The head of Jewish Hospital & St. Mary's HealthCare says the company is dropping 500 positions from its work force.

Transitional Chief Executive Officer Janice James told The Courier-Journal that the layoffs at the 8,100-employee hospital system will be across the board but those closer to patient care, such as nurses, are less likely to be affected.

She said some middle managers will lose their jobs.

Company spokesman Jeff Polson says the cuts will come 250 layoffs, attrition and not filling open positions.

James said the effort is part of a larger cost-cutting plan made necessary by such changes as reduced patient volume and the growing numbers of uninsured patients.