The BJC Hospital group is laying off 160 employees from it's 13 hospitals.
BJC officals say the lay-offs necessary because of a decline in in-patient care. The problem, they say, is that people are delaying treatments, some for lack of insurance, others because of high co-pays.
Layoff notifications started going out Wednesday.
Most of those affected work in administrative and management positions. BJC says those laid off will receive severance pay based on years of service.