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Fresno hospital system quietly cuts hundreds of nursing supervisor roles

In the Spotlight is a Fresno Bee series that digs into the high-profile local issues that readers care most about. Story idea? Email tips@fresnobee.com.

Fresno’s largest healthcare system discreetly slashed hundreds of nursing supervisor positions in recent weeks as part of a staffing shakeup.

Nearly 300 clinical nursing supervisors employed by Community Health System were informed that they had to decide whether to take a pay cut, apply for a leadership position or accept a severance package.

A March 4 letter obtained by The Bee confirms CHS notified Fresno city and county officials about plans to eliminate 285 positions due to the hospital system “restructuring its operations.” The letter said the layoffs impacted 180 positions at Community Regional Medical Center, as well as 19 positions at Fresno Heart & Surgical Hospital and 86 positions at Clovis Community Medical Center.

The layoffs at CHS took effect May 3, weeks before news broke that the health system agreed to settle a federal probe and pay a $31.5 million fine, raising questions for some staff members.

Last month, CHS entered a massive settlement agreement announced last month by the U.S. Attorney’s Office. The settlement addresses allegations that CHS was involved in a multi-year kickback scheme in which hospital executives provided expensive wine, liquor, cigars and meals to physicians in exchange for patient referrals.

CHS denies the settlement was the reason for the staffing changes.

“Community frequently evaluates our care model to assure that we have the right staffing mix to meet changing patient care needs,” Daniel Davis, R.N. division president of hospitals for CHS, said in a statement.

“This shift was driven solely by clinical best practice and patient care needs and was not designed to achieve cost savings,” Davis said.

Any company with 75 or more employees must file a WARN notice if it lays off 50 or more employees in a 30-day period, according to state law.

Hospital spokesperson Mary Lisa Russell said a WARN notice was sent out in early March, as required by law.

However, a spokesperson for the state’s Employment Development Department said they had no record of a WARN notice from CHS.

Two nurse supervisors said the 285 impacted employees were forced to apply to new leadership positions, or take a demotion, with the majority taking big pay cuts.

“We were told that these changes had nothing to do with finances. That is incredibly hard to believe,” said one former nursing supervisor who spoke on condition of anonymity due to fear of professional retaliation.

Supervising nurse says layoffs may impact patient care

The nursing supervisor said rumors started circulating in February about the elimination of clinical nursing supervisor roles.

She said affected staff met individually with human resources to explore their options — either applying for assistant nurse manager, charge nurse or clinical nurse ladder positions, or accept a severance package. CHS also offered two-year retention bonuses. Most positions offered lower pay than the eliminated supervisor role.

Another nursing supervisor who had worked at Community for more than a decade — who said she loved her job and had no discipline record — accepted a severance package after her position was eliminated. The supervisor said she thinks the restructuring was a cost-saving measure.

She said employees and patient care were sacrificed to pay for leadership’s actions. Clinical supervising nurses who accepted other nursing positions have to be retrained on charting and other bedside nurse responsibilities, she said.

“I loved working here, I love my team,” she said.

Davis said CHS developed a new job description for assistant nurse manager, which is a model of clinical leadership and staffing followed by other local hospitals like Kaiser, Kaweah Health and Sutter Health.

“Based on those needs and industry best practice to support nursing at the bedside, we transitioned away from Clinical Nursing Supervisors and toward a combined Assistant Nurse Manager and Charge Nurse model,” Davis said.

Davis said that 247 of the 285 affected nurses transitioned to new roles.

“Only a small percentage chose to separate,” he said.

He also said in the coming months, “nearly 95% of our workforce will see compensation increases as we continue to implement an organization-wide set of adjustments to align with California’s new healthcare minimum wage.”

A new state law signed by Gov. Gavin Newsom in 2023 requires an increase in the minimum wage for workers at several eligible healthcare facilities.

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