I’m available to talk. I don’t know what to do for the people that have been hurt. I don’t know what they want. I know that we keep on hearing the negative over and over and over again, and we need to focus on the positive. There are so many positive things happening, so many. And I think that they get lost in the negative back and forth.”

Later in the meeting, Avanzino said it was up to the hospital to share the positive news it’s wanting.

“Their perception is their reality, plain and simple,” he said of the public’s view of the hospital. “You cannot change it. What you can do is start sharing the positives. And that’s y’all’s job, you guys and the staff. Because if you think the press is going to do it, they’re not until you start proving that you can do it consistently.

“Because what the press has seen consistently so far is things that you cannot do. Such as, let’s see here, being on divert two times. There are a lot of things that the press has picked up on because you know what, that’s their job. That’s what feeds people is the discourse, the scandal or whatever you want to call it. So give our reporters in town something positive to work for. … You move forward, you do good things, you share them on your social media platforms, you share with your staff, share staff moments with the public. Until you start doing that, it’s just going to be the same thing over and over with the press and you’re going to die in the papers.”

‘THERE’S NO RETALIATION’

Members of the hospital commission said former hospital staff members, even ones who have voiced complaints in recent months, are welcome to reapply for any positions that come open.

“… Is there something in place to give the employees that were either felt they were fired unfairly or quit because they were afraid of retaliation and whatever, is there a plan in in place to get those people back to work?” Avanzino asked.

Martin responded: “If we have an opening, they’re certainly able to apply.”

“Will they be able to apply for a position and get a fair and unbiased interview to come back to the hospital?” Avanzino responded.

Martin replied: “Sure. There’s no retaliation.”

While he said he sees that there would be no retaliation from the commission, he was still concerned about ‘the retaliation and hostility with the current administration.”

“I’m not the HR director, but as along as someone gave their notice and fulfilled that term of notice and left … they’re eligible for rehire, which is the same standard in any hospital or clinic I’ve worked in,” Dryer said.

“I just want to make sure that our neighbors that want to go back to work at the hospital … unless they were terminated for something that was very severe, that they are welcomed and treated respectfully, interviewed respectfully and given a second chance,” Avanzino said.

Martin replied: “Absolutely.”

OTHER OPTIONS ON TABLE

Martin said she would reach out to Washington Regional Medical Center and Mercy Hospital this week to see if there might be any interest in taking over Eureka Springs Hospital.

While the commission is in the final stages of interviewing for a new CEO, other options are on the table, including an outside management company and re-visiting a possible offer from Dr. John House to run the facility.

“…. As you know, Dr. House pulled his proposal and then … we received an email that if we’re interested in it, he would be interested in going back at the table,” Martin said. “We are actively looking for a CEO. We’ve got a couple good candidates that we’re vetting. If Dr. House wants to give us a specific proposal, because I’m sure you’ve seen the same documents we all have, there are no specifics in it. We will be more than happy to workshop it with him at our April 7 workshop, but we need specifics to go by to consider it. And then we can fairly weigh that against a good CEO or a management company.”

Avanzino shared that the council was in support of an outside hospital or company taking over the hospital.

“At our last council meeting we had made suggestions for the commission to sort of reinvent itself as an oversight committee, that y’all should not be managing and running the hospital,” he said.

“We would love that,” Martin responded.

Council members were reminded that things didn’t go well the last time the hospital was run by an outside management company.

“Yeah, management companies, but I’m thinking more along the lines of Washington Regional, Mercy, Harrison hospital,” council member Terry McClung said.

Martin said “several years ago” Mercy was looking to reduce its services and had no interest in managing Eureka Springs Hospital.

“That’s several years ago,” McClung said, urging the commission to reach out again to see if situations have changed.

Martin reminded the council that the only reason the commission is being so hands-on with daily activities at the hospital is because of the current situation.

“… In our bylaws that I sent you a copy of, that is exactly the way we’re supposed to operate, as an oversight commission…,” she said. “We only stepped in in an active role when this all blew up. We don’t want to micromanage the hospital. We want to be the advisory commission. That’s why we need either a strong CEO or a strong management company. And in my way of thinking, it’s … one and the same, actually. If you have a good, strong CEO, they are the management. And you don’t need a secondary management company to come in and layer. Or you get a management company, you work out the financial arrangements, and they appoint a CEO.”

‘GOT COMMUNITY DAMAGE TO REPAIR’

Martin echoed much of what the other commissioners said, saying things have been happening to move the hospital in the right direction. She admitted that improvements still need to be made in various areas.

“We’ve got a lot of work to do, there’s no question about it,” she said. “We would just encourage the council to kind of reflect back on what the hospital, the staff has gone through in the last year. Our goal when we went into REH, because it’s a good model for Eureka, when we were getting on track toward the end of the year, we actually were in the black. It gives us an opportunity to grow outpatient services, which we wanted to do. We were on that path identifying several that we could do and then we got diverted. We need to get back on that path.

“We’ve been working to stabilize the hospital, get it calm, calm the environment, which we think we have. We think the workplace environment is good. They’re painting the place. They’re doing outside cleanup. I mean, there’s pride in the hospital from the employees. There are still [employees] that are walking on eggshells, walking on eggshells because of the negative press. And they’re afraid. They’re afraid to go to the grocery store, because they’ll be accosted by somebody. That’s out of our control. We can control our environment, and that’s what we’re trying to do. It appears to be improved quite a bit, but, we’ve got community damage to repair. We’ve got reputation to repair. The staff has been directed to focus on their jobs and to make sure that they focus on quality health care, and I think they’re doing that.

“When we get the marketing director in, we will do community outreach. We will start pursuing outpatient services now that we can present new things. We have the agreement with UAMS on the tele-health. One of the community outreach things we want to do is a large open house where we can announce with UAMS the tele-health opportunities. Also, they can meet the medical staff … our new employees, take a tour of the hospital because it’s quite different and cleaner now, and then start from there. We’re anxious to get to that point.”