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Coulee Medical Center ER and Walk-In Care

Hospital CEO asking what community wants


Ramona Hicks started “turning over the rocks” in June, as she took the lead position at Coulee Medical Center after the resignation of the last CEO.

And lately, Hicks has been meeting with as many community groups as possible to tell the story of the hospital’s current status and finances, and to ask what the community really wants and expects from the hospital.

Hicks, the interim chief executive officer, spoke at the Rotary Club last Wednesday.

Although business has been brisk, so is the rate at which expenses pile up, and the hospital is suffering more than it would otherwise after a series of mistakes that took cash too low, leading to a dependence on county “registered warrants” — basically a loan from the Grant County treasury.

The latest decision that backfired led the prior leadership to lay off internal billing staff in favor of outsourcing to an Alabama company. The hospital’s accounts receivable — the money it’s waiting to collect — shot up by $2 million, worsening the cash crunch, instead of helping.

Hicks said that’s been reversed; a new plan is in place changing direction with the help of a consultant she said is highly recommended by CMC’s creditors, with whom he has worked in the past, and she’s been busy forging alliances for a long-term plan.

She’s been meeting with local mayors and city councils, the Grand Coulee Dam School District, and health insurance giant Kaiser Permanente, which got its start in Grand Coulee.

The local hospital District 6, which falls in four counties, shares a problem with all those local governments: they can’t tax most of the area they serve because its federally owned land.

Hospital District 6, which operates CMC, takes in less than $200,000 a year, compared to similar-size districts that take in well over $1 million.

After building the new hospital in 2011, CMC’s monthly payment on its debt for the construction is $179,000, Hicks said.

In the 1970s, Hicks noted, the community came together to pressure the U.S. Bureau of Reclamation to help build a new hospital then. She said the bureau had stopped contributing as it had in the past. The effort was successful, she said, and a similar push is being given some thought now.

But she’s also asking what services the community really wants. All of them cost, but some amount to a loss after writing off deductions for Medicare and Medicaid, insurance companies and bad debt, about 30 percent last year.

“For example, OB services,” she said. But the hospital must be able to take care of mothers giving birth, even if it loses money.

She said she would like to have public discussions with the community to lay out the facets of the problems faced by CMC and to get input on what the community wants most.

She said increasing the number of patients coming into the service by 10 percent is a goal that would go a long way toward solving the cash crunch.

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