BRUNSWICK

To counter reduced revenue and outstanding debt from the state’s subsidized health care program, Parkview Adventist Medical Center plans to lay off up to 16 employees, merge programs and cross-train personnel to work in more than one department.

The cuts and layoffs were announced Monday.

Parkview must trim $2.5 million from its 2013 operating budget to avoid finishing the year more than $1.25 million in the red — the end result of fewer patient visits and balky state payments of more than $3.1 million owed for services provided to MaineCare enrollees.

Nurses, technicians, managers and other staff positions are to be eliminated to make up some of the shortfall. Additionally, some positions — such as nurses in the medical surgery unit — will be cross-trained to work in the intensive care unit.

A list of eliminated positions was unavailable today because not all of the affected employees have been notified, Parkview spokeswoman Tory Ryden said.

“We’ve also cut and adjusted management positions to save $500,000, which means some departments won’t have second or third level of management,” she said.

Another $600,000 in on-call fees paid to Parkview’s doctors also has been chopped out of the budget.

“They don’t like it, of course,” Ryden said, “but they agreed to it and, unfortunately, it’s the reality of the situation. Restructuring is the ‘new normal’ in the world of hospitals. I mean, (my position) could be eliminated tomorrow, too.”

Hospital officials “are still working” to identify another $500,000 in cuts.

Officials said Parkview’s current gross revenue is 1 percent higher than a year ago, but down 7 percent from its operating budget of $2 million.

During the past four months, Parkview has lost more than $1.2 million and is on track to lose another $300,000 by the end of the fiscal year.

Part of the problem is a low occupancy rate for the 55-bed facility: Only 22 percent of its beds have been in use, down from 23 percent a year ago.

“If we don’t have the number of patients, we don’t need as much staff,” Ryden said. “You don’t need two nurses in the intensive care unit if you have one patient.”

Hoping to nudge the process along, Ryden also sent a copy of Monday’s announcement to Gov. Paul LePage’s press secretary, Adrienne Bennett.

LePage, congressional Republicans and Democrats are deadlocked over how to pay the state’s medical bills.

LePage wants to tie payoff of existing debt to proceeds from future liquor sales. Legislative Democrats want to expand the state’s Medicaid eligibility and recoup the money from federal sources; a bill to cover an additional 70,000 people passed the House on Monday.

Regardless of which way debate goes in Augusta, Parkview and other creditor hospitals will be waiting months to get their money.

“Even if they came up with the money today, we still wouldn’t even see it until probably October,” Ryden said. “You can’t operate a business like that, because sooner or later you run out of cash.”

Other hospitals face similar dilemmas.

Although Mid Coast Hospital in Brunswick has maintained a steady 60 percent occupancy rate, it, too, is waiting on $14 million in MaineCare payments, Mid Coast Hospital spokesman Steve Trockman said.

Further south — and citing many of the same reasons — Maine Medical Center in Portland recently implemented a hiring freeze to stem a $13 million revenue shortfall.

Parkview has operated either at a loss or on a thin profit margin for several years.

Central Maine Health Care Inc., based in Lewiston, bailed it out of debt with more than $10 million in cash and staff support from 2008 to 2010, then submitted an application to the state in August 2012 to take over Parkview’s financial control and management.

In January, the state told CMHC that its application was incomplete and, unless more information was provided, it would reject the merger request. The Lewiston medical group subsequently withdrew its request, but has until February 2013 to resubmit it.

Chuck Gill, CMHC’s vice president of communications, said Monday CMHC will resubmit its plan.

CMHC’s staff who work at both facilities are likely to be affected by Parkview’s announcement, he said. But, he added, the Lewiston headquarters will let Parkview work out restructuring on its own.

“What Parkview has done is make their expenses match their revenue,” Gill said. “Within CMHC, every entity has to stand on its own, and they’re aligning the staffing with patient demand.”

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