Recent comments made by members of the Eureka Springs City Council — primarily council member Rachael Moyer — are “inaccurate” and “misleading,” according to hospital commission chair Sandy Martin.
That was Martin’s message during a portion of the hospital commission’s monthly meeting held Monday, Aug. 18, at The Auditorium.
Martin said she wanted to address comments made by the council in recent meetings and workshops that “are important to put on the record.”
“Once again, we find ourselves in the position of fact-checking and correcting statements made by city council members during the July 22 workshop and reported in the press,” Martin told commissioners. “We were not invited to that workshop, and could not respond or correct the statements. We are compelled to put the facts on public record. We have a workshop with city council scheduled for this Thursday, the 21st, and we will repeat the facts at the public meeting and provide them with the backup that we’re going to review today.
“To be clear, this is not a statement about the press. They report what they hear and see from the videos and transcripts. This is about council comments that are inaccurate and misleading the public.”
Four topics needed clarification and correction, Martin said.
“The first issue is the COVID funds carried as a liability,” she said. “We’ve answered this question publicly and reported on it several times. Our auditor, Forvis, recommended we carry it as a liability until such time we would not be subject to repayment. There were two primary conditions that would trigger repayment. One was if the hospital received any taxpayer dollars to operate the hospital. We do not. We did not receive any local, state or federal taxpayer dollars to operate the hospital. The second condition was a timeframe. They could only ask for repayment within the first four years after we received the funding. We passed that four-year mark in April of 2025. We anticipate that Forvis will recommend eliminating that expense from our liabilities when they report the 2025 audit.”
Cynthia Asbury, the hospital’s chief financial officer, agreed.
“We have been in discussion with [Forvis] to meet the criteria of what they’re going to need to release us when they do our 2025 audit,” Asbury said.
The second point involves a checking account that was recently closed that was an account for the hospital commission, not the hospital, Martin said.
“The commission has had a separate checking account since 2004,” she said. “The reason for the account was to have a reserve to pay bills that previous management companies weren’t paying. It came in handy because some of the management companies forfeited on payroll. The checking account in question was opened in 2018 and reported on in the hospital financials through 12/31/22.”
The latest balance of the account was $16,901.01, Martin told commissioners.
“…The then-CFO, Bill Couch, decided not to include it in the financials anymore because in his opinion, no one at the hospital could access that account and he presumed the funds were not available for the hospital operations,” Martin said. “It is true that nobody at the hospital has access to the commission checking account, just commissioners, but it is still intended for hospital operations and expenses, which is what it was used for. [Couch] was incorrect in that, but anyway, it got eliminated from the financials. The balance was $16,901.01. The account in question was opened in 2018.
“In this bank statement that we’ve recently received from CS Bank, there was no activity until 2021 when a check for $118 was written.” Martin said. “That was to cover a post office box and postage.”
There were three deposits to the account in February 2023, Martin said.
“They hit the wrong GL account,” she said of the deposits. “They hit the commission checking account when they should have hit the commission money market account, and those on the same day have been deposited in the correct account. So, both transactions were corrected that leaves a balance of the current 16,901.01.”
The next issue involves the amount of monthly hospital losses, Martin said.
“The 2025 financials, a council person stated twice in their workshop, that the hospital is ‘operating at $370,000 a month loss,’ ” she said. “And she said she calculated financial losses averaging $366,226 per month for the past five months of a loss. False on both counts. You have a spreadsheet that we have been tracking for our last budget workshop, maybe a review that you can clearly see the profit and loss, the net operating profit and operating expense. There is not one month that hit a negative $366,000. The highest was $273,000. We have had two, now three through July, profitable months. May and June were $200,000-plus on that. So, again that stands to to be corrected on that.
“… I kept saying that we’re going in the right direction and things are going well. I repeat that. Things are going in a right direction. Things are doing well.”
Martin said the commission did get a bit concerned during a dip in revenue in 2024, and at that time decided to get more involved in the operations with administration.
“You can see the difference in the trends in 2025 in comparison,” she said. “Expenses down, revenue up, profit up. …. Again, I stand by the comment that I and several other commission members have made that we are going in the right direction.”
Another point questioned by council members has been a budget item for construction.
“Regarding the $863,000 in construction, construction in progress that we’ve been carrying,” Martin said. “The construction in progress is architectural services and other fees that were approved by previous administrations and previous commissioners when they explored renovation of the existing hospital. These will be adjusted in the 2024 or 2025.”
Asbury said that an adjustment has already been made for 2024.
“Excellent,” Martin said. “So, we’ll be adjusted in 2024. … These expenses were from 2022 and 2023. There is no construction in progress. The total is cumulative dating back for those several years.”
Martin’s final point was about the hospital’s annual budget, saying that the commission did do a mid-year budget review that council members have claimed never happened.
“The last thing I want to address is the budget,” Martin said. “The commission was criticized for failing to produce a revised budget for 2025 and a council person further claimed that we did not do a mid-year budget review. We did indeed do a mid-year budget review as we had always planned to do, which we also did the first budget that the hospital has ever had. We did it in August of 2024.
“We were only in our [Rural Emergency Hospital] conversion model for a couple of months, and we didn’t really have a solid baseline at that point so it was a bestguess scenario. At our mid-year workshop we elected not to revise the budget, but rather track the actuals and continue the cost-saving measures that the staff was already pursuing. We also felt it was prudent to wait until our CEO was in place to get her direction on revenue- generating opportunities and their cost-savings ideas.
