Negotiators from Mount Sinai West and Mount Sinai Morningside and NYSNA had their first meeting with a mutually agreed-upon mediator.

During the session, Mount Sinai and NYSNA exchanged language on a number of proposals.  

The sides will meet again with the mediator on Friday, January 9. 

Negotiators from Mount Sinai West and Mount Sinai Morningside and NYSNA have mutually agreed to mediation, which will begin with the next scheduled bargaining session on Thursday, January 8.

During today’s bargaining session, negotiators from Mount Sinai provided further assessment of their costing analysis of NYSNA’s economic proposals.

NYSNA today provided Mount Sinai West and Mount Sinai Morningside a Notice of Intent to Strike, which would commence on Monday, January 12, at 6 am. Mount Sinai negotiators reminded NYSNA that it is their right to strike, but that the hospital’s obligation is always to provide great patient care in every situation, so it will continue to prepare for a potential strike. 
 
During today’s bargaining session, the two sides met briefly to discuss some open items. Mount Sinai negotiators requested responses to some of their recent proposals, including on artificial intelligence. Mount Sinai also gave the union counterproposals on non-nursing duties and staffing enforcement tracking, as promised during the last bargaining session earlier in the week. 
 
The sides are scheduled to meet again on Tuesday, January 6.  

During today’s bargaining session, NYSNA delivered counterproposals on workplace safety and staffing enforcement. Mount Sinai West and Mount Sinai Morningside negotiators gave counterproposals on artificial intelligence and their own counter on staffing enforcement. The parties also discussed making changes to the Clinical Divisions used for floating. 

Mount Sinai and NYSNA reached new tentative agreements on providing call rooms to Cardiac Cath Lab and Interventional Radiology nurses, and removing an antiquated contract provision that allotted paid time off during each pay period for staff to cash their paychecks.

Mount Sinai negotiators also made significant improvements to their previous economic proposal. Management proposed an annual $4,500 increase in compensation (wages and benefits) per nurse over each year of the new three-year contract—an additional $27,000 in wages and benefits, and nearly $50 million invested in nurses over the life of the contract.

The parties also agreed that it would be beneficial to explore working with a mediator at future bargaining sessions and said they would discuss that further. 

The sides are scheduled to meet again on Friday, January 2.

During today’s bargaining session, negotiators from Mount Sinai West and Mount Sinai Morningside made a number of counterproposals to the union.   

Mount Sinai proposed that PACU nurses float within their Clinical Divisions if they have no patients, but also float to the ICU, where they would not be required to take a primary patient assignment. NYSNA negotiators said they would consider this proposal. Mount Sinai also made a counterproposal on Clinical Divisions, clarifying units where nurses could float and adding new units to the Clinical Divisions list. The union said they recognized a lot of work had been done on this topic but indicated they were not going to accept the Mount Sinai proposals to broaden places where nurses could float, and they also requested adding staff to the existing float pools. 

The union also provided proposals regarding staffing grid changes, including positions that are covered by a different union, and counterproposals on Advanced Practice Nurse cross- credentialing and artificial intelligence. 

NYSNA did not make any new economic proposals or move to reduce the costs of its previous asks, but concluded the session by providing Mount Sinai with its costing analysis of the economic proposals that the union originally made more than two months ago. Mount Sinai said it would review NYSNA’s analysis.  

The sides are scheduled to meet again on Tuesday, December 30. 

Negotiators from Mount Sinai West and Mount Sinai Morningside opened the session by welcoming a member of the Mount Sinai nursing leadership to speak to members of the NYSNA bargaining committee about the benefits of the TimeKeep payroll management system, which is the industry gold standard used by peer hospitals across the country. Following the presentation, NYSNA negotiators asked for an opportunity to ask follow-up questions at a future session. 

NYSNA negotiators then welcomed nurses from units at both hospitals to share experiences and explain why they were asking for additional staffing. Mount Sinai negotiators listened to each story and asked questions of the nurses to better understand their perspective. 

NYSNA then presented a new economic proposal that reduced their annual wage increase demands from 10 percent during each year of a new three-year agreement to 8 percent during each year of the contract. The union did not make new adjustments on any of its numerous other economic proposals. 

Hospital negotiators acknowledged that the union had reduced some of its economic demands, but said that because the initial asks were so high, the newly reduced proposal was still not close to a range that would be acceptable. NYSNA said they were asking for these wage increases to keep up with inflation, but Mount Sinai negotiators said they had previously shared analysis showing that, historically, NYSNA wage increases had outpaced inflation.  

