Claxton-Hepburn Hospital in Ogdensburg has laid off six people and cut a total of nine positions.
Another 13 people, including several managers have 'revised duties,' according to a statement from the hospital.
Prominent among the reasons for the layoffs: the Affordable Care Act of 2011, better known as 'Obamacare,' the sweeping health care overhaul that is the signature achievement of President Obama's first term.
Health care reform "has decreased the amount of reimbursement for the care we provide," said Laura Shea, hospital spokeswoman.
The hospital expects to receive $450,000 less this year than last in Medicaid reimbursement, and that number is expected to grow.
"We have to make up the shortfalls," Shea said.
Other factors include charity care amounting to more than $950,000 this year, and a large amount of uncollectable debt.
"These economic pressures require Claxton-Hepburn to implement a plan that is difficult but necessary to ensure a strong future for the medical center," said Mark Webster, President of Claxton-Hepburn.
Shea said "the hospital, financially, is strong," and the layoffs are an effort to keep it that way.
She said some of the people laid off could apply for open positions elsewhere in the hospital.
Shea also said the hospital has not only looked to personnel for savings; "We've looked at other ways to decrease business expenses," she said.
Sunday, August 2, 2015, Watertown, NY
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