Musical employment chairs at Barton Health

By Kathryn Reed

On the one hand Barton Health is struggling because the number of patients is declining. On the other hand based on the agency’s 2012 tax return the top 12 people in the organization collectively had annual salaries of more than $3.2 million, with CEO John Williams taking in nearly $600,000.

Those figures don’t include benefits or bonuses. And while bonuses were suspended for some in 2012, they were back in vogue in 2013.

However, not now and not when Barton laid people off a few years ago did upper management take a pay cut. For someone like Leanne Kankel, vice president of human resources who is No. 6 on the 2012 pay scale at $250,063 a year, she also gets free health insurance because her husband is a retired South Lake Tahoe firefighter.

While substantive salaries and perks are being handed out, so are pink slips. Several positions between Tahoe Medical Group and the Community Health Center have been eliminated. But before people were let go they first had to apply for their jobs. Those not selected were shown the door.

To compound the pain of being out of work some of their jobs have been handed to people from outside the area. They were not given reasons for why they are no longer employed and Barton isn’t telling Lake Tahoe News.

Three of the people let go at the health center were registered nurses. Two RNs kept their jobs. The difference between those who got to stay is they have a bachelor’s degree, are younger and are lower down on the pay scale. Those let go were not offered the opportunity to return to school to get their degree.

People have already been hired to replace them; some are RNs, some are medical assistants.

“We have hired registered nurses who fit a patient-centered care management model,” Monica Sciuto, Barton spokeswoman, told Lake Tahoe News.

Why the RNs who were let go couldn’t fit that model isn’t known.

“This was not in an effort to save costs, but rather to put the correct level of expertise into positions to fit the needs of our patients,” Sciuto said of the layoffs.

But that in part contradicts a letter Williams sent to staff on Jan. 6. He went through a litany of concerns regarding decreased patient admissions (it’s at 78 percent of the volume compared to 1998) as well as a drop in births – 57.7 percent from 1998 to 2012.

“In addition, due to the Affordable Care Act we anticipate payment for services will decrease across the board from our government and private payers,” Williams wrote. “To address these shifts, Barton department heads and the executive team will be taking a closer look at how we run our organization.”

Novia Strategies has been hired at an undisclosed cost to “objectively evaluate how we do business and where we can be more efficient,” the PR department said.

Changes for employees

Hours for the janitorial crew have also been cut. Barton would not talk about these changes.

Nurses who were used to working 10- or 12-hour shifts now have to work five eight-hour shifts, at least at the community center.

Barton would not release the number of people who have been laid off, the number of new hires or the job titles of the people. Many of the workers had been with Barton a decade or longer.

Others have told Lake Tahoe News that in addition to the three RNs being let go, seven medical assistants, and one receptionist were released. Some of those positions, though, have been filled.

Now all office staff must at least be a medical assistant. This means front desk people will be able to give shots, wound care and assist doctors.

With Barton owning most of the doctors’ groups in the area, it means those professionals work for the health care system. They don’t have a say in who works in their office, who is hired, who is fired.

“They changed the receptionist to a different receptionist and laid off the one I had. I wasn’t consulted,” Ronald Roth, a physician with Tahoe Medical Group, told Lake Tahoe News. “It was a little disruptive to have spontaneous changes without consultation.”

Other doctors are reluctant to talk on the record because of the possibility of retribution. Tahoe Carson Valley Medical Group, which includes 28 doctors, just renewed its contract with Barton. Tahoe Orthopedics and Sports Medicine is in contract negotiations.

Doctors are being evaluated and paid based on productivity. How productivity is evaluated is not being made public.

Going forward

Some of the people who are now in the unemployment line who spoke with Lake Tahoe News said what they fear most is the level of care patients will receive.

Barton says there is no reason to be worried.

“(It’s) so they can provide more clinical knowledge and facilitate the ongoing care of patients. Barton’s front desk staff completed Barton University’s accredited National Center for Competency Testing program to qualify to become medical assistants,” the PR folks said.

Barton has changed how it recruits for employees. The “career website” is being revamped. In Williams’ letter he asked for “individual written testimonials on why you enjoy working for Barton and what in particular you find rewarding about your job.”

Some who were let go say Barton is all about the positive, wanting to put a Disney-esque spin on things instead of listening to concerns.

“Though change can be challenging, we see this as an opportunity to create a new environment that holds a brighter, financially sustainable future at Barton. Barton is committed to coming to thoughtful, well informed solutions,” Williams wrote to employees.