Kelly Hughes named CEO of Coulee Medical Center

Seven years ago, Coulee Medical Center was in trouble.

Financial challenges going back to 2012 combined with an administration publicly described by staff as "incompetent and hostile" had led to layoffs, unpaid bills, and high-profile provider resignations at the public hospital. 

In summer of 2017, the CEO hired to turn things around had resigned - after just one year on the job. 

To alarmed community members at the time, the hospital itself appeared to be in critical condition.

It was then that two women - one longtime staff member, one new hire - took on key leadership roles in the ailing organization.

Ramona Hicks became CEO that summer while also continuing in the chief nursing officer position. And Kelly Hughes, a recently hired staff accountant and self-described "learn as you go kind of person," was promoted to chief financial officer of an organization with several recent years of annual losses in the millions of dollars.

During a time of uncertain transition when things looked to be falling apart, Hicks and Hughes  may be the two most responsible for saving the Coulee Medical Center. 

Last week marked another transition for the two. But rather than the turmoil from years past, this one came as a result of a planned succession strategy developed by Hicks, along with the hospital board of directors and a private consultant who has been working with CMC for Hicks' entire time as CEO.

"I've been here for 30 years, been through nine CEOs - nine incredibly different types of ways that [transition] happens," Hicks said in an interview in May. "Having had that experience, I really started thinking about, 'How can we do it better here? How can we make it so that it's not such a difficult transition for people? I've been thinking about it for a long time."

Now that strategy is being put to the test.

Last week the hospital board named Hughes as the next CEO, while Hicks voluntarily stepped back from that position in order to focus on the other hat she's worn all these years: chief nursing officer. The change became effective June 27.

"I said to the board in my interview that I would not be considering this job if it wasn't for the leadership team, if it wasn't for Ramona staying an extra two years [as CNO], if it wasn't for the board," Hughes told the board Wednesday.

"I am set up with a wonderful team of people to work with, and we're going to continue with the collaborative model that Ramona set in place, hopefully strengthening all of our relationships, and just keep on pushing forward with all of the good work that we've been doing," Hughes added.

In her final CEO Report to the board, Hicks expressed gratitude for the board and staff.

"Not many [hospital CEOs] have it as good as I have had, with a very dedicated group of people that care about their community, care about the hospital, care about all of the staff," she said. "Thank you for being the board members that you are. I feel very confident in Kelly and the entire team, and that means every employee of Coulee Medical Center."

Board President Jerry Kennedy praised Hicks' tenure as CEO.

"Ramona, as always, you're too kind," he said. "The job that you've done for Coulee Medical Center for so many years - doing two jobs, and three jobs, sometimes at the expense of your health, the heart and the care that you have for Coulee Medical Center, and the way that you've shown that, and the way that you care for everyone on the staff, and for our patients, of course: The board is truly grateful."

Hicks joined CMC in 1993 as a surgical technician and has served as operating room supervisor, infection control nurse, employee health nurse, quality director, risk manager and chaplain. She has been the chief nursing officer since 2011 and said she intends to remain in that role until retirement in early 2026.

As the new CEO, one of Hughes' first orders of business is to hire a replacement CFO, which she hopes to hire internally, she told The Star last week.

And then there's everything else on the list. Like in 2017, 2024 presents a challenging landscape, even if senior leadership appears to be navigating it with renewed confidence.

At the top of Hughes' priorities: improving access to care for community members. This involves recruiting medical providers to fill open positions, increasing available services, tending to employee morale, and hiring for the newly-created chief operations officer position - someone to oversee day-to-day operations so the CEO can focus on the bigger picture.

One recent but persistent challenge facing not just CMC but many rural hospitals is what to do about insurance companies refusing to pay bills for services their policyholders - CMC's patients - receive.

"This is the biggest thing that keeps [Kelly] awake, and keeps me awake, is: What are insurance companies doing to us?" Hicks told the board. "There's been no time in the 30 years that I've been in the industry that we have had such a difficult time getting paid for the good work that we're doing. That takes people, it takes manpower, it takes time."

It takes about three times as long to get a bill paid by an insurer than it used to, she said, whether private insurance, Medicare, or Medicaid. Hospitals all over the country have noticed the trend, and Washington State Hospital Association has provided tracking software for its members to keep data on claims denials, including at CMC. 

"It's a really interesting dilemma that we're in, that has got to have some resolution," Hicks said in an interview in May. "It's going to take people way smarter than I am. I just see it on the sharp end of the stick. We have got to rewrite how healthcare is done. It's systemic."

Undaunted, Hughes told the board last week she is "super excited and honored" to be chosen as chief executive.

"I will strive to do my best," she said. "I have big shoes to fill."