It was a grim day at Enloe Medical Center Thursday, as 179 employees learned their jobs were being eliminated.

Officials said 79 of those workers might be able to take other jobs at Enloe.

The cuts affect workers in several categories. Hardest hit were the certified nursing assistants (CNAs). Ninety-one of them received layoff notices. The others who got notices were 13 registered nurses, eight administrators, 34 clerical workers and 33 members of the technical staff.

Hospital leaders said the cuts are needed because costs are rising faster than revenue.

"To be a sustainable organization, you have to make some adjustments," said Darby Makel, chairman of Enloe's board of trustees, in an interview Thursday.

Reducing the work force by 5 percent is one of several elements in what hospital officials are calling "an intensive performance improvement plan."

A big goal is saving money, but officials said they also hope they can provide better service even while reducing the staff.

The financial squeeze Enloe now feels is something hospitals around the nation are experiencing, Makel said.

The money pinch has a number of causes, including the shortage of nurses, rising costs of medical technology and a shortage of physicians, he added.

Another factor is the rising cost of Enloe's upcoming expansion, the Century Project. Two years ago the price of building a five-story hospital tower, a multideck parking structure and a community park was put at $85 million. Now it's pegged at $130 million.

But even if Enloe wasn't doing the Century Project, the cost cutting would be necessary, Makel said.

"This has been a tough week for the hospital — it's about people," said Beth O'Brien, Enloe's interim CEO. She, Makel and hospital spokesperson Laura Hennum discussed the cuts with an Enterprise-Record reporter Thursday morning.

According to a memo distributed to Enloe's 2,205 employees Thursday, the 179 positions were to be eliminated as of March 12. Also, 36 employees were to have their hours reduced.

O'Brien said the picture wasn't quite as bleak as it might at first appear. Seventy-nine of the 179 workers would be eligible to apply for about 60 new or existing unfilled positions at Enloe.

Those included 24 CNA positions with different duties, Hennum said. Where CNAs have been doing direct patient care, the new plan calls for them to help nurses by lifting and transporting patients.

Also, 22 of the CNAs who got notices are studying to be RNs, she said. When they complete their studies, they would be hired as nurses at Enloe.

The 13 RNs who received layoff notices will be offered other nursing jobs at Enloe involving work at the bedside.

Hennum said patients will benefit from the change since RNs will be doing more direct patient care than they have been.

For the last three months, two committees including senior managers and physicians have been analyzing Enloe's situation. A consulting firm, Navigant, was hired to help with the process.

One goal is to achieve a $20 million cut in Enloe's annual expenses by 2011. The layoffs announced Thursday should reduce expenses by $5 million to $6 million a year, Makel said.

He said statistics show Enloe is overstaffed compared to similar hospitals.

In judging how appropriately a hospital is staffed, he said, experts talk in terms of "full-time equivalents per adjusted occupied bed. "Enloe is well over six per bed while comparable hospitals around the state are "in the mid-fours."

Other elements of the "performance improvement plan" that have been put in place include improving purchasing of supplies, streamlining billing practices and "enhancing case-management protocols."

More initiatives are planned over the next 18 to 24 months.

As they left the hospital to go home Thursday, several Enloe workers told an E-R reporter it had been a difficult day.

"People go through a whole range of emotions — anxiety, nervousness, sadness," said Laurie Weimer, a secretary in the hospital's education center. "There's a lot of anger and sadness yet to come."

Weimer, who has worked at Enloe for 25 years, said she didn't get a layoff notice. But like most employees she was affected emotionally.

People don't like the prospect of their friends' leaving and "don't like to see co-workers hurting," she said.

O'Brien said Enloe will work with employees who got notices, trying to ensure that their lives are disrupted as little as possible.

"We're hopeful we'll be successful in helping many find their next position within the next 60 days," she said.

Staff writer Larry Mitchell can be reached at 896-7759 or lmitchell@chicoer.com.

BACKGROUND: For three months, leaders of Enloe Medical Center have been considering how to make the hospital more efficient and financially secure.

WHAT'S NEW: On Thursday, 179 Enloe employees were told their jobs will be eliminated in 60 days. Some are eligible to be rehired.

WHAT'S NEXT: Enloe plans other initiatives to try to reduce its annual expenses by $20 million by 2011.