More than half of the 82 hospitals that responded to a recent Tennessee Hospital Association survey have already cut staff, in the face of rising costs and tight revenue, with most of the rest considering cuts.
Roughly the same breakdown of hospitals have either reduced services or are thinking of reducing them because of the recession and a spike in uncompensated care, said the association's chief executive, Craig Becker.
"Everybody is looking right now for places where they can save money and keep their core business going," Becker said Monday.
The organization, which represents more than 125 Tennessee hospitals, conducted the survey Dec. 15-24.
Forty-three of the responding hospitals said they've cut jobs, though the survey didn't ask about the types of jobs. Eighty-five percent said they've put a freeze on hiring or are considering it.
Association spokesman Phil Martin said all types of hospitals in all areas of the state are affected. Cuts at Erlanger Medical Center in Chattanooga, Sumner Regional Medical Center in Gallatin and Le Bonheur Children's Medical Center in Memphis alone represent more than 400 jobs, he said.
"In terms of membership surveys we do, this is as good a cross-section as we find," Martin said.
Becker said more than three-quarters of hospitals in the state have experienced a drop in elective surgeries, which tend to be moneymakers for hospitals.
At the same time, 95 percent have seen costs grow for charity care, the medically indigent and bad debt. With unemployment on the rise, things are expected to get worse.
The survey shows that emergency department visits increased at two-thirds of the hospitals, while the number of patients seeking care for behavioral health needs — a symptom of a slumping economy, according to the hospital association — is up at 38 percent of them.
The association also says the value of invested hospital reserves is down across the board, adding to the hardship. Earlier this year, Trinity Hospital in Erin filed for bankruptcy.
Besides cutting jobs and services, the association says hospitals are delaying vendor payments, trimming administrative costs, delaying pay raises for employees and postponing construction and information technology projects.
"I have not seen a recession hit health care as this one has in the 30 years I've been in this business," Becker said.
With a new state Legislature preparing to convene next month, he hopes lawmakers will be "gentle" with the state's TennCare program.
"We recognize that the state has big problems, but if they're going to cut as much as they're talking about out of TennCare, it's only going to make things worse," Becker said.