ESH ironing out fiscal wrinkles

The Eureka Springs Hospital Commission’s Monday, March 23 meeting focused on staff reports that worked to assuage concern about the hospital’s financial situation.

While Tiffany Means’s CEO report noted past issues with billing and payments, she emphasized the hospital is committed to resolving those issues, as did CFO Doug Hoban. Both went over financial issues at the hospital and how staff is working to resolve them which included:

A chargemaster that is years out of date will require review. Means noted that a full review would typically cost $15,000 but they are working with others in the REH system to bring the chargemaster up to date without as significant a cost. Agreements with vendors that were “creating unnecessary financial burden” on hospital finances, requiring them to renegotiate services. Billing statements being issued to customers before the finalized bill. As mentioned in the last meeting, not all providers had been properly credentialed for professional services and staff is working on getting each provider on staff credentialed with Medicare/Medicaid so professional fees may be charged. Discrepancies with payments to vendors are being negotiated with the hospital attorney to make sure payments are made. It was noted by both Means and Hoban that the Electronic Health Record system the hospital uses would need to be fully rebuilt as it was improperly configured, which would take 4 – 6 months.

Hoban briefly went over the history of the hospital’s switch from a Critical Access Hospital to Rural Emergency Hospital in context with the original Electronic Health Record rebuild that began in 2023. He said that when the hospital switched designations, which happened in the middle of the EHR being built, it was not configured correctly for the change. He said the executive staff is working to stabilize operation of the hospital and rebuild the “revenue cycle” for the hospital including working closing with Forvis to make sure their financial restructure is sound.

Hoban also noted the average monthly cash inflow of $401,000 compared to an outflow of $693,000 though he emphasized that the figures reflect a “period of identified operational inefficiencies” and shouldn’t be used as the sole metric for whether the hospital is sustainable while staff works to correct the issues. Means mirrored the same sentiment later in the meeting, saying that using cash flow does not provide a “complete or accurate representation” of the hospital while they fix operations.

Means also went over activities at the hospital including the helipad upgrades with SWEPCO looking to install a new pole and light for helicopters to have an easier time landing at night. The hospital has partnered with UAMS Women’s Health to provide monthly clinic services as well as the clinic renovation on the back side of the hospital is complete with plans for rotating clinics in the space. Hospital partnership with Survival Flight is complete with first day in May. And she said the hospital plans to continue with community engagement events on the third Wednesday of each month from 3 – 5 p.m.

ESH ironing out fiscal wrinkles

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