ProMedica is laying off approximately 100 people and will not fill 60 non-direct-care jobs that are vacant, the healthcare system said Friday in a statement to the media.

The announcement came almost exactly a month after a July 25 vote that led to ProMedica and real estate investment trust Welltower controlling assisted living and skilled nursing facility operator HCR ManorCare via a joint venture. ProMedica announced the finalization of the transaction on July 26, saying that the addition of ManorCare to the organization made ProMedica the 15th-largest healthcare system in the country.

None of the eliminated positions are at HCR ManorCare, ProMedica spokeswoman Tausha Moore told the Toledo Blade. Many of the jobs involve “leadership roles and corporate functions” at the health system’s headquarters, the company said. ProMedica, Welltower and HCR ManorCare all are based in Toledo, OH.

“While we recently partnered with HCR ManorCare and expect the partnership to bring opportunities for growth and synergy, we still must address pre-merger ProMedica financial issues now,” ProMedica Chief Human Resource Officer Karen Strauss said in a statement.

Decreasing reimbursement rates for services and increasing operational costs led to the decision, Strauss said.