Community and industry leaders are concerned about changes at Natchez Regional&160;Medical Center, brought about by a need to trim expenses.

The 1999-2000 budget includes cuts to both personnel and services in an attempt to bring the hospital into line financially.

The major cuts in the new budget will be elimination of the Level II&160;nursery and the skilled nursing unit and the reduction of staff hours in the operating room. These service changes will reduce paid staff positions by 36.

Virginia Salmon, president of the Adams County Board of Supervisors, said she understands the economic pressures that produced the budget cuts.

&uot;I&160;can see and respect the decisions the hospital is making because of general economic conditions,&uot; she said. &uot;Occupancy is down. Perhaps when the mainstream economy improves, that occupancy will increase.&uot;

David Cronic, assistant administrator of finance at NRMC, said the census at the hospital has dropped over the last several years.

According to hospital records, the average patients per day in 1996 at the hospital was 53.88; in 1997, it was 56.18; in 1998, it was 53.95; and in 1999, it has been 50.25.

Adams County supervisor Sammy Cauthen said he believes the cuts are a necessary part of running the hospital.

&uot;It’s a darn shame they have to do it, but it’s like running any other business. If you’re losing money, you’ve got to make the necessary cutbacks in services and personnel,&uot; Cauthen said.

Before the hospital made its cuts this year, hospital board president Billy Gillon anticipated a $3.8 million loss for the hospital’s 1998-1999 fiscal year.

The hospital has compensated for that projected loss by staff reductions in June 1998, staff reductions this month, and an anticipated profit of $1 million in year 2000, said Gillon.

Adams County supervisor Thomas &uot;Boo&uot; Campbell said he is concerned about the current management of the hospital.

&uot;Since that team has been on board, that hospital has gone down, down, down,&uot; he said.

&uot;My contention is that management team has been bad for that hospital,&uot; Campbell said.

Natchez Regional Medical Center is a county owned hospital managed by Quorum Health Resources of Brentwood, Tenn.

Mayor Larry L. &uot;Butch&uot; Brown emphasized that while the city has nothing to do with Natchez Regional’s administration or its board of trustees, he is disappointed to see the hospital have to cut professional jobs.

&uot;As unfortunate as it is, I would rather see that happen than see the hospital closed,&uot; he said.

One of Natchez Regional’s burdens, Brown said, may be that it must care for everyone who walks through the door – regardless of whether the hospital is reimbursed.

&uot;We need to educate our public that head colds and cuts and bruises are not necessarily something that requires treatment at a hospital,&uot; he said. Those treatments take a toll on the budget if the patient cannot pay.

Zack Nauth, director of Local 100 of the Service Employees International Union, said the Natchez Chapter of his union has witnessed other layoffs in June 1998 when NRMC laid off 40 positions.

&uot;It’s been a strange ride over the last years with Natchez Regional,&uot; Nauth said.

&uot;We’ve looked at their annual audited statements and they seem to be a fairly strong operation.&uot;

Nauth said unionized nurses have always been willing to share in the sacrifices to provide care, but they also want to be fully informed.

&uot;Natchez Regional has made too many decisions in closed meetings,&uot; he said. &uot;Our nurses have always fought to bring things out into the light of day.&uot;

Brent Alexander, Vice President of Government and Media Relations for the Mississippi Hospital Association, said the cuts Natchez Regional is making in their budget is reflected throughout Mississippi.

&uot;The Balanced Budget Act is especially devastating to rural hospitals whose most important payment source is Medicare,&uot; Alexander said.

Alexander said that hospital resources are being strained to a breaking point.

&uot;Hospitals across the state have cut fixed costs to the bone,&uot; he said. Mississippi’s rural hospitals do not have the cash reserves to offset the reimbursement shortfalls.

&uot;Hospitals don’t have the option to take care of patients, it’s what we do. We won’t provide lesser quality services. Hospitals will be forced to limit the type and scope of services, which will in turn force patients to drive greater distances to access these services.&uot;

Elaine Lewis, a registered nurse who works on 4 South at NRMC, said nursing staff at Natchez Regional is justifiably concerned about the budget cuts.

&uot;We’re real concerned about our hospital,&uot; said Lewis. &uot;We want to keep it open for the people in the county.&uot;

Lewis works nights at NRMC and said the information she gets is generally information through the hospital grapevine.

&uot;Morale is the lowest it’s ever been because we don’t feel like we know what’s coming next,&uot; Lewis said.

In the nursing services area, Lewis said layoffs were made according to seniority so that the last ones hired would be the first ones laid off.

Lewis said she is also concerned that services may become so restricted that the hospital won’t be able to meet the needs of the community when flu season comes in February.

Census goes up dramatically in the winter months hovering close to a full hospital, said Gillon.

&uot;We would anticipate watching our census very closely to establish a baseline for staffing. If we need to add staff again, we will,&uot; he said.

Lee England, M.D., Internist, said the changes at NRMC&160;should have no bearing on his practice.

&uot;It won’t have any bearing at all on what I&160;do at the hospital,&uot; he said.

Ken Stubbs, M.D., practice Internal Medicine and said he sees a growing trend in medicine toward slimmer work forces.

&uot;The biggest cost of running any hospital is personnel,&uot; Stubbs said. &uot;There will be natural fluctuations in staffing levels in the different seasons.&uot;

Stubbs also said he has noticed a higher staffing level at not-for-profit hospitals in the past.

&uot;Not-for-profit hospitals have traditionally carried an excess of employees. This cutback will actually bring Regional closer to the staffing level of other hospitals,&uot; Stubbs said.