Raleigh, N.C. — The North Carolina Department of Health and Human Services is cutting 351 positions from seven state-operated health care facilities because of state budget woes.

"We looked very hard at not having to take out any filled positions, but that was not the case," said Luckey Welsh, director of the Division of State-Operated Health Care Facilities.

More than a third of those cuts affect Cherry Hospital, which has lost nearly $1 million monthly since last fall when the U.S. Centers for Medicare and Medicaid Services withdrew federal reimbursements from the facility.

The agency that oversees the government insurance programs revoked the facility's certification following the death of a patient who died after choking on medication and being left unsupervised for nearly 24 hours.

Cherry will lose 92 vacant positions and 27 filled positions.

The department says it is managing the cuts as to not affect negatively the number of patients the facilities take in and the quality of care they receive.

"We believe we can lower our costs and improve our quality by doing the right position cuts where they are," Welsh said.

Patient advocates, however, are concerned the recent cuts will hurt patient care even more.

"I'd be shocked if this didn't impact health and safety," said Jennifer Mahan, director of policy and advocacy initiatives at the Mental Health Association in North Carolina.

She believes the effect from the overall cuts to mental health will be tough to recover from.

"This is sort of a path of disaster for people with mental illness," Mahan said. "Cuts in community service, cuts in hospital staffing – the combination of the two means people don't get care."

The department admits it is faced with many challenges, one of which is changing public perception about the quality of care that patients receive.

"Most of the time, we do an excellent job, but we're not perfect, nor is any other hospital in this state perfect," Welsh said.