While the hiring of a new chief executive offer at Eureka Springs Hospital seems to be closer to reality, members of the hospital commission gave positive feedback to a proposal from local physician Dr. John House to take over operation of the facility.

“…My goal today is to show you how I can be your partner in achieving your mission of operating a top-notch healthcare facility for our community,” House said during a presentation of his proposal at the commission’s regular meeting on Monday, April 21.

The presentation laid out how House’s company would run the hospital, what the commission’s role would be, and House’s plan for helping the facility financially and earning back the public’s trust after months of discourse over a series of controversies Continued from Page 1

centered around hospital administration.

“I want y’all to understand something, because somebody in one of these meetings made a comment, like: ‘Well, what’s in it for him?’ in referring to me,” House told commissioners. “And I can tell you what’s in it for me, it’s better healthcare for our community. One hundred percent of the profits that we make off of this will go back into investing into this hospital.

“I’m at the end of my career. I’m not looking to build some great medical empire or something. I want to do what’s best for our community and make sure that when I do finally retire, that there’s a hospital around the corner, not 60, 70 miles away that I can go to when I’m having a … stroke or whatever else may happen. And I think that most people in this town feel that way. They want this hospital to stay. And so I will take every penny above and beyond what it costs to run it and put it right back into this hospital. A remote management company, as we’ve seen in the past, will not do that. It will get siphoned off out of our community and it will go, who knows, to line somebody’s pockets.”

Proposal highlights Key highlights of the proposal include that House’s company, House Health and Life Services Inc., would manage the hospital “in totality including all patient care, financial management, compliance with government regulations, public relations, employment decisions, etc.”

Other key parts of the proposal, according to the proposal, include: • The commission would retain all legal rights to operation of the hospital.

• The Rural Emergency Hospital license would remain in the name of the commission.

• All funds generated by clinical activity at ESH, as well as incentive money from government programs such as Medicare, would continue to be deposited in the commission’s bank account.

• House’s company would employ the hospital’s management team and provide all staffing, and ensure continuous operation of the emergency room at all times, “with diversion status no more than 5% of the time.”

• The commission would be responsible for the cost of maintaining the exterior structure of the hospital and parking lot, while House’s company would be responsible for remodeling and maintaining the interior of the building.

• The agreement would be for a term of five years with an automatic renewal for an additional five years if either party is not notified of non-renewal at least 12 months before the renewal date.

The proposal calls for House’s company to receive “whichever is greater:” a flat fee of $650,000 a month or a percentage of clinical services revenue.

“…When I joined this commission back in 2015, I think it was, and Allegiance (Health Management) was running the hospital, they kept all the money and then they just paid us rent, basically,” House said. “They rented the license from the commission and they rented the building. So, the only accountability they had to the commission was strictly what was in their contract and it did not give us much accountability.

“So, I wanted to make it clear that the commission would still be 100 percent in charge just as you are now. In exchange for that, then you would pay my company $650,000 a month to cover everything else. Now, there was some balking at that number, I think, initially, but if you look at your expense reports over the last 12 months, it’s a little bit more than the average of that monthly expense. Obviously, the only way that I can stay in business is if the expenses are covered, particularly if you’re getting all the money. So, that money has to flow back to my company to pay payroll and to pay all these contracts for equipment and those sorts of things.

“Now, as the situation improves and the revenue to the hospital increases, then the amount that you would pay my company would go up as well. The reason behind that is that presumably that increased revenue would come because we’ve hired additional staff, we’ve brought in new equipment, we’re offering new services. So that would be to cover those expenses.”

Management team

House told commissioners his company would bring in its own management team, and he already has commitments from those individuals.

“We have three people who have committed on the management team, myself, and I can’t mention the other two names because they are currently employed with someone else,” he said, “but one’s an ER doctor and one is an RN who has 25 to 30 years of hospital management experience.”

Hospital financial woes have been a main topic in recent commission and city council meetings, and are something that House said he’s had an eye on, saying he feels that area is one where it wouldn’t take long for his company to make big strides in making improvements.

“…If you go back pre-COVID, revenue in the hospital was a million dollars a month,” he said. “It wasn’t always that, but it was frequently. When Allegiance was operating, of course we had inpatient and swing bed then, so that was an additional revenue, but it was also additional cost. But, at that time the revenue was a million dollars a month or more so.

“In the first year, if you decide to use me as a management company, in the first year, I project that we will get back to a million dollars a month pretty quickly. … Now, I’ve got an assumption there that this implies that the economic climate and the political climate stays the same. That’s a big assumption … but given that all things stay the same, I feel confident within a year we’ll be back to where we were a few years ago.”

