The Dallas-based hospital chain expects the layoffs to save $18.6 million a year. It has five hospitals in Palm Beach County, four in Miami-Dade County and two in Broward County. The layoffs, mostly affecting support staff, will be at hospitals in Broward and Palm Beach counties. "At some point, you've got to match the staffing levels with patient volume," a Tenet spokesman said. He said the company's hospitals are still recovering from the last round of hurricanes, which he said prompted many of Tenet's patients to move out of state. He also listed a decline in tourism and rising real estate prices for driving people out of the state and affecting patient volumes.