Like many rural healthcare facilities, Eureka Springs Hospital (Ark.) has seen its fair share of challenges – such as an immediate jeopardy warning following a leadership transition in 2024. Now, the hospital has two healthcare veterans working to turn things around to ensure care is provided to the community it serves.
Tiffany Means, RN, DNP, became CEO of Eureka Springs in August 2025, and Doug Hoban joined her as interim CFO in early January. Mr. Hoban’s initial contract was for 90 days, with the option to continue services every four weeks for up to one year. The two had previously worked together at Mercy Hospital Cassville (Mo.) when Dr. Means was a clinical nurse and Mr. Hoban served as CFO.
“My roots are very centered around rural care,” Dr. Means told Becker’s. “Having those opportunities to come in and serve this community and rebuild this hospital is what has motivated me to bring back the services that this community needs.”
Eureka Springs converted from critical access hospital status to rural emergency hospital status in 2023. The transition came with a fixed monthly payment from the federal government, but eliminated inpatient beds. The hospital now operates primarily as an emergency department and is building out extensive outpatient services.
When Mr. Hoban arrived, his priority was clear: improve the Eureka Springs’ cash position and revenue cycle.
“We are working with our software vendors continuously to try to rebuild the foundation of our revenue cycle,” Mr. Hoban told Becker’s. “It is a relooking and rebuilding [process], and trying to do it in the most cost-effective management approach has been our challenge over the last three months.”
Eureka Springs holds reserve accounts it hopes not to dip into, and Mr. Hoban monitors them multiple times a day.
“Our hope is to start to rebuild,” he said. “As we rebuild the foundation of the revenue cycle and actually improve the collection on the open accounts receivable, we start to rebuild the cash reserves of the facility.”
The Rural Emergency Hospital designation, which took effect Jan. 1, 2023, lets qualifying facilities convert from either a CAH or rural hospital with no more than 50 beds. It also does not provide acute care inpatient services. Forty-four facilities across 18 states have adopted it so far.
“I think it’s survivability,” Dr. Means said. “The government gave opportunity for rural hospitals to stay alive although they were struggling, inpatient was a challenge that was hard to sustain. I think the transition gives the opportunity to flip over, offer outpatient services … utilize your money wisely, reinvest it, don’t spend it and be able to preserve your hospital in a manner that is long-term sustainable.”
Dr. Means said smaller hospitals are most vulnerable to fluctuations in Medicare reimbursement policy, but the REH supplemental payment offers a buffer to continue operations. When Dr. Means started at Eureka Springs, outpatient utilization was almost nonexistent at less than 2% of patients seeking outpatient services. Now, the facility is building a regional community health hub.
While its infusion center is operational, specialty clinic space is set to open April 15, with cardiology and orthopedic partnerships targeted for July 1. A mobile women’s health unit will launch in June, alongside a telemedicine program in partnership with the University of Arkansas for Medical Sciences. The facility will partner with Survival Flight, an air medical service that will base a helicopter on the hospital’s helipad starting May 18.
“The best thing we can do is have readily available services to get them where they need to be,” she said.
Lastly, Dr. Means applied for a licensure addendum to allow the hospital to offer lower-acuity services at a reduced fee under the emergency department umbrella, something she described as a hybrid care model. The hospital is working with its Oracle Community Works EHR to finalize things, with a June 1 launch goal.
Looking toward the future, Dr. Means and Mr. Hoban are disciplined about where they are measuring progress. For Mr. Hoban, that looks like an improved revenue cycle, rebuilt payment streams and a permanent CFO successor. For Dr. Means, it looks like growth and trust.
“Gaining the trust back from the community, and believing in the hospital that we can serve them in any way to keep them close to home. If we do that, that’s success.”
The post ‘Gaining the trust back’: The mission driving 1 Arkansas rural hospital appeared first on Becker's Hospital Review | Healthcare News & Analysis.
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