Larry Paine and the rest of the city leaders in Hillsboro, Kan., have a problem.
EmpowerHMS, the North Kansas City-based company that manages their hospital, owes the city thousands in unpaid utility bills. A check written to the city in December bounced, and Paine, the city administrator, can’t get anybody from the company to resolve it.

Empower, headquartered at 1700 Swift Ave., operates 14 rural hospitals nationwide, including three in Kansas (Hillsboro Community Hospital, Oswego Community Hospital and Horton Community Hospital) and two in Missouri (Fulton Medical Center and I-70 Community Hospital in Sweet Springs).

But Paine and leaders in other cities worry whether their hospitals can continue to operate under EmpowerHMS management, as signs of financial distress multiply.

At least two cities — Hillsboro and an Oklahoma town — are now trying to force Empower to pay up.

(Read more: KC Star Local News)