Porter Medical Center in Middlebury has laid off eight registered nurses. The small community hospital has lost $11 million since 2012.
Porter is now trying to cut costs and increase revenue.
Ron Hallman, Porter Medical Center vice president for development and public relations, says the hospital hasn't covered all its costs through patient revenues since 2012.
“It’s a difficult time, it’s a challenging time, there’s a lot of complexity and headwinds that community hospitals face in Vermont and across the country,” he said.
Lead by a new CEO, Lynn Boggs, the hospital is working to increase revenue. Recently it began offering cardiac testing and opened a new infusion center for patients needing intravenous treatments. The hope is to keep some patients from traveling to other hospitals for these procedures.
But Porter is also cutting costs. Last fall, it increased the number of hours part-timers need to work to qualify for health insurance. Managers are looking for efficiencies both in the hospital and at its 12 physician practices. Porter will also close Tapestry Midwifery, its certified nurse-midwife practice in Vergennes, and merge those providers into Addison Associates in OBS/GYN in Middlebury, which will be re-named Porter Womens’ Health.
And Porter Hospital also laid off eight registered nurses from the physician practices. Chief Medical Officer Dr. Carrie Wulfman says they plan to use more medical assistants.
“I think it’s inaccurate to say that we are replacing RNs with MAs because that’s not a replacement situation. It is utilizing a different sort of a team player in a situation where an MA would be appropriate and an RN may not be able to operate to the top of his or her license,” Wulfman said.
"I think it's inaccurate to say that we are replacing RNs with MAs because that's not a replacement situation. It is utilizing a different sort of a team player." - Chief Medical Officer Dr. Carrie Wulfman
“That is so insulting,” said Alice Leo, head of the Porter Federation of Nurses and Health Professionals, which represents registered nurses at the hospital. “A registered nurse has a role. When you go into the physician’s office and you have questions about your medication, you have a registered nurse who can answer those questions. A medical assistant can’t do that. When you call the doctor’s office because you’re not feeling well, you talk to a nurse who can help determine if you need to be seen today.”
Leo says the union understands the hospital’s financial challenges, but doesn’t think laying off front line caregivers is the right approach. The administration says they’d like those nurses to stay with Porter and consider one of the 20 open nursing positions at the hospital and nursing home.
Leo says the available positions, especially 12-hour shifts, might not work for nurses who are older, or who have families.
Porter Vice President Hallman says the changes will help the hospital improve its bottom line. And he says administrators are learning more about the all-payer health care system planned by the Green Mountain Care Board.
"When you go into the physician's office and you have questions about your medication, you have a registered nurse who can answer those questions. A medical assistant can't do that." - Alice Leo, Porter Federation of Nurses and Health Professionals
“For small community hospitals like Porter, we do not have a deep balance sheet. We really need to pay attention to these changes and make sure that we do everything we can to navigate these challenging times, because we’re working without a net,” he said.
Hallman says the hospital and its 780 employees will need to focus on quality if it wants to be around to serve the community and continue to be a major economic influence in Addison County.
