UVM Medical Center’s closed geriatric unit becomes a flashpoint in hospital cost fight
The main entrance of the University of Vermont Medical Center in Burlington. Photo: Gopats92, CC0, via Wikimedia Commons.
The University of Vermont Medical Center’s Baird 3 unit had 30 beds and, by the account of the nurses who worked there, almost never an empty one. It is one of the casualties of the latest round of cuts at UVM Health, and it has become a focal point for people worried about what Vermont’s push to hold down hospital costs means for the patients who need the most care.
UVM Health announced on Sept. 15 that it would eliminate 199 positions across the network, 118 of them at the Burlington medical center. The network also said it would create 55 new jobs, for a net loss of 144. The reductions are expected to save about $16.8 million as the system prepares for what it projects will be roughly $300 million less revenue over the next several years.
Workers whose jobs were cut were given 45 days to look for other positions, the Vermont Cynic reported. The September cuts came on top of 142 positions eliminated in June.
A unit for older patients
Baird 3 was a general medicine floor that specialized in geriatric care and absorbed overflow from elsewhere in the hospital. UVM Health has said the closure, along with an alternative care pod, reflects a drop in occupied beds and that those patients can be cared for on other units.
Staff who worked there don’t see it that way. “Baird three was always full,” Mary Lefebvre, a licensed practical nurse on the unit, told the Cynic. “Patients were boarding in the [emergency department] for days waiting for a bed.”
Lefebvre said adding licensed practical nurses to the unit had improved staffing and the quality of care. She worries that asking remaining nurses to absorb the work will lead to longer waits and more preventable harm. “Doing more with less staff means that patient care suffers,” she said.
Families and nurses have raised similar questions about whether the attention older patients got on Baird 3 can be matched on general floors, WCAX reported, citing reporting by Seven Days.
The regulator’s role
The cuts land in the middle of a long fight over hospital spending. The Green Mountain Care Board, which sets hospital budgets, voted 3-2 in September to require UVM Medical Center to lower its commercial insurance prices by 4.4% for fiscal 2027. Hospitals statewide are under orders to cut what they charge private insurers, part of an effort to slow the growth of health insurance premiums.
The board doesn’t decide staffing levels or layoffs. That is up to the hospitals, and UVM Health has said the September reductions were planned before the board’s budget decision. The network has also cut back on traveling nurses and other contract labor, limited discretionary spending and eliminated executive jobs.
Rosemary Dale, who chairs UVM’s Department of Nursing, described the position hospitals are in plainly. “I think all of us are in a really tight position right now, financially,” she told the Cynic. “The reality is if [hospitals] fail to meet their targets, there will be no care.”
Clinicians at other hospitals have told VTDigger about fewer transfers for specialist and critical care, lost social work support and colleagues retiring early. Meanwhile the board itself is going through a leadership change, with a confidential search underway to choose its next chair.
The workforce squeeze
The cuts are an odd fit for a state that can’t train enough nurses. Vermont health care employers need about 1,200 registered nurses a year, but only about 400 nursing graduates become eligible for licensure annually, according to Vermont Talent Pipeline Management.
Jordan Bushway, a licensed nursing assistant at the medical center for more than a decade, is studying for a nursing degree at Vermont State University through a hospital-supported program. Her worry isn’t that she won’t find work somewhere. “It’s whether I’ll have the opportunity to build a stable career within the organization I’ve already dedicated so much of my life to,” she said.
Dale said part of the answer is that nursing itself is moving. UVM is preparing more students for jobs in outpatient clinics, schools and home care as treatment that once required a hospital stay shifts elsewhere. That shift may help the budget math over time. For an 85-year-old admitted with pneumonia this winter, it is less clear what replaces a floor that was built around patients like them.
