published Thursday, December 22nd, 2011

Erlanger hospital's management plan outlines furloughs, buyouts and also possible layoffs

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    This is a part of the Erlanger campus as shown near downtown Chattanooga on Wednesday.
    Photo by Tracey Trumbull.
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Erlanger hospital employees have been asked to take 12 days off in the next two months, consider voluntary buyouts and face possible layoffs as Chattanooga's only public hospital bleeds money.

The hospital has lost more $6 million in the last five months, half of that in November.

The hospital outlined their labor management plan for 2011-12 in an email sent to managers on Monday. The Times Free Press obtained a copy of the plan.

"We understand that this is a difficult message to hear, however it is vital that we take swift action to overcome our financial challenges," the plan states. "If we don't take immediate steps, we have the potential to affect our strong bond rating, leading to disastrous results for Erlanger and (the) community we serve."

Erlanger officials did not respond to repeated emails and phone messages requesting more information throughout the day on Wednesday.

While patient admissions at the hospital have increased this year, monthly fiscal reports show surgical outpatients and outpatient revenue has fallen.

The cost-cutting measures come during a time of turmoil for the hospital, with the departure of a seven-year CEO and questions over board appointments.

In October, the hospital announced CEO Jim Brexler would retire at the end of the year. Chief operating officer Charlesetta Woodard-Thompson has been named interim CEO.

The board voted earlier this month not to give Brexler a more than $700,000 severance package, but the issue may be brought back up, board members have said.

County officials recently appointed a new board member after some members of the board asked them to wait on the appointment, while city officials said this week they would wait to approve a new appointment until the turmoil over Brexler's resignation died down.


The two-page plan outlines several ways the hospital will cut costs over the next three months, noting labor represents 50 percent of costs at the hospital. The plan asked managers to meet with employees to discuss the measures before noon on Wednesday when the information was posted on Erlanger's intranet site.

The hospital has about 4,700 employees.

Some departments will require that all full-time employees take 12 days off before March 1, using their paid annual leave.

Salaried employees should work if they do not have enough paid annual leave to cover their time off, the plan says.

The measure will save $1.4 million by the end of June, the plan says.

It was not clear if the policy applied only to Erlanger hospital employees or the Erlanger Health System. Erlanger has five Tennessee-based medical campuses and took over management of Hutcheson Medical Center in Georgia earlier this year.

According to newspaper archives, most Erlanger employees accrue about one vacation day per pay period. At the time the employee earns that vacation day, Erlanger records the expense.

As employees take days off, the hospital draws from the bank of accumulated "paid" days, which means it doesn't have to pay again for days that were already recorded as expenses. The result is reduced labor expenses in the pay period in which paid time off is used up, archives noted.

Erlanger spokeswoman Pat Charles did not respond to questions about how many employees will be affected by the policy or how the hospital would ensure proper patient care with employees taking off 12 days in two months.

The plan also says some departments cannot work premium overtime hours and other departments cannot exceed budgeted overtime hours, beginning Jan. 1.

The $5 premium for working extra shifts will be eliminated on Feb. 1, the plan says.

A voluntary buyout program will be implemented in select departments in beginning in January.

The hospital is not implementing a job-hiring freeze but will review all current and future open positions to evaluate which positions are not needed, the plan says.

The plan also notes there may be layoffs.

"We also anticipate that positions will be eliminated in selected departments, starting with the executive level," the plan says.


In response to questions about the labor plan, Charles sent an email noting that Memorial Health Care System was also implementing reductions in staff time.

"Assume you are calling others to see if they have implemented similar labor management plans," Charles wrote in the email to the Times Free Press.

Memorial spokesman Brian Lazenby said Memorial asked nonclinical and office staff to take off four days between Christmas and New Year. All other staff would work a regular schedule during the holidays, he said.

Lazenby said he did not know how many of the hospital's 4,300 employees were affected. He said the hospital was not implementing any additional furloughs.

"The economic recession of the past four years has been difficult for all industries," Lazenby said in an emailed statement. "Memorial has identified a host of projects to ensure strong performance for the remainder of our fiscal year, and one of those is related to the flow of work in areas that are not directly related to patient care."

Alison Counts, spokeswoman for Parkridge Health System, said the hospital did not anticipate any layoffs, furloughs or other cost-cutting measures at this time.


Erlanger's board will meet in a special called meeting sometime next week, according to board trustee James Worthington.

Worthington said Wednesday he did not have much information about the labor plan, but said it was important that the hospital return to firmer economic footing.

"Someone has gotten us in a terrible situation at Erlanger. We must find some way to get ourselves in a better economic situation," he said.

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about Mariann Martin...