During the afternoon session, Mount Sinai negotiators pointed out that the union had previously said it would respond to Mount Sinai’s proposals on Advanced Practice Nurses Cross-Credentialing and provide costing analysis of the union’s economic proposals. The union representatives said they still planned to respond to the nursing proposal and would give a cost analysis, but have not had the opportunity to prepare the analysis. 

Mount Sinai then made a number of counterproposals. One would make PACU nurses available to float to the ICU but would not have them take a primary patient assignment. Mount Sinai also offered a trade that would keep the current probationary period in exchange for the union dropping its proposal keeping nurses with 20 years of experience or more from being available to float.  

The next bargaining session is scheduled for Tuesday, December 23. 

Negotiators from Mount Sinai West and Mount Sinai Morningside opened the bargaining session by providing NYSNA negotiators with a number of new items, including: 

• A written representation of systemwide security plans and an anticipated timeline for implementation 
• A proposal for nurses who are orientees to become part of the grid once they have completed more than 50 percent of their orientation 
• A supplemental compensation proposal that would be an alternative to staffing enforcement language 
• A staffing enforcement proposal 

After breaking to caucus, NYSNA negotiators said they would provide a response to the new proposals.  

The two sides then asked to make a series of trades for proposals and did reach a new tentative agreement, where each side agreed to withdraw their proposals to adjust the number of days of notice required for a layoff. 

There was also discussion around NYSNA’s proposal on staffing for float pool nurses, with a focus on three specific units. Mount Sinai negotiators asked questions about the union’s requests.  

The sides are scheduled to meet again on Friday, December 19.

The Mount Sinai Morningside and Mount Sinai West negotiating team opened today’s session with a presentation from an external expert on artificial intelligence (AI), who has extensive experience advising other nursing organizations and health care/nursing unions on the use of AI.  

Following a detailed 45-minute presentation, Mount Sinai spent approximately three hours answering questions from nurses and members of the NYSNA bargaining committee, during which NYSNA members acknowledged that AI tools are already in use in their practice.  

Mount Sinai negotiators responded to concerns about technology impacting nursing jobs or clinical judgment, and explained how evaluating information from AI tools is no different than any other situation where a clinical decision needs to be escalated. Afterward, NYSNA requested that Mount Sinai accept their previous proposals on AI that would give NYSNA executive decision making on the use and development of AI tools, which hospital negotiators declined to do.  

There was no progress on core economic proposals. Mount Sinai negotiators asked NYSNA for a response to the hospital’s economic proposals, which would cost more than $44 million over three years, but NYSNA declined to respond. Hospital negotiators also again requested NYSNA provide its costing analysis of the union’s proposals, which they did not provide but said they would share at a future session. 

NYSNA responded by asking whether its other economic proposals, including those on staffing and retiree health, had been rejected, and Mount Sinai said that they had been rejected.  

Mount Sinai negotiators provided a set of 13 new proposals on a variety of issues, including a proposal that would move away from traditional leave balances and implement a paid time off program; expanding the probationary period to include the specialties of perioperative and psychiatric nurses; and establishing that NYSNA representatives could only meet with nurses during non-working times and in non-working areas. The union rejected all 13 of these proposals.   

Mount Sinai also agreed to add Tuesday, December 30, as an additional bargaining date. The upcoming bargaining dates are Wednesday, December 17; Friday, December 19; Tuesday, December 23; and Tuesday, December 30.  

Today’s bargaining session opened with negotiators from Mount Sinai West and Mount Sinai Morningside answering questions from the union about the hospitals’ economic proposal. Mount Sinai negotiators had the opportunity to clarify the numerous ways that its annual $4,000 increase in compensation could be allocated, such as wages, health care and pension benefits, experience differential, charge pay, and preceptor pay.  

Mount Sinai and the union also reached two new tentative agreements:  

• Per diem nurses – For per diem nurses who apply for full-time or part-time work in the same unit, the hours worked will be credited to their probationary period time.
• New graduate nurses or RNs with less than one year of inpatient/ED hospital experience – These nurses will not be assigned to the charge role during their first year of employment and no floating for their first six months of work.

Mount Sinai negotiators also provided five new proposals, which included: 

• TimeKeep – Mount Sinai proposed transitioning to TimeKeep, a digital time management system that is widely used by top systems across the city and the country. This would replace the outdated payroll systems currently in use and ensure nurses receive accurate and timely payments.

• Quality Incentive Program – Negotiators put forward a proposal that would create a committee made up of union and management representatives that would explore monetary incentives for nurses related to improvements on carefully measured patient outcomes, such as falls and pressure injuries. The rationale is that if the hospital receives additional payments for improved outcomes, the nurses would share in that collective success at improving patient care.
• Advanced Practice RN (APRN) cross-credentialing – Mount Sinai shared a written proposal that would enable APRNs to provide and support continuity of care and improve patient access across the Mount Sinai Health System.
• Sick Time – Negotiators proposed that sick time will not be counted as time worked in the calculation of overtime.
• Working Suspension – Mount Sinai proposed that nurses can continue to work and receive pay for non-egregious disciplinary actions, but that any discipline would still be part of their employee record.

