Everyone in Western North Carolina knew the battle between HCA Healthcare, the owner of Mission Health, and National Nurses United, the labor group seeking to unionize at Mission, would be bare knuckle.
What no one knew was the unusual playing field on which the battle would be fought.
Not only is the quarrel taking place during the coronavirus pandemic, but the company’s handling of the crisis has become a key point of contention between the parties.
In a sworn filing, one nurse accused Mission of forcing nurses to attend anti-union meetings during their working shifts despite the ongoing health crisis.
A statement from the company did not deny this but characterized these sessions as “an important investment,” with group sizes limited at each session because of the crisis.
Unionizing effort and corporate countereffort
On March 6, California-based National Nurses United stated its intent to the National Labor Relations Board to conduct a union campaign among a group of nurses at the Asheville-based regional hospital system.
HCA, the Nashville, Tenn.-based for-profit health care giant, had acquired nonprofit Mission in February 2019, assuming a dominant market position across an 18-county region.
Almost from the start, HCA had been aware of whispers about unionizing within Mission’s ranks and was ready to address any organizing head-on, having dealt with union strike authorizations in several other states.
But what no one ever expected was that each party would be trying to win the hearts and minds of employees during a national health emergency.
National Nurses United’s filing with NLRB seeks to represent “all full-time, regular part-time and per diem registered nurses” employed by Mission at 509 Biltmore Ave. and 428 Biltmore Ave. in Asheville.
Its filing indicates that it expects 1,600 employees to be represented by the union if it wins a pending election.
Now, in additional documents filed with the NLRB, labor and management have butted heads at the very time hospital staff and managers are working side by side in the shadow of the new coronavirus.
Mission reported its first positive coronavirus case on March 21.
Mission requests delay, citing coronavirus
In a letter to the NLRB dated March 12, Mission said that, as an acute care hospital, it “has been and will continue to be significantly impacted by the spread of coronavirus disease.”
It told the labor board that the size of the cohort of nurses eyed by the union warranted a delay in a pending March 17 representation hearing so Mission could “complete its investigation, prepare for the hearing and prepare its statement of position form.”
A statement of position form is used by management to identify all individuals in a proposed unit of union representation. It also allows management to put forth a proposed broadening or narrowing of the group.
“Extraordinary circumstances exist that justify a postponement of the hearing and statement of position form deadline” due to the coronavirus pandemic, Mission management wrote.
“The (Centers for Disease Control and Prevention) has issued a guideline expressly for health care facilities, such as the employer, that emphasizes the criticality of ensuring health care systems continue to function during this pandemic. … The CDC emphasizes health care facilities should anticipate that as they face a surge in patients, they may simultaneously face ‘increased absenteeism caused by employee illness or illness in employees’ family members that would require them to stay home.’”
The scheduled March 17 hearing would divert employees’ attention from preparing to combat coronavirus, Mission said.
“As COVID-19 spreads and potentially causes a surge in patients and increased employee absenteeism, the employer, including its nurse managers and directors and other management-level employees, will need to focus their activities on responding.
“The employer anticipates that due to the size of the unit, which the petitioner states includes 1,600 employees, substantial (NLRB hearing) evidence will be required from these managers and directors. These same managers and directors will have limited availability to prepare or testify, however, as they need to focus on responding to issues related to COVID-19.”
In closing, Mission asked for the representation hearing to be postponed until March 31 and that it be moved from Winston-Salem to Asheville so participants could be closer to the hospital.
In its same-day response to Mission’s request for a delay, the union organizing committee said that Mission “has failed to show extraordinary circumstances” that would justify a delay in the hearing.
“Rather, it offers mere speculation about COVID-19 to delay the representational proceedings so that it can engage in its union-busting tactics,” the union response to Mission’s statement said.
“The employer’s argument that the representational proceedings will distract employer management from responding to COVID-19 is utterly preposterous. … The employer is currently engaged in round-the-clock captive-audience meetings with 15-20 nurses at a time at the hospital. Management is also having frequent one-on-one conversations with the nurses, urging them to oppose the union.
“If the employer can hold captive-audience meetings and have managers lobby nurses against the union while preparing for COVID-19, they can participate in a representation hearing.
