Progress that has been made, along with a glimpse into 2026, was the main focus of the final meeting of the year for the Eureka Springs Hospital Commission.
To wind down what was a tumultuous year — particularly the first three quarters — commissioners heard at the regular meeting held Monday, Dec. 15, an array of reports, mainly from CEO Tiffany Means, who discussed all aspects of the facility and an initial budget for the new year.
Despite what Means called a November that was slower for patient traffic than previous months, she said the hospital is “actively implementing strategies to enhance outpatient services and improve patient experience.”
“These efforts aim to stabilize revenue and strengthen our community engagement during the winter months,” Means said. “So we’re experiencing a little bit of what has been typical trending in the past, and during these times, we take opportunity to see how we can further enhance and, again, serve our community.”
Means said the hospital is continuing its alignment with the Arkansas Department of Health, the Arkansas Hospital Association and Rural Emergency Hospitals “for rural sustainability and financial resilience.”
In addition, the hospital has been researching expanding infusion services at the hospital, Means said.
“It’s a program that we’re going to start implementing after the first of the year,” she said. “We will be networking closer with the clinical providers to ensure that we are all working towards the same goals, to treat our patients locally with the orders of infusions that they would like to see here.”
The hospital is continuing to research grant opportunities and will apply for any grants that may meet the needs of the facility, commissioners were told.
“There’s a lot centered around behavioral health, mobile service clinics, telehealth,” Means said. “… So there’s a lot out there. We just need to make sure that we’re eligible for those and apply for those.”
Other recent activities include exploring additional services to attract patients during low-volume months for the emergency department, a focus on emergency preparedness planing, and coordination with the police department on workplace violence, Means said.
Financially, the hospital was down $344,000 in November versus October, and the year-to-date revenue for the hospital is $6.58 million compared with $8.2 million a year ago, she added.
“Our operating margin was just slightly a little bit negative due to our low volumes and seasonal trends, which that was to be expected through that,” Means added.
As far as workforce and culture, the CEO said policies and procedures are continually being revised “to ensure compliance and regulatory alignment.”
“That’s something that when I came in, there was just a lot of gaps there in years of reviewing and updating to the current rules and regulatory,” she said. “
In facility updates, Means said a new HVAC system was recently completed and bids are still being solicited for needed replacement of flooring in certain areas of the building.
The removal of trees that were interfering with views of the helipad was also recently completed, she added.
The hospital saw 191 patients in November, commissioners were told, and 20.4 percent of those were reached to poll for patient satisfaction.
“All of the responses we had for the ED patients was 100 percent positive in that,” Means said.
A LOOK TO THE BUDGET The budget for 2026 will be a work in progress. It will also be “conservative” and “disciplined,” the CEO told commissioners.
“We’ve grounded in historical performance, current utilization trends, and the realities that are facing rural hospitals today,” she said. “So, as a rural hospital, we must be thoughtful in how we plan, balancing access, safety and sustainability. This budget is not about aggressive growth or speculative assumptions. Instead, it reflects responsible planning to design and to ensure that Eureka Springs Hospital remains stable, accessible and financially sound. I think we all agree with that.”
When discussing projected revenues, Means again said a conservative approach was taken.
“We did not assume increased utilization, improved payer mix, or changes in reimbursement,” she said. “Instead, we planned conservatively around how services are currently used and reimbursed. Outpatient services and access-driven care continue to represent a significant portion of revenue, and we’re reflecting on how patients in our community seek care today.
“When we look at this, we are focused on key service areas where community need is clearly demonstrated. Emphasis is placed on delivering care at the appropriate level to improve efficiency, reduce unnecessary high cost utilization and support financial sustainability.
“Because of the many unknowns we are facing in 2026, the budget will remain a working budget. The commission and leadership will continue to do quarterly reviews, and if adjustments are necessary, they will be made during the standard mid-year budget review process.”
A similar mindset was taken with expense projections, Means said.
“On the expenses, again, we’re very disciplined in our approach for operational efficiency and sustainability,” she said. “Stewardship has been something that has been at the forefront since August. … So we continue to be on the same mission and path. Staffing expenses reflect current workforce levels with adjustments only were required to maintain safe operations and meet regulatory requirements.
“The budget prioritizes the workforce stabilization, productivity alignment and minimizing reliance on contract labor where possible.”
Required expenses needed for patient care will be the focus.
“Supply, pharmaceutical and purchase service expenses are budgeted conservatively as well based on historical utilization, contractual obligations, and known inflationary pressures,” Means said. “There’s no discretionary expansion or non-essential capital investments that are assumed. Overall, expense planning supports longterm stability while ensuring continued access to safe, high-quality care.”
Commission chair Sandy Martin dove a little deeper as far as specific budgetary numbers.
“Just to top line it a little bit, the revenue goal is $14 million with the REH reimbursement and $12 million without,” Martin said. “The budget was viewed as: ‘You know what? If REH goes away can we sustain? What benchmark do we have to have, and the assumptions clearly proves that we can sustain.’ ” In all, the budget projects a profit of $528,963 for 2026, Martin said.
“With the quarterly review and with Tiffany continuing the 16-week rolling budget adjustments, there are some things that have been flagged that if we have significant changes in revenue decreasing, there are some things that could be postponed or moved.” Martin said. “They’re big chunks. … From the revenue distribution, or the expense distribution, facility is a huge jump. It went from, we spent approximately 11 percent of our expenses in 2025 on the facility, and it’s going to jump minimal to 26 percent, and the purchase services have reduced, but you see those percentages in the investments of what you’ve been hearing about the equipment and the service line that still aren’t quite adjusted.”