Mount Sinai negotiators also discussed exploring if the hospital has a room that could be permanently assigned for on-call Cath Lab and interventional radiology nurses.

Management also agreed to look for additional bargaining dates in December. The sides are scheduled to meet again on Tuesday, December 9. 

Today, members of the Mount Sinai Health System security team started the bargaining session by answering questions from the union about Mount Sinai security procedures, and detailed several proactive measures that are already moving forward across the system, including a new visitor management system and weapons detection technology. This discussion built on the security team’s presentation last week, when they provided a detailed accounting of last week’s event, the morning after it happened.

Mount Sinai Morningside and Mount Sinai West negotiators then presented an updated economic analysis of the 128 pages of union proposals, taking into account their 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 Mount Sinai Morningside and West would be $1.08 billion on top of current costs—which is a nearly 257 percent increase from the current annual spend of $420 million.
• By the third year of the contract, the new annual spend for Mount Sinai would be nearly $844.5 million—an additional $424.5 million from the current spend of $420 million.

On a per-nurse basis:

• $92,000—By the third year of the contract, NYSNA’s proposals would increase the average RN’s annual pay by $92,000.
• $256,000—The average compensation per nurse would increase from $164,000 to $256,000.
• 101 percent increase in nursing costs—the union’s proposal would 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.

Management outlined that the cost is more than $44 million over three years. NYSNA immediately stated that the proposal was rejected. In response, Mount Sinai negotiators stated that it was a substantial offer, particularly if NYSNA would consider implementing the same cost controls that other union health plans have that would significantly reduce their costs, preserving the same excellent health care, and leave more to allocate toward wages.

Mount Sinai negotiators noted that NYSNA’s health plan costs $10,000 more than their colleagues’ in 1199SEIU who have a virtually identical health plan with the same coverage and benefits. They noted that if they could better control costs—without reducing benefits—both parties could discuss how to allocate more toward wages. NYSNA responded by effectively stating that they would not consider any type of cost-saving measures.

The security experts outlined the timeline for installing the previously announced enhanced visitor management system across Mount Sinai hospitals, addressed questions, and offered analysis about other security enhancements that have the potential to strengthen safety. Mount Sinai’s CEO reiterated this, stating, “We are in the process of expanding both our enhanced visitor management and weapons detection programs. We expect that cutting-edge weapons-detection technology implementation will be completed at our major campuses in 2026.”

The security experts agreed to return to the next session to address additional questions.

The union made presentations regarding additional nurse staffing for specific ED units. Hospital negotiators reiterated that they are undertaking additional operational and financial analysis in order to determine the hospital’s response to the union’s demands.

The next bargaining sessions are scheduled for Friday, November 21, Monday, December 1, and Tuesday, December 9.

A majority of the fifth bargaining session focused on NYSNA’s workplace safety and security proposals. Mount Sinai West and Mount Sinai Morningside negotiators reinforced the system’s commitment to providing a safe environment for everyone in its community. 

The session included presentations from some Mount Sinai West and Mount Sinai Morningside nurses. Following the presentations, NYSNA requested that Mount Sinai negotiators discuss security procedures. The Mount Sinai bargaining team said that discussion would be more effectively led by security personnel, who as subject matter experts would be best positioned to answer their questions. Mount Sinai negotiators offered to arrange for a presentation from Mount Sinai Security, who would provide details at a future session about all of the measures taken to protect patients, staff, and visitors. 

Despite the fact that Mount Sinai’s bargaining team had not had a chance to fully assess the impacts of their proposals, NYSNA demanded that Mount Sinai negotiators either accept their workplace safety proposals or provide a counter. Mount Sinai negotiators reiterated the central importance of safety for everyone who comes through the Health System’s doors and said they would assess the complete impacts of the proposals, including cost impacts, before providing any response. 

During the afternoon session, NYSNA made several requests for additional information about security incidents, which Mount Sinai negotiators agreed to provide. The sides also discussed NYSNA proposals on health insurance and artificial intelligence. Mount Sinai negotiators also said they would be preparing a comprehensive presentation on the economic impacts of all of NYSNA’s proposals at a future session.  

The two sides are scheduled to meet again on Friday, November 14, and agreed to several additional bargaining dates in December. 

Negotiators for NYSNA and Mount Sinai Morningside and Mount Sinai West focused the fourth bargaining session on reviewing proