Eureka Springs Mayor, City Council, ESH Hospital Commission, and citizens,
It has been a year since my company submitted a proposal to operate Eureka Springs Hospital. The commission chose a different path — hiring CEO Tiffany Means — and from my vantage point, Ms. Means has made meaningful progress in stabilizing operations. Significant challenges remain, and I offer the following observations and recommendations in the interest of ensuring the hospital continues to serve our community.
- CFO Termination
The decision to terminate the CFO was the right one. For nearly two years, dozens of former employees — both those terminated and those who left voluntarily — raised concerns on the record before the commission and council about this employee. Lawsuits were filed. Yet corrective action was minimal until outside leadership intervened. I would encourage the commission to reflect seriously on that pattern. The employees who suffered through that period deserve acknowledgment, and those responsible should be held accountable.
- Closure of the Endoscopy Suite
I have concerns about converting the operating/endoscopy suite into a simulation lab and infusion center. Over twelve years of practice in Eureka, I have ordered hundreds of EGDs and colonoscopies — most performed at ESH — compared to fewer than five infusion orders. Eliminating this service forces patients who prefer not to use Mercy in Berryville to travel multiple hours to Fayetteville for procedures that were previously available locally. For many patients, the travel burden will result in cancelled or deferred care. The physician who previously performed these procedures at ESH has indicated willingness to do so again. I strongly encourage administration to reassess whether the infusion center justifies the loss of endoscopy services.
- Oracle EMR System
The Oracle EMR system warrants urgent review. At a reported average of seven patients per day, a $45,000 monthly EMR cost translates to approximately $215 per visit — before any other expenses. By contrast, the EMR used at my three-provider clinic that treats far more patients costs roughly $6,000 per month and is used by hundreds of thousands of providers in both clinics and hospitals. There are dozens of cost-effective alternatives better suited to a facility of this size.
- Governance and Leadership
Two lessons from recent years deserve emphasis going forward: The commission must resist the urge to manage hospital operations directly. Healthcare administration is a highly specialized field, and well-intentioned but inexperienced oversight by volunteers contributed to significant operational dysfunction, employee harm, financial exposure, violation of state and federal law, and near-closure.
Should Ms. Means depart, her successor — whether an individual or a management company — must be an experienced healthcare administrative professional. That standard cannot be compromised.
John House, MD
Health First Clinic