Long-range planning and belt tightening are helping region hospitals endure tough economic times and continue to be a source of jobs.

"Like every organization we're going to have to pay close attention to our expenditures," said John Gorski, Community Healthcare System senior vice president of hospital operations.

But streamlining that began several year ago is paying off for the group of hospitals that includes The Community in Munster, St. Catherine's in East Chicago and St. Mary Medical Center in Hobart, Gorski said.

"We've taken advantage of economies of scale and come together as a three-hospital system," Gorski said. "We've standardized a lot of things that we all did differently before and that helps us to purchase more efficiently and utilize staff more efficiently."

The effort helped earn the hospital system recognition "as a quality organization," Gorski said.

"We've seen a migration of more patients coming to our facilities," he added.

The $42 million combined cost of a new emergency department and the addition of 100 private rooms at the hospital system's Munster facility already had been budgeted before the economy began to decline, Gorski said.

Projects like those are likely to continue throughout the health care industry, helping to generate construction and employment dollars, a hospital industry spokesman said.

"There's no question there's still a great amount of development on the books," said Douglas Leonard, president of the Indiana Hospital Association.

"There are still pressures on hospitals that cause them to grow," especially in areas where populations are expanding, Leonard said.

"Some of that growth is because of the increasing demand for emergency room services and the demand for private rooms in hospitals," Leonard said.

The 225-bed, $210 million Porter hospital system facility planned as a replacement for the hospital in downtown Valparaiso is a demonstration of "our continuing commitment to Porter County," Chief Executive Officer Jonathan Nalli said.

At the same time, "we continue to be prudent in our approach to good investment," Nalli said. "Everything we've done has been done with a watchful eye, and we continue to watch like a hawk."

The focus for now is on investment made last year, including surgical robotics and heart-care technology, Nalli said.

"We made careful investments in 2008," Nalli said. "We're maximizing them in 2009."

The Sisters of St. Francis Health System hospital group is delaying any new construction projects "given the liquidity crisis and the ensuing economic downturn," Regional Chief Executive Officer Gene Diamond said.

However, the hospital system's $38 million Franciscan Point which opened last year in Crown Point "is doing well," Diamond said.

"It's exceeding expectations in terms of (patient) volumes," especially in the facility's immediate care center and some of the therapy services, Diamond said.

Patients like the location, at Interstate 65 and U.S. 231, Diamond said.

"Our hope was that placing it there would make it more accessible, and we're seeing some evidence of that," Diamond said.

Throughout its system of local hospitals, which includes St. Margaret Mercy in Hammond and Dyer and St. Anthony hospitals in Crown Point and Michigan City, patient volumes are "generally up," but some elective surgeries are being postponed.

To balance the budget, "we're imposing some pretty tight controls over nonessential expenditures," Diamond said. "We're trying to reduce or eliminate unnecessary travel and education expenses and we're trying to control the number of folks we hire."

Some hospitals around the country and locally have cut staff, including physician-owned Pinnacle Hospital in Merrillville, which announced layoffs in November.

The industry is seeing less turnover as those who were prepared to retire instead held on to jobs in the deepening economic decline, the Indiana Hospital Association's Leonard said.

Overall, "the job growth estimates are still pretty strong," Leonard said.

The online health resource guide Health Guide USA reported that health care would generate 3 million new wage and salary jobs in the decade between 2006 and 2016, more than any other industry.

The need for nurses continues, said Kim Genovese, executive director of the LaPorte office of Nursing 2000, a support organization for careers in registered nursing.

Fewer nurses are retiring, but the aging baby boomer population will continue to drive employment in the nursing profession, Genovese said.

"They're the largest population, and they will need health care," Genovese said.

The Methodist Hospitals, with facilities in Gary and Merrillville, is on a hiring track, President and CEO Ian McFadden said.

"I'm seeing a lot of people come through the door," McFadden said, including physicians looking to practice in Northwest Indiana.

"I can't tell you the number of new physicians who are interested in practicing here, because it's an opportunity," McFadden said. "They're expressing interest in becoming part of the Northwest Indiana market."

Methodist Hospitals, at the center of a hoped for collaboration with Indiana University medical school as a teaching hospital as well as a potential trauma center for the region, "is going to continue to grow," McFadden said.

"We know we're going to have to go through lean times, but everybody is recognizing that long term this organization has a lot of potential, and people are excited," McFadden said.