Contract Negotiations Update

Barton Health is committed to delivering safe, high-quality care to the Lake Tahoe community and its visitors. Our nurses and staff provide outstanding patient care to this community, and we value their contributions.

Background Information

In November 2017, Barton Memorial Hospital Registered Nurses (RNs) voted to join the California nurses’ union. In March 2018, Barton Health and the union began negotiating a first contract. Three nurse representatives and two union representatives meet with representatives from Barton Health, including Barton’s Chief Nursing Officer, Human Resources Director and an outside labor attorney, to negotiate the many proposals that make up a contract.

This initial contract sets decisions and agreements in place for years to come, and Barton understands the importance of getting this initial contract right. We believe this contract should be fair to both our nurses and our organization. We have taken and will continue to take special care with each proposal and tentative agreement that results in the full contract.

Negotiations Summary

As of November 19, 2024, 75 sessions have been held; Barton and the nurses' union have agreed on 45 Tentative Agreements with six left to discuss:

• Association Security
• Compensation: Wages, Premiums & Differentials
• Health, Dental, Vision Benefits
• Management Rights
• Employment Categories

Six bargaining sessions have been attended by a representative from the Federal Mediation and Conciliation Service.

Timeline

• November 2017 - Barton Memorial Hospital nurses voted to join the California Nurse's Association (CNA).
• March 2018 - Initial contract negotiation meeting.
• April 2019 - Barton Health and CNA both filed Unfair Labor Practice (ULP) charges with the National Labor Relations Board (NLRB) against each other contending each party was refusing to engage in good faith collective bargaining.
• May 24, 2019 - Nurses participated in a California nurses' association strike.
• August 2019 - NLRB found no merit to the ULP filed by the union against Barton Health.
• September 20, 2019 - Nurses participated in a California nurses' association strike.
• September 2019 - NLRB substantiated the ULP charge against the union and required the union comply with Barton’s request to provide a copy of a contract from a hospital similar to Barton. In the spirit of cooperation, Barton has dropped the additional charges.
• February 2020 - Barton presented the union a final, comprehensive contract which has not been ratified.
• September 2020 - Barton informs the union we are at impasse; an impasse happens when the parties are not able to come to an agreement on contract terms.
• April 16, 2021 - Nurses participated in a California nurses' association strike.

Nurses at Barton Health

By The Numbers

• 172 – number of nurses in the CNA bargaining unit
• 225 – number of nurses employed at Barton Health

Compensation (Benefits, ETO, Wages)

Barton nurses and all employees are fairly compensated, receive a generous vacation package and competitive health benefits.

• The average wage for a full-time nurse at Barton is $69.28 per hour or an equivalent of a full time annual salary of $144,102 per year.
• New employees receive 4.5 weeks of earned paid time off a year, and this quickly grows to 7 weeks -- almost two months -- of earned time off after 5 years for full time employees. After 10 years, full time employees accrue 8 weeks of ETO annually.
• Barton offers a choice of three health benefit plans, where the most popular plan costs just $25-74 per pay period* for medical healthcare coverage depending on the size of their family.
  (* Based on Employee Wellness Program completion.)
• Barton offers a 403b Retirement plan matching funds up to 5%.

FAQs

• Which nurses are included in the bargaining unit? Nurses represented by the California Nurses Association include nurses at Barton Memorial Hospital and Lake Tahoe Surgery Center. Outpatient nurses at Barton Health locations outside of the hospital or surgery center are not represented by CNA or a part of this contract negotiation.
• How are wages determined? Barton takes many factors into consideration when setting wages. We must be competitive with similar-sized hospitals in both CA and NV. We must be fair, treating employees equitably regardless of whether they are part of a labor union. Since we do not have a parent company healthcare system to support us in challenging times, we must ensure that our overall financial picture is balanced without increasing the cost of care to our patients.
• What is Barton’s turnover rate for RNs?
  2016: Barton = 9.5%/ CA = 10.7%
  2017: Barton = 8.7%/ CA = 11.4%
  2018: Barton = 11%/ CA = 10.5%
  2019: Barton = 11.7%/ CA = 10.7%
  2020: Barton = 13.7%/ CA =12.3%
  2021: Barton = 19.2%/ CA = 13.8%
  2022: Barton = 17.3%/ CA = 16.9%

