Arnot Health is cutting 83 jobs at St. Joseph's Hospital in Elmira. Hospital officials blame what they call operational challenges, as well as the federal budget sequester and reductions in Medicaid payments. Beginning next month, St. Joseph's will shift its focus to outpatient, acute, long term and chronic care. Some services will be consolidated with Arnot Ogden Medical Center. Affected employees will learn of their layoffs this week.