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Economy's effect on your hospital


Mabel Adams
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Does anyone's hospital have hiring freezes, no salary increases (or even has salary cuts), required days off without pay, layoffs, or limits on capital expenses this year due to the fallout from the economic crisis? Let's hear everyone's stories. We can vent and know we are not alone while creating a blog-like record of the impact of the crisis.

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We are preparing for the worst (no raises & hiring freeze for now), but we've seen no decrease in workload yet. The CFO may be seeing a change in payor mix or maybe just reading too many articles.

It makes sense, though, if people are losing their jobs / health insurance, that elective stuff will disappear. If your facility depends on it for their profit, you will expect a revenue decrease and make plans accordingly.

Then there's the RePO effect (Reid - Pelosi - Obama), with Daschle as HHS secretary. If they get aggressive after Jan 20th, we could all be civil servants in short order. And why make capital purchases now if the government will pay for it later? Expanded SCHIP is a certainty, and some local companies are already dropping family health coverage for 2009.

Less than 10 years to retirement ...

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Yes, we're in bad shape here in NY state, thanks in part to our new governor. As far as our hospital, they just closed our offsite detox hospital (with layoffs), they are closing many of our mental health beds, and "restructuring". They have told us there will be no raises this year, and for now positions are in limbo. We've lost lab positions as techs retire of quit, we're down to bare bones now, if another couple leave we'll be in trouble.

Business is booming; we're a trauma center so we've been busy, census is full. But with Medicaid cuts, and more people without insurance, financially it's sketchy.

:cries: OK, venting done for now...

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Mabel,

The facility that I work with full time has put a cap on overtime. I imagine a hiring freeze will come next. The facility that I worked at previously, I work prn there currently, has both an overtime cap, hiring freeze and a freeze on pay raises. I left in the nick of time.

Jim

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We have a cap on overtime and a hiring freeze. So far the administration has not gotten rid of pay raises, but we are expecting that. Our lab is at bare bones and the manager is currently looking to bring in more business to increase profits.

Our hospital is critical access and doesn't does next to no elective surgery, but with layoffs, etc. around the area, a lot more people will not have insurance to help them pay costs, so the hospital is expecting to see a significant drain on revenues.

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We've been doing that for 6 years due to our rate of payments from Medicare and under insured patients. We have one of the lowest rates in the country. Medicare thinks it costs us a lot less to run tests here than else where in the country. We had a RIF at the beginning of it at both hospitals. Mary

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Same here in St. Louis. We experienced a MAJOR reorganization in June '08 and our current productivity numbers for '09 are lower than they were in '08 and our test volumes haven't increased dramatically in the last 5 years.

We are "encouraged" to take paid time off to help meet the numbers but so far no RIF's, we are on track for a raise but if someone leaves I doubt we will replace the position.

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You may be able to find money in a place that nobody is looking. The outdate rate for Apheresis platelets is 11% according to the 2007 NBCUS study and 22% for WBD platelets. Nationally, this equals (using NBCUS costs) $100,000,000 for Apheresis and almost $50,000,000 for WBD. The problem is 5 day storage.

If 7 day storage was in effect the outdates drop considerably, possibly to as low as 0.5%. Almost all of this money is recoverable with 7 day platelets. The FDA is looking for a way to revive the PASSPORT study. The likely path to 7 day platelets is using a rapid test on day 5,6 or 7. Would you spend $20 to save a $500+ bag of platelets?

For blood banks, outdates equal cost without offsetting revenue (use or lose). For suppliers, outdates mean lost revenue and ultimately higher costs that are passed along to hospitals ultimately. It's worth looking into. You may find enough cost savings to hold off the wolves at the door.

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Our hospital has been busy. We just took over a physician's office laboratory practice, so our numbers are up, all of our outpatient numbers are up. This doesn't impact transfusion service directly much (a few more prenatals), but overall lab numbers are fine for us so far.

We have not had any cuts, just 'cautions' for the future.

We are bringing automation into the blood bank. Most techs are getting older, and will be difficult to replace, but perhaps no one will be able to retire now, if their 401k's lost too much value!

Linda Frederick

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Here in NY we have our wonderful governor to thank for a lot of things, but as far as our facility we lost a licensed tech thru layoffs (med techs with a NYS license are like gold, so you can tell that decision was made by someone without a clue). We also have received no cost of living raises for going on 2 years now and the lab is on a pseudo-hiring-freeze. Since there's no techs to be found in NYS, I guess it's a wash.

We are currently in the process of entering into a 'partnership' (re:acquisition) with a larger facility. The step we're at now post-layoff is now adding up the daily hours in the lab and, if we're above the 'magic number' of hours that the powers-that-be have deemed to be our cutoff, we have to send people home.

The part that bothers me the most is that no one here can afford to leave and find something better if it's out there. I personally do not want to be the newest hire at any facility because I'm the first to go if staff gets cut. It happened to me once before - never again. :mad:

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  • 1 month later...
  • 10 months later...

The hospital that I am at had pay freezes only for no-union employees, hiring freezes, desolving positions through attrition, and very careful watch of overtime. It seems that union rep employees recieved thier raises as per their contracts and our hospital CEO's also recieved significant salary increases; talk about a slap in the face. Is it me or is this country heading back towards pre- French Revolutionary times?? I do feel lucky however at the moment because I was able to aquire full-time employment with a salary increase.

