Times Observer file photo by Brian Ferry Members of Pennsylvania Association of Staff Nurses and Affiliated Professionals (PASNAP) — which represents nurses, social workers, and medical technologists at Warren General Hospital — and supporters participate in a picket outside the hospital on Friday, Oct. 15. Members of the hospital’s negotiating team have taken exception to some of the statements made by union officials.

Warren General Hospital recognizes the importance of its nurses.

Management wants to have happy nurses.

“We love our nurses,” the hospital’s negotiating committee’s lead negotiator Mark Kuhar said. “We value our nurses. They’re professional.”

“This place closes if we don’t have fantastic, hard-working nurses,” he said.

At the same time, the hospital’s negotiating team is disappointed in how the negotiations have been publicly portrayed, especially by union representatives from far outside the Warren community.

“For them to take the position in the paper and characterize us that we’re not being fair to them economically and it’s all about patient care, it’s nothing but a money grab by people who are extremely well compensated,” Kuhar said. “This is the best package any hospital employer has offered any group of nurses within 10 years within 80 miles of here.”

The nurses’ contract expired on Sept. 30. The union members are working under the terms of the previous contract, but not under a formal extension, according to the hospital’s team.

Last week, the Pennsylvania Association of Staff Nurses and Associated Professionals held an informational picket outside the hospital. Local members were joined by local supporters and union representatives from outside.

Many of the signs carried by marchers called for staffing changes and more pay. Speakers mentioned proposed changes to the retirement benefit in the contract.

The two sides are not so far apart.

“All the issues have been resolved at the table except for three, and one of the three has been resolved with a footnote,” Kuhar said.

Those issues are wages, retirement, and staffing.

With respect to pay — PASNAP leaders said the hospital’s proposal includes “a 2-percent across-the-board wage increase.”

There is language in the offer that includes 2 percent base increases – but every employee who is impacted by the contract will get more than that.

“No one is going to get (just) 2, 2, and 2,” Kuhar said. “No one would get less than 7.6 percent” over the course of the contract. “Some will get 18 percent.”

Every employee fits somewhere on the contract’s longevity scale.

“Employees hired on or before the effective date of this agreement will be paid a longevity premium of $1.15 from their third anniversary through their fifth anniversary,” according to the proposal.

A new hire’s pay will go up 2 percent effective Jan. 1, each year of the contract, and, when that person reaches three years, they will receive a bump of $1.15.

Personnel who have been at the hospital longer will receive more.

The five-year longevity bump is $2.25 under the proposal. The old rate was $1.75. Under the proposal, effective Jan. 1, 2022, all employees with five, but not 10, years of longevity, receive the $2.25 bump in addition to the base rate, which is 2 percent higher than the 2021 rate.

Those longevity bumps increase for each year of the contract. In the example above, on Jan. 1, 2023, employee would go from $29.52 to $30.11 in base pay with a bump of $2.48. On Jan. 1, 2024, the rate would be $30.71 and the bump would be $2.72. That employee would be paid $33.43 an hour for the last year of the contract – unless they hit the 10-year longevity point during that time.

Each longevity step has a similar increase, but the change is greater for those who stay longer. For those who have been with the hospital for 30 years, but not 35, the proposed bump is $4.57. Under the existing contract, that bump is $3.57.

The proposal removes the old three-year longevity category (while providing the same $1.15 at the same time for existing employees) and adds a 35-year longevity category.

Kuhar said the contract’s starting points and longevity rates will be applicable to new hires who come to the hospital with experience.

“There’s a contract provision, if someone has prior experience as an RN, we are allowed to push them up in the schedule,” he said. “We’re allowed to give them credit up to 10 years. In this market, we absolutely would.”

The proposal includes other pay increases — 20 cents per hour more for the second- and third-shift premiums, team leader pay up 75 cents per hour, “increase on-call pay by $1 per hour for most employees,” and a clinical ladder program that would pay employees up to $3 per hour more as they achieve professional development milestones.

The clinical ladder is not something the union had to bargain with the hospital for. “That’s a give,” Chief Nursing Officer Joe Akif said. “We are looking for professional development of our team… to bring that world class care that Mr. Allen really wants to bring to the table.”

“That is what recruits and retains new nurses,” Kuhar said.

Particularly during the COVID pandemic, ICI incentives allow nurses to pick up bonuses for agreeing to work up to three extra shifts per week for six weeks. In addition to regular pay, and overtime pay, the bonus is $1,700 for six weeks at one extra shift per week, Executive Director of Operations Kathryn Carlson said. More extra shifts means more bonus. There was no bargaining needed for that item, Kuhar said.

During the picket, union members mentioned the amount CEO Rick Allen is paid.

The negotiating team pointed out that his compensation is in line compared with other hospital administrators.

“Rick Allen is paid at the 50th to the 60th percentile,” Kuhar said. “Our nurses are paid between the 55th and the 90th.”

