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Seeking to reduce $120M in its funds, Dartmouth Well being plans hiring freeze, job critiques

Editor’s Be aware: This story by Nora Doyle-Burr first appeared within the Valley Information on Jan. 21.

Dartmouth Well being, New Hampshire’s largest personal employer, has carried out efficiency enchancment plans and a “place assessment course of” at a few of its member organizations because it seeks to shut a $120 million funds hole by the top of September, in line with an e mail despatched to workers .

After an preliminary hiring freeze, DH officers have decided that every one open positions at Dartmouth Hitchcock Medical Middle and the Dartmouth Hitchcock Clinics are topic to a hiring assessment by the Place Management Evaluation and Medical Workforce Committees, in line with the Jan. 17 e mail obtained by the Valley Information. This assessment may also be required of job adjustments reminiscent of worker transfers, changes, promotions and filling positions after an worker leaves “for the foreseeable future.”

The Lebanon-based well being system will proceed to actively recruit for some key “Tier 1” positions that “are important to retaining sufferers secure and offering high-quality care.” Such positions embody those who would permit DH to interchange these at the moment stuffed by a staffing company; positions which can be at the moment understaffed and have a direct impression on scientific care; analysis positions which have a full two years of grant funding accessible; and positions required to satisfy regulatory necessities, in line with the Tuesday message.

Audra Burns, a DH spokesperson, confirmed by e mail on Friday that DHMC and the DH clinics have carried out a efficiency enchancment plan “to deal with our working and monetary challenges on this extremely advanced nationwide well being care setting.”

Separate efficiency enchancment plans are additionally in place for 2 different DH members: the Visiting Nurse and Hospice for Vermont and New Hampshire and Cheshire Medical Middle in Keene, New Hampshire.

The system additionally consists of Alice Peck Day Memorial Hospital in Lebanon, Mt. Ascutney Hospital and Well being Middle in Windsor and New London (NH) Hospital.

“MAHHC doesn’t have a hiring freeze and continues to actively recruit in lots of departments,” Dr. Joseph Perras, CEO of Mt. Ascutney, mentioned in a Friday e mail. “We’ll proceed our long-standing apply of reviewing each open place regularly to find out if that place continues to be wanted, and any new or non-budgeted place is at all times put underneath the microscope.”

Burns mentioned the continuing workforce scarcity is a “major contributor” to the well being system’s monetary challenges. In complete, the system employs about 12,000 folks. DHMC and the DH clinics had about 800 job openings listed on-line on Friday. Cheshire Medical Middle had about 150 openings, whereas every of the three smaller hospitals had near 100. Nearly all of the openings are for nursing or allied well being positions.

DH’s most up-to-date monetary outcomes, filed with bondholders in November, present that it ended the primary quarter of this fiscal yr on Sept. 30 with a $41.4 million loss, or practically 6%, on a virtually $770 million working funds. That loss included $1.8 million in federal stimulus funds, however the well being system wasn’t anticipating any extra federal stimulus cash this fiscal yr.

DH relied on $98.8 million in federal stimulus funds to realize a close to break-even consequence within the fiscal yr that ended June 30, when it had a $22.1 million loss, lower than 1%, on a $2.9 billion working funds.

The loss reported in November was largely on account of staffing challenges, together with a nationwide scarcity of nurses, which has pushed up the price of short-term nurses. DH can also be challenged by an incapability to discharge sufferers to different settings in a well timed method on account of a scarcity of beds and workers throughout the area. In the meantime, Covid-19 has continued to drive provide chain points reminiscent of product shortages and the price of drugs has risen.

In consequence, DH CFO Dan Jantzen informed bondholders in November that DH was “curbing capital spending as a lot as attainable to enhance liquidity.”

He additionally mentioned on the time that DH and its members “proceed to discover all choices to enhance our monetary efficiency.”

Fitch Rankings supported the concept DH can navigate its present challenges when in December it affirmed the “A” score on DH’s bonds, calling it “secure.” The score displays the function DH performs “because the main acute care supplier in a broad, multi-state and demographically secure market,” in line with Fitch’s Dec. 14 assertion.

The scores company mentioned it believes DH’s “robust market place” and “excessive acuity affected person combine” will permit it to “preserve a stable monetary profile” sooner or later.

On this week’s missive, DH officers mentioned the group’s efficiency enchancment plan job pressure is concentrated on three most important areas: income enhancement, margin enchancment and expense discount.

On the income entrance, DH goals to extend its skill to satisfy demand for outpatient companies at DHMC and its clinics in southern New Hampshire; enhance coding and documentation to make sure it captures “applicable reimbursement” for companies; and enhancing the charges it is paid by industrial insurers partially by opening up negotiations on multi-year contracts forward of schedule.

To handle margin enchancment, DH seeks to develop companies the place new bills are lined by will increase in income, together with growth in pharmacy companies.

To chop prices, DH is trying to scale back the price of provides; discover extra environment friendly methods to handle its workforce; and is welcoming workers’ solutions for additional concepts.

In the meantime, DHMC is slated to open its new $150 million affected person pavilion this spring. The pavilion, for which funding was secured previous to the Covid-19 pandemic, will open 64 new beds in early Could, however on the similar time DHMC will shut one 36-bed affected person care unit for renovations, in line with the worker e mail this week . Subsequently, it can simply have to workers a further 28 beds to begin. DH is at the moment working to make sure that workers are employed and able to look after folks within the new beds.

“We’re experiencing bigger affected person volumes than ever earlier than,” the e-mail mentioned. “We have to meet the elevated demand for offering high-quality care in probably the most medically-appropriate setting, which is commonly the tutorial medical middle.”

As well as, DH is anticipating to learn from the associated will increase in income.

“Expanded entry will place us for the longer term and positively impression our monetary efficiency,” the e-mail mentioned.

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