The layoffs were seen as necessary to head off further losses should the trend continue, according to HRMC CEO David Rice and hospital board members.

“The re-engineering process we are going through is the solution to avoid any possible long-term financial problems,” Rice said. “In view of the two months of losses and the trend of decreasing margins, it was clear that changes needed to be made.”

Bob Browning, a hospital board member, said the board made it clear to Rice at their last meeting they wanted to see an end to the trend before it went any further. Other hospital board members didn’t seem as concerned.

“It is just dollars and cents,” said Glenn White, board treasurer. “All companies go through it at one time or another.”

Steve Sorrells, a farmer on the hospital board, agreed.

“Any business has a few ups and downs,” Sorrells said. That said, Sorrells supports the workforce reduction as necessary to get the hospital back in the black.

The workforce reduction amounts to 5 percent of the hospital’s full-time staff. (The hospital has 734 full-time employees, and 205 part timers, for a total of 939.)

Rice and hospital board members say the reduction in workforce will not impact patient care.

“What is going to be done or has been done will in no way impact the care given the patients. I can say that unequivocally,” White said. In fact, Rice and hospital board members said the staff cuts will improve patient care.

It might seem unclear just how the hospital plans to improve patient care while cutting staff. Rice said it is about efficiency. The remaining employees on staff will be more efficient in their duties and be able to shift across department lines.

Being more efficient also means employees will have to do more, according to inside hospital sources. For example, the hospital eliminated its four EKG technicians that run heart monitor tests. This means nurses will have to run the heart tests. The hospital also cut several supervisory jobs in nursing.

Fewer patients

One reason for the slide in operating margin is fewer patients. A press statement released by the hospital cited “an extended period of wellness in the region” as contributing to fewer patients.

Neighboring hospitals have not witnessed a similar decrease in patients, however. Harris Regional Medical Center in Sylva has seen a 14 percent increase in patient load so far this year. Mission Hospitals in Asheville has seen a 3 percent increase. Angel Medical Center in Franklin hasn’t seen an increase or decrease — their admissions are off by three patients for the entire year.

Board members said they don’t know why Haywood Regional’s patient numbers are down.

“We have talked about that at some length, but I really don’t know,” said Glenn White, hospital board member. “It could be people aren’t as sick this year.”

The problem with that theory is that it doesn’t hold true for surrounding counties. Typically, patterns of sickness and wellness that guide demand for hospital care happen regionwide, not in one county but not another.

Steve Sorrells, hospital board member, said it is hard to tell why patient numbers are down.

“How do you go out and ask people why they aren’t in the hospital?” Sorrells said.

The hospital has been the center of controversy in the past year over a decision to oust a long-time group of ER doctors despite overwhelming pleas by physicians throughout the county not to do so. The long-time ER doctors were replaced with a national physician staffing company who are staffing the ER with fewer doctors and fewer man hours.

When hospital board members up for reappointment were interviewed this spring by county commissioners, who make appoints to the hospital board, the hospital’s reputation in the community was one of the issues discussed. Three sitting hospital board members — Dr. Nancy Freeman, Dr. Richard Steele, and Jim Stevens — said the hospital needed to correct a public perception problem partly stemming from the ER decision. However, patient load in the ER has been up 4 percent, according to Rice, who sees no correlation.

Surgery Center

One looming question is whether the hospital has enough money to peruse a $16.5 million surgery center currently in the planning stages. The project also includes a new hospital lobby and office wing for administration.

Rice said the surgery center plans are still on schedule. In fact, a new surgery center will bring in patients who are currently traveling out of the county to Asheville, and therefore could help improve revenue.

“Demographics show HRMC has significant growth potential in surgical services that cannot be met in our current facility,” Rice said. “Our success in delivering an efficient and cost effective surgery program is required in order to grow the organization. Its successful completion is critical to sustaining a quality hospital for this community.”

Hospital board members, however, said they will have to make that decision as they go.

“When it is time to stick the spade in the ground, we will look to see where we are,” White said. “When it gets to that point we will sit down and look at finances and decide whether it is ready to go or not. It is an on-going evaluation.”

Browning said the hospital board discussed putting the surgery center on hold if hospital revenues don’t turn around.