CHOC Layoffs Surpass 15% of Its Work Force : Downsizing: Restructuring of the pediatric hospital is expected to save $11 million over the fiscal year starting in July. The reductions include the elimination of 199 positions, some of which were vacant.

Children’s Hospital of Orange County on Wednesday cut 183 jobs--a day after laying off 16 managers--in a restructuring to help offset losses of $500,000 a month during this fiscal year.

The reductions cut the hospital’s work force by more than 15% and are expected to save about $11 million over the next fiscal year, which begins in July, said Jena Jensen, director of marketing and public affairs.

It was the first time the hospital had to whittle its staff in its 31-year history, Jensen said.

The layoffs, which are permanent, hit management, nurses, maintenance and security. The cutbacks included a mix of employees and vacant positions.

The drastic measures reflect the national trend in hospital streamlining, according to CHOC officials.

“Like other health-care providers in Orange County and nationwide, [CHOC] is experiencing a shrinking census, declining patient days and reduced revenues,” Thomas Penn Jones, president and chief executive officer, said in a statement.

“Combined with competitive pressures resulting from the managed-care marketplace, these factors have forced us to re-evaluate the size and structure of CHOC’s staff,” according to Jones.

CHOC has suffered a 12% drop in patients, hospital officials said.

Jones’ explanation failed to comfort jobless workers or staff members who are worried about job security.

“I’ve heard about [impending layoffs] for weeks now, but I never really thought it would happen,” a distraught nurse said as she was leaving the hospital at the end of her shift Wednesday afternoon.

The nurse, who did not want to give her name, said officials broke the news to dismissed employees in separate meetings Tuesday and Wednesday.

“Right now, I’m still in shock,” said the 35-year-old woman, who has been with CHOC for seven years. “I think we’re all just walking in a daze.”

Some employees fear they could be next.

“Many of us are very worried,” an employee said in the hospital parking lot on his way to the night shift. “I don’t know if they are going to get rid of me. They say it’s because there are not enough patients, so I don’t know.

“If they don’t lay off this time, will they later?”

Jensen said no other layoffs are being considered.

“Essentially, what this allows us to do is to get down to a staffing level that makes sense for the number of patients that we have now,” she said. “Previously, we were staffed to handle the higher census level.”

The staff reduction came in the wake of a CHOC survey that compared its staffing level with hospitals in the county and the state.

“What we found was we were significantly overstaffed, compared to . . . those hospitals,” said Jensen. “That was where we started and we realized that we needed to make difficult decisions.”

The dismissed employees will receive one week’s severance pay for each year of continuous employment, provided they have been with the hospital for at least a year, Jensen said. They will also receive pay for unused vacation and sick time.

To help employees cope with the job loss and find new employment, the hospital has brought in an outplacement firm for counseling.

The employees who lost their jobs join a growing list of casualties of sweeping changes in the health-care industry.

Hospitals in California and across the country are under pressure to downsize to meet the demands created by the managed-care industry that rewards physicians and hospitals for limiting the number of in-patients.

Other factors bringing in fewer hospital patients have been advances in drugs and technology, home-care services that have prevented many hospitalizations and lower levels of insurance reimbursement.