Hospital CEO gets kudos from council

What a difference a year makes.

Just months after meetings of the Eureka Springs City Council were filled with discussion of controversy surrounding Eureka Springs Hospital, a more positive tone has emerged.

At its regular meeting held Monday, April 27, the council heard an update from hospital CEO Tiffany Means on the ongoing behind-the-scenes work being done to clean up years of financial deficiencies, while also sharing positive front-facing happenings at the facility.

“… I want to say something very clearly,” Means told the council. “I’m here as a partner to this community, to this council and to the commission.

“I did not step into this role to defend the past. I stepped into it to understand it, correct it and move this hospital forward responsibly.”

Means, who has served as the hospital’s CEO since August, gave her report to the city council a week after she and interim hospital CFO Doug Hoban updated the hospital commission on the numerous financial issues being discovered at the facility, with some of those issues dating back to 2024.

Hoban told the hospital commission on Monday, April 20, that he wasn’t yet confident in the hospital’s financial reporting after audit adjustments revealed a swing of more than $1.2 million from previously reported numbers.

At the April 27 council meeting, Means echoed many of Hoban’s points, explaining why she feels it would be irresponsible to give any updated financial numbers.

“I want to begin by acknowledging the council’s fiduciary responsibility to this community. I share that responsibility fully, and I take it seriously,” Means said. “Since stepping into this role, we have identified long-standing system-level deficiencies across financial reporting, revenue cycle and operational alignment. These did not develop overnight and they will not be corrected overnight. However, they are now clearly identified and actively being addressed. I will walk through  … what we can responsibly report, what we have uncovered, and what we are doing to correct it.”

There’s a difference in basic financial data and “fully validated” financial statements, Means told the council.

“At this time, we are able to provide reliable information related to cash position, receipts, disbursements and operational performance,” she said. “What we are not yet able to provide are fully reconciled and certified financial statements due to the ongoing correction of Legacy system and process issues.”

Arkansas code requires that financial information go through the hospital commission and be certified before it is submitted, Means said.

“Given prior financial reporting required significant audit adjustments, we will not present numbers that are not validated. This is not transparency. It is risk,” the CEO said. “So, as of March 31, the hospital maintains approximately $3.49 million in cash. Over the past four months, average monthly collections have been $403,000. Average monthly expenditures, $701,000, operational gap of $298,000 per month.”

“… So, this reflects a hospital in active stabilization, not a finalized financial position, but a real-time operational snapshot while we correct underlying systems.”

Until the finances are entirely cleaned up, the council will still receive monthly bank statement balances. In addition, the council has requested monthly presentations.

“In our key discoveries over the past three-and-a-half months, we have identified revenue cycle disruption, system configuration gaps, outdated charge master, financial reporting inconsistencies and provider credentialing failures impacting revenue,” Means told the council. “And these findings confirm that prior financial reporting does not fully reflect a reliable ... or a validated financial position.”

POSiTIVES ONGOING

While Hoban is still wading through financial records, the hospital is taking many positive steps in other areas, Means told the council.

“We’re preparing right now, any day, for the Arkansas Rural Health Transformation Program as it opens up, expanding services, strategic partnerships, ensuring provider information is correctly aligned with all payers to restore billing accuracy and reimbursement,” Means said. “This is something that we really need to be doing. We’re actively negotiating with Oracle right now to correct system configuration issues as quickly as possible. We’re working to resolve denied payments from a payor vendor since the [Rural Emergency Hospital] conversion, and that was as of December 2023.”

Means told the council that approximately 66 percent of the patients seen at ESH are from Eureka Springs and surrounding counties.

“That’s from August 2025 until now,” Means said. “What does this mean? This hospital is a critical access point for care for the people who live here.

“As of today, we are up approximately 48 percent in patient volumes year-to-date. This community is relying on this hospital more than it has in recent years. In addition, we had 100 percent CMS validation. Our EMS volume is up over 100 percent year-to-year. We have strong patient satisfaction. We’re expanding services and partnerships of which I cannot wait to share more as soon as they become official.

“This hospital is actively serving and growing while we correct its financial system. So, at the end of the day, this is about more than financial reports. It’s about access to care for this community. It’s about the patients who rely on this hospital every day. And it’s about our shared responsibility to ensure that it remains here to serve them. My commitment is to lead with integrity, correct what needs to be corrected and build a hospital that is stable and sustainable. That requires discipline, it requires accountability and it requires partnership. I’m here to do that work, and I’m asking that we do it together, because this community deserves a hospital that is strong. Not just today, but for the future.”

