Mount Sinai negotiators presented an updated economic analysis of the 150 pages of union proposals, taking into account the scale and complexity, which negotiators needed additional time to fully understand and evaluate. Negotiators shared the following summary of those proposals:

• The total cost of NYSNA’s proposals for The Mount Sinai Hospital would be $2.97 billion on top of current costs—which is approximately a 345 percent increase from the current annual spend of $861.6 million.
• By the third year of the contract, the new annual spend for Mount Sinai would be nearly $2 billion—an additional $1.15 billion above the current spend of $861.6 million.

On a per nurse basis:

• $113,000—By the third year of the contract, NYSNA’s proposals would increase the average RN’s annual pay by $113,000.
• $275,000 for 10 Days of Work/Month—By the end of the contract the average nurse at The Mount Sinai Hospital—who would work 10 days a month under NYSNA’s proposals—will earn $275,000 per year (rising from the current average of $162,000).
• 133 percent increase in nursing costs—The union’s proposal would more than double Mount Sinai’s nursing costs.

Mount Sinai negotiators concluded by stating that the significant cost of NYSNA’s proposals, coupled with the impacts of the Big Beautiful Bill (H.R.1), make them unsustainable. Hospital negotiators then put forward a counterproposal on compensation.

Economic Proposal

• Mount Sinai proposed an annual $4,000 increase in compensation (wages and benefits) per nurse over each year of the new three-year contract.
• This means that by the third year of the contract, Mount Sinai would have increased the annual compensation of every full-time nurse by $12,000, which is a cumulative total of $24,000 in additional compensation over a three-year period.
  • This is $4,000 additional compensation in year 1, $8,000 in year 2, and $12,000 in year 3.

The cost of this proposal is more than $90 million over three years, which NYSNA characterized as “insulting.” After the union questioned how they should consider allocating this increase across wages and benefits, Mount Sinai negotiators suggested that one area NYSNA could discuss is implementing the same cost controls that other union health plans have that would significantly reduce their costs, leaving more to allocate toward wages.

Negotiators noted that NYSNA’s colleagues in 1199SEIU have a medical plan with annual costs that are $10,000 less per member than the NYSNA plan, while offering virtually the same coverage and benefits. Management made clear that these types of reforms would not in any way be reducing benefits, but are mechanisms designed specifically to control costs—something NYSNA has inaccurately stated is a reduction in benefits. NYSNA also stated that they were unwilling to negotiate any cost-saving measures to the current health plan.

After a break, members of the Mount Sinai Health System security team joined the bargaining team to answer questions from the union about Mount Sinai security procedures, and outlined several proactive measures that are already moving forward across the system, including a new visitor management system and weapons detection. In addition, the security representatives provided a detailed accounting of last week’s event.

The parties spent a majority of the fifth bargaining session discussing staffing for individual units. Mount Sinai nursing leadership emphasized that the current staffing levels are in line with—or exceed—those at other systems, and negotiators from The Mount Sinai Hospital reiterated that the hospital’s vacancy rate is currently low, below the national average, and that retention has also seen dramatic improvement during the current contract.   

A large portion of the session also included presentations from more than a dozen Mount Sinai nurses, which included acknowledging how much Mount Sinai has done to improve staffing. 

Mount Sinai negotiators also presented a counterproposal during the bargaining session, agreeing to add gender identity to the nondiscrimination clause of the contract as a protected characteristic. 

The next bargaining session is scheduled for Friday, November 21.

For the fourth bargaining session, The Mount Sinai Hospital negotiators came prepared to finish asking NYSNA questions regarding its 150 pages of demands; however, the union requested that they first be able to make presentations regarding immigration, LGBTQIA health care, and workplace safety. Mount Sinai negotiators agreed to their request and listened carefully to their proposals, while outlining that although they understand the union’s position on the issues, there are several areas regarding immigration and LGBTQIA healthcare where hospital policy must remain in compliance with federal and state law.

Workplace Safety
There was extensive conversation about workplace safety. Several nurses told their stories about disruptive patient and visitor behaviors and Mount Sinai negotiators outlined some steps already being taken to address the issue.

• After listening to accounts from nurses, negotiators said directly to them that they were sorry they experienced this, that no nurse should ever have to face what they described, and that they want to partner with them to find solutions.
• The hospital representatives stated that preventing these types of situations is paramount and that the system recently announced it would begin to deploy a new visitor management system at its campuses, and has also conducted a number of pilot programs for cutting-edge weapons detection technology.

Economics—The Cost of NYNSA’s Proposals
Following the presentations, Mount Sinai negotiators continued with detailed questions around NYSNA’s staffing demands and cost.

• When NYSNA was asked if it had estimated the cost of its staffing proposals, they responded that they had not.
• Mount Sinai negotiators asked the union if it had conducted an analysis for how many nurses their demands would require the hospital to hire and they also replied they had not.
• Hospital representatives outlined to the union that their proposals would require the hospital to hire a couple thousand nurses on day one, which is nearly impossible; NYSNA did not dispute that.

