The Wyoming Medical Center laid off five "leadership" employees on Wednesday, according to a press release issued Wednesday afternoon.

"In response to rapid and challenging changes in the healthcare market, Wyoming Medical Center regretfully announced today the elimination of five leadership positions," according to the press release.

"Other management positions will be realigned in order to streamline operations and become more efficient in the way we deliver care," the release said.

The press release did not identify which management positions, or names of these managers, were affected.

"While we understand the impact and pain that comes with any realignment, we have an obligation to provide quality care to all who depend on us. We must be fiscally responsible. The process, while painful, is absolutely necessary given the realities of payer mix changes, diminishing reimbursements, decreasing bottom lines and increasing local competition," according to the press release.

The claim of financial issues is supported by the WMC's "confidential & unaudited" quarterly financial statement of operations for July through September -- the first quarter of the 2014-2015 fiscal year -- it filed with the Electronic Municipal Market Access website for municipal bonds. These financial statements are the "continuing disclosure" of entities that have public, or publicly endorsed, bonds. In this case, the WMC files these financial statements because of the Natrona County Wyoming Hospital Revenue Bonds issued in 2011.

The hospital's "consolidated target" of total unrestricted revenues, gains and other support for the first quarter was $50.5 million.

However, it received $47.6 million in revenues in that category.

The WMC's consolidated target of expenses -- salaries, professional fees, operating expenses, depreciation and amortization, and interest income -- was $48.2 million for the first quarter, compared to an anticipated $49.5 million, according to the financial statement.

That resulted in in an operating income loss of $631,000 compared to a targeted $941,000, for a gap of $1,572,000.

After factoring other income sources, the first quarter excess of revenues over expenses amounted to 230,000, compared to a projected $1.5 million, for a gap of nearly $1.3 million, according to the report filed with EMMA.

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Here's the official release from the Wyoming Medical Center:

"In response to rapid and challenging changes in the healthcare market, Wyoming Medical Center regretfully announced today the elimination of five leadership positions. Other management positions will be realigned in order to streamline operations and become more efficient in the way we deliver care.

"While we understand the impact and pain that comes with any realignment, we have an obligation to provide quality care to all who depend on us. We must be fiscally responsible. The process, while painful, is absolutely necessary given the realities of payer mix changes, diminishing reimbursements, decreasing bottom lines and increasing local competition.

"Patient care and safety remain our top priorities. We are committed to keeping people at the bedsides of our patients, and this move will not affect patient care. Our senior leadership underwent a very thorough, objective, yet difficult assessment of all non-clinical positions. They considered how to best streamline our management structure, which functions should go where and how to effectively manage operations. Decisions were not based on who was in a certain position, but in the function and responsibilities of the position itself.

"As part of Wyoming Medical Center’s commitment to financial stewardship, we are working on other cost-cutting measures as we adjust to the new realities of the healthcare market. This realignment and other measures will improve our financial stewardship as we move forward.

"We value our people and regret that we must take this action. We remain committed to providing excellent patient care while streamlining operations. This will help us achieve our budgeted margin, compete with for-profit healthcare organizations and ensure our long-term viability."