Repairing reputat ion

Repairing the hospital’s reputation is also a key and needs to be addressed quickly, House told commissioners.

“I’m wearing two hats today,” he said. “One is as somebody who’s proposing to manage the hospital, but the other is as a local physician. And I’m sure that anybody that’s worked in clinical care can vouch for this, but doctors, nurse practitioners, we are incredibly busy. And when we do something, when, for instance, on Saturday I saw more than 30 patients. So, when I ordered a CT or I ordered physical therapy or speech therapy, I want it to be once and done. I want to know, I placed that order, it’s gone, the patient will get called and scheduled. That has not happened with our hospital. It’s still not happening with our hospital. So, we need to fix that. And that’s part of the management proposal, but it’s also a perception.

“So, when we think about how do we improve this, first off, we have to talk to the doctors and nurse practitioners. We have to convince them that the problem is fixed because if you — I’m a founding member of the Carroll County Medical Society — and I can tell you that if you ask those doctors: ‘Do you feel like Eureka Springs Hospital is a reliable place to send orders?’ they will say ‘no.’ So we’ve got to fix that.

That starts with himself, House said.

“One of the ways that we can fix that is me,” he said. “These doctors trust me. So, if you decide to go with me, every week, I and a member of the staff, whether it be radiology, lab, nursing, whomever, will be going. We’ll be going to these doctor’s offices and these various places that order from your hospital and saying: ‘Hey, you know, you trust me, let me make this right for you.’” While building a reputation locally in the healthcare industry is important, it’s just as important to repair the perception of the public, House told commissioners.

“The number of orders that I have sent to the hospital over the last six months to a year has probably gone down by about 90 percent, maybe 95,” he said. “And in almost every case, the patient says to me: ‘Oh, I don’t want to go to Eureka Hospital.’ Now, they don’t want to go to Fayetteville. They don’t want to go to Rogers. So, we’re sending people to Mercy in Berryville. And I’m here to tell you, that’s not going smoothly either.

“But they’ve read in the newspaper and seen on YouTube and talked to their neighbors about all of the stuff going on, so they don’t want to do that. They don’t want to come back here. … I may be a little full of myself here, but I believe that if I told a patient: ‘Look, you trust this clinic. Will you trust what we’re doing at the hospital?’ they would say yes. And I believe we can turn that around.”

House said he would focus on going to various civic organizations, churches and schools sharing the good things happening at the hospital if his company took over.

“… Here’s why you can trust us, because your neighbor is the person that’s going to take care of you when you get there, the doctor that you know and you’ve known for years is there … and is going to take care of you,” he said.

It all starts with the hospital staff and building a positive working environment, House said.

“… Creating an environment where every member of the team, from the person cleaning the floors to the person starting a central line, knows that they have a voice,” he said. “And that if they have a problem, they can talk to the top person and say: ‘Here is what my issue is,’ and not worry about being fired.

“That’s the way I operate. Every person in my clinic knows that they can talk to me about whatever it is, and I’m going to take it seriously. And if it’s an issue that we need to deal with, we will deal with it.

“You put [all the] things together, and I think we can repair this damage that’s been done over the last year.”

‘Just a proposal’

House indicated he’s up for negotiations on various aspects of his proposal.

“… This proposal is just a proposal, OK?” he said. “So if there are things that you’re like: ‘Gosh, you know, we like what you say, but this is a deal-breaker,’ we’ll talk about it,” he said. “We can figure that out. And then once we get it all worked out and ironed out then our various attorneys will sit down and make it all pretty and legal …”

Commission response

Commission chair Sandy Martin reminded House that if the commission opted to proceeds with his proposal, certain steps have to take place, including a Request for Proposal and notifying state officials. She also reiterated that the commission was still planning to move forward with hiring a new CEO.

When asked about House’s proposal, Martin told the Times-Echo by email on April 22 that the next steps have not been determined other than future discussions at commission workshops.

“There is not a specific timeline on Dr. House’s proposal,” Martin wrote. “We will discuss it at one of our workshops. As I mentioned in the meeting, a management proposal is a long process requiring several steps.

“In the meantime, we are focused on getting a CEO in place and continuing to move the hospital forward. Obviously, if we hire a CEO and pursue any type of management agreement, that will be part of the negotiations.”

During the April 21 meeting, most of the commissioners gave House positive feedback regarding his proposal.

“Thank you for this. It’s well thought out. You put a lot more time into it than I thought,” Martin said at the meeting, later adding, “… We look forward to continuing the conversation with you and appreciate you coming and appreciate giving such a comprehensive report,” Commissioner David Carlisle echoed those feelings.

“… I want to thank Dr. House for his excellent presentation,” Carlisle said. “It’s very promising.”