Mount Sinai negotiators then presented their current economic analysis of the 150 pages of union proposals highlighting the following key numbers:

• $92,000–By the third year of the contract, NYSNA’s proposals would increase the average RN’s annual pay by more than $92,000.
• $254,000 for 10 Days of Work/Month—By the end of the contract the average nurse—who works 10 days a month under NYSNA’s proposals—will earn more than $254,000 per year (rising from the current average of $162,000)
• 114 percent increase in nursing costs—The union’s proposal would more than double Mount Sinai’s nursing costs.

The union said that they developed these proposals despite what they understood to be the realities from pending changes in federal policy, which is universally accepted to cost New York hospitals $8 billion and 35,000 jobs. Negotiators underscored they were still conducting additional analysis, and there was some agreement with the union when hospital negotiators reiterated that Mount Sinai has increased the net number of nurses by more than 1,000 over the last three years and that the vacancy rate has been cut by more than half. The union responded, saying: “We appreciate and acknowledge the vacancy rate has improved.”

AI and Technology
Toward the end of the bargaining session, Mount Sinai negotiators asked questions regarding the union’s AI proposals and made the point that they would restrict Mount Sinai’s ability to implement AI. Mount Sinai has previously publicly stated that AI is designed to reduce repetitive workloads for our care team members so they have more time to use training, expertise, and judgement to deliver unparalleled medical care.

Next Steps
At the end of the session, the union asked for additional information and Mount Sinai responded by asking that they send formal requests, which the hospital would respond to it as timely and completely as possible. The next bargaining session is scheduled for Monday, November 3, and the sides anticipate an in-depth discussion on staffing grids and ratios.

Negotiators for The Mount Sinai Hospital had their third bargaining session with NYSNA and spent a majority of the full-day session asking questions about the more than 150 pages of the union’s proposals. 

Hospital representatives noted that while they have not yet completed a full analysis of the economic impact of NYSNA’s proposals, their initial evaluation indicates that the union has asked for significant increases on every economic term and that their proposals would cost billions over the life of a new three-year contract. 

NYSNA negotiators conceded that all of their economic proposals included increases and yet in most cases they had failed to evaluate the financial impact of these proposals, and that there was no math to show how these requested increases were determined.  

The hospital representatives also stated the importance of contextualizing these proposals against the impact of the pending changes in federal policy, which are universally accepted to cost New York hospitals approximately $8 billion and 35,000 jobs, which would come before any new costs of a new collective bargaining agreement. NYSNA acknowledged that they understood these impacts and made these proposals despite these challenges. 

To better understand the economic impact of NYSNA’s proposals, the hospital negotiators also asked questions related to increases in differentials, staffing and developmental programs, and vacation days, among other items.

Hospital negotiators said they would continue to evaluate the NYSNA proposals, including a few additional proposals that were shared during today’s negotiating session, and were looking forward to the next meeting. The next bargaining session is scheduled for Wednesday, October 22.

Negotiators for The Mount Sinai Hospital had their second bargaining session with NYSNA, which presented a comprehensive package of demands.

It was apparent that NYSNA’s demands seek sweeping economic increases to virtually every financial term in the current collective bargaining agreement.

Mount Sinai’s negotiators expressed at the table that while they have the utmost respect for Mount Sinai’s nurses and their incredible work and dedication to patient care, NYSNA’s proposals are disappointing because they are untethered to the economic reality of the Hospital and the health care industry as a whole, and are fiscally irresponsible.

The Mount Sinai Hospital bargaining team said it would more fully review the demands and assess the complete economic impacts and come prepared to discuss at the next scheduled meeting, on Wednesday, October 15. The sides also agreed to schedule additional bargaining sessions.

Negotiators for The Mount Sinai Hospital held their first official bargaining session with NYSNA at Mount Sinai’s offices on 42nd Street.  

The negotiating team came ready to discuss proposals and bargain, particularly since this session had been scheduled for weeks and NYSNA recently presented extensive demands to other hospitals that are currently bargaining with it—including wage proposals. 

NYSNA negotiators stated that they would not share any contract proposals until there was an agreement on where to hold future bargaining sessions. NYSNA continues to insist that sessions take place on the hospital campus, while Mount Sinai negotiators have explained that the hospital does not have the appropriate space to routinely host negotiations without interfering with patient care, scientific research, student and trainee education, and employee activities.  

In previous years, bargaining has taken place at Mount Sinai offices on 42nd Street and NYSNA’s headquarters, and Mount Sinai said that its preference is to continue meeting at either or both of those locations. Nevertheless, Mount Sinai’s negotiators listened to NYSNA’s concerns and agreed to explore off-campus locations closer to the hospital. 

There was no final determination made on future locations; however, both sides agreed to meet next on Friday, October 3, and Wednesday, October 15.