Recent meetings of the Eureka Springs Hospital Commission and city council have had current and former employees alleging harassment and unjustified terminations, including the firings of CEO Angie Shaw and Chief Nursing Officer Jessica Petrino. Shaw and Petrino filed lawsuits claiming they were terminated for fulfilling their duties to report workplace conditions that have led to firings or resignations of key hospital employees.
The upheaval coincided with a Medicare audit by the Arkansas Department of Health. A recent corrective action plan was rejected by ADH with a second response being prepared that was expected to be filed Dec. 17. The future of the Rural Emergency Hospital could hinge on being able to keep Medicare certification.
On Monday night, the hospital commission meeting came to agreement that the best solution would be to enter into a management agreement with local family physician and businessman John House, MD, who operates two clinics on Passion Play Road.
The hospital commission indicated being in favor of a management agreement with House but said the hospital must first have a satisfactory plan to correct deficiencies discovered during the recent Medicare audit.
Liz Collins was hired as Compliance Officer at the hospital before being asked to take on additional duties in quality assurance, infection control, and other areas before being laid off earlier this year. She disagreed with Turner’s assessment that the clinical staff was to blame for the poor Medicare audit, saying problems resulted from cutting expenses including on personnel and supplies critical to patient care.
House linked the problems at ESH to a crisis in healthcare in this country where financial considerations often outweigh the need for patient care.
“Nowhere is that more obvious than in rural hospitals,” House said. “They are closing all over the country and have been for several years. A year ago, our little hospital succumbed to the disease afflicting so many other rural facilities. It ceased to be a full hospital and is now an ER with outpatient services.”
House prepared a letter of intent to take over management of the hospital and said a complete reset is needed. His qualifications to manage the hospital include being the only doctor in Eureka Springs who has worked in the ESH ER, served as its hospitalist, as medical Chief of Staff, and a term on the hospital commission including two years as chair.
“[Our clinics] don’t deal with trauma and we don’t have a real-time lab, but otherwise we offer many of the same services, including x-ray, ultrasound, EKG, PFTs, and minor surgical services, and we do it seven days a week,” House said. “We are partnered with physical therapy and psychiatric services, and are bringing on new services on a regular basis.
“In addition to caring for patients, I am experienced in medical coding and billing, management of several multi-provider operations, as well as handling the financials of those organizations and interfacing with Medicare, Medicaid, and other payers. On top of that, I have worked hard to earn the trust of my patients, their families, and other doctors and medical professionals in the area.”
House said when he moved to Eureka Springs more than 11 years ago, ESH had been operated by a Louisiana company for about a decade. He said it took no time to see that that company was mismanaging and sending whatever money it made to the parent company out of state, ignoring needed maintenance and upkeep of ESH.
“I joined the hospital commission and after some months we were able to replace that company,” House said. “Knowing that the commission was ill-equipped to run the hospital ourselves, we hired another company out of Oklahoma to run the operation. The CEO of that group was dynamic, charismatic, and capable. The excitement at the progress his company was making was palpable as he brought in new services, new equipment. Unfortunately, his tenure was cut short due in large part to being undermined by some of the same people involved in the current controversy, including some members of the commission.”
House said that since then, the hospital has made a steady trend downward.
“ESH is now a place that few doctors in the area will send patients to, for any service, a place that patients routinely state they do not want to use,” House said.
His assessment is that the commission has options:
- It can close the hospital.
- It can hire a new CEO, and possibly earn the trust of the local medical community and citizens.
- It can step back and allow a management company to come in. House said even with this option, with all the changes in healthcare, there is no guarantee that the hospital will make it, particularly if the incoming U.S. president and his administration implement cuts to Medicare and Medicaid that they’ve been threatening.
House said if his management company isn’t selected, he urged the commission to consider hiring another management company.
Chair Kent Turner said that the hospital commission wants to entertain House’s proposal but needs to wait until the hospital gets past its Medicare audit. “I think it is imperative to look at alternative solutions,” he said.
Turner said the hospital has hired a new lab manager and a new nursing director, and was in the black by $38,000 this past month, and up $200,000 year-to-date.
This was Turner’s last meeting as chair after a two-year term. Sandy Martin will be chair after the first of the year.