“2025 will give us a far better baseline and better inform the CEO, staff and the commission on the development of the 2026 budget. As stated in state and local law and the hospital commission bylaws, the hospital budget is the business of the commission and the CEO and the staff only. It is our job to do the budget and our job to make sure that we stick with the budget and revise the budget. So, we do know that it’s gonna be fluid. It’s still gonna be fluid. We have a whole bunch of unknowns in 2026, Medicare and Medicaid. So, I defy anybody to sit down and say they can project anything. We just have to stay on top of it….”
MEANS STILL ASSESSING Martin gave Tiffany Means’ CEO report, saying the new director of the hospital was “literally on a plane.”
“[Means] says ‘I am still assessing and have met with all leaders last week one-on-one,” Martin said. “Met with our attorney Gabe Mallard and discussed outpatient clinics and current contracts. We are actively recruiting jobs posted on our website and we have replaced a couple of contract employees with PRNs.”
During her comments at the end of the meeting, Martin said she has come away impressed with Means in her early days on the job.
“… I just want to say with Tiffany in place, working with her closely, two observations,” Martin said. “One, she is a phenomenally easy and effective and consistent communicator. She is completely thorough, completely honest, completely transparent. She is thrilled with the team. They have built a good, strong team. We have talked a lot about that and building. She’s working on her 30/60/90-day plan. I would imagine it’s going to be pretty dynamic and exciting for us with her experience. But, she still has a whole bunch of assessing to do and research to do.”
Martin told commissioners that Means will be staying in Eureka Springs four nights a week and then driving home to Fayetteville for weekends.
“She had a tendency to come in at 6:30 in the morning because she thinks it’s important to meet with and mix with the night shift,” Martin said. “She is a working CEO, not a sit-in-youroffice CEO. She does rounds, she travels, and I think the feedback I got on the 1-on-1s that she had with the team, they were all excited. They felt, most importantly, they felt comfortable. And I think a lot of that is that they have confidence in her ability. She is an expert in her profession.
“Not disparaging to any of the people in prior administrations, but we have never had experience at this level before, and that’s coming through..”
CFO REPORT
Asbury reported that ending July 31, the bank account balance was down “about 9 percent for the month.”
“Some of that is timing variables, invoices being paid, claims being paid processed,” Asbury said.
Billable revenue was down compared with June but overall July was a good month for volume and patient visits, the CFO said.
“We had a profit of $87,000 for the month of July,” she said. “ Some expenses in July that we have, some contracts and invoices that we paid that aren’t typical every month, ones from wrapping up our audit from Forvis and stuff like that that impacted our, you know, overall profit for the month.”
Martin clarified that July made it three profitable months in a row.
“Which is extremely encouraging,” Martin said.
The Forvis audit has been wrapped up and the company told Asbury they were available to send a representative to Eureka Springs for the audit report on either Sept. 22, Sept. 23 or Sept. 24.
“Is there a date because we need to coordinate this obviously with city council because we’ll be calling a special meeting that will be strictly discussing the Forvis 2024 audit?” Martin said.
Commissioner David Carlisle said Sept. 22 wouldn’t be ideal so Martin said she would suggest Sept. 23 or Sept. 24 to the council. The meeting would likely need to be held around 10 a.m., Asbury said.
CLINICAL UPDATE
The hospital continues to hire nurses to replace contract labor, clinical director Velvet Shoults told commissioners.
“We continue to hire nurses and paramedics and we have four more interviews on Thursday for nurse/paramedic and I think Jodi (Edmondson, the hospital’s human resources director) mentioned we’re down two contract labor, so we’ve cut out two of our travelers, one at night, one during the day, and the plan is to continue to vet them out as their contracts expire going into the fall,” Shoults said. “We’ve opened up the options for local contractors. They call it seasonal contractors. So, they’re nurses or medics that live in this area, want to do a travel contract, but they want to stay home. They contract with us for 13 weeks. They don’t actually have to go somewhere to do that. But it makes them our employee. So, we’ve kind of thrown that out there to see what kind of interests so far. The interest has been pretty good because there’s not a lot of places right now doing seasonal contracts in this area. So, obviously, labor continues to be our number one priority. We’re going to try to get in nursing and to get away from our contract labor, get our expenses down…” Shoults said the hospital recently learned that it was awarded a full trauma grant of $40,000 that can be used for “whatever we need for trauma-related care.”
Hospital visits have continued to be steady, Shoults told commissioners.
“It’s still tourist season, so it continues to stay kind of high,” she said. “The weekend was very busy, and the EMS volume continues to be up. “At the end of this month, we’ll be able to provide you guys with some quarterly volumes that you can look at, EMS, what happens during the day, what at night, and that kind of thing, so you can have a look.”
PRAISE FOR STAFF
Commissioners gave administration and staff high praise during comments at the end of the meeting.
“I’m just excited about the changes and the way, the direction that we’re going,” commissioner Sharon Deramus said. “I think it’s pretty exciting. Good job, everybody.”
Carlisle said it’s good for the public to get a glimpse at how well things are going.
“I think we’re making progress,” he said. “What you guys are doing and just the way the numbers are going, and the great opportunity to clarify to the public that we’ve been through difficult times and we’re doing the things you do to come through difficult times and make it, even in the uncertainty of the current world.”
Commission vice chair Brian Beyler said there’s a drastic difference how things are now versus how they were.
“It’s a great thing for Eureka Springs, and I think going long-term, people are going to look back and say: ‘Wow, what a group of people leading and running that hospital,’ ” Beyler said.
