FAYETTEVILLE — Workers at theCape Fear Valley Medical Centerin Fayetteville are bracing themselves for major layoffs.

Marcia Holder has worked at the Cape Fear Valley Medical Center as a patient financial counselor since November. However, her finances could soon change. Within the next month, Holder could be one of up to 250 people out of a job at the Medical Center due to a cutback in federal money.

"You can tell there's a lot of tension. You've got to laugh about it to keep from crying because you don't really know what's going to happen," she says. "Whatever happens happens. I don't worry about it from day to day. It's in the Lord's hands."

The Balanced Budget Act of 1997 drastically cut the amount of money hospitals get from Medicare reimbursements. Cape Fear Valley lost more than $350,000 since December. Administrators say with that kind of money, jobs had to be cut.

Parks says although the cuts are drastic, patient care will not be affected. He says the layoffs would probably come from managerial positions. Nurses could also be included in the layoffs.

"I don't sleep well candidly. Nobody wants to do this type of thing," Parks says. "My fear is if it gets any worse, the cuts would have to be more drastic than if we go ahead and do something now."

Hospital administrators predict by the year 2005, they will lose more than $50 million in Medicare reimbursement rates. Cape Fear Valley is not the only hospital affected by the cutbacks. According to theNorth Carolina Hospital Association, 30 percent of hospitals in the state are losing money.