The Washington Hospital Center, the area's largest private hospital, is reducing its capacity and laying off employes because of an apparent shift of patients from the massive institution to smaller hospitals in the surrounding suburbs.
The center lost $608,000 in June and between $400,000 and $500,000 in July, hospital spokeswoman Jane Snyder said.
The losses reflect a growing national shift of hospital use from the inner city to the suburbs - a shift ex-acebrated at the hospital center by a 31-day strike of registered nurses two months ago.
At the beginning of the year, the 911-bed hospital was caring for more than 683 patients that it needs to serve in order to break even. Since then, the hospital has reduced its capacity to only 871 beds and is caring for only about 591 patients. This is well below the break-even point of 75 to 80 percent.
During the strike, the number of patients cared for varied, but it never rose out of the 500s.Hospital officials had hoped that the number of patients cared for would rise to about 730 daily after the strike ended on June 26, but that never happened.
As a result, the hospital has begun to lay off more than 5 percent of its 3,000 employes, Snyder said.
Snyder said the layoff notices are being handed out in all departments, which would include nurses, maintenance workers and others except physicians. that's hard money we have to spend,"
"We have to meet a payroll every two weeks of $1.4 million - $1.8 million including fringe benefits - and Synder said. "In your own house you can only go for so long spending more than you're bringing in."
Those who have watched the situation closely say that the nurses' strike may have made the situation worse because it forced some physicians to use other facilities, mainly in the suburbs, and those physicians then found the suburban hospitals to be more convenient and just as good for routine services as the larger hospital center.
George Washington University, a major downtown beneficiary of patient shifts during the strike, was still operating at about 91 percent of capacity - well above normal - a month after the strike.
Snyder said the center is doing very well in such specialties as open heart surgery and cardiac care, but has lost patients who would have come in for what some term "bread and butter" operations, such as hernia repairs, which can be performed almost anywhere.
The administrator of a major hospital in the suburbs said that the loss of patients by inner-city hospitals to those in the surrounding suburbs is a "trend you can see across the country. All the inner-city hospitals are having trouble with suburban jurisdictions.
"As people have moved into the suburbs for their jobs they're no longer dependent on the inner city," he said. "They don't work there and they don't shop there. In metropolitan Washington most all doctors have two to four offices. Even the doctors downtown have a foot down on K St. and a foot out here. I know surgeons who work a day a week over in Clinton and then a day" in other suburbs.
"I would say if the hospital center is in fact laying off (employes) and closing beds, that could happen in the suburbs as well as in there. That is an appropriate, healty reponse to an underutilized facility [President] Carter. [Health Education and Welfare Secretary Joseph] Califano and all the rest said this is what hospitals have to do, close down the assembly line when it is not being used."
According to Snyder, the opening of new hospitals in Laurel and in southern Prince George's County has been one of the factors that have hurt the center.
The last time the hospital center experienced a decline in patient use was in 1973, she said. "We laid off 200 employees then and 1974 was the biggest year we'd ever had. Employes are being informed this week and we are trying to inform them as soon as possible. This is an across-the-board cut, but because of attrition," there will probably not be as many nurses laid off as other employes.
Nurses have a particularly high turnover rate at the hospital center and at many other Washington institutions, making it possible to do less trimming in that department.
One of the major concessions won by the nurses during their strike was hospitalwide seniority for layoffs and recalls of nurses. Thus nurses will be laid off on a last-hired, first-hired basis, and because the center launched a hiring campaign during the strike, it seems unlikely that any striking nurses will be laid off. The hospital's notification of layoffs comes just days before yet another round of labor negotiations is scheduled to begin, this with the Service Employees International Union, which represents about half the center's employes.
One of those in the first group of employes receiving termination notices was John Monte, who has worked for the hospital center or its predecessors for 32 years. Monte, foreman of the three-man maintenance crew in the radiation department, said he received his notice Friday and it was "such a shock" he didn't do anything about it them. He said the other two workers in the department have about five- and ten-year's seniority. Monte, however, is the only foreman.
Snyder said the hospital Center's personnel department is attempting to work with other area hospitals to find jobs for employes who are laid off.