RETIREMENT BENEFIT

In 2019, the sides agreed to eliminate the defined pension benefit. Kuhar has been the lead negotiator for the hospital for over 25 years and remembers that item from the previous negotiations. “There was no way we could wrap up negotiations” without eliminating the pension, he said.

Hospital management gave up defined benefit pensions in 2005, Kuhar said. The hospital’s other union — AFSCME, representing over 200 members — also gave up the pension in 2006.

In 2019, management and PASNAP agreed to move forward with an existing 403b plan and to do away with a policy that had the hospital paying 4.5 percent of employee pay into the 403b even if the employee put in nothing, Kuhar said. It was called a discretionary contribution, but it was in the contract, so it was not at the discretion of the hospital.

The new proposal includes an increased match to the 403b — matching employee contributions of up to 6 percent. The previous match topped out at 4.5 percent.

Kuhar said the union wants to “resurrect” the 4.5 percent discretionary contribution. “Our peers don’t do that,” he said. “We won’t resurrect that.”

STAFFING

Nurses at the picket said the hospital wouldn’t even negotiate on staffing.

That’s true, Kuhar said.

Staffing is a “core function” of the management of a hospital, especially when there is a shortage of nurses, he said. “We are not going to give the nurses union the say regarding how many nurses we have.”

“The key is tying the right resources with the patients,” Akif said. “We take a hard look on a weekly basis. We review daily. In certain circumstances, we look at it almost hourly.”

“Grids and ratios tie our hands,” he said. “If you use hard-and-fast numbers, you lose that flexibility.”

“There is only one state in the country that has legislated ratios – California,” Akif said.

Regionally, the hospital’s peers typically have a ratio of one nurse to every eight to 10 patients.

At Warren General, that ratio is about one nurse to ever six patients, he said.

The two sides essentially agree on staffing.

“We have an understanding with the union that resolves the staffing issue,” Kuhar said.

According to the hospital’s team, the union didn’t want to resolve that issue before the picket.

“Staffing took up most of the space on the billboards,” Kuhar said. “Every single time we’ve come into negotiations, the nurses try to leverage their influence on the community regarding safe staffing.”

“They made their safe staffing proposal on Aug. 5 and didn’t talk about it with us one time until Monday, Oct. 11,” Kuhar said. “Everybody in the room knew and knows why it was there, which is so they could point to something and unsettle people, unfortunately, which is exactly what they did.”

He described the staffing issue being the “centerpiece of their public outreach” as “hyper-ironic.”

“It wasn’t so much the staffing levels that they were worried about, it was their opportunities to get extra shifts,” Kuhar said. “They’re not even proposing that we have more staff.”

When Carlson proposed a method of inviting nurses to respond to extra shifts, Kuhar said, “they said, ‘that would be fine, we won’t push the staffing issue any further with that, but we need to inflict some pain on the hospital because you’re changing our retirement plan, so we’re not going to agree to it until after we picket.'”

“They officially turned down our proposal, but when I talked to them about it later, they said, ‘it’s not that we dislike that option, that’s going to work fine for us, but not until you all have had some pain, which is the picket,” Carlson said.

“The pain was because we’re changing their retirement plan so we have to experience pain and if they agree to it officially, they couldn’t put it on their signs,” Kuhar said.

NEXT STEPS

Tentative dates were set aside, but there are no negotiating sessions going on this week, Kuhar said.

Members of the negotiating committee expect the bargaining to wrap up fairly soon.

“We are looking forward to getting together and wrapping this up as soon as possible,” Kuhar said.

“I have been in these negotiations forever and we have never offered anything close to as generous as an overall package as this. The hospital is more organized, it’s more effective, it has a better leadership team.”

“All of those things were agreed upon prior to Oct. 11,” Kuhar said. “Oct. 11 is when the regional PASNAP rep arrived and just blew everything up. We were on track to have this done by now prior to that.”

The team is not as concerned with regional leaders.

“Our relationship is with our employees,” Akif said. “They’re local employees. They’re neighbors. They’re friends. We want to work together with them.”

That negotiations are sometimes contentious is not a surprise. Members of the hospital team know they want to have continued good relationships with union members and team members moving forward.

“We work with these people,” Akif said. “They are negotiating for the best that they can get. We understand that.”

“At the end of the day, we’re all here to provide great patient care,” he said.

The hospital is working to get the word out about the opportunities that are available locally.

“Two years after graduating high school, if you come to work at Warren General, you’re making approximately $58,000 a year,” he said. “You can make a great living right here in Warren.”

“With overtime, we’ll have people who make $80,000 this year,” Kuhar said.

“Warren General Hospital is a safe, high quality and successful hospital,” Allen said. “Through the dedicated and compassionate work of physicians, clinical and support staff, management and volunteers we have transformed our organization in to an award winning, economically stable and growing hospital.”

“We are updating our facility, expanding services and technology and most importantly investing in and recruiting more staff,” Allen said.