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Jim Gattis and Sam Downing

These are unprecedented times. Health care is in a whirlwind of change. At Salinas Valley Memorial, we are taking steps to be able to continue to provide high quality care for our patients, now and in the future. This process is challenging, but as a result we are a more effective and efficient hospital. Responsible leadership calls for decisive action during challenging times. Salinas Valley Memorial is a public district hospital meaning Comprar Levitra it is owned by the residents of our district. We are responsible to them, as well as every patient we serve. This is not a private, for profit hospital with shareholders. Any margin that remains after our operating expenses is reinvested into the organization and community outreach projects. This is how we purchase technology and equipment, provide new services, maintain our infrastructure and recruit and retain the best physicians, nurses and technical staff. A margin is essential to maintain quality care. We remain one of the area's largest hospitals, employing about 1,900 people with an annual payroll of $235million. The worldwide recession is impacting hospitals across the country. According to the American Hospital Association, about nine out of 10 have had to make cuts to address the current economic situation. Managing a hospital requires close attention to labor costs, since approximately 65percent of our costs are salaries, wages and benefits. A study shows that our staffing levels are in the upper percentile compared to other California hospitals. In order to keep costs Sustanon 250 4 Ml A Week down for the people who use our hospital, it is important that we staff appropriately. Many factors are converging to force this issue right now high unemployment has left people without health insurance, forcing them to defer medical attention. More people are unable to pay their hospital bills, resulting in $15million in charity care at Salinas Valley Memorial. Also, the state has mandated unfunded seismic retrofitting that is taking money out of cash reserves. It is imperative to run the hospital as efficiently as possible. In our case, as at hospitals across the country, that means reducing the work force because staff costs represent so much of our budget. In an attempt to reduce staffing levels to meet a reduced census, we offered voluntary buyouts to employees last year, starting with management. Forty management positions were eliminated the largest single job classification impacted in the reduction. Voluntary buyouts did not reduce costs enough, however, so last month the organization needed a further reduction in work force. While this is unquestionably the right thing to do for our "Anadrol 50" organization, our community, and "Achat Anabolisant Belgique" the future of health care in our region, these decisions are some of the most difficult we have ever faced. These people affected "Oxandrolone Powder India" are valued colleagues our longtime friends and trusted co workers. However, the decision to restructure our organization is necessary, and as a result our hospital will be in a stronger position to continue to Masteron Side Effects For Women' deliver "4-chlorodehydromethyltestosterone Ireland" quality care. Quality continues to be our guiding principle. In every case, Salinas Valley Memorial continues to meet or exceed the state mandated guidelines of nurse/patient ratios. We will make sure the needed resources are available to care for every patient. Our leadership remains on guard, with an eye toward the ever changing marketplace, ready to act as necessary to do what it takes to keep us on the leading edge of change. That is our promise to you, the region Proviron Y Taxus we serve. Gattis is president of the Salinas Valley Memorial Health System board of directors and Downing is president and CEO. They wrote this in response to a commentary last week by union members critical of recent and upcoming layoffs at the hospital.

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