Valley News – Dartmouth Health looking to cut its budget by $120 million, plans hiring freeze, job review

LEBANON — Dartmouth Health, New Hampshire’s largest private employer, has implemented performance improvement plans and a “situation review process” at some of its member organizations as it seeks to close a $120 million budget gap by the end of September, an email said. According to the employees.

Following an initial hiring freeze, DH officials have determined that all open positions at Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Clinic are subject to position control review and hiring review by the Clinical Workforce Committees, as per a January 17 email was received by Valley News, This review will also be necessary for job changes such as employee transfers, adjustments, promotions, and filling positions after an employee leaves “for the foreseeable future.”

The Lebanon-based health system will continue to actively recruit for certain key “Tier 1” positions that are “essential to keeping patients safe and providing high-quality care.” Such positions include positions that would allow the DH to replace positions currently filled by the staffing agency; conditions that are currently underreported and that have a direct impact on clinical care; research positions that have a full two-year grant available; The posts needed to meet regulatory requirements, according to Tuesday’s message.

DH spokeswoman Audra Burns confirmed by email Friday that DHMC and DH Clinics have implemented a performance improvement plan “to address our operational and financial challenges in this highly complex national health care environment.”

There are also separate performance improvement plans for two other DH members: Visiting Nurse and Hospice for Vermont and New Hampshire and the Cheshire Medical Center in Keene, NH.

The system also includes the Alice Peck Day Memorial Hospital in Lebanon, the Mount Escutney Hospital and Health Center in Windsor, and the New London Hospital.

“MAHHC does not have a hiring freeze and continues to actively recruit in many departments,” Dr. Joseph Peras, Mount Ascotney CEO, said in an email Friday. “We regularly review every open position to determine if there is still a need for that position, and any new or non-budget positions are always placed under a microscope. Will continue his long-standing practice of

Burns said the current workforce shortage is a “primary contributor” to the health system’s financial challenges. Overall, the system employs approximately 12,000 people. Around 800 jobs were listed online on Friday in DHMC and DH clinics. The Cheshire Medical Center had about 150 openings, while the three smaller hospitals each had closer to 100. Most of the openings are for nursing or allied health positions.

DH’s most recent financial results, filed with bondholders in November, show that it ended the first quarter of this fiscal year on Sept. 30 with a loss of $41.4 million, or about 6%, on an operating budget of nearly $770 million. Finished it. That loss included $1.8 million in federal stimulus funds, but the health system was not expecting more federal stimulus money this fiscal year.

DH relied on $98.8 million in federal stimulus funds to achieve a near-break-even result in the fiscal year ended June 30, when it lost $22.1 million on a $2.9 billion operating budget, less than 1% .

The reported losses in November were largely due to staffing challenges, including a nationwide shortage of nurses, which has driven up the cost of temporary nurses. DHs are also challenged by the inability to discharge patients to other settings in a timely manner due to a lack of beds and staffing across the region. Meanwhile, COVID-19 has continued to raise supply chain issues such as product shortages and drug costs.

As a result, DH CFO Dan Jantzen told bondholders in November that DH is “reducing capital spending as much as possible to improve liquidity.”

He also said at the time that DH and its members “continue to explore all options to improve our financial performance.”

Fitch Ratings supported the view that DH could navigate its current challenges when in December it affirmed the “A” rating on DH’s bonds, calling it “stable”. 14 statement from Fitch, DH reflects on the role “as a leading acute care provider in a broad, multi-state and demographically stable market.”

The ratings agency said it believes DH’s “strong market position” and “high acuity patient mix” will allow it to “maintain a solid financial profile” going forward.

In this week’s message, DH officials said the organization’s performance improvement planning task force is focused on three main areas: revenue growth, margin improvement and expense reduction.

On the revenue front, DH aims to increase its ability to meet demand for outpatient services at DHMC and its clinics in southern New Hampshire; improving coding and documentation to ensure “fair reimbursement” for services; and improving rates paid by commercial insurers by starting to negotiate multi-year contracts ahead of time.

To address margin improvement, DH seeks to develop services where new spending is covered by increased revenue, including expansion into pharmacy services.

To cut costs, DH seeks to reduce the cost of supplies; Find more efficient ways to manage your workforce; And is welcoming staff suggestions for further ideas.

Meanwhile, DHMC is set to open its new $150 million Patient Pavilion this spring. The Pavilion, for which funding was secured before the COVID-19 pandemic, will open 64 new beds in early May, but at the same time DHMC will close a 36-bed patient care unit for renovations, according to employee emails this week . Therefore, it would require an additional 28 beds to start with. DH is currently working to ensure staff is hired and ready to care for people in the new beds.

“We are experiencing higher patient volume than ever before,” the email said. “We need to meet the increased demand by providing high-quality care in a medically appropriate setting, which is often an academic medical center.”

In addition, DH is expecting to benefit from a related increase in revenue.

“The expanded reach will prepare us for the future and positively impact our financial performance,” the email said.

Nora Doyle-Burr can be reached at [email protected] or 603-727-3213.


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