Thousands of healthcare workers nationwide are negotiating for new contracts, and staff at some facilities are preparing for the possibility of strikes in the coming months.
Nurses at HCA Healthcare’s MountainView Hospital in Las Vegas voted last week to authorize a strike if no progress is made in negotiating for a contract that ensures higher pay, meal breaks for nurses and better retention strategies. National Nurses United members at the health system’s Mission Hospital in Asheville, North Carolina, are conducting a strike authorization vote. These moves, combined with dozens of pickets, protests and contract fights across the country, exemplify the ongoing tension between healthcare employers and staff.
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Here is the latest on contract negotiations between healthcare employers and their unionized workforces.
HCA Healthcare
Nearly 10,000 registered nurses represented by the National Nurses Organizing Committee/National Nurses United are bargaining at 17 HCA hospitals in Florida, Kansas, Nevada, Missouri, North Carolina and Texas.&
Negotiations are being conducted locally so some are further along than others. Nurses at some facilities, including MountainView Hospital, are poised to call a strike.
Bargaining began in April at Mission Hospital and the contract covering 1,600 nurses expired in July, said Hannah Drummond, a registered nurse at the hospital and bargaining team member.
Bargaining sessions have yielded little progress on proposals related to recruitment and retention efforts, or meal and rest breaks for nurses, Drummond said.
“The reason that we are having to take a strike vote is because we do not yet have offers to ensure the safety of our patients’ well-being in this hospital,” she said.
HCA Healthcare said in a statement that nurses' main concern at the bargaining table is pay. The health system said it pays all nurses a competitive salary, with experienced nurses making an average of $110,000 annually including benefits.
"During our current negotiations, the NNU continues to present unreasonable demands — in some cases more than 50% wage increases over the life of a three-year contract," the health system said.
Albany Medical Center
More than 1,700 Albany Medical Center nurses represented by the New York State Nurses Association are bargaining for a contract they want to include enforceable staffing ratios, higher pay, better employee benefits and opportunities to have more of a say in patient care.
The previous contract expired July 31, and nurses recently conducted an informational picket about staffing issues.
In a statement, Albany Medical said it has made 20 proposals over 14 negotiating sessions, including bids to increase hourly wages, to offer tuition reimbursement and to standardize vacation policies.
"We will continue to negotiate in good faith," the center said. "We value our nurses and the demanding job that they have and we want the contract to reflect that."
Sharp HealthCare
Around 5,000 frontline healthcare workers at Sharp HealthCare, based in San Diego, are bargaining for their first contract.
Lab assistants, ultrasound techs, nursing assistants, pharmacists and others at its Grossmont Hospital were the first to unionize in 2023, followed by workers at Sharp HospiceCare, Chula Vista Medical Center and Metropolitan Medical Center locations. All four facilities hope to join together as one bargaining unit represented by Service Employees International Union-United Healthcare Workers West, said Renée Saldaña, press secretary for the union.
Unionized workers have conducted informational pickets for weeks on various staffing issues and the wages they say are needed in a city as expensive as San Diego, she said.
“We're hearing from workers who are just living in Mexico because they can afford to live somewhat better down there,” Saldaña said. “But nobody wants to have to cross a border to get to work every day if they can help it.”
Sharp HealthCare said in a statement that the union has delayed reaching an agreement by attempting to combine all its bargaining units and "filing baseless charges against Sharp with the National Labor Relations Board."
Since fiscal 2022, Sharp HealthCare said it has made a $150 million investment in staff compensation and offers free employee health insurance coverage, contributions to retirement plans and other competitive benefits.
The health system said it has conducted 30 bargaining sessions with the union.
Kaiser Permanente
At Kaiser Permanente hospitals and clinics in Southern California, more than 2,200 mental health professionals represented by the National Union of Healthcare Workers are in contract negotiations.The contract expires Sept. 30, and workers are advocating for more time to manage patient care as well as more staff therapists, psychologists and licensed social workers.
“Workers are absolutely united to threaten an open-ended strike,” said Sal Rosselli, president emeritus and founder of the union.
The union plans to conduct a strike authorization vote this week, and could strike in early October, he said.
“In California, there isn't a shortage of therapists like the industry claims,” Rosselli said. “There's a shortage of therapists that want to work for Kaiser because of the low reimbursement and hoops that people have to jump through.”
Kaiser Permanente said in a statement it started bargaining July 31 and is committed to reaching a "fair and equitable agreement."
More than 75,000 Kaiser Permanente workers went on strike in October 2023 and subsequently won a four-year contract with pay increases of 21% over four years and minimum wages of $25 per hour in California.
Keck Medicine of USC
Healthcare workers at Keck Medicine of USC, based in Los Angeles, voted Aug. 22 to authorize a strike following seven months of contract negotiations.
The National Union of Healthcare Workers represents 2,400 employees at Keck Medicine, including licensed vocational nurses, nursing assistants, medical technicians and respiratory therapists, all of whom are working under expired contracts. More bargaining sessions are scheduled but it increasingly looks like a strike will be necessary given the issues of chronic understaffing, burnout and low pay, Rosselli said.
“[Keck Medicine’s] current position is a wage freeze for a significant number of workers, while we're demonstrating that their competitors are paying more in Los Angeles,” he said.
The health system said in a statement that both parties are making progress at the bargaining table around compensation, paid time off and benefits.
University of Michigan Health-Sparrow
In Lansing, Michigan, around 2,000 registered nurses and other healthcare professionals at the University of Michigan Health-Sparrow are in the early stages of contract talks. The contract expires Oct. 31.
The workers, represented by the Michigan Nurses Association, are focused on issues of retention and ensuring better patient safety at the bedside, said Jamie Brown, union president.
"We hope to emerge from these negotiations with a stronger relationship and a collective commitment to building a better future for our health system and our community," University of Michigan Health-Sparrow said in an email.