Gail Zumwalt never thought she would be looking for a new job.
The 56-year-old has spent nearly her entire adult life -- 34 years -- working at PeaceHealth Southwest Medical Center. As a unit secretary in the hospital's Family Birth Center, Zumwalt answers phones, directs visitors, submits birth certificate information to the state, helps nurses process paperwork and, as a long-time employee, helps train new staff.
She'd planned to work another 10 years at the hospital and then retire.
But on Tuesday, Zumwalt was called in from her vacation and told she was among the 124 PeaceHealth Southwest Medical Center employees being laid off.
PeaceHealth, with operations in Washington, Oregon and Alaska, announced Tuesday that it is eliminating about 500 positions systemwide -- 340 positions in Southwest Washington. The nonprofit, Catholic-sponsored health care company said the reductions will come through a combination of layoffs, unfilled positions and reductions in employee hours as it tries to slash this year's budget by more than $130 million.
It's a situation that has prompted laid-off workers to question how those who still have jobs will absorb the work they once handled. It has exposed the corporate culture of PeaceHealth -- which acquired the former Southwest Washington Medical Center in 2010 -- to renewed criticism.
What's more, PeaceHealth's workforce reductions underscore the rapidly changing nature of the health care industry, with overall employment declining in the past year in Clark County even as providers seek to grow in the long run by providing better, more coordinated care under federal health care reform.
For now, PeaceHealth's laid-off employees are reeling. Before PeaceHealth came to town -- when Southwest Washington Medical Center was still an independent hospital -- employees felt like they were a community hospital, Zumwalt said. Now, the hospital feels more like a business.
Rainy Atkins, chief administrative officer for PeaceHealth Southwest Medical Center, acknowledged the change in an interview Thursday with the Columbian.
"There's some truth to that," said Atkins, who is set to retire Sept. 6 after 10 years in Vancouver. "There's some truth that it feels different."
But PeaceHealth officials say the cuts are necessary because of cutbacks in reimbursement connected to federal and state health care reforms; flat or reduced patient volumes, especially in the Columbia Network (encompassing operations in Vancouver and Longview); the upcoming loss of a Kaiser Permanente contract, which will lead to sharply lower patient volumes; and required investments in electronic health records.
As PeaceHealth reduces its workforce and adapts, patient care will remain a top priority, Atkins said.
'Now it's gone'
After 34 years on the job, Zumwalt's last day will be Sept. 26.
"I'm optimistic. There's a reason for everything," Zumwalt said. "It's just stressful. I've never, ever, ever not had a job."
Only nine years from retirement, Zumwalt is worried about her financial future. She can't afford to not work. She'll also be without health insurance and is losing more than 600 hours she had accrued of extended illness leave, a bank of hours worth about $13,000, Zumwalt said.
"That was always a comfort to know that I had that time built up," she said. "And poof, now it's gone."
While Zumwalt is worried about her own future, she's also concerned for the co-workers she's leaving behind. All of the birth center secretary positions were eliminated in the cuts, as were the team leaders who supervise shifts. Zumwalt is concerned those extra duties will fall to already busy nurses.
"I just don't know how they can physically take on more," she said.
Hospital admissions nurse Danielle Coates was also notified Tuesday she was being laid off. The 39-year-old has worked at the hospital for 61/2 years. Her last day is Sept. 27.
"We knew cutbacks were coming, but we didn't realize it was going to be direct patient care personnel," she said.
As an admissions nurse, Coates takes care of all the paperwork to admit patients who need to stay at the hospital longer than 24 hours. That means collecting all their medical information and history and helping nurses working the hospital floor gather information about the new patients. She also makes sure patients are comfortable, getting them warm blankets and anything else they may need.
In a 12-hour shift, Coates typically admits eight to 10 patients. All of the admissions nurse positions were eliminated, she said. Nurses working on the hospital floor will now be responsible for those duties, Coates said.
"I worry that it'll impact the nurses, and I'm not sure what that will mean for patients because now (nurses) have more on their plate," she said.
"Nurses are always finding a little more to give when patient care is at stake, but eventually, there's a limit of what administration can ask," Coates said. "You can only push so far."
PeaceHealth officials have done everything they could to minimize the impact at the patient bedside, Atkins said.
"This is not reducing the people directly giving care at the bedside," she said.
A majority of the layoffs are people in leadership and management positions and support staff, she said. Atkins wouldn't elaborate on the types of positions eliminated because officials are still notifying affected employees.
The hospital has also taken steps to try to make the workflow shift manageable. Staff members are connected electronically so they can talk to one another more easily while working. Computers in patient rooms make it easier for physicians and nurses to complete tasks away from nurses stations, Atkins said.
Still, the hospital is cross-training some staff to pick up additional duties. For example, clinical nursing assistants will pick up some secretarial duties, Atkins said.
The workforce reductions at PeaceHealth aren't unusual. PeaceHealth officials say other health care providers, both locally and nationally, face similar challenges.
In Clark County, the health care sector -- historically a strong part of the county's economy -- has softened. In July, 15,200 people were employed in health care in the county. That's down 3.2 percent, or 500 jobs, from 15,700 in July 2012.
In fact, the health care sector has softened even as Clark County's overall economy recovers, adding a net 3,200 jobs in the 12 months through July -- an annualized growth rate of 2.5 percent.
Scott Bailey, regional labor economist for the Washington state Employment Security Department, said Thursday he thinks the downturn in the county's health care sector is a short-term trend.
"The industry goes through a kind of consolidation and cost-cutting from time to time," he said, "and we're right in the throes of one of them."
In the long term, demographics will determine otherwise, Bailey said, with an aging population increasing demand for health care services, and health care employers adding jobs in response.
For now, PeaceHealth remains in cost-cutting mode.
Some laid-off employees will be eligible for severance packages, depending on the number of years of service and additional criteria, Atkins said.
Coates was not offered severance pay. Zumwalt, however, was given a six-month severance because of her long tenure with the hospital.
Coates was called in on her day off and told she was laid off. Hospital officials offered her a relief position, filling in for other nurses when they're out sick or on vacation, but that can't compare to her full-time position with benefits, she said.
Coates hopes to apply for some of the 30 or so open nursing positions available at the hospital, but she's unsure how many vacancies will fall within her scope of practice.
The hospital is offering a number of resources to those who have been laid off, Atkins said. Each employee is being assigned a human resources partner who will walk him or her through the process and provide career counseling. The hospital is also working with community resources, she said.
'Not an easy task'
Zumwalt said the hospital hasn't felt quite the same since PeaceHealth merged with Southwest Washington Medical Center in 2010.
"I've always been proud to work at Southwest Washington, but these last few years, since PeaceHealth got involved, it's gotten bad," Zumwalt said.
The health care industry is in turmoil, Zumwalt said, and she understands tough decisions have to be made in order to meet budgets. But rather than feeling like a member of a community hospital, Zumwalt said she feels like she's just a piece in a number-crunching, bottom-line-focused corporation.
The hospital and its staff have been in the midst of a significant transition for the past 21/2 years, Atkins said. It takes time to get used to any change, she said, and the merger is no exception.
Still, Atkins said the layoffs are difficult.
"This was not an easy task," she said. "We understand this is a hard transition. We just have to stay present and continue to focus on quality patient services."