SIOUX FALLS, S.D. (AP) — Sanford and Avera say they've avoided the job cuts that have hit other systems nationwide.

But they acknowledge that every new hire is under scrutiny because of stress in the medical industry.

Sanford chief operating officer Nate White says it eliminated 50 management jobs in June to save $10 million a year, but apart from that has not gone through any significant reductions.

Avera McKennan Hospital CEO David Kapaska says it also has not had to lay off anyone.

The Argus Leader reports both systems have hundreds of jobs that are vacated and refilled in a year.

Sanford has 11,500 employees in metro Sioux Falls and 26,000 in eight states. Avera employs 6,170 in its Sioux Falls region and 13,500 in five states.

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