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Hi Folks,

The money squeeze is worldwide (read articles in the Dark Report). Regulatory audits can be used in your favour - if workload is too high due to staff lack, the first thing that will suffer is the extras (audits etc). If the inspectors are good, they should detect lack of staff as a reason and raise it with management. Reg Audits are not all bad news.

Cheers

Eoin

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Our area of Virginia has the highest umemployment in the state(20%). OUr main industries used to be knitting mills and furniture plant. The knitting mills are long gone and the furniture plants are hanging on by a thread. During the summer, our hospital had mandatory flexing. Fortunately, the lab could not schedule the flexing and people would go home early as workload would permit. We are watching every penny and hope that we can keep the current staff. People can't afford to have elective procedures and put off tests the doctor may want. After 33 years, this is the worst I have ever seen.

Yesterday our CEO showed a progression of unemployment across the nation from 2007. It was like a shadow starting in the east and west coasts and spreading toward the mid west. Really creepy.

:disbelief:fear::cries:

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Our area of Virginia has the highest umemployment in the state(20%). OUr main industries used to be knitting mills and furniture plant. The knitting mills are long gone and the furniture plants are hanging on by a thread. During the summer, our hospital had mandatory flexing. Fortunately, the lab could not schedule the flexing and people would go home early as workload would permit. We are watching every penny and hope that we can keep the current staff. People can't afford to have elective procedures and put off tests the doctor may want. After 33 years, this is the worst I have ever seen.

Yesterday our CEO showed a progression of unemployment across the nation from 2007. It was like a shadow starting in the east and west coasts and spreading toward the mid west. Really creepy.

:disbelief:fear::cries:

I'm sorry to make light of a very serious situation, but (there is always a but) shouldn't it have been the knitting mills that held on by a thread????????

SORRY!

:eek::eek::eek::eek::eek:

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Hi Folks,

The money squeeze is worldwide (read articles in the Dark Report). Regulatory audits can be used in your favour - if workload is too high due to staff lack, the first thing that will suffer is the extras (audits etc). If the inspectors are good, they should detect lack of staff as a reason and raise it with management. Reg Audits are not all bad news.

Cheers

Eoin

I agree with all you have said Eoin, the only thing is that lab folk are being told that there is 'no money in the pot' and labs will have to maintain compliance anyway regardless of what the regulators say about staffing levels.

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I'm sorry to make light of a very serious situation, but (there is always a but) shouldn't it have been the knitting mills that held on by a thread????????

SORRY!

:eek::eek::eek::eek::eek:

Malcolm, I often smile when reading your posts. Our textile plants did hang on by a thread until it stretched to Mexico and the far east - it finally broke!

:raincloud:raincloud:raincloud

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We're with Alabama with some of the lowest Medicare reimburesment in the nation. Two of our same size (large-ish) neighbors laid off across the board a year ago. We've seen a bunch of bad revenue months but our bottom line was in pretty good shape going into this mess, so we survived last year without anything drastic - watching overtime, no new hires, postpone major purchases, watch supply inventories, etc. Time will tell how things go this year. We had just gotten good and started with a major remodel/expansion project hospitalwide when this hit, talk about good timing! We've had no 'real' raises for over ten years, just tiny so-called cost of living raises. My stats for last year actually show an increase in blood useage - why? I have no idea. Our jobless rate is lower than the national average, so we are hoping to survive another year without anything drastic. Time will tell.

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Hanging on by a thread - Good One Malcolm,

On the furniture side - I like Fran Lebowitz' quote - “No animal should ever jump up on the dining-room furniture unless absolutely certain that he can hold his own in the conversation.”

Seriously though, it is a sad situation that could result in a patient being compromised and we all know where the blame will be deposited - in the bank.

Cheers,

Eoin

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Same story here in Texas. Hospital admin put a freeze on overtime and we had to restucture our scheduling quite a bit. We have 12, 10 and 8 hour shifts and it gets a little hairy sometimes with the 12 hour people getting overtime.

We don't have a hiring freeze in departments who can show at least 95% productivity. Lab was at 88% over the holidays so we were frozen.

We have not had any educational or travel expeditures for a while now and reacently were asked by our CFO to further cut the department budget by 10%. I am looking at new vendors myself.

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Other than layoffs, hiring freezes, low census time off, have any of you had benefits cut? Pay more for your insurance or had PTO (paid time off) accrual cut? One of our hospitals has cut the PTO you receive if you retire or quit. Example: you have 120 hours PTO, you retire or quit and you get paid out for 80 hours. Sure takes a lot of money off the books.

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I have to admit, our corporation has done okay. They gave us a nominal raise last year and did not cut any benefits. We avoided layoffs but did cut jobs through attrition. They had a goal to cut many millions of dollars out of the budget and succeeded. We haven't heard if we will get raises this year but we are expecting bonuses through our Performance Improvement initiatives for 2009. They held us to a hard line of 100% productivity with flex scheduling a must. If no one was on vacation, people got mandatory days off (paid or unpaid was their choice). And we just merged with another hospital so I give our higher management good marks for aggressive business sense. Now lets see if Medicaid reimbursement decreases further and takes into a downward spiral.

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We had no raises this year and our pension plan is about to change. I have not been able to get approval to fill vacancies. I always love the reasoning behind this...it is because I have too much overtime in the department. The overtime is because I have to use existing staff to perform the work that would have been done by the person in the vacant slot. This is what you call a "no win" situation!

Edited by adiescast
Flying finger disease
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