The Eureka Springs Hospital has a new CEO and fresh faces throughout the facility.

Now, it needs a revamped identity.

That’s one thing that’s planned for future talks when discussing the 2026 budget, chair Sandy Martin told fellow members of the hospital commission during the commission’s monthly meeting held Monday, Oct. 20.

“I’ve been real excited working with [CEO] Tiffany [Means] and the team … because of the ideas,” Martin told commissioners. “Not only do they bring the experience, but they came in not with: ‘Here’s my box of experiential toys and I’m going to make them fit in Eureka.’ It was like: ‘Holy mackerel, here is an opportunity and there’s a lot of potential here, and it’s different and I never had this opportunity to do this,’ and it’s really inspiring to hear some of the things.

“I think some of things have come up in different conversations that we’ve had at the commission, but there were no legs underneath them. There wasn’t anything but an idea. I think we’ve got good strong legs now and a good strong, strong team that’s working this.”

With that, there’s a future need for new hospital branding to go along with the rest of the positive outlook, Martin said.

“One of the things that we are going to be doing is looking at refreshing our brand,” the chair said. “We’re a different hospital than we were, and we’re going to probably be even different next year and in the future. So, what is it that we want to project?

“… That’s something we also have to budget for in 2026 because rebranding isn’t cheap. There’s signage and there’s a whole bunch of other things.”

New marketing efforts were just one area discussed at the Oct. 20 meeting in regard to early ideas for the 2026 budget.

Martin told commissioners that there’s not yet been any word on the status of a grant application for a mobile van for the hospital, and if it was not awarded, whether it would be in the best interest to purchase a van outright anyway.

“As we’ve discussed before, if we don’t get the grant, do we think it’s important enough to allocate funds or come up with other sources for funds to do it?” Martin said. “How does that fit in with the vision and the plan as far as accessibility?”

That decision, along with an array of other ideas Means has for next year are exciting for the hospital despite some uncertainty going into next year, the chair said.

“… It’ll be a good year and I’m excited about it,” she said. “I think it’s going to be a challenging year, but I think it’s going to be a good challenge. “

LAB CERTIFIED

Means told commissioners that the hospital’s laboratory received its Clinical Laboratory Improvement Amendments certification on Sept. 30, and is fully staffed.

The CLIA lab survey is a mandatory inspection to ensure the lab meets federal standards.

“This accomplishment reflects ongoing compliance with state and federal standards and a strong commitment to patient safety and quality,” Means said.

When asked for further details about the lab’s current functionality, Means said things that weren’t done properly in the past have been corrected, impressing the CLIA surveyor during the recent visit.

“… We know our past, but we need to work towards the future, and that future is structure, organization, compliance, safety,” Means said. “So, lab is something that we were at risk because we were not truly following the rule well, and now we have things in place that are holding ourselves accountable and meeting weekly and bi-weekly on those things to ensure that we are compliant.

“When I say everyday survey readiness, the team knows that just because we had a survey and we got our license, we can’t take our foot off the pedal. What we need to continue is every day we are compliant and we’re providing safe care to our patients.

“Barring that anybody calls in, we’ve been fully functioning and we’ve not had any issues. … We had a couple of things that we found out from the past that were not being followed, and now we have learned from those and we are following those processes.”

AGING FACILITY

One of the challenges that Means said she has faced in her first couple of months on the job is an issue that has plagued the hospital for years: the age of the building.

“We have a building that was constructed in 1929 and 1967,” Means said. “… Deferred maintenance and aging systems are creating safety risk and financial strain.”

Means said she is going through a facility assessment the commission had done in 2023 — before the transition to a Rural Emergency Hospital — when plans were being discussed for a new or remodeled building.

“… We definitely need to address some of the issues and concerns that were mentioned on that [assessment], and I think we’ve had additional concerns with the facility itself as far as aging and forecasting in our budget for 2026,” Means said. “We really need to dive deeper to see where our major issues are going to lie and forecast if these things don’t get repaired, what the cost is going to be when it finally hits us when it’s broken.”

Means said the HVAC system in the building built in 1967 recently failed causing the patient care side of the facility to lose air conditioning.

“When the company came out and they looked at it … they put $1,000 worth of Freon in it,” she said. “And $1,000 just went up in the air because the pipes were so bad. They were just leaking through. So, the decision was made to get a bid to replace with new units. This is going to help us be more efficient as we go into the winter months, and then with our air conditioning, have a brand-new system.”

The new units had a price tag of $90,000, Means said.

“But I can tell you that my feeling is it’s just like the Band-Aid effect,” she said. “You keep putting a Band-Aid over the hole, the hole gets bigger, but you’re going to put a bigger Band-Aid, and then you’re going to put a bigger Band-Aid. But at the end of the day, when you lift the Band-Aid you still have the hole.

“So we needed to address this right on and be able to replace this because it was just beyond … we would just continue to have service and maintenance and service and maintenance, and at the end of the day we still would need a new HVAC system.”