Mariann Martin covers healthcare in Chattanooga and the surrounding region. She joined the Times Free Press in February 2011, after covering crime and courts for the Jackson (Tenn.) Sun for two years. Mariann was born in Indiana, but grew up in Pennsylvania, Tennessee and Belize. She graduated from Union University in 2005 with degrees in English and history and has master’s degrees in international relations and history from the University of Toronto. While attending Union, ...

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ThinBlue706 said...

Honest question. How much of the $6 million shortfall has been spent on the following:

  • Uninsured "victims" and true victims of gang violence.
  • Victims of repeat offenders that should have been incarcerated at the time of the attack.
  • Children and elderly victims of violence.
  • Illegal immigrants...including birthing "anchor babies".
  • Uninsured d.u.i.'s and their victims in accidents.
  • Victims of alcohol abuse in general.
  • Lastly and possibly the most costly, the uninsured, homeless or welfare patient that goes to the e.r. every time they have a runny nose, stub their toe, or need a warm spot to sleep.

I am not attacking any of the above. How much of that taxpayer money and lives could be saved by demanding stiffer sentencing of gang as well as domestic violence? How about stiffer enforcement and sentencing of d.u.i.'s? Immigration laws? Demand the Federal government abide by and enforce the Constitution. How about a triage system for the uninsured. Guarantee needed health care, but put the "pretenders" out. No more $1000 taxpayer ambulance rides at 0300 because you are drunk and cold.

I am empathetic to those that truely need taxpayer funded health care. But, save our taxpayer dollars and spend it wisely on those that deserve it and/or have earned it. When are those blatantly abusive of our "free" health care system ever going to be held accountable?

December 22, 2011 at 8:05 a.m.

Thinblue....Erlanger has a public mission to assist the weakest among us in our society....what you are missing is the longer list of inept moves by the leadership of the hospital system over the last five years. Oh, and by the way, you sound like one of those dried up GOP dinosaurs that will soon be extinct....

December 22, 2011 at 8:33 a.m.
AlmostAmanda said...

I wonder how much Erlanger has spent advertising in and around the Chattanooga area. The production costs combined with fairly regular air time on TV and radio had to be expensive. Given that people in Chattanooga already knew about the hospital's benefits, I see no reason why they felt the need to invest so much in promotions.

December 22, 2011 at 9:16 a.m.
ThinBlue706 said...

BillyBob, I agree with you on two accounts. Erlanger has a mission, as ALL hospitals do to assist the weakest in our society. Second, there have been terrible waste and bad management at or near the top of Erlangers hierarchy. What I am asking is how much money is being spent on street level issues that can be rectified under current local, state, and federal laws and statues. I am all for helping those in need. I volunteer hundreds of hours a year, I have a direct draw from my account every month to a charitable organization to help the needy. But, there is a significan minority of the "needy" that use and abuse the system. The charitable group I volunteer for, and donate to, does alot of work with spanish-speaking immigrants. I know some of my money goes to help illegals, I know some of my time is spent helping illegals. I don't care about that AS LONG as they are trying to become legal citizens and start to live THEIR American Dream. Just be responsible.

How about the gang issue? A serious gunshot wound can cost hundreds of thousands of dollars. Mostly taxpayer expense. We then turn this healed gang member out on the street. They go and extract their revenge on another. More expense. Why should the American taxpayer be saddled with these bills? The innocent victims are another issue. The same with domestic violence. We have a duty as society to care for the these victims of senseless violence. Whether they be collateral damage from gang violence or targeted abuse of a domestic attack, these victims deserve the best we can offer. BUT, put away the abuser, gang member, rapist, and so on to where the abuser can not run up a larger butchers bill and hospital expense for the taxpayer to swallow.

One last thing, I never called names, made fun of, or used derogatory slang names for any of the people(s) I have discussed. Why is it the apparent left-wing liberal, the ones that believe in tolerance for all, using derogatory terms like "dried up GOP dinosaur" and wishing them "extinct". Isn't that dead? I ask for fiscal and self-responsibility of EVERYONE, and I am wished extinct?

December 22, 2011 at 9:18 a.m.
Facts said...

I don't know & don't care who billybobbillygoat is but running a public hospital should have no partisan concern. I'd almost be willing to bet you're on the board & part of the problem. And Thinblue, I'd be willing to bet you've met my wife in the ER scraping some of Chattanooga's "victims of society" out of the back of your squad car. If the average citizen understood what Erlanger "had" to accept that Memorial or Parkridge refused in the way of patients, I'd hope our community would refuse to patronize the private hospitals. Maybe BillyBobantiGOP could explain why it's ok for those hospitals to dump on Erlanger-without blaming Pres. Bush, big business, or the rich. It's simple. Our community allows it.

December 22, 2011 at 9:21 a.m.

