Hospital Employees Express Concern to Board
Outsourcing Services, Budget Cuts Have Some Employees Concerned
By Ryan Schlehuber

Ongoing changes and budget cuts at Mackinac Straits Hospital and Health Center have some employees concerned, and they attended the hospital board's meeting Monday, June 18, to complain that laundry services have been farmed out to an area prison. Some staff said they felt uninformed and questioned board actions to outsource hospital services and even the reasoning behind the need for a new facility.

"The stress level at Mackinac Straits has been terrible," hospital housekeeper Marla Bentley said, addressing the board. "Morale is terrible. We're disgusted because we're told, 'Like it or not, we're going to make these changes.'"

She contended that staff has never been involved in any discussion of the changes taking place at the hospital to cut costs and meet changing state and federal funding priorities.

"We're getting information in bits and pieces," she said.

Outsourcing the hospital's laundry service to Michigan State Industries, Straits Correctional Facility Laundry, a move that could save the cash-strapped hospital about $50,000, was the center of concern for the more than 15 employees who showed up at the meeting. The unexpected large audience forced the meeting to be moved from the Mackinac County Airport to the Quality Inn conference room.

Patricia Gustafson, a former nurse assistant and human resource risk management assistant, along with other employees, questioned the board's decision to allow prisoners to clean hospital laundry, which would include personal items from residents of the Long Term Care Facility.

Mrs. Gustafson, who said she has become active in learning about the board's moves to save money and to build a new facility, questioned the ability of prisoners to handle the laundry with care, as the hospital employees did.

"Our laundry department takes the extra effort," she said. "Do you think that's going to happen at the prison? These residents, those personal clothings - quilts, Afghans, teeth, hearing aids - this all goes through the laundry. Don't they deserve a little bit more than sending it up to the prison to be bulk washed?"

Ms. Bentley, one of the hospital's three laundry department employees, said having prisoners cleaning the laundry is a bad idea for many reasons.

"Many times we find wallets, earrings, Grandma's rosary she had all her life," she said. "I don't think you'll get those back if it goes to the prison."

Mrs. Gustafson also questioned whether the dirty linens would be taken and brought back at an efficient time, and criticized maintenance of the hospital building.

Ms. Bentley agreed.

"What happens when there is a lock-down or bad weather or epidemics?" she asked, suggesting that some long term care residents would not have proper clothing and would be forced to wear hospital gowns if the laundry was delayed.

The hospital, which employs 250 people, has been preparing for possible cuts in state funding and Medicaid next year, as well as making preparations to move into a new facility on North State Street, near the Mackinac County Airport.

Last fiscal year, Mackinac Straits Hospital lost $400,000 in net income in the first three months and ended the year with a $482,000 loss. It had $1.34 million less net revenue in fiscal year 2007 and expenses had to be reduced by $900,000, with outsourcing many of its services as a way to cut expenses, such as lawn care, snow removal, and biochemical laboratory operations.

So far, only four positions have been eliminated in the past couple of years, said hospital CEO Rod Nelson. While the three positions in the laundry department are now eliminated, the employees will be retrained to work in other positions in the hospital, such as nurse and dietitian assistants, said Karen Cheeseman, the hospital's human resources director.

Outsourcing the laundry is one of the many initiatives the hospital is taking to prepare for more cuts from Medicaid this fall, said Mr. Nelson, in an attempt by the state to shore up a $3.5 billion deficit.

Medicaid saps 20% to 25% of each general fund dollar, Mr. Nelson said. "It' s a big target. If they go after it again, it would impact us by $360,000. I told our legislators that if they do that, it will cause a huge hardship.

"If we get a big hit in October, the beginning of the fiscal year, we can't turn around and make a change quick enough to prepare for that," he continued. "So we have to prepare for what's going to happen to the state budget."

Mr. Nelson sent a letter to Governor Jennifer Granholm in May to plead with her to not cut into the Medicaid fund. He said he will prepare another letter which will have the signatures of all the hospital's staff regarding the same issue.

Mrs. Gustafson and other employees questioned why the board is seeking a new facility when it is financially strapped.

Board members argued that the combination of state funding cuts, high cost of fuel, and a decline in tourism and health needs has impacted the hospital's financial status.

"The bottom line is that, with our current facility, we cannot make a profit," said board Vicepresident Richard Smith. "All we can do is hope to break even. We'll be doing a lot more things in the new hospital than we can in the one now."

Mr. Smith said Mr. Nelson is doing everything he can to retain all of the hospital's employees as the hospital prepares to move into a new facility.

"As far as people working here, I don't think there are going to be job cuts," he said. "I think it's going to be just the opposite. I think we're going to be adding jobs as time goes on. It's not reasonable to say we will cut jobs" when more services will eventually be available at the new facility.

Concerns about whether the Long Term Care Facility will continue to operate after the new hospital is built were also raised by members of the audience, since long term will not move to the new facility.

"Yes, it's going to be there," assured Mr. Smith.

As previously reported, the Long Term Care Facility will remain at the existing building, but federal funding for such care is changing so drastically that hospital officials predict it will be used in the future only for terminal patients, advanced cases of Alzheimer's, and those with longterm handicaps, such as closed head injuries. Funding is, instead, now being directed toward assisted living and home health care. Assisted living will be accommodated at the new facility.

In September 2006, the number of licensed long term care beds were reduced from 99 to 75, owing to a lesser demand for long term care and changing Medicaid coverage qualifications. People who are able to dress or feed themselves, for example, are no longer qualified for long term care under Medicaid.

Hospital board Chairman Ron Mitchell said with long term care demands not as strong as they used to be, and with less available funding, certain adjustments to the hospital's operation had to be made.

"There's no way, with the current funding through Medicaid, that we're able to provide a long term care facility and make money," he said. "We used to be able to do it, but the whole demographics have changed. People are no longer in long term care anymore. They're in places like assisted living now, or being cared for at home."

Board Secretary Kathy Lawnichak, a former Licensed Practical Nurse, sympathizes with staff and understands frustration with the many changes. She praised the staff for its dedicated work.

"Not all of the accolades go to Rod," said Mrs. Lawnichak, speaking to the audience. "You are the ones that helped make us."

Mrs. Lawnichak remembers in 1991 when the hospital's financial situation was so bad that there was a real threat of closing the hospital. She believes today's situation is much better, considering the hospital's bright future.

"I'm just happy we don't have that situation anymore," she said, and "that we're actually growing, and we're going to get a beautiful new hospital, and it will create more jobs, and give us better health care."