Dosher Memorial Hospital will lay off 31 employees, three of whom are department leaders, cut hours for some workers and offer early retirement to others, according to details officials released Thursday about their recent decision.

Trustees of the Southport hospital decided in a closed-door meeting Wednesday that the most effective way to balance its books is by paring its workforce.

Dosher has lost about $1.3 million in its operating budget in the first nine months of this fiscal year, according to a news release Thursday from the hospital. After adding in revenues from the Smithville Township hospital tax, the hospital's balance sheet still shows a loss of $27,000.

The hospital announced in the release that it would "implement an early retirement option and a reduction in staffing" to address its "continued financial shortfall." It also stated that hospital employees were informed of this decision on Wednesday and Thursday.

"Those meeting the criteria for the early retirement incentive program totaled 38," the release stated. "Since it is a voluntary program, it is not yet known how many will take advantage of the offer."

Layoff notices were issued to the 31 employees. Another 17 employees will have their hours reduced, according to the news release.

Last year, the hospital reported its staff size at 350 employees.

“The Board feels it’s being proactive in addressing the hospital’s continued shortfall now in order to continue its long-term growth plan,” Sherri Marshall, chairwoman of Dosher's board of trustees, said in the release. “Our goal is to provide the highest quality of care for our patients ... consistent with staffing standards used in other area hospitals.”

Trends in health care in general and at Dosher specifically have had a negative financial impact on the hospital, Marshall said.

“Declining volumes, coupled with a reduction in payments have hurt the hospital financially,” she said in the release. “And write-offs for patients unable to pay have grown substantially. This past year, Dosher experienced over $10 million in bad debt and charity care, compared with $7 million just 5 years ago.”

Dosher's money woes are shared by hospitals all over the country, resulting in the elimination in 2013 of more than 52,500 health care positions nationally, the hospital's president and CEO Tom Siemers (left) said in the release, pointing to the recent decision by Wake Forest Baptist Medical Center to eliminate 350 jobs and the announcement from Mission Health System, a major employer in western North Carolina, that it will cut its costs next year by $42 million and possibly include  layoffs, Mission said.

Dosher leaders also recognize the importance of recruiting new physicians - especially primary care physicians - to the area, as 32 doctors have left the area in the past five years, the release stated. Southport shares this problem with many communities across the nation. The American Association of Medical Colleges predicts a shortage of about 46,000 primary care doctors by 2020, according to the release.

Dosher Memorial Hospital is a critical access community hospital with 25 acute care beds and 64 licensed skilled nursing center beds, according to its website.