Coulee Medical Center has been making remarkable strides toward digging its way out of debt, is heading toward profitability, and is even expanding its services, unlike many rural hospitals, administrators and other public officials say.

"It's an amazing story as compared to where they were a year ago," Grant County Treasurer Darryl Pheasant said Tuesday. "This is a great success story for them."

As treasurer, Pheasant oversees all county finances, including the debt incurred by municipalities and junior taxing districts that get into financial trouble, covering bills with "registered warrants" drawn on the county treasury.

CMC and its clinics are run by Public Hospital District 6. For a variety of reasons, it was in debt to the county by nearly $4 million last October, and the county commissioners were concerned.

Pheasant said Tuesday that balance currently hovers around $200,000, and the current trend gives him hope it will hit zero by October or November. "We didn't have an expectation that it would be this quick," he said, noting that some other small hospital districts in the county are not doing as well.

Pheasant attributed CMC's success to a change in leadership and praised current administrators for reversing a decision by their predecessors to outsource billing to an east coast company.

That move had been part of a turnaround plan hatched in March 2017, which included cutting in-house business office positions. But by that June the amount owed to the hospital by insurers and patients had ballooned as bills were slow to get out.

At the end of that month, Ramona Hicks, a nurse and hospital employee since 1993, was appointed as interim chief executive officer, and Kelly Hughes the new chief financial officer. Hospital district commissioners have since dropped the interim from Hicks' title.

Hicks brought on a consultant, Jason McCormick, a partner in B2B CFO, to help guide a way out of the financial troubles.

Hospital employees have also contributed in the effort, forgoing a cost-of-living raise for months until recently.

Hughes reported to commissioners Monday night that the registered warrant balance on hospital books had actually hit zero briefly for the second time in two months, and that August should end "on a good note."

The hospital's cash position has improved by nearly $3.8 million since October, she reported at the end of July, the last month for which financial reports are currently available. The hospital's bottom-line gain for 2018 through June is about $1.4 million.

Hughes said last month that CMC has also been setting aside money each month in anticipation of next spring's Medicare and Medicaid "cost report." That will likely result in a $2 million bill from those federal insurers, McCormick cautioned Monday night.

Not setting funds aside for that possibility had also been a factor in the hospital's past financial troubles.

Hospital commissioners Monday approved a $30,000 "off-site" retainer contract with McCormick for his continued advice over the next year. His more hands-on services this past year earned his company $120,000 from CMC.