Memorial cutting 212 jobs

Santa Rosa Memorial Hospital will close the only inpatient psychiatric care unit in Sonoma County and lay off 212 employees as part of cost-cutting efforts, hospital officials announced Wednesday.

George Perez, the hospital's president and chief executive officer, said the cutbacks will save $7.7 million and help stave off a looming deficit.

In addition to the psychiatric unit, Memorial plans to close its skilled nursing and acute rehabilitation units. The closures and layoffs take effect in 60 days.

"We are at a loss situation," Perez said at a news conference at the hospital. "We have been able to mask the losses in these programs over 18 months, but we are losing money."

The closure of the 18-bed psychiatric care unit comes less than a year after Sonoma County essentially closed its only mental health facility, retaining only emergency services.

Memorial officials conceded the closure creates a void in the county's health care system but said it was increasingly difficult to staff a psychiatric unit.

"It is clearly a gap, we see that," said Dr. Gary Greensweig, the hospital's medical director. "It became a bigger gap when the county closed their program a year ago."

The gap has become a concern for advocates and law enforcement, with police and sheriff's deputies often being call on to assist people with mental health problems.

Three such calls have ended with officer-involved shootings in the past 11 months.

"It is a larger issue than just Sonoma County, but it is an issue for Sonoma County," Sheriff's Capt. Dave Edmonds said. "It is difficult to give a measurement of the impacts on law enforcement, but I think a loss of that resource will be felt."

The closures also come as Memorial negotiates with Sutter Health, which wants to close its Santa Rosa hospital and transfer its county health services contract to Memorial.

Those talks will not be affected by the closures, Perez said.

All three of the affected facilities are separate from the main Santa Rosa Memorial Hospital.

The 31-bed skilled nursing unit is on Sotoyome Street. The 15-bed acute rehabilitation unit and the psychiatric unit are on Fulton Road. An urgent care unit on Fulton and a palliative care program on Sotoyome will remain open.

The units being closed were acquired as part of the purchase of North Coast Rehabilitation Center by Memorial Hospital in 1998, Perez said.

The skilled nursing unit has 46 employees and currently has 22 patients, the acute rehabilitation unit has 38 employees and eight patients, and the inpatient psychiatric unit has 55 employees and eight patients.

Jobs also are being eliminated for 51 employees who provide therapy and other support services to the skilled nursing and acute rehabilitation units and 22 people who work outside patient care throughout St. Joseph's Health System.

Perez said the cuts were being made because the hospital was falling short of meeting its break-even point of $400 million in revenue this fiscal year, which ends June 30.

St. Joseph's employs 2,922 workers at Memorial and Petaluma Valley hospitals.

The last time Memorial had layoffs of this magnitude was 1988, according to a hospital spokeswoman.

Perez said the units that are being closed have been a financial drain on the hospital.

"It's hard to be all things to all people," said Mark Knight, Memorial's vice president of strategic services. "The trend in health care is to focus on what you're good at."

Hospital officials said the closures will not affect Memorial Hospital's core services, which include the emergency room, operating facilities, obstetrics and inpatient care.

"I see it as an opportunity to make these core services stronger," Greensweig said.

Greensweig said there are other facilities in Sonoma County that provide skilled nursing and rehabilitation services.

The inpatient psychiatric unit, though, was the last one in Sonoma County, following the closure of the Norton Center last June.

Greensweig said Memorial's inpatient clinic was not only losing money, but also was not able to provide consistent care because of the difficulty of hiring and keeping psychiatrists.

The unit at one time had eight psychiatrists on staff, but now is served by two traveling and one part-time psychiatrist because of low insurance reimbursement rates. It is licensed for 38 beds but has been staffed since last year for 18.

"Some of it has to do with the payment mix," Greensweig said. "The reimbursement was 25 cents on the dollar."

Greensweig said people needing inpatient care will have to go outside Sonoma County. The closest facilities are in Napa, Marin and Solano counties.

Memorial's emergency room will have to gear up to deal with psychiatric cases on a short-term basis.

The 212 employees facing layoffs include nurses, technicians, clerks and food service personnel, among others, said Debra Miller, the vice president of human resources.

Miller said they will be first in line for the 120 current openings at St. Joseph's Memorial and Petaluma Valley hospitals in Sonoma County and for openings at Queen of the Valley Hospital in Napa.

With the need for health care professionals, Miller said, "the majority will find positions within this geographic region, but some will not."

You can reach Staff Writer Bob Norberg at 521-5206 or bob.norberg@pressdemocrat.com