Declining in-patient volumes lead to furloughs

Experts: Staff adjustments common in medical field today

Due to a decreased in-patient volume in January, Capital Region Medical Center (CRMC) has required its non-nursing and non-clinical staff to take time off over a six-week period as a cost-savings measure.

Bob Mazur, CRMC’s vice president of human resources, said the Jefferson City hospital has periodically required employees to do so.

“This approach is also employed to ensure fairness across the organization by not requiring only direct, patient-care staff to bear the burden of these necessary cost-saving, operational adjustments,” he said.

In-patient is when a patient is admitted to a hospital and must stay overnight. Out-patient procedures typically don’t require an overnight stay, although sometimes they can.

Staff adjustments because of in-patient volume aren’t uncommon at hospitals across the country.

St. Mary’s Health Center (SMHC) hasn’t had to reduce staff hours, but the hospital’s vice president and chief operating officer, Tony Houston, said hospital officials are always looking at in-patient volume.

“We’re always looking at volume, whether it be in-patient or out-patient, and adjusting our teams appropriately, either up or down,” he said. “If volume is down, you need to flex folks (staff) down, and when it goes up, you flex people up.”

He said that hopefully when SMHC’s new campus opens in November on Mission Drive, the hospital will flex up as patients try out the new location and facility.

Amy Berendzen, director of marketing and public relations at CRMC, said the weather and this year’s less serious influenza strain could be the cause of a decline in in-patient stays at CRMC in January.

But, she said, obviously a less severe flu strain is a good thing.

She said the recent trend in declining in-patient volume, even before January, could be because health care consumers are listening to prevention and wellness messages from doctors and are taking better care of themselves.

She also believes an increase in out-patient procedures could be the cause.

“It used to be that the delivery of care for a hospital encounter was 40 percent out-patient and 60 percent in-patient,” she said. “In the last two to three years, that has switched on a dime.”

CRMC broke ground last month on a $37 million expansion of its Madison Street campus with the intent to put more focus on out-patient services and patient-centered care.

“Our out-patient volumes are crazy,” Berendzen said.

Last May, CRMC President Ed Farnsworth and SMHC President Brent VanConia told the News Tribune their respective hospitals were seeing a decline in general volume, the number of patents visiting the hospitals for care.

The presidents attributed some of the decline to sequestration cuts — a combination of expiring Bush-era tax cuts and automatic, across-the-board spending cuts resulting from failures of Congress and President Barack Obama to make a budget deal.

They also attributed it to consumers’ purchasing behaviors.

“Folks are changing their purchasing behaviors, which is affecting utilization and the number of beds, the number of X-rays, lab tests and other things,” VanConia told the News Tribune.

CRMC’s reaction last May was to cut some staff overtime and part-time hours to make up for the cuts. The hospital is still doing so.

In October, SSM cut 10 positions at SMHC and Audrain Medical Center in Mid-Missouri. Some of the positions were eliminated through attrition.

VanConia had said in May that SMHC was looking to increase market share for both in-patient and out-patient services, and wanted to expand outside the four counties around Cole County. He believed SSM Health Care’s purchasing of Mexico’s Audrain Medical Center and the creation of SSM’s Mid-Missouri Region was a way to do that.

SSM Health Care owns SMHC.

Houston said Thursday that he certainly believes there is a benefit of having Audrain Medical Center as a part of SSM.

“Certainly volume could be one (benefit) as we better align our resources and our service lines,” he said. “Again as the market changes, certain services aren’t as busy as they were in years past.

“That’s just the way medicine is changing.”

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