At 19 beds, Grace Cottage Hospital is Vermont's smallest, and Andrea Seaton knows it's hurting.?
The vice president of development said the hospital is cutting 10 percent of its 154-member staff, across eight departments.
Seaton said the decision was not easy, but said the economy? and recent federal policies have left them no choice.
"With the economy trying to bend the cost curve, with the Affordable Care Act, we have to look at all of our costs," said Seaton.
Most patients at Grace Cottage are on Medicare and have been referred to the hospital's rehabilitation unit. Their rehab offers treatment for each patient twice a day, seven days a week. Seaton said that kind of care comes with a price tag and because of costs, they have seen a decrease in referrals.
"Most of our patients are on Medicare and those costs are allocated for a procedure from when they enter a hospital until they leave the hospital. So our referring hospitals are looking carefully at our costs as well," she said.
According to the Vermont Hospital Association, all of Vermont's hospital lose money on Medicare and Medicaid.
"The federal government has significant debt and deficit and they're looking to limit their financial liability around Medicare," said Bea Grause, president of the Vermont Hospital Association.
Grace Cottage is also paying $600,000 in a new provider tax and another million in free care for the uninsured, the highest they've ever paid.
"Times change, and you have to adapt to those changes," said Seaton.
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