By now we all know that Natchez Regional Medical Center is in debt. The once strong, bastion of healthcare has turned into a brick and tile tower of debt.

Hopefully, the bankruptcy plans in the works will help resolve some of the problems as the board — and ultimately the citizens who own the facility — figure out its long-term future.

So the obvious question is: How did this happen and who is at fault?

While it’s easy to point to many things — these types of problems rarely happen overnight and rarely involve just one mistake — there is one continual, underlying problem — the hospital’s management.

Members of the board of trustees — most of whom are just everyday citizens, not hospital professionals — have suggested they aim to oust Quorum Health Systems, the Brentwood, Tenn., based company that has provided management assistance to the board since 1992.

Since that time Quorum has brought several chief executive officers and chief financial officers in to provide expertise to help run the hospital.

Obviously, their efforts have failed — miserably.

Quorum’s performance was so bad that only a month or so after announcing the first profitable fiscal year in half a dozen years, the hospital board discovered the previous chief financial officer was reporting inaccurate data.

The “cooked books” left in the wake of the poor executive choices isn’t the reason the hospital is in debt. All the CFO’s shenanigans did was delay the discovery of how bad things had become.

The mismanagement goes much deeper and the only logical person to blame is Quorum. They’re a cancer on Natchez Regional that needs to be removed — quickly.