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Possibility of Mission nurses’ strike rises as labor contract expires

Members of the Mission nurses union picketed at the hospital in mid-April.
Watchdog photo by Victoria A. Ifatusin
Members of the Mission nurses union picketed at the hospital in mid-April.

Mission Hospital and the Mission Nurses United union didn’t reach a deal on a new labor deal by midnight July 3, the expiration date for the current contract, increasing the possibility of a strike.

Nurses told Asheville Watchdog that they and the hospital remain far apart on key issues, including compensation and retention.

“I feel like we still have a long way to go and I think (Mission) feels the same way,” union nurse and bargaining team member Kelly Coward told Asheville Watchdog before the three-year contract expired. “The main goal is, we’re focused on patients and our community. We need the resources and we need the nurses and we need retention and we need the tools in order for us to take care of our patients and our community.”

Union nurse and bargaining team member Jeanne Mould said there has been some progress on proposals centered on safety and working conditions, “but when it comes to some of the proposals that would increase nurse retention, we get a lot of, just, pushback and not even budging.”

Though nurses and Mission have planned several bargaining sessions into the summer, the union is circulating strike pledges, commitments members sign to be a part of a work stoppage.

“In other hospitals where a majority of nurses sign these strike pledges, it’s a very powerful escalation on our part that makes HCA (Mission’s corporate owner) take pause or at least take us seriously because they know a strike is possible,” said nurse Mark Klein, a member of the union bargaining team, in a video posted to the Mission Nurses United Facebook page.

Mission Health spokesperson Nancy Lindell said a strike is “absolutely unnecessary, given the serious efforts we have invested in bargaining since mid-April.”

“We would be disappointed in National Nurses United leadership if they made the decision to strike,” Lindell said Tuesday before the contract expired. “In addition to our current wage increase proposals, Mission gave a $20 million increase in annual wages outside of the current contract and above and beyond that agreement. Mission also made a significant proposal that will address RNs’ concerns regarding workplace safety by enhancing our existing security measures.”

Even if nurses were to vote to strike, there is no guarantee it would happen because the hospital and union might reach a deal between the vote and the date of the strike. If a strike were to become imminent, the union would likely notify the hospital at least 10 days in advance, a union spokesperson said.

Should nurses decide to strike, they would be protected by law from being fired. National Nurses United is hosting three strike education sessions for nurses in July, according to a flier obtained by The Watchdog that is circulating among members.

Lindell said if there is a strike, “Mission Hospital will remain open,” and noted HCA Healthcare “has resources to support our patients’ needs.”

She said Mission has taken “proactive measures including contracting with fully qualified, licensed, and certified nursing staff who can provide high-quality care to the communities we serve.”

Mission is legally required to maintain the status quo of the expired contract until a new labor agreement is reached, National Nurses United spokesperson Lucy Diavolo said.

“Anything that would be subject to mandatory bargaining (e.g., working conditions, hours, employee policies) can’t be changed except through negotiations with the nurses,” Diavolo said. “‘Status quo’ is the really important concept here.”

But nurses are still exploring options around the fight for what they say will be a better contract. Negotiations will now continue indefinitely into the summer.

At a recent bargaining session, Mission proposed a 3.5 percent pay increase for registered nurses over the life of the three-year contract, said Klein, the union bargaining team member. Taking into account inflation, Mission’s proposal was “totally unacceptable,” Klein said in the Mission Nurses United Facebook video.

“The nurses union and HCA are still very far apart on the most important issues, which are staffing and compensation,” Klein told The Watchdog. “They don’t want to move on the things that are really going to cost them money.”

Strikes are expensive for hospitals, which must pay to make up for a sudden deficit in workers, Klein said in the video.

“It’s a very heavy lift for the hospital to bring in over 1,000 nurses to cover the nurses that are on strike,” he said. “It’s extremely expensive, even for one day.”

More than 10,000 union nurses at nine HCA bargaining tables in six states currently are working through the negotiating process, according to the union flier. National Nurses United is offering strike classes to those hospitals.

Mission has circulated at least one document, obtained by The Watchdog, that is a list of FAQs informing nurses of various rights and choices regarding union membership and a potential strike.

The labor impasse comes during a tumultuous year at Mission. In February, the U.S. Centers for Medicare & Medicaid Services placed the hospital in immediate jeopardy, the most serious sanction a hospital can receive. A report related to deficiencies in care that triggered the immediate jeopardy detailed the endangerment of 18 patients between 2022-2023 because of Mission’s lack of adherence to federal care standards. Four of those patients died, according to the report.

Attorney General Josh Stein, the Democratic gubernatorial candidate, sued HCA in December 2023, alleging the country’s largest healthcare corporation wasn’t honoring the commitments it made when it bought Mission. In February, lawyers for the hospital chain asked a court to dismiss the lawsuit, saying HCA never promised to provide quality health care.

But nurses aren’t convinced these external pressures have changed much.

“I would hope that all the immediate jeopardy and all the press that… has been focused on Mission would make a difference, but I’m not convinced that is helping anything,” Coward said. “HCA doesn’t care about the patients or what happens to our patients. It’s 100% profit.”

Mission’s nurses union formed almost immediately after HCA purchased the Mission Health system in 2019 for $1.5 billion. The union represents more than 1,600 registered nurses at Mission. Just more than half of those are due-paying members. Between 2022 and 2023, at least 660 registered nurses left Mission,a Watchdog investigation found.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@avlwatchdog.org. The Watchdog’s reporting is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/donate.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County.