Nurse staffing is an issue throughout our region and country. Barton continues to focus on recruitment on staffing through the following efforts:
- Continuously recruiting for nurses
- Filling positions with temporary nurses
- Implemented a New Grad program to mentor and teach new nurses fresh out of school

• What is union membership (“Association Security”)? The state laws of Nevada and California are different when it comes to union membership: Nevada state law makes it unlawful to require employees to join a union while California law says an employer and union can decide together if RNs are required to join the union. Barton employs nurses in both states and wants the same rule to apply to all union nurses regardless of the state in which they work. All union nurses would have the choice to opt in or out of the union once the contract is final; and we will respect and support their decision.
• Are staffing ratios safe? Yes, staffing ratios are set by law and and Barton Health meets all staffing ratios required by the state of California. Barton Health meets or exceeds California state requirements for staffing ratios. In 2017, Barton Health requested to remove the rural ratio waiver from the state to increase its required staff ratio to 1 nurse for every 5 patients in Med/Surg/Ortho (previously it was 1 to 6). Once approved, Barton began recruiting additional RNs to reach the 1:5 ratio. Additionally, since 2017, Barton has added 60 nurses to the team increasing coverage for all departments.
• Do nurses receive adequate breaks? Many of our nurses work 12 hour shifts. Barton Health offers three 15-minute breaks per 12 hour shift in addition to a 30 minute meal period, so our nurses are rested and ready to provide exceptional care. If a nurse cannot take their third break. Barton then pays them for one additional hour based on the missed 15-minute break, in compliance with California law.
  Barton Health offers 15 minute break periods exceeding the 10 minute break periods required by California law.
  

  	Breaks Per Shift
  CA Law	3 10-minute breaks per shift
  Barton Health	3 15-minute breaks per shift

• What healthcare benefits does Barton provide its nurses? Barton provides all employees with three health plans to choose from. The plans provide coverage levels with differing deductibles: two PPO plans with different premiums and deductibles ($750 or $2,500) or a high deductible health saving account (HSA) that falls between the two PPOs in terms of cost, but includes a deductible that must be met before the financial benefits kick in.
  Each option includes this 50 percent reduction to the premium if the employee participates in Barton’s wellness plan, which helps employees achieve optimum health by offering education, classes, and support toward other health-related goals such as activity and smoking cessation.
  Additionally, copays for the PPO plans are deeply discounted, and don't require employees to meet deductibles, if the employee uses a Barton facility or provider. Some examples include:
  
  • Doctor visits and urgent care: $25 per visit
  • Rehabilitation: $25 per visit
  • MRI/ CT/ PET: $250
  • Inpatient hospital visit: $750 per admission
  • X-rays and Lab: $35
  • Generic drugs: $15
• What does Barton do with its profits? As an independent, non-profit hospital, Barton Health reinvests all of its earnings back into the health system to provide care for the community we serve. This includes contracting quality providers, purchasing modern technology and equipment to save lives, and offering a breadth of services for our community. 
• If nurses strike, will the hospital remain opened? All services at Barton Memorial Hospital will remain open to serve the community. We have made arrangements during the event a strike is called to hire qualified replacement nurses. The staffing agency is well known for employing nurses with experience during labor actions. Barton has made clear to the staffing agency all the necessary qualifications needed in each department. These experienced, high-quality nurses will work alongside Barton staff, leaders and physicians providing the care needed to our patients and community.
  The Lake Tahoe Surgery Center will reschedule patients during this time period to either Barton Memorial Hospital.
• How long will replacement nurses be used? When hospitals and healthcare providers receive a strike notice from CNA – which has occurred numerous times over the years – the union knows that healthcare providers such as Barton Health are required to hire qualified replacement nurses to replace striking nurses. Barton's contract with the staffing agency requires a 5-day minimum for the replacement nurses, which is standard. The National Labor Relations Board has upheld as lawful healthcare employers' right to a 5-day replacement period for contract nurses to work.
• Will this affect patient care? No, Barton Health will maintain the mandated amount of nursing care using qualified RNs. Patient safety is of utmost importance and safe patient-nurse ratios will not be compromised.