Thursday, Feb. 6, 2003 | 11:02 a.m.
Clark County officials detailed plans Wednesday to save more than $10 million annually at the area's largest hospital, keeping the financially floundering University Medical Center afloat.
The package includes layoffs for 15 Quick Care doctors, seven nurses, three senior managers and 12 mid-level managers; the elimination of 128 vacant positions; and numerous "downgrades" that will cut pay and benefits for 16 administrators, including five Quick Care medical directors.
The county said the layoffs and pay cuts will save about $4 million annually. The elimination of the vacant positions should save $6.4 million annually at UMC, the largest hospital in Nevada and the region's only trauma center.
More cuts are likely. Consultants with Lewin Group, one of a small army of professionals examining the hospital, will come back to the county with a study that would provide the basis for more cuts in about 60 days, County Manager Thom Reilly said.
County administrators and commissioners said they do not believe the cuts will affect the quality of care, but the president of the union representing about 3,000 rank-and-file workers at the hospital and UMC's 13 Quick Care urgent care centers disagrees.
"How could it not affect the quality of care?" asked Vicky Hedderman, president of Service Employees International Union Local 1107 and an office specialist at UMC.
She said the layoffs and the elimination of vacancies could affect her union members and the quality of care in two ways: directly, through the loss of needed employees; and indirectly, through additional work to nurses and other employees who are already overburdened.
"The bottom line is that these layoffs, even without any consideration of further layoffs, is completely reckless and premature," Hedderman said.
But Reilly said the cuts would affect few patients.
"We went to great pains not to affect line staff, or the core functions of trauma, neonatal or burn," Reilly said.
County and hospital administrators said the cuts fall most heavily on the Quick Care Centers, which have seen a 13 percent drop-off in patient volume this year. Reilly said the county will monitor and try to manage any negative impacts, which he said might include longer waits at some centers.
UMC administrative assistant Dale Pugh said fewer patients at the centers demand fewer staff members to serve them. That will limit the impact of the 15 Quick Care doctors who were laid off, he said.
The Quick Cares now employ 87 doctors, he said.
Other staffing cuts -- again, mostly affecting the Quick Cares -- will mostly hit administrators, not the nurses, doctors and other staff who directly serve the public, Pugh said.
Reilly said that does not mean the cuts were easy.
"These numbers, although not large in relations to the total number of employees, are, no question, painful to go through," he said.
But the county, facing a situation where cash is generally very tight and the hospital is running a deficit of more than $20 million a year, has to find ways to save money and increase efficiency, Reilly said.
"Any good business looks for ways to be more efficient," he said.
The cuts were formally announced the same day that Hedderman's union presented a plan that calls for the county's private hospitals to contribute more toward the care of indigent, uninsured and underinsured patients -- the one area that UMC officials say is hurting their bottom line the most.
In Carson City, union officials and UMC employees are lobbying lawmakers to force for-profit hospitals to shoulder more of the burden of indigent care.
Thomas Beatty, executive director of the Service Employees International Union local chapter, said UMC was able to bear the disproportionate share of charity care in past economic times.
"But in today's climate, with such a high number of non-paying patients, the current charity care funding structure just isn't working," Beatty said at a news conference Wednesday outside the Legislative Building.
Clark County's five largest for-profit hospitals committed an average of 4 percent of their expenses to charity care, he added. If those hospitals had spent the national average of 6 percent, they would have paid for $16.5 million more in indigent care, Beatty added.
SEIU is pushing for creation of a Safety Net Fund, requiring all hospitals to provide the national average of indigent care. Those who fail to meet the standard would have to pay the difference into a fund that would be distributed to hospitals such as UMC and Lake Mead that exceed the national level of charity care.
Jerri Strasser, a registered nurse in UMC's pediatric intensive care unit, said she has seen a huge jump in the number of uninsured patients since the layoffs that followed Sept. 11, 2001.
"I'm afraid that if this trend continues, UMC will only require more subsidies, which will ultimately cost taxpayers more and jeopardize our safety net hospital," she said.
In 2002, UMC provided about $56 million in indigent care -- slightly more than half of the total amount provided countywide.
Danny Thompson, secretary-treasurer of the Nevada AFL-CIO, called on Clark County legislators to spread the burden of indigent care around and save programs.
"The trauma center at UMC is the only one in Las Vegas," Thompson said. "The trauma center is not always a for-profit endeavor."
Thompson said private hospitals should be willing to meet the national average to keep UMC's trauma center and other specialized units open.
The private hospitals have said they already pay millions of dollars in charity care and should not have to pay more, especially at a time when the Legislature is considering a gross receipts tax that could further hurt their bottom line.
Reilly said he is not opposed the union's position, but believes it will be part of starting a larger dialogue that should include UMC's relationship to the community, the private hospitals' responsibility to the community and how responsibilities for uninsured and unreimbursed patients should be shared.
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