Holy Cross Hospital CEO Bill Patten told Taos County Commissioners Tuesday (March 13) that the community hospital’s financial picture is improving, but a hospital union representative and two Holy Cross staff members later took to the microphone to say hospital morale remains in the red as a result of recent layoffs, unstable bedside systems and rapid change.
In January, Patten said the hospital hit a record-breaking $11.8 million in gross revenue, a financial milestone he attributed to the high volume of transactions processed by the end of the month.
After paying contracts, writing off bad debt and covering standard operating costs, the hospital was left with about $162,000 in the bank. Still, Holy Cross sits at a $2.2 million operating loss this fiscal year, Patten said.
But Patten assured commissioners money has been set aside to cover the hospital’s next two pay periods, meaning that county mill levy funds will not be tapped for payroll expenses at this time.
After hospital administrators laid off about 16 employees in January, payroll expenses were reduced by about $300,000, one factor that allowed the hospital to come in $109,000 below budget that month. While Patten was not planning additional payroll cuts on Tuesday, he reiterated that the hospital is still looking to cut non-essential services.
Administrators are seeking input from the local community regarding which services they could do without. Patten said the hospital has already identified three “smaller departments that lose over $500,000 a year,” but didn’t say which ones. He is also planning to eventually eliminate locums, temporary hospital workers that he said can be expensive.
Most of the commissioners and Taos County Manager Leandro Cordova lauded Patten’s financial report. District V Commissioner Candyce O’Donnell emerged as the lone critical voice.
As Patten discussed cutting services, O’Donnell pointed to one that may be missing, questioning what role the hospital has taken to combat the county’s deadly opioid epidemic.
In response, Patten acknowledged that the number of addicts the hospital sees has risen sharply in recent years. He said some stay on a gurney for days due to a lack of long-term treatment centers in Taos County and a shortage of beds at centers throughout the state.
Holy Cross maintains a social worker to assist addicts, but he added the hospital does not track the number it sees. When an addict leaves the hospital, he said, the social worker generally does not follow up.
O’Donnell requested that Patten return to future commission meetings with an estimate on the number of addicts that arrive at the hospital’s door, calling the current lack of tracking at the hospital “a problem.”
Lori MacIver, a nurse who has worked at University of New Mexico Hospital in Albuquerque since 2006 and is the New Mexico District President of the National Union of Hospital and Health Care Employees Union, described other problems she sees under Patten’s leadership.
While she acknowledged the shared struggles of rural hospitals, she believes that too many changes have taken place too quickly under Patten’s tenure, leaving “bedside” staffers, for example, without the resources they need to perform their jobs properly. One solution, she proposed, could be a partnership with UNMH, a hospital where Holy Cross patients are often transferred when they need a trauma center.
Martha Jaramillo, a union delegate and an intensive care unit nurse at Holy Cross, and Margie Cisneros, union vice president and a medical technologist who has worked at the hospital’s lab for more than 30 years, took turns at the microphone.
Jaramillo expressed frustration over what she called a “rough” rollout of the hospital’s new charting system that tracks crucial information on patient wristbands. She added the hospital’s internet has not been functioning properly, making it difficult to perform other basic duties, such as scanning medications.
Supplies, including masks worn by nurses when treating flu patients, have also been in short supply, she said.
Cisneros said that hospital staff has been overwhelmed by the rapidity of changes over the past year, adding that new systems installed months ago are still incomplete and difficult to use. She said she knows that change is necessary, but said the current approach has been ineffective, leaving gaps in service at a hospital that thousands of residents rely on.
“We need to have a vital community hospital here in Taos,” Cisneros said. “The people here deserve it.”