Indian River Medical Center President and CEO Jeffrey Susi announced Thursday that, following the elimination of 21 jobs earlier this summer, the hospital has cut an additional 39 jobs effective immediately.

In explaining the need for staff reductions, Susi said IRMC expects to loose $5 million this year and another $5 million in the next fiscal year.

According to Susi, because of changes in Medicare and Medicaid reimbursement, the Florida Legislature’s decision not to expand Medicaid, and a trend toward more outpatient care, IRMC is not anticipating increased revenues, but is looking to cut $10 million in operating expenses in hopes of breaking even in 2014.

Susi said that in addition to reducing staff, IRMC will also cut costs through changes in employee benefits.

Susi said that no bedside nurse positions had be cut and that direct patient care should not be impacted by the staff reductions, which will affect every other department within the hospital, including executive staff.