Means said the HVAC system in the building built in 1929 that serves as office space for staff is also outdated and inefficient.

“I get word that in the wintertime, there’s a lot of frost on the windows and it’s very cold in the building,” she said. “We had to address first things first, patient care first, patient areas first. But this is something, again, looking at the 2026, we’re gonna have to be looking at a new system on that side as well.”

Installation of the new unit is currently paused pending approval from the historic district commission since the unit will need to be installed on the hospital’s roof, Means said, adding that other issues such as drafty windows, plumbing, electrical and parking lot improvements will need to be addressed soon.

Most of the expenses for any improvements and maintenance will likely come from the hospital’s money market account, said chief financial officer Cynthia Asbury.

“That’s where you’ll see the expenses mostly being when we have to make transfers over, we’ll be coming out of the money market, which is the money we did for the REH conversion that we were given for that,” Asbury said. “The biggest thing is looking forward to any other grants, any other opportunities we can have or see within the infrastructure. … Of course, our office area, the 1929 building, got placed on hold. I mean it’s plug-in heaters and it’s window units, and everything is very drafty in there, because we know we couldn’t take on this year doing the repair for both.”

Hopefully the hospital can share some of the cost of expenses with the hospital, which owns the building, commissioners were told.

Martin said she has talked with Mayor Butch Berry and public works director Simon Wiley, and gotten agreement to help with parking lot repairs.

CEO REPORT

Means said she recently attended the Arkansas Hospital Association annual meeting where much of the discussion was on the future of rural hospitals.

“The biggest key takeaways included statewide workforce challenges,” she said. “We’re all experiencing the same challenges and how we’re competing with the same people and what does it mean to be viable in rural areas when the smaller is not attracting as much as the larger facilities are.”

Reimbursements were also a hot topic, the CEO said.

“What I thought was interesting is … statistics about how Arkansas is a lower reimbursement state for certain practices, and that they’re working on trying to be more agile … so they can get more reimbursement off Medicare and Medicaid than our surrounding states,” Means said. “So for example, they gave a procedure that is being conducted in Oklahoma and they’re actually getting a higher reimbursement rate than we are in Arkansas. So, they are at the legislature at hard work trying to be more proactive in trying to get those reimbursements for Arkansas, especially when we have these challenges that are for us.”

The current government shutdown is also a concern, commissioners were told.

“The longer that we stay in shutdown, it’s going to impact our financial reimbursements …,” Means said. “We are just in a great area right now of the uncertainty, how this is going to resolve, when it’s going to resolve, and what’s going be the reimbursements when it does resolve.”

The hospital saw 213 patients in September, Means told commissioners.

“We had 23 outpatient visits, we transferred 22 patients, we had six that flew out as critical care patients and we had a total volume of 48 EMS,” she said.

The hospital is at 96 percent staffed on the clinical side and had 100 percent positive feedbacks during September, Means said.

In community plans, Means said the hospital will be handing out candy to trick-or-treaters on Halloween evening.

New for 2026, Means said she wants to develop a patient advocacy committee.

“I would like to look at forming a committee of community members that can help participate being part of patient care improvements and health education initiatives,” she said. “These initiatives line with national and state-level standards for community engagement in healthcare. So, the purpose and goals of this committee are to empower community voices in shaping patient- centered care strategies, enhance transparency and trust between the hospital and the public, and community quality improvement through lived experience and feedback.

“We’re going to promote health literacy and education and we’ll continue to do that through local needs.”

Means closed her report giving compliments to the hospital staff after much of the city lost power for a number of hours on Saturday, Oct. 18.

“I just have to give a huge shout out to our team this weekend for managing patients, people in the facilities during our five hours without power and doing it with excellence,” she said, adding that generators worked and aided in patient care during the time.

“My quote is, crisis does not create strong teams, it reveals them,” she said.

FINANCIAL REPORT

Asbury said the bank balance was down about 6 percent in September.

“We have identified … how our charge capture had decreased, and we had identified areas and that we were not fully capturing all the charges before billing it out for the month,” she said, adding that the addition of a specialist in that area will help with the monthly capture numbers moving forward.

In all, the hospital had a loss of about $166,000 in September, commissioners were told.

“So, our operating margin percentage-wise in August was at a negative- 43 percent. At September ending, we were at a a negative-18 percent,” she said. “So we are definitely seeing a better, we are seeing improvement within the financials. It does take some time to kind of get through that, identifying the areas. … Our charge capture has significantly improved overall.”

HR REPORT

Human resources director Jodi Edmondson, said the hospital has only two contract workers remaining, replacing others with full- and part-time employees. In August, the hospital had 10, she said.

NEXT MEETINGS

The next hospital workshop, focused on the 2026 budget, will be held at 10 a.m. Wednesday, Nov. 12. The next regular meeting will be held at 2 p.m. on Monday, Nov. 17.