Tennessee hospitals are feeling the effects of a slumping economy, forced into cutting staff, increasing charity care and dipping into hospital reserves to pay bad debt.
In a membership survey completed this month, the Tennessee Hospital Association found that a majority of the state's hospitals that responded have reduced staff or are considering cuts. Nearly as many have also cut services or are thinking about reducing them.
A total of 88 hospitals responded to the survey. Not all hospitals responded to all questions.
Craig Becker, president of the Tennessee Hospital Association, which represents 134 hospitals across the state, said the survey revealed dramatic changes in three categories: a spike in charity care, namely because of an increase in uninsured patient visits to emergency rooms; at least a 20 percent to 25 percent decrease in hospital reserves because of losses in the stock market; and a drop in the number of elective surgeries, profits of which typically help pay a hospital's debt.
Ninety-one percent of responding hospitals said they've reduced or are considering reducing staff. And 85 percent said they've implemented or are considering hiring freezes.
"A lot of the hospitals have either laid people off or are considering laying people off, have shut services or are considering shutting services," Becker said. "We're getting down to the point where, for some hospitals at least, the concerns are what's going to happen next."
Becker said hospitals across the state are affected. Hospitals in Georgia, Alabama and Mississippi are experiencing similar situations, he said.
Vanderbilt University Medical Center, which accounts for nearly half of the uncompensated care in Davidson County, has not had to reduce staff, but has had to cut discretionary spending and anticipates more belt-tightening next year, said Joel Lee, associate vice chancellor for medical center communications.
Already, corporate investments and charitable giving has been trimmed, marketing budgets have been cut and the expansion of Monroe Carell Jr. Children's Hospital at Vanderbilt has been delayed because of the economy, Lee said.
'Recession-resistant'"The old adage used to be health care is recession-proof, and it's not. It's still recession-resistant, but what gets deferred are the things that could lead to future problems," Lee said.
Rebecca Climer, chief communications officer for Saint Thomas Health Services, said the health system has been finding ways to respond to the economic pressure.
"(The survey) confirms what we all know," Climer said. "The downturn in the economy is affecting every hospital in Nashville," Climer said. "We are in a position to anticipate significant changes to come as we move into a time of sweeping health reform.
"We are developing nearly 30 multi-disciplinary teams across our organization to review our operations and evaluate opportunities for improvement."
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