Palomar Health in North County has laid off 42 employees as part of a reorganization, citing a shifting health care landscape locally and nationally.

“Now is a vital time to be proactive and stay aligned with healthcare trends to remain competitive in today’s market,” Diane Hansen, president and CEO, said in a statement Jan. 26. “To better position the organization for the future, Palomar Health took a critical step by realigning the operational structure. These changes allow for more efficient staffing and an opportunity to strengthen accountability while enhancing the system’s financial foundation.”

Palomar Health has 4,000 employees, with several North County facilities, including hospitals in Escondido and Poway, health clinics in Escondido and San Elijo Hills, and a skilled nursing facility in Poway.

The layoffs were “focused on areas other than direct patient care,” according to the statement. It goes on to say more details will be available after Palomar Health shares the reorganization plan with employees.