Layoffs coming at St. Joe’s; some doctors worry about outcome

Dozens of positions are flagged for layoffs in December at St. Joseph Medical Center in Tacoma, mostly in a secretarial unit.

Of 40 health unit coordinators, 36 will lose their jobs Dec. 3, said Nilda Warren, a bargaining team member for SEIU Healthcare 1199NW and a health unit coordinator at St. Joseph’s.

Up to 10 care assistants, a blend of the patient interaction of a CNA and the secretarial duties of a health unit coordinator, also could lose their jobs.

Certified nursing assistants are having to reapply for their jobs, which may mean reduced hours, Warren said.

The health unit coordinators admit and discharge patients, make medical appointments for patients, help with charting patient health records, answer phones, retrieve medications, help patient families and more, according to Dr. Ali Thomas, a doctor based at St. Joseph’s who works for Group Health.

Such cutbacks worry Thomas. Making doctors and nurses do that work will not improve patient outcomes, he said.

“They (hospital administrators) are acting as if they have shareholders, that they need to have a high profit margin,” Thomas said. “Our shareholders are the community. Our shareholders are the patient population.”

In response to questions about pending layoffs, which it numbered at 44, CHI Franciscan Health issued a statement:

“CHI Franciscan Health is always making staff changes — in fact we have nearly 600 openings posted on our public website right now, and we have more than 12,000 employees. Providing exceptional patient care requires constant assessment, and we need to change and adapt to meet our patients’ needs,” the statement reads.

The loss of so many health unit coordinators means other workers will have to perform those duties, Thomas said.

“They handle that burden so I can keep typing a note or look through several different charts while someone else is reaching out and trying to track down a kidney specialist or the on-call lung specialist,” Thomas said.

St. Joe’s is the flagship hospital for CHI Franciscan Health, which operates seven other acute-care hospitals and about 200 clinics in Pierce, King and Kitsap counties.

Health unit coordinators are “a central cog in the communication between patients and other physicians, family members and other staff,” said Dr. George Gleva, an internist based at St. Joe’s who also works for Group Health.

Gleva said health conditions, such as a blood clot, that once required a patient to stay in the hospital for several days are now outpatient procedures. Those who stay overnight are very sick, often with multiple medical issues, he said.

Sicker patients, he said, are more likely to “code” — an alert to staff that signals a life-threatening issue like a heart attack or breathing problem. During those events the health unit coordinators will rally the teams to respond.

“I don’t know who is going to do that if we’re cutting staff,” Gleva said. “I will be honest, I have fear of what’s going to happen.”

Warren works on the oncology floor and has been a health unit coordinator for nearly 24 years. She helps patients schedule appointments, including chemotherapy and specialist visits.

“They said they don’t need a secretary anymore because everything’s in the computer now. All of us here are still working hard,” Warren said.

Crystal Knight, a care assistant at St. Joe’s and worksite leader with SEIU 1199NW, said the paperwork part of the job has “pretty much gone away” because of computerized records. But other tasks are crucial.

At the same time, federal health care reimbursements for older or low-income patients are declining, and hospitals across the country are taking note.

A New Hampshire hospital system is laying off as many as 460 workers to close a budget gap of $12 million. A western Massachusetts hospital said laying off 2.5 percent of its workforce, or 300 workers, will save it $20 million.

CHI Franciscan Health CEO Ketul Patel said in an article this week that the hospital’s largest expense is labor.

“We have to find ways to be a lot more cost effective,” Patel said. “Our employers are going to demand it, our individual insured folks are going to be demanding it, because of the premiums.”

The hospital is also CHI Franciscan Health’s largest revenue generator. Documents filed with the state Department of Health show last year St. Joseph Medical Center posted $56.1 million in net revenues — generally what’s left over after expenses are paid. That’s a nearly 38 percent increase from the 2014 net revenue of nearly $40.8 million.

During that time, hospital admissions dipped by almost 1 percent, and the number of patient days climbed by more than 5 percent, to more than 110,000 in 2015, according to the Department of Health.

The announcement of the staff cuts comes weeks before the union’s contract expires Oct. 31, Warren said. SEIU 1199NW represents more than 800 workers, including health unit coordinators, care assistants, CNAs and janitorial staff.

This story was originally published October 12, 2016 at 12:15 PM with the headline "Layoffs coming at St. Joe’s; some doctors worry about outcome."