Eureka Springs Times-Echo
Members of the Eureka Springs City Council have made it a point in recent meetings to stress that they are seeking an “independent review and reconciliation” of the current hospital budget and finances starting in January 2025 — not an audit of past years.
Some of the Eureka Springs Hospital Commission apparently continue to not get that memo.
At its monthly workshop held Monday, Aug. 4, the commission repeatedly used the word “audit,” and questioned the timeframe of what was requested when the council voted to have a Request for Proposal drafted for an outside entity to take a look at 2025 numbers.
“My understanding in layman’s terms is that … a financial review and reconciliation is a process of verifying the accuracy of specific financial transactions and balances by comparing internal records with external sources,” council member Rachael Moyer said at the July 28 council meeting.
Moyer cited at the meeting a list of things she questioned about the current unaudited budget that she would like an outside person or agency to take a look at.
With the help of Michael Akins, the city’s chief financial officer, the council agreed to put out an RFP for an “Agreed Upon Procedures” financial review of hospital numbers from Jan. 1 to June 30, 2025.
“AUP is where they come in and kind of just do an overview, and they do some of these proofs of cash and some things like that,” Akins told council members July 28. “They don’t actually go in and look at every bill, every payment, that kind of stuff. It’s more of an overview. It’s not as in-depth as a yearly audit that you’re going to have from like Forvis or from Legislative Audit.
“Legislative Audit does approve you to be able to use these kind of audits, so we’ve used them for several year for our water department since it’s an enterprise kind of like the hospital.”
Many of the questions the council has been asking should be answered with an AUP audit, Akins said.
“The main question that’s kind of asked is if cash has been accounted for, and it’s been accounted for in a right way,” Akins said. “So, you could do some proofs of cash with your bank statements. When you have an audit, and I was telling Rachael this earlier, when you have an audit, the very first thing they usually ask us for is our bank statements with the reconciliations on them. So, it would be interesting to see if those reconciliations are up to date at the hospital. …” With the expectation that the 2024 audit from Forvis will be released within the next month or so, Akins said the council could go ahead and start the RFP process on a 2025 financial reconciliation. Then, if the 2024 audit eases the minds of council members and the need for the 2025 review right now isn’t needed anymore, then the process could be halted, he said.
When the subject came up at the Aug. 4 hospital commission meeting, chair Sandy Martin opened discussion on the RFP by saying “they do want to pursue putting out an RFP to get an independent audit of us.”
“Michael Akins, the finance director of the city, counseled them and suggested a kind of a truncated, not a full audit, because that would be expensive, that would take forever, it’s not necessary, blah, blah blah blah,” Martin said, “But there is one that’s kind of truncated that they come and they look at the financials and basically do what anybody can do, you know, with it and give their observations.
“They did decide to go ahead and have an RFP developed. It’s probably going to take anywhere from three to six months for that process to get it out. They have no idea what the cost is. We, of course, they wanted us to pay for it. I refused to pay it. So they’ve got to come up with the money and appropriate that money.”
In the meantime, Martin said she plans for a special meeting with a representative from Forvis to attend and present the findings of the 2024 complete audit, which is set to come out within the next month or so.
“That hopefully will put 2024 to bed,” she said. “And so [council] agreed to that, and then that’s why they shifted their financial curiosity into 2025.”
Commissioner Kate Dryer asked Martin if Forvis also does financial audits for the city, why the council is so concerned about the audit of the hospital.
“Since Forvis does the city of Eureka books, and it’s the same company that does our books, the hospital’s books, audits, I mean, has the council in the past then had concerns about the audit results of the city of Eureka?” Dryer asked.
“Not that I know of since I’ve been here, since 2007,” Martin responded. “That has been brought up by the mayor several times since it’s the same company.”
Dryer continued to inquire about the council’s concern with the hospital’s Forvis audit, despite the fact the council hasn’t brought up or questioned any audit results in recent meetings.
“Has the council said that they thought that perhaps Forvis had taken a different audit approach to the hospital than they do with the city’s books?” Dryer asked.
“No, they more or less gloss over that topic, and of course, they’ve got all four Forvis audits that we have,” Martin replied. “We provided those to them, so no, that doesn’t seem to be their focus.
“Their focus seems to be continuing to dig and find something.”
In its end-of-June balance sheet, the hospital shifted more than $1.3 million from the line item for “cash and cash equivalents” to the line item for accounts receivable after Moyer pointed out a discrepancy between the hospital’s reported bank balance and the cash and cash equivalents listed on the facility’s balance sheet at the end of May.
NEW HIRES
Human resources director Jodi Edmondson — who also served as the hospital’s acting chief executive officer for approximately nine months before Tiffany Means took over as CEO on Friday, Aug. 1 — and clinical director Velvet Shoults announced that the hospital is beginning to hire more full-time employees to take the place of contract workers.
“We are doing onboarding for the laboratory department,” Edmondson said. “It will be staffed 24/7. We just have to get them through orientation and competencies. So by mid-month, we should be covered 24/7.”
New nurses have also been recently hired, Shoults said.
“We hired two fulltime nurses,” she said. “… One started [Monday] and he starts orientation on [Wednesday]. He’s a 35-year nurse, paramedic. He used to manage the air-evac base in Springdale. Critical care background. I actually worked with him at the freestanding ER down in Fayetteville. So he’s used to a small ER, little resources. He’s familiar with several of our staff, and of course, the facility and the community.
“We also hired a second full-time nurse. He’s moving here, his mother-in-law lives here. … He’s coming out of Nebraska, and he won’t be here until November.
“… So, that takes out two of our contractors. And then we hired a PRN nurse out of Cox Branson, who is PRN down there, in their ER and their cath lab, looking to pick up a couple days every other week.”
One of the hospital’s paramedics is wanting to go full-time, Shoults said.
“So, between that person and the PRN person, that wipes out another contract position,” Shoults said. “That’ll be three in the next couple of months.”
TRANSPORT VAN UPDATES Martin said the commission should find out in September whether it was awarded a grant to help pay for a medical transport van for the hospital.
After a lengthy discussion around licenses and ways the hospital should utilize the vehicle, Means said she would like to gather more information from other facilities that have such a van and report back to the commission.
“I would like to do some research on some similar entities that have something that we’re looking into to see what the cost is going to be, what the costs benefit basically,” Means said. “So it would be great if we could come back and I can bring to you a couple of entities if they’e willing to share this information. You know, what is the cost to have a selective truck that is basically under the umbrella of their hospital.
“… It sounds great. … I think that this is something that we need to kind of dive into a little bit more, look into that a little more.”
