Barton hospital layoffs

unedited March 2009 Tahoe Mountain News

By Kathryn Reed

Barton’s simultaneous downsizing and growth may seem incongruous, but hospital officials say it makes sense.
On March 27, 43 of the 989 employees in the health care system were shown the door. The current cutbacks represent 4.3 percent of the staff. Twenty-six worked full time and the rest were either part-time employees or worked per diem.
Gone are six nurses (two full time, four part time), 19 non-nursing patient care jobs (10 full time, seven part time, two per diem), and 18 support staff (14 full time, three part time, one per diem).
Some had worked for the organization for more than a dozen years.
While these middle class workers are off the payroll, the top salary makers are still cashing checks.
Barton officials say those who are left will not face a pay cut, will continue to receive bonuses and will not have to take a furlough.
Salaries for the laid off workers is not public information. However, as a 501(c)3 nonprofit, the hospital must disclose to the IRS the wages of the top money-makers. The CEO of this little hospital makes the same amount as the president of the United States.
Here are the annual salaries from the 2007 IRS form (the most recent available):
CEO John Williams -- $399,103;
CFO Dick Derby -- $268,851;
Director of Hospital Operations Kathy Cocking -- $212,991;
Pharmacy Director Barry Kiel -- $162, 337;
Human Resources Director Leann Kankel -- $153,828;
VP of Nursing Mary Bittner -- $147,291;
Director of Risk Management Kathryn Biasotti -- $144,454;
Information Systems Director Robert Quadri -- $140,296;
Former employee Pamela White -- $137,515;
Clinical pharmacist Terri Cherry -- $136,443;
ER nurse Aran Borgman -- $121,739
Former PR Director Linda Thompson -- $113,331.
What they are making in 2009 is unknown. These figures also don’t represent what the hospital pays in terms of health and retirement benefits, or bonuses.
On they day the layoffs occurred, Barton’s website listed seven job openings.
The nearly 1,000 employees in Barton’s system work at the hospital, community clinic, Stateline urgent care, various doctors’ practices, Carson Valley and other Barton owned sites. No one at Carson Valley Medical Center is gone. Barton owns half of that facility.
Barton is one of the largest employers in South Lake Tahoe. Lake Tahoe Unified employs 445, South Lake Tahoe a couple hundred and U.S. Forest Service about 100 full-timers.

Internal workings

On the flip side are the rather recent newbies to the Barton system who continue to garner a paycheck.
The March issue of the Tahoe Mountain News had an ad welcoming Drs. Stephen Bannar and Terry Orr to Barton. They had been with Tahoe Fracture. Ear-nose-throat specialist Dr. Ronald Roth joined Barton this year, too. A year ago Barton acquired Lake Tahoe Orthopaedic Institute in Round Hill.
Sciuto would not say the downsizing was the result in any overlap of services created by the acquisitions.
She attributed the layoffs to the lack of patients, loss of reimbursements from the state and feds, and the uninsured not paying their bills.
“… with less people coming through our doors, we need less employees to service those patients,” Sciuto said.
She said the decrease in patients is the result of unemployed locals not getting regular health screenings and others putting off elective procedures. A substantial part of Barton’s business is from people playing here who get hurt. Barton would not disclose those numbers, but other businesses in town are reporting revenues down 20 percent from a year ago.
Sciuto also said the diminishing permanent population is causing problems. However, the truth is that base is not going away as fast as people are wont to say. The 2000 Census counted 23,609 residents in South Lake Tahoe. A 2008 city report tallied 23,517 residents, with expectations of it growing to 24,179 by 2013.
According to one hospital board member, the operating margin is 2 percent on an annual budget of $127 million – which doesn’t leave much wriggle room when the economy starts to go sideways.
The board had been talking for a little while about what to do about cutting costs. The ultimate decision was made March 26. A handful of employees had been laid off earlier in the year as well.
Between staff cuts and slashing the operating budget, Barton expects to save $6 million. Each department is facing cutbacks – from cutting paper usage to banning bottled water to slashing advertising budgets.
Most displaced workers received a severance check. Counseling will be available, as well as services to help find a new job and referrals to local employers.
Sciuto would not promise this is the only round of layoffs, but said the board and management do not anticipate more.
She added that patients should notice no changes at any Barton facility because of the layoffs.

Looking forward

Barton plans to use its 16 orthopedists to create an institute that people from out of the area will want to come to. As in, don’t use your local doctor; use a specialist on the South Shore of Tahoe.
“We hope to draw people from outside the basin to come here, recognizing they will get better care here than in their own home town,” Sciuto said. “Orthopedic care will help sustain our entire health care system in South Lake Tahoe.”
She points to things like the community clinic and home Hospice which drain the coffers, but that are services Barton wants to provide if another component of the operation can fund them.
Sciuto says a change in leadership at the hospital (CEO John Williams came on board a few years ago) for the willingness to create a state-of-the-art orthopedic center. Dr. Richard Steadman wanted to do that, too, but was turned down. He went to Vail to open a world renowned clinic there in 1990. Steadman wanted to do research and Barton said no at the time.
Nineteen years later and research is OK at Barton. In fact, a research component was necessary before Barton could get its accreditation in January for its orthopedic fellowship program.

Front desk issues

A full-time person now helps run the information desk instead of being solely staffed by Auxiliary volunteers. This change had nothing to do with the layoff situation.
Sciuto said the change was made “because there were a lot of things being asked of them that we didn’t feel comfortable to ask them to do. We have to be very careful of patient privacy and make sure visitors don’t know who is there and why they are there.”
She said the volunteers are still a vital component of the hospital.

Telemedicine coming

By June Barton plans to have a telemedicine program in place. This will allow consultations with specialists not on staff at the hospital who can assist in patient care around the clock.
As a small private hospital, Barton doesn’t have the resources to employ specialists across the spectrum. Telemedicine could save a patient time and money. Patients will also be able to interact with the specialists.