Blue Mountain Health System will eliminate 28 jobs, laying off 15 full-time employees and one part-time worker, and not filling another 13 vacant positions.

Hospital spokeswoman Lisa Johnson on Tuesday said that another seven employees will have their hours cut, some by a few hours. Others will go from full-time to part-time.

All departments and levels have been affected in one way or another, she said.

"One department may have had a vacant position not filled, another may have a person laid off, or hours reduced."

"Over the last couple of months, we have had a number of contributing factors," she said. "The mandate of the (federal) Affordable Care Act concerning meaningful-use in information technology and electronic medical records. We actually had to spend $5 million to receive $3 million back in subsidy from the federal government.

"That $2 million difference hit our bottom line this past fiscal year, ending June 30," Johnson said.

"That mandate will continue to affect us throughout the next few fiscal years because there are a number of phases to meeting the meaningful use. We're already through phase one, and we're in the process of phase two now," she said.

Other factors include the federal government sequester, which involved a 2 percent reduction in Medicare reimbursements that went into effect April 1.

"Also, we have seen declining volumes in admissions. That's not uncommon because of health care reform and wanting to have people stay out of the hospital and have health care at home," she said.

Johnson said that BMHS has also had an increase in employee health care expenses of more than a $1 million this past fiscal year.

It's not just regular employees who will be sacrificing.

"To offset some financial restraints, department directors will take a temporary 5 percent pay reduction," Johnson said. "Senior directors will take a temporary 7 percent pay reduction. If in next three months, we show consecutive profitability, that decrease will be restored. If in next six months we can maintain profitability, it will be restored retroactively."

BMHS employs about 1,100 people. The health system has added about 200 employees in the past three years.

While the cutbacks are painful, "we need to be mindful of some of the financial restraints that are affecting the industry as a whole," Johnson said.

She said the cuts are about "right-sizing," with patient safety taking priority.