“NNOC (National Nurses Organizing Committee)/NNU (National Nurses United) has been at the forefront of the fight against the spread of COVID-19. However, nurses’ Section 7 rights do not cease because of COVID-19, and COVID-19 shows the acute need for nurses to have a union so that they can ensure that they are working under safe working conditions.”
In its response, the union had no objection to moving NLRB’s representation hearing to Asheville.
In a third filing with the labor board, also on March 12, Mission nurse Kerri Wilson claimed in a sworn statement that nursing unit managers and on-call nurses have been covering certain shifts at the hospital so nurses can attend management’s anti-union gatherings.
“I am aware that the employer has been holding these types of meetings daily at all hours of the day with 15 to 20 nurses at each meeting beginning this week,” Wilson said in a sworn declaration filed with the NLRB.
Asked by CPP about the nurse’s claims in the legal filing, Mission spokesperson Nancy Lindell issued a statement late Monday.
“As part of our ongoing commitment to providing our nurses with factual information, Mission Hospital has engaged labor relations specialists to meet with nurses and help them understand their legal rights under the National Labor Relations Act,” Lindell said.
“We consider this an important investment in helping nurses make an informed decision regarding unionization. In light of the current pandemic and the importance of ‘social distancing,’ we are making every effort to limit all classes to no more than 10 participants and are making the labor specialists available to nurses on an informal basis as requested to answer any additional questions that may arise.”
As a result of coronavirus-related issues in some of NLRB’s regions, the March 17 hearing originally scheduled for the Mission-National Nurses United case is now scheduled April 6, an agency spokesperson said.
Several National Labor Relations Board field offices were temporarily closed last week so certain employees could be tested for COVID-19.
In response to the pandemic, the federal agency said that it has implemented an agencywide telework system that remains in effect until April 1.
In Lindell’s statement to CPP on behalf of Mission late Monday, she expressed the company’s satisfaction with the rescheduled hearing.
“We appreciate that the NLRB understands Mission Health’s critical role in protecting the health of our Western North Carolina community,” Lindell wrote. “It’s currently unclear whether there will be additional delays in the hearing, and as a result, the decision to set an election date.”
Once the Mission-National Nurses United hearing takes place, the NLRB will issue a decision on the specific class of workers to be represented. Both parties will then have the right to appeal that decision.
Jennifer Corbin, an NLRB agent at the Winston-Salem office that has jurisdiction over the case, said it is entirely possible the union vote at Mission may not occur as early as it might have.
“In a noncorona world, without any objection to the unit that we determine is appropriate, there could be an election within six weeks of the hearing,” Corbin told Carolina Public Press.
“But I don’t see that happening here.”
Mission makes billing policy adjustment
A report Monday from WLOS indicates that Mission Health also issued a statement of plans to adjust billing practices that have drawn complaints from patients, including complaints that have gotten the attention of Attorney General Josh Stein.
Stein has told HCA that it has until the end of March to answer a range of questions about the billing problems and other issues that have been brought to his attention. Doubts have been raised about whether HCA’s management of Mission is in full compliance with stipulations it agreed to when the state approved its acquisition of Mission in early 2019.
The billing issues that Mission addressed Monday involved additional charges for patients who saw a physician working at a Mission facility other than a hospital.
In a statement reproduced by WLOS, Lindell said, “The change unfortunately created confusion for commercial insurance and Medicare Advantage patients who previously received one bill, rather than two, and whose out-of-pocket payments may have changed. We sincerely apologize and are taking immediate actions to fix this issue.”
You can strengthen independent, in-depth and investigative news for all of North Carolina
Carolina Public Press is transforming from a regionally focused nonprofit news organization to the go-to independent, in-depth and investigative news arm for North Carolina. You are critical to this transformation — and the future of investigative and public interest reporting for all North Carolinians.
Unlike many others, we aren’t owned by umbrella organizations or corporations. We are an independent and nonpartisan 501(c)(3) not-for-profit organization, founded and operated in North Carolina. And we haven’t put up a paywall — we believe that fact-based, context-rich watchdog journalism is a vital public service. But we need your help. Carolina Public Press’ in-depth, investigative and public interest journalism takes a lot of money, persistence and hard work to produce. We are here because we believe in and are dedicated to the future of North Carolina.
So, if you value independent, in-depth and investigative reporting in the public interest for North Carolina, please take a moment to make a tax-deductible contribution. It only takes a minute and makes a huge difference. Thank you!