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City-owned hospitals seem to be going the way of the rotary dial telephone and the 8-track tape player in Arkansas, where only eight of the 103 hospitals that belong to the Arkansas Hospital Association are listed on its Web site as being owned by cities.

County-owned hospitals fare only one better, with nine, according to figures from the AHA.

The vast majority of hospitals in Arkansas are private non-profits (51), with corporate controlled hospitals accounting for 28, according to the AHA. There are two state-controlled hospitals, two federal-controlled hospitals, one not for profit, one partnership and one operated by the Department of Defense.

In the last 20 years, many hospitals have given over management to corporations or private non-profits, partly because the Arkansas Constitution puts limits on things government entities can do, including borrow money, said Paul Cunningham, senior vice president of the Arkansas Hospital Association.

"The flexibility of being a not for profit organization has a lot to do with the change," Cunningham said. "It's not an unusual thing for a city or county to go with a non-profit."

According to a chart on the AHA Web site, Arkansas' city-owned hospitals are:

• Booneville Community Hospital, critical access, 23 beds


• Eureka Springs Hospital, critical access, 22 beds


• Magnolia Hospital, rural, 44 beds


• Mena Regional Health System, rural, 65 beds


• North Logan Mercy Hospital in Paris, critical access, 16 beds


• Piggott Community Hospital, critical access, 25 beds


• Five Rivers Medical Center in Pocahontas, rural, 50 beds


• Siloam Springs Memorial Hospital, urban, 73 beds

County-owned hospitals include:

• Little River Memorial in Ashdown, critical access, 25 beds


• Dallas County Medical Center in Fordyce, critical access, 25 beds


• Chicot Memorial Hospital in Lake Village, critical access, 25 beds


• McGehee-Desha County Hospital in McGehee, critical access, 25 beds


• Drew Memorial Hospital in Monticello, rural, 49 beds


• Pike County Hospital in Murfreesboro, rural, 32 beds


• Mercy Hospital/Turner Memorial in Ozark, critical access, 25 beds


• Fulton County Hospital in Salem, critical access, 25 beds


• Lawrence Memorial Hospital in Walnut Ridge, critical access, 25 beds

Although the hospitals are generally owned by their cities or counties and have a board of directors, the day-to-day operations are often contracted out to large companies, such as Allegiance Health Management, which manages Five Rivers Medical Center in Pocahontas and Eureka Springs Hospital, or they are part of a system of hospitals, such as the St. Edward Mercy Health System, as in North Logan's case.

Magnolia Hospital is operated by CHRISTUS St. Michael. "They provide us with a lot of support and education," said Karen Weido, director of marketing for the hospital. "We have a seven-member board of commissioners and they are appointed by our mayor and city council."

In Pocahontas, according to a June 16 Associated Press article, the city council is attempting to bring Five Rivers under the control of the city and hospital board. The city council unanimously approved a resolution giving a committee permission to negotiate termination of its operational agreement with Allegiance Health Management. The board, which will remain the same as the present advisory committee that helps oversee the operation of the hospital, will report directly to the city.

Pocahontas officials said the breach involved an improper and unauthorized payment from Five Rivers Medical Center to Allegiance. The hospital oversight committee and the city council have to approve such payments. No other details were available regarding the payment.

Last year, the city had to take action to prevent the former Randolph County Medical Center from closing when difficulties came to light. Ninety-seven percent of the city's voters cast ballots agreeing to a 1-cent sales tax increase to help save the hospital.

City officials told the Jonesboro Sun that they felt they were "forced to take action" to keep the hospital viable and moving in the direction the community had envisioned when it overwhelmingly approved the sales tax increase.

Except for Siloam Springs, city-run hospitals tend to be rural. They might be small, but they are growing.

• 
  Magnolia Hospital is currently building a 49-bed replacement hospital, which is slated to be completed in winter 2009. A sales tax was passed in May 2007 to fund the construction of the state-of-the-art facility.


• According to its Web site, Piggott Community Hospital is planning to expand its Piggott campus, the rural health clinics and home health care programs.


• Mena Regional Health System completed a major expansion and renovation project in 2005. The hospital provides care to the communities of Mena, Polk County, and the surrounding counties in Western Arkansas and Eastern Oklahoma.

Cunningham said he doesn't expect the hospitals that are city- or county-controlled to be sold to corporate or private non-profit companies.

"My guess is, if they haven't made that change by now, they're not going to," he said. "I think a lot of it deals with the fact that the local community wants to have control of the hospital."

Weido agrees that her city of 14,000 takes pride in the hospital, especially with the new hospital in the works.

"We provide a service to our community," she said. "We do a great deal of charitable care."

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