Trouble spots

Hospitals around the country are struggling to stay afloat amid the recession, although many have had financial problems for years, often blamed on Medicare, Medicaid and other government health programs that don’t fully cover the costs of care for millions of patients.

Some recent developments:

•In mid-December, the prestigious Cleveland Clinic started a hiring and salary freeze across the 33,000-worker health system; it also restricted travel and use of consultants and contractors.

•In New Jersey, five of the 79 acute care hospitals in business at the start of 2008 have closed, most recently Muhlenberg Regional Medical Center, and a sixth may close soon. In early December, the state health department said it would dole out $44 million to six others to keep them from closing or slashing services.

•Other recent hospital closures include the 617-bed Physicians Medical Center Carraway in Birmingham, Ala.; Century City Doctors Hospital in Los Angeles, and Lincoln Park Hospital, in an upscale Chicago neighborhood.

•The Healthcare Association of Hawaii in November reported hospitals there posted their eighth straight year of losses and said the situation will worsen. The two-hospital Hawaii Medical Center filed for bankruptcy, several hospitals have laid off large numbers of workers and the Hawaii Health Systems network of about a dozen public hospitals needed a $13 million advance in late August to avoid shutting down.

•Numerous hospitals have filed for bankruptcy, including Charlotte, N.C.-based Hospital Partners of America, which operates four hospitals; Michael Reese Medical Center in Chicago and Associated Healthcare Systems Inc., which has four rural hospitals in the South; and North Oakland Medical Centers in Pontiac, Mich.

•Many hospitals are laying off workers, trimming the hours of part-timers and reducing use of more-expensive temporary nurses hired through agencies. Among them are the four-hospital St. Vincent’s Health System in Alabama; Boston Medical Center, which primarily serves immigrants and poor people, and the Columbia St. Mary’s system, which has four hospitals in Milwaukee and Mequon, Wis.

•Nashville-based HCA Inc., the nation’s No. 1 private hospital chain with about 160 hospitals, is cutting about 110 jobs and closing most functions — even the emergency department — at its Portland, Tenn., hospital, and laying off roughly 100 headquarters staffers.

•For-profit Tenet Healthcare Corp., which operates 56 hospitals in 12 states, has seen patient volumes dip, missed Wall Street expectations in the third quarter and warned it may not make its financial targets next year. Its shares have been hammered, plunging from $6.55 in early September to $1.10 by Christmas.

•Some hospitals have been posting multimillion-dollar losses or had credit rating agencies put their bonds on credit watch or downgrade their ratings. Some investor-owned hospital companies have seen share prices plummet, missed Wall Street forecasts or lowered their own financial performance predictions. Along with trimming expenses and delaying capital projects, some are discussing mergers or selling medical office buildings to raise cash.