Thinblue...."extinct" longer in use; obsolete: an extinct the "know-nothing party" or the "trickle down economics"....

December 22, 2011 at 9:36 a.m.
ThinBlue706 said...

Facts, I delivered my fair share of both the victims of irresponsibility and well as the irresponsible to Erlangers' E.R. department. Both from the back of my squad car as well as from the back of my ambulance as a medic. I find this experience makes me both more empathetic to the ones in need and deserve it as well as more spiteful for the ones that do not.

As always, when dealing with Erlanger, in the end the two (2) classes of people that will be hurt by these cuts are: (1)The truly needy patients in the e.r. that due to volume, get overlooked or have hours long waits. (2)The day-to-day, in-the-trenches Erlanger worker. Forced to take your vacation time when management tells you to. Possible lay-offs right after Christmas. Short-staffed due to forced vacations/days off and then held responsible when the feces hits the rotating oscillator. Yeah, I have ridden that ride at the amusement park before also.

December 22, 2011 at 9:37 a.m.
ExecAsst said...

Here's my take: 1) ThinBlue706 is right 2) billybobbillygoat is a whiny pathetic liberal (I hate to insult people but I'm sick of hearing it) 3) If more people thought like the "dried-up GOPers" (as billybobbillygoat so eloquently put it), then maybe this country wouldn't be in the shape it is in today with all of the whiny pathetic liberal ideas and we could go back to the good, moral, traditional values that this country was built on: Godly values.

December 22, 2011 at 9:51 a.m.
ThinBlue706 said...

Ah, but when "extinct" is used towards a living creature, dinosaurs were living creatures, the word means the entire species is dead. You are right about the Repbulicans having extinct customs such as this one you may have heard of, The Emancipation Proclamation. Freed an entire race of people from slavery. Balance that with such forward thinking Democrats as George Wallace and his followers. All of this said "tongue-in-cheek" to show that no one party has a monopoly on good or bad. The demonization of "parties" or "peoples" is easy, but incorrect and inflammatory. As long as these type of road blocks are thrown down, by the right and left, by neo-cons and liberals, by republicans and democrats, NOTHING is going to be accomplished EXCEPT the ruination of our econmy and ultimately our country.

December 22, 2011 at 10:03 a.m.
duckhunter said...

My wife is a RN at Erlanger and I know first hand how horrible management is at Erlanger but I think that is such a small part of why they are tanking. The real problem is that there are not enough paying customers to cover the overhead for the leeches that get free healthcare. I know some are really needy but the majority are just section 8 bums. Because of these bums my wife who has saved up her vacation days for the birth of our daughter will not have any vacation and possibly no job when she returns. Liberalism is a disease that we can see eating away at Erlanger.

December 22, 2011 at 10:05 a.m.
ExecAsst said...

Right on the money duckhunter! That is a shame about your wife saving up the vacation for your daughter's birth and now she will be forced to use it elsewhere. Absolutely not right, makes me angry!!! Liberalism is DEFINITELY a disease and will be the destruction of this nation unless something miraculously changes.

December 22, 2011 at 10:10 a.m.
mkelley said...

Erlanger is in the business to help. They've given away at least $50 mil per year in uncompensated care. All while Hamilton Co. & Chattanooga only assist with less than $5 mil in help. If you think this is unfair, ask yourself, if someone was hurt in an accident would you just allow them to die because they can't afford the treatment? We're not just talking about common colds, but killer accidents and illnesses.

As far as why they still run ads, they still have to compete with for-profit hospitals like Memorial and Parkridge - all who don't have to open books or tell the media about their problems. As far as TV time, it's relatively cheap in Chattanooga.

December 22, 2011 at 10:51 a.m.
SandraOnSignal said...

Didn't the majority of the losses happen quite recently? I think it was the number of surgeries or something like that according to one of the stories. Did that business go elsewhere? If so, why? Instead of blaming the hospital, why don't you ask the Doctors why they moved business.

December 22, 2011 at 11:28 a.m.
ThinBlue706 said...

Sandra: You mention the many surgeries lately that have cost a significant amount. Think about how many gang related shootings, stabbings, and violent attacks we have had in Chattanooga in the last six (6) months. Each one of those potentially over $100k+. Some of them life time debilitating injuries that will never recover. All the while Erlanger and the taxbase is responsible. If you could check, you would find that none of the victims had self-pay or partial pay (job related) insurance. Good old Joe Taxpayer with his wallet out. This does not even take into account the innocents that have been wounded that DID have insurance and had to pay their deductables. MKelly is correct when he states we can not just let someone die because they can not pay. What we CAN stop is the reoccurance of the these crimes that costs Erlanger (taxpayer) so much money. We CAN stop the fraudulant abuse of the system and we CAN vote for candidates that promote fiscal responsibility. We CAN hold CEO's and upper management RESPONSIBLE for their actions. Quit punishing the workers of Erlanger such as duckhunters' wife and 4500+ others and hold the managers accountable. Want to save money? How about the upper management each "donating" a month salary to the hospital. Let duckhunters' wife have her time off to have a child. We the people have allowed this to happen. We the people can fix it.

