The latest medical personnel at the Eureka Springs Hospital to report being terminated with no notice or explanation are all the emergency room (ER) doctors—including Dr. Gary Parkhurst, the hospital’s medical director and chief of staff associated with the Emergency Staffing Solutions (ESS) group that was hired in October 2023.
Parkhurst is a local resident who has been on the medical staff at ESH for ten years working for whatever group was currently staffing the hospital. He is not primarily an ESS physician.
Parkhurst wrote in a text message that he went into the hospital Jan. 26 and was told that he was not allowed in the building. That is the first he learned that he had been removed as medical director and chief of staff, and that ESS was no longer handling staffing for the ER. Parkhurst said hospitals do change contracted staffing groups, but he believes ESH was required to give ESS proper notice.
“I am relatively certain that it is pretty irregular for a hospital to carry out such a change so abruptly,” Parkhurst wrote. “I do know their rationale was that they had learned that the ESS doctor on duty at the time did not have his Arkansas Medicaid approved. It was apparently still pending. That is not that unusual. They usually just bill retroactively.”
Parkhurst said he is puzzled how the hospital got all the doctors with the new group, 360° Medicine, credentialed without Parkhurst’s involvement, knowing that physician credentialling can be time consuming.
Hospital bylaw 7.1.2 states: “All applications for appointment to the medical staff shall be in writing and addressed to the CEO of the Hospital. The applications shall contain full information concerning the applicant’s education, licensure, practice, previous hospital experience, and any unfavorable history with regard to licensure and hospital privileges.”
Bylaws 7.1.1 states, “The Commission shall organize the physicians and appropriate other persons granted practice privileges at the Hospital into a medical staff under medical staff bylaws adopted by the medical staff and approved by the Commission. The Commission shall consider recommendations of the medical staff and appoint to the medical staff in numbers not exceeding the membership as set forth in the bylaws of the medical staff.”
Parkhurst said he was not consulted about hiring the new group. Most other top medical staff have been fired or resigned in the past several months.
The hospital commission has made no announcement regarding terminating Parkhurst and ESS. This comes at the same time the ESH is expecting the results of a Medicare audit, started Nov. 4, that identified many deficiencies. Some of the proposals to remedy deficiencies have been accepted by the Arkansas Department of Health and the final correction report is expected any day.
With the laboratory not fully functional, the ER has recently been on divert for a number of types of patients, including those who might be on blood thinners or are not sure if they are on blood thinners. The decline in use of the ER was the reason given for the hospital losing $132,000 in December.
Parkhurst is the latest to be terminated out of a dozen staffers who signed a letter three months ago outlining toxic workplace problems caused by Human Resources Director Jodi Edmondson and Chief Financial Officer Cynthia Asbury that allegedly included bullying, harassment, unfair HR treatment, and failure to approve purchases of supplies necessary for patient care. Most of those staffers have been fired or quit since the letter was sent after the firing of CEO Angie Shaw on Nov. 1.
The hospital commission responded by firing one of the people who signed the letter, Chief Nursing Officer Jessica Petrino, on Nov. 4. Emergency Room Manager Joy Kennedy left that same day after reporting being bullied at work by Barbara Dicks, former vice-chair of the commission.
The hospital commission said recently the hospital is now fully staffed, primarily with contract employees rather than local residents.
Since Nov. 1, about 25 present and former hospital employees and their supporters have filled the audiences at hospital commission and city council meetings reporting bullying, wrongful terminations and a concentration on finances instead of patient care. Frustrated with being limited to three-minute public comments, they are planning a protest at 5:30 p.m., on Monday, Feb. 17, outside of the Auditorium prior to the regular meeting of the hospital commission. At 6 p.m., they will proceed from the Aud to the large meeting room at the library where people will have no time limit to speak of their experiences that led to demands for the firings of Edmondson, who is now interim CEO, Asbury, Kent Turner, who was then hospital commission chair, and then vice-chair Dicks. Dicks resigned at the request of the mayor, and Turner was removed by city council on Jan. 27.
At a recent city council meeting, hospital chair Sandy Royce Martin said some of the problems with staff were as a result of unhappiness with having to learn a new electronic medical records system. That was denied by former employees, one of whom said that the hospital entered an agreement with the new EMR company without realizing it still had to pay for the old EMR contract for another ten months at a cost of more than $40,000 to $60,000 per month—in the range of $400,000 to $600,000.
Parkhurst said that, as in a number of other clinical decisions at the hospital, he was not included in the decision-making process about moving to a new EMR provider. As medical director, Parkhurst was supposed to be consulted about major decisions at the hospital but says he strangely had little interaction with the administrative staff. Parkhurst said he was not personally bullied by the administrators and that his concern and reasons for signing the letter was the treatment of other employees of the hospital.
“And as far as hospital admin instructing the front desk clerk to not let me into the hospital Wednesday night, that, unfortunately, just seemed consistent with the manner in which they have handled things for a while now—abruptly, disrespectfully and without explanation,” Parkhurst said. “It’s certainly not against the law to manage a business or other entity poorly but it’s a completely different matter if things are not carried out consistent with established rules and regulations. It is all very unfortunate and sad to see what has happened to our little hospital. I can tell you there were a lot of good, quality folks that are no longer there who genuinely cared about the patients, and those employees have been treated very unfairly. I believe I did all I could from within.”
In early December, ESS Dr. James Brecheisen arrived at a city council meeting and was told he was too late to sign up for public comments. He went to the podium anyhow and tried to talk before he was escorted out by police.
“I’m not going to be told I can’t speak about something this important,” Brecheisen said in a telephone interview afterwards. “This is ridiculous. I had important things to say about the attitude of fear at the facility generated by Chief Financial Officer Cynthia Asbury. I love working at this hospital. I don’t like seeing nursing staff getting bullied. I’ve seen some good people fired and others who left. Everyone is deathly afraid to speak out. There is rampant corruption there. …The administration basically doesn’t care about any of the employees there and it shows.”
Brecheisen was quickly removed from the ER physician roster at the hospital.
The hospital has received millions in grants to agree to transition to a Rural Emergency Hospital, a federal program designed to help struggling rural hospitals. The hospital can offer clinical services but most of those have closed because of the recent turmoil. Currently the hospital has about $7.7 million in savings.