Hospital finds another costly contract

Another month, another startling financial revelation about recent financial practices at Eureka Springs Hospital.

Hospital CEO Tiffany Means told the city hospital commission at its regular meeting on Monday, May 18, that the facility has been paying more than $25,000 a month for unnecessary services since early 2025.

“During our review process, we identified a full-service archival contract entered on in February 2025 that included service levels the hospital did not operationally require,” Means said. “This contract represented a cost exceeding $25,000 per month.”

While Means didn’t provide details on the monthly expenditure, she told commissioners the hospital has been working with Pinnacle IT and other behind-the-scenes services “to reduce unnecessary expenses and stabilize our information systems environment.”

The latest financial revelation was another example of issues that apparently existed before Means was hired in August 2025.

The latest news also comes approximately five months after the December 2025 termination of Cynthia Asbury, whose tenure as the hospital’s chief financial officer was marked by controversy.

Doug Hoban, who was hired to replace Asbury as CFO on an interim basis, has been filtering through months and months of financial data, raising a number of red flags during the past handful of hospital commission meetings.

Many of the issues stem from a lack of proper communication over the years with vendors and service providers, Means said. As a result, she said, the hospital continued to pay for services that were no longer necessary.

“Doug and I continue investigating each situation thoroughly to determine why the invoice exists, whether services remain necessary, whether agreements were properly terminated, and whether communication failures occurred historically between departments and vendors,” Means said.

“Although difficult, each discovery creates another opportunity to improve accountability, strengthen operational oversight, and continue rebuilding organizational integrity.”

The hospital is also working with Oracle to get its system properly implemented, Means said.

“Significant progress is also being made with Oracle regarding our electronic revenue cycle platform,” she said. “Oracle has committed to an on-site engagement with leadership within the next 30 days to begin rebuilding system configurations, workflows, and operational structure. … They gave an estimate of approximately six to nine months before a full operational recovery state is completed.

“Operationally, this means your Eureka Springs Hospital will continue functioning within a partially broken and unreliable electronic revenue cycle environment throughout this rebuild period. Accounts receivable reporting will continue experiencing inconsistencies, workflows will continue having operational disruptions, and manual oversight will remain necessary while systems are rebuilt appropriately.”

The Times-Echo reported in January that Asbury’s dismissal came after Means learned that the hospital owed Oracle more than $200,000 for unpaid invoices dated from July to November 2025.

The hospital also has discovered reimbursement issues dating back more than two years, Means added.

“We are currently finalizing negotiations with a payor related to reimbursement issues dating back to January 2024,” she said. “The payor has acknowledged their error and is expected to settle the outstanding issue within the coming months. This issue occurred after the payor failed to appropriately update Eureka Springs Hospital designation transition from a Critical Access Hospital to a Rural Emergency Hospital, resulting in significant reimbursement disruption. After months of validation, documentation review, timeline reconstruction and persistent follow-up efforts, our diligence and persistence has ultimately paid off.”

Commissioner Kate Dryer asked about vendors that the hospital has been erroneously paying.

“So the vendors that we’re discovering that we really don’t have an actual relationship with as far as services rendered, when we approach them in these contracts, are they amenable to ending it?” Dryer asked.

Means responded: “Some are, some are not. That’s where we evaluate on our side the business process to ‘where does that lead us next?’ We have one primary example that just popped up that wasn’t even on the list that we just discovered, and we were going back and trying to validate, ‘do we really need this?’ The answer that we’ve gotten so far is, no, we don’t need it. …”

DIVING A BIT DEEPER

Hoban echoed much of what Means reported, saying that a “significant organizational milestone” was recently completed with the finalization of the December 2025 financials.

“This work required extensive restructuring, validation, reconciliation and operational reviews due to the financial environment inherited during the leadership transition,” Hoban said. “While substantial progress has been made, financial reporting and revenue cycle reconstruction efforts remain ongoing.”

The reconstruction of the December 2025 financial statements gave a more accurate picture of the hospital’s financial performance, Hoban said.

“Total operating net revenue was approximately $5.1 million, total operating expenses approximately $8.3 million, ultimately, reflecting a net loss from operations of $3.4 million,” Hoban said. “As far as the balance sheet overview goes, the cash and equivalents, we have approximately $4 million in cash and equivalent reserves, total assets of approximately $8.95 million and total liabilities of about $7.7 million.”

With the closing of the 2025 financials, additional financial reporting and revenue cycle workflows remain active in a reconstruction and validation phase, commissioners were told.

“Because of this ongoing work, portions of the current financial reporting should continue to be considered preliminary, unaudited and subject to ongoing review and validation with the auditing company,” Hoban said.

SURVIVAL FLIGHT TAKES OFF

While news of the latest financial red flag was part of Means’ update to commissioners, it came only after a sprinkle of positive news.

Specifically, Means kicked off the meeting by raving about the community turnout at Monday’s ribbon-cutting and “blessing” of the hospital’s new Survival Flight med flight service.

“Today is a remarkable day at Eureka Springs Hospital and our partnership with Survival Flight,” Means said. “… As CEO and representative of this hospital, I cannot be more proud, grateful and honored to witness this monumental occasion for our organization, our region and the patients we serve.

“Today represented more than just a ribbon-cutting .... It represents progress, partnership, access to critical emergency care and the continued rebuilding of trust and service for our community. To see the support from our commission, council, staff, leadership teams, community members and regional partners was truly overwhelming in the best possible way.”

The addition of Survival Flight is another feather in the hospital’s cap as the facility continues to rebound from the controversies of the past couple of years, commissioners were told.

“As we continue our work to stabilize, rebuild and strengthen Eureka Springs Hospital, I remain committed to transparent, accountable leadership that is grounded in our mission, vision and organizational pillars,” Means said. “Patients first, people matter, progress always. Over the past month, our focus has remained consistent: to identify, validate and correct system-level challenges while continuing to deliver safe, high-quality care to our community. While many of our discoveries and reconstruction efforts continue to be difficult, progress is happening, accountability is strengthening and our organization continues to push forward.”

VOLUME CONTINUES UPWARD TREND

While behind-the-scenes work to improve financial stability continues, forward-facing activity at the hospital continues to thrive, commissioners were told.

“On April 15, 2026, Eureka Springs received 100 percent clear CMS validation re-survey with no findings and no conditional level deficiencies,” Means said. “… Several year-to-date trends demonstrate continued growth in utilization and community confidence in Eureka Springs Hospital.

“… From January 2025 through April 2025, our [emergency department] patient volume was 510 with EMS encounters of 105. As you can see, in 2026, January through April, we have an [emergency department] patient volume of 789 with an EMS encounter of 259. These increases reflect substantial growth in emergency services utilization and demonstrate continued community reliance on our hospital for emergency care access.

“Patient satisfaction scores continually remain exceptionally strong. During April, 33 percent of our patients participated in our follow-up phone survey process. Out of 240 patient encounters, 99 percent of respondents rated their care as a 5, and 99 percent stated they would recommend Eureka Springs Hospital to others.”

UPCOMING HAPPENINGS

Other new services will have ribbon-cuttings in coming weeks, Means told commissioners.

The UAMS Women’s Health Mobile Clinic’s arrival at ESH will be celebrated at 10 a.m. Wednesday, May 27, she said.

“They will officially go live with their clinic on June 9,” she said.

The hospital also recently participated in the Northwest Arkansas disaster preparedness exercise on April 29.

The Arkansas Department of Health will be visiting the hospital on June 11 for a “provisional trauma survey.”

The ADH will examine charts to ensure certain practices were sufficient, commissioners were told.