COUNCIL RECOGNIZES PROGRESS

While many council members were critical of the hospital commission and administration before the hiring of Means and the departures of former commission chair Sandy Martin and former chief financial officer Cynthia Asbury, Means was met with only positive comments from council members at Monday’s meeting.

“I’m concerned, like a lot of people, with the lack of numbers, but I also commend the commission and your new temporary CFO …,” council member Steve Holifield said. “Reporting numbers is important, but it’s also important to report accurate numbers and understand what you’re going through. Not being able to report those numbers has to be frustrating, but that’s the way to do it. If you don’t have correct numbers, please don’t just put a number out there to make everybody happy.”

Council member Rachael Moyer, perhaps the most critical of the commission in recent months — especially regarding finances — took things a step further while voicing her current level of satisfaction with the facility’s leadership.

“The metrics that you’ve reported really demonstrates the important community need that you guys are meeting every day,” Moyer said. “And the fact that that continues to increase shows growing trust in our community and what you’re providing. I want to just say that I very much appreciate all of the work that has gone into getting to this point, and I’m consistently encouraged and excited about the expansion of services that you have planned and that need that you’re meeting every day.

“I think it’s unfortunate that our communications are so much about financials, because I agree with you, that’s one part of your job, your operations, to take care of this community, and that’s really important. And I think just being a member of this council, I just want to be a partner to you guys and support to make sure that financially, you guys are going to be here for the duration.

“I can see that you’re doing a tremendous and difficult job, and I appreciate the transparency and the respectful communication. … It’s refreshing and no one would know that probably if I didn’t say it publicly, so I just want to be on record as saying that the transparency, communication, effort and respect is noticed and appreciated. So thank you.”

Terry McClung, the longest-tenured council member, said he’s hopeful about the current efforts.

“That’s my prayer, that we can weather the storm financially, that we don’t lose the hospital,” McClung said.

It’s all about partnerships, Means responded.

“A hospital in this day and time is really challenged when they’re on an island by themselves,” she said. “I think it’s about partnerships, and how you work those partnerships and who those partners are in health care. We have lots of plans to go forward with those partnerships, and I think it will definitely help the hospital.”

Previous personnel issues also came up when council member David Avanzino referenced ongoing public comments submitted by former employees Richard and Samantha Webb, who allege mistreatment and unfair termination of many former employees by the hospital administration at the time — including Asbury and human resources director Jodi Edmondson, who served as the hospital’s interim CEO from November 2024 until Means’ arrival.

“I would be remiss without bringing this up because we do hear about it every single meeting, the human side of what happened at the hospital, with the termination of staff members and the way that they were terminated,” Avanzino said. “I know we can’t get into discussions about employees because of law; however, I want to know— or I want those people to know — that you are doing something to hear them or listen to them.

“I don’t know if there will ever be any resolution, but at least an attempt at something.”

Means didn’t dive into the personnel questions.

“I think that that’s a personnel issue that we can’t really talk about at this time, and that will have to be vetted in a different way,” she said. “I know moving forward the culture is definitely different, and I think we’re doing a more close-up view of how the coworkers are feeling about their place of employment. So, if we can learn from the past, right, then we take that and say, ‘How can we make it better for the future?’

“And that’s all I can say on that.”

EMOTIONAL THANKS

Having a hospital nearby for residents and visitors is important, council members have said frequently, and Monday’s meeting gave a prime example.

At the end of his regular report to the council, public works director Simon Wiley thanked the hospital for its work when he was recently rushed to the facility for a serious emergency injury that left him recovering for more than a week.

“I would like to express my sincere thank you to the Eureka Springs Hospital,” Wiley said, his voice frequently cracking with emotion. “So last week I had an accident and ended up having to go to the emergency room at Eureka Springs Hospital, and I wanted to take a moment to sincerely thank each of you for the care, the kindness, the professionalism you showed during my time in the hospital. Your dedication to help others was evident in every interaction, and it made a meaningful difference to me.

“From the medical team to the nurses, support staff, and everybody working beyond the scenes, I truly appreciate the compassion and hard work you bring to your roles every day. Being in a hospital can be stressful, but your warmth, patience and attention helped make my experience easier. Please know that your efforts do not go unnoticed. I am deeply grateful for the excellent care I received and for the positive impact you’ve had on me during my difficult time.”