OCH History

Where We Came From

• OCH was formed in 1991 and briefly took over a failing nonprofit hospital, licensed for 100 beds, in Springfield, Missouri.
• OCH sold it in 1995, and the buyer closed it in 1997.
• OCH re-acquired it and reopened it January 1, 2000, as a 45-bed hospital, bringing the building up to code after it sat empty for two-and-a-half years. When OCH reopened that closed hospital, it did so as a privately-owned, safety-net provider, which is as unusual in the hospital industry as it sounds.
• From 2000 through 2008, approximately 90% of our patients were either covered under a government benefit (Medicare, Medicaid) or were uninsured.
• Beginning in 2005, OCH began opening provider-based clinics in the Springfield urban market and rural health clinics in rural communities surrounding Springfield.
• In 2005, the 100-bed hospital in Gravette, Arkansas closed.
• In 2007, OCH was approached by community leaders of Gravette about the possibility of reopening its closed hospital (after all the other health systems in the area turned them down).
• OCH reopened the Gravette hospital on Monday, April 14, 2008, as a 25-bed hospital, bringing the building up to code after it sat empty for two-and-a-half years.
• In 2008/2009, OCH Springfield was recognized as the lowest cost hospital in the nation based on the Dartmouth Atlas Project, as reported in the US News & World Report.

• From 2008 through 2016, OCH operated two hospitals and grew its number of satellite clinics to 18. Our employed providers were also seeing patients in over 50 nursing homes. We averaged 240,000 clinic visits a year. We were accepted into the Medicare Critical Access Hospital program in early 2009.
• Unfortunately, the news of that period was not all good. In 2014, the Medicare Recovery Audit Contractor (RAC), armed with a poor understanding of Medicare regulations pertaining to inpatient geriatric psychiatric units announced that OCH should have been treating these geriatric psych patients (who had been removed from the nursing homes where they resided because they had become a threat of harm to other nursing home patients and were in need of psychiatric care) on an outpatient basis. The RAC, then empowered by CMS to recoup money first and allow hospitals to ask questions later, recouped six months of payments to OCH. We were forced to close our ten-bed unit which had run with a full census of ten patients for 15 years. We appealed the RAC decision by asking, “Where should these dangerous psych patients have slept—Motel 6?” We won but the damage had been done. With the ten-bed unit closed, our average daily inpatient census shrank from 16 to 6.
• In August 2016, CMS decided that the Springfield hospital was not “primarily engaged in providing inpatient care” and therefore failed to satisfy the definition of a hospital. CMS closed our hospital because it could not believe we were not admitting more patients from our clinics. We replied that we were doing the best we could to keep people healthy and out of our hospital ER and hospital beds, because that is what CMS had told us to do. We appealed. In response to our bringing these issues to light, CMS completely rewrote its audit guidance on how that federal definition should be interpreted and enforced. We reopened it as a psych hospital in late 2018, but the economic damage had been done. We sold the hospital in 2019 to reduce debt which had grown burdensome while the hospital was closed. We also closed most of the clinics in the Springfield area.

From 2019 to the present, we have focused our mission on rural communities in southwest Missouri and northwest Arkansas. We survived the Covid pandemic and often led the way in our commitment to continue care while others closed facilities temporarily. Today, we may be smaller than we were a decade ago, but we believe we are stronger. We are now providing 140,000 clinic visits a year. Our inpatient and swing bed census averages 18 patients a day. Our net patient service revenue in 2026 will exceed $80 million: by far the highest revenue of any critical access hospital in Arkansas.