Joining a growing number of Maryland hospitals revamping their organizations because of competition, St. Agnes Hospital will lay off about 20 managers this month and eliminate 60 other positions by the end of the year.
The layoffs at Central Maryland's fourth-largest hospital account for about a fifth of the hospital's management positions, said Robert E. Pezzoli, St. Agnes' president and chief executive officer.
"In reality, the only folks hurt will be from the management group. There will be no patient care or support care [staff laid off]," Mr. Pezzoli said. "All of those will come from attrition."
The positions that the Southwest Baltimore hospital will cut over the next two weeks will include vice presidents, managers, division directors and assistant directors, foremen and support staff. In addition to about 20 management layoffs, the hospital will reassign four secretaries and eliminate about eight vacant positions this month, Mr. Pezzoli said.
In addition to those cuts, St. Agnes this year will eliminate:
* Twenty-nine patient-care positions, including nurses and nurse's aides, through attrition. Although the hospital will maintain its license for 407 beds, the job cuts will effectively reduce the staffing level to serve 387 beds, Mr. Pezzoli said.
* Twenty-two positions through streamlining services and cross-training employees.
"We think that, as the inpatient component gets smaller, you need less management to run the organization . . . as we see a changing institutional level of health care, we need to streamline and consolidate," Mr. Pezzoli said.
In a July 1 letter to St. Agnes workers, Mr. Pezzoli wrote that the hospital had begun to lose certain outpatient services to nonhospital-based providers and that its inpatient census had fallen below its 1994 budgeted levels.
"These trends simply mean that we are losing some of our revenue base, and as a result, there is a need to reduce costs," he wrote.
St. Agnes' revenues are projected to be about $190 million this year. The hospital is "making money," Mr. Pezzoli said. St. Agnes' admissions grew 1.5 percent in the year that ended March 31, but its average length of stay has dropped about 8 percent, and its average daily census dropped about 6 percent, he said.
The cutbacks at St. Agnes come as the area's hospitals are re-examining their organizations in response to competition and the prospect of health care financing reforms. Sinai Hospital in Northwest Baltimore recently cut or revamped a half-dozen management positions, including three vice presidents' jobs. Other hospitals, including Greater Baltimore Medical Center and Johns Hopkins, are reviewing operations.
St. Agnes has been among the most aggressive Maryland hospitals in responding to competition from nonhospital providers. Four years ago, Mr. Pezzoli helped organize St. Agnes' doctors into one of the area's first physician-hospital organizations to bid for contracts with managed-care companies, primarily health maintenance organizations. In March 1993, the hospital purchased an outpatient surgical center in Ellicott City, and last month, St. Agnes joined with three other Maryland hospitals to create a health care network to compete for managed-care patients.