Natchez Community Hospital cut three nursing supervisor positions last week in an ongoing effort to keep the hospital profitable.

&uot;It’s never easy – we have to constantly evaluate our staffing and services for maximum efficiency and cost effectiveness,&uot; said Raymond Bane, executive director of Natchez Community Hospital.

Bane said the cut was not directly related to the Balanced Budget Act of 1997 and its cuts in reimbursements from Medicare and Medicaid government-funded insurances.

&uot;It’s not directly related to the BBA, but more toward efficient operation of the hospital. The positions were archaic,&uot; he said.

No services have been cut at Community because the services that would likely be cut – such as home health or skilled nursing – were simply never started, Bane said.

Bane was just one of 36 Mississippi hospital administrators who went to Washington, D.C., earlier this month to meet with Mississippi senators on the issue of Medicare cuts and their impact on Mississippi hospitals. Bane said &uot;not a whole lot&uot; has happened since that trip to change the downward spiral of health care finances. U.S. Sen. Thad Cochran, R-Miss., sent Dr. Robert A. Berenson of the Health Care Finance Administration to Mississippi to see the impact cuts have made.

&uot;(Berenson) had his eyes opened to the situation in Mississippi,&uot; Bane said, but no action by HCFA is likely. &uot;HCFA takes the position that they merely enforce what Congress legislates,&uot; Bane said.

Bane said he has talked with Community’s physicians to brief them on the continuing effects of the BBA.

&uot;We are in a position now where we have to constantly evaluate staffing and services to see what is most efficient in terms of our operations,&uot; Bane said.

Vernon Stevens, administrator at Riverland Medical Center in Ferriday, La., said a similar group of Louisiana hospital administrators went to Washington the week after the Mississippi delegation went.

&uot;We went in about the same force they did,&uot; Stevens said. &uot;I didn’t get to go because of commitments here, but I heard they were well received.&uot;

Riverland has cut 25 positions either through layoffs or attrition over the last 18 months – most of those cuts coming in the home health section. Now the hospital staff numbers approximately 190 full time employees and 50 part-time employees.

Stevens credits Louisiana’s Rural Hospital Preservation Act with saving many rural hospitals in the state. &uot;The state pays hospitals a percentage of their uncompensated care costs,&uot; he said. Riverland has received 70 percent of their uncompensated costs back through this act. &uot;If it wasn’t for that, many rural hospitals would already be closed in Louisiana,&uot; Stevens said.

Stevens said he fears another increase in the minimum wage for hospitals already struggling to meet operating expenses.

&uot;Small hospitals have no way to pass on that cost,&uot; he said. Hospitals would likely cut positions to make up that extra expense.

Natchez Regional Medical Center has laid off 76 positions and cut three services since June 1998 due to funding shortfalls associated with the BBA.