December 22, 2011 at 12:02 p.m.
Walden said...

Sandra said, "Instead of blaming the hospital, why don't you ask the Doctors why they moved business."

Uh, Sandra, if the Doctors are moving to the OR's of other hospitals, it is precisely because of something the hospital did to piss them off. The two cannot be separated.

December 22, 2011 at 3:54 p.m.
Facts said...

Just a bit of clarification. The decline in surgeries is most likely the result of patients choosing other doctors rather than the ones on campus at Erlanger. Don't forget Erlanger paid a settlement (a negotiated fine)of $40 million because of contracts physciians and their practices had with Erlanger for referrals. From the buzz around the Baroness, doctors are wanting preferred contracts with Erlanger and didn't get what they wanted and fired the block. This Board is either dim or all in the pocket of these doctor groups who are going to get Erlanger right back in the same mess. I want my wife to change jobs before she gets the "down-size". It may be a blessing in disguise.

December 22, 2011 at 9:37 p.m.
Littleoleme2 said...

Let's get real.
Several months ago the mangers at Erlanger received nearly two million dollars in bonuses.

This spring Erlanger formed a partnership with Hutcheson Medical Center, a hospital losing 1 million dollars a month.

Also this year Erlanger opened a new facility at VW.

A couple of months ago Erlanger paid Ritz Carlton $500,000 dollars for service improvement, which along with forcing hundreds of employees to purchase new uniforms, informed them that they would need to wear "nice clothes" as they walked in from the parking lot before changing into their new work attire.

A week or so ago, 1/2 the board voted to give the captain of this disaster a $700,000 severance package.

The problem is the board. They subscribe to the Red Bank, East Ridge, and Chattanooga City Council form of leadership: Help your buddies at all costs and be held accountable for absolutely nothing.

We can talk about care for the poor all day long--and it is partially accurate, but in the end, it's bad decision making and classic nest feathering that's the root of Erlanger's problems.

December 22, 2011 at 10:06 p.m.
Movingon2 said...

Lets face it. The state that Erlanger is currently in can not be blamed on any one factor. There are multiple contributing factors. Most of you that have commented all have valid points and I agree with statements that many of you have made. I do feel that there needs to be a better ER triage system. The ER is constantly seeing people that are homeless and just want to be out of the cold, they are constantly seeing people with headaches, toothaches, sorethroats, and runny noses. There should be a triage system in place that immediately identifies these folks as not having "an emergency medical condition" and promptly refer them somewhere they can get the proper level of care (PCP's, walk in clinics, etc...). These people continue to abuse the ER because we let them. A system needs to be put in place to weed these people out. The ones that do not meet criteria for emergency level of care should be required to pay a fee up front (just like you would at a Dr office). What is happening is that we are allowing people to use the ER as a primary care doctor and we are never seeing any fees for the service we provide. If required to pay up front for non emergency care (again just like you would at a Dr office) people would not abuse the ER in the way they do.

December 22, 2011 at 11:35 p.m.
dju2207 said...

There are valid points, concerns and opinions expressed here and some are informed and others are common sense and some are a little out there. What I know is that we DONT know the real story. This paper seems to do a great job at putting just enough information into an article to create controversy and get people fired up for a day, a week or a month. It is sensationalism and irresponsible journalism that is running rampant across our country and we just buy into it all of the time. I catch myself at times as well. Erlanger has obviously not had a good year, but their last few have been good and since I am not a board member just the spouse of a physician at Erlanger, I am going to reserve my judgements, name calling and finger pointing until I can obtain more and accurate information. The information around the water cooler at the hospitals is gossip laced with truths, the reports in paper are little teasers skewed to support opinion of author or create controversy. My point is all of these opinions need to be respected because they are someone's personal beliefs, I choose to gather real information that is as complete as possible on the topic before I express all of my righteous indignation. SHAME on the Times News Free Press and the people in charge there for supporting writers that don't provide us with enough information to express informed opinions that could make a difference in our community.

December 27, 2011 at 10:35 a.m.
hjussila27 said...

Somehow, a labour management plan always gives rise to the idea that layoffs are going to happen. It has always been like this, sugar coat the cruel reality with a nice sounding name, and make it sound like it is a routine exercise.

Harri -

February 23, 2012 at 11:01 p.m.
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