Union nurses negotiate staffing, pay after deaths led to federal sanctions at Mission/HCA

ASHEVILLE - After their history-making 2020 unionization, nurses are now engaged in key negotiations for a second contract with Mission Health, calling for more staffing, more focus on patient care and higher pay.

The negotiations come as Mission, owned by the for-profit HCA of Tennessee, looks to avoid federal sanctions over patient deaths and seeks to fend off a lawsuit by Attorney General Josh Stein alleging the health provider failed to maintain emergency department and cancer care levels.

The first contract signed in 2020 by the nurses — represented by the country's largest union, National Nurses United — and Mission, which is owned by the country's largest health care system, will expire July 2. There are currently some 1,500 nurses at Mission, according to NNU, which is based in California.

Bargaining has happened behind closed doors, though parties gave some general objectives and a few details.

While pay remains an issue, nurse Molly Zenker of Weaverville, one of the union negotiators, said there are higher priorities.

"Our main focus is our patients," said Zenker, a 36-year-old mother of three married to another Mission nurse. "I literally think you could give us the salaries of the CEOs and we would still be in the streets holding signs and making noise if our patients weren't receiving the care that they need."

Mission spokesperson Nancy Lindell in a May 8 statement criticized union efforts as aimed more at "attracting media headlines than making meaningful progress." She said some of the proposed base salary increases were as high as 80% and were "not a serious proposal."

"It is important for our nurses and community to know that we will bargain in good faith on this new contract and we are committed to reaching an agreement that is fair and equitable and allows us to continue to provide excellent care for our community," Lindell said.

Asked to comment on the salary figure, Kerri Wilson, a Mission cardiology stepdown unit nurse and bargaining team member, said nurses were disappointed management was "discussing contract proposals with the press" instead of focusing on negotiating at the bargaining table "especially if they are set on providing misleading information."

"Any conversation about wages should include that HCA executive compensation continues to grow to unprecedented heights off our patients' suffering," Wilson said in a statement provided by the union.

Nurses' proposals were aimed at improving recruitment and retention, something that would increase patient care and that HCA has failed to do, she said.

In an early response to a March 12 Mission/HCA staffing plan nurses said it was reported company CEO Sam Hazen's 2023 pay rose by almost $7 million to $21.3 million and that he would get a 170% pay bonus if hospitals meet profit goals.

"We have not seen any incentives for HCA executives to reach patient care goals," the nurses' written response said.

In response to criticism of executive salaries, HCA has said that corporate leaders took a 30% salary reduction during the worst of the COVID-19 pandemic and that Hazen donated two months of his salary in spring 2020 to a company fund to help employees during natural disasters, illnesses and other hardships.

Federal regulators placed Mission under an "immediate jeopardy" designation in December 2023 following prior year incidents that regulators said risked patients' health and led to four deaths. The Centers for Medicare and Medicaid Services cited staffing as a main problem. To avoid losing Medicare and Medicaid funding the hospital submitted a plan of correction and the March 12 staffing plan to CMS.

The plan laid out different tactics to evaluate and improve staffing saying, "Mission Hospital is committed to staffing to our current guidelines" and "is committed to sustaining adequate staffing levels," it said.

It said Mission had given more than $20 million in pay increases in 2022-2023 and reduced turnover to 14%, something Lindell, the spokesperson reiterated.

In their written response nurses said they were not allowed to give input for the plan and that many of its claims were false.

"For the past 2 1/2 years, on a monthly basis, Mission nurses have warned the chief nursing officer, managers on the Staffing Committee and HCA executives about the dangers our patients face when staff is stretched so thin," the response said.

Along with more nurses, the union is asking for guaranteed bathroom and meal breaks and that greater efforts be made to assign nurses to areas in which they specialize, Zenker, the other nurse bargainer said.

"This is not because we're greedy or want something better for ourselves, primarily," she said. "We want our working conditions to be nice, but we really want a hospital that patients can come to where they can get amazing medical care that we've been trained to provide."

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Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess at jburgess@citizentimes.com, 828-713-1095 or on Twitter @AVLreporter. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Union nurses renegotiating staffing, pay after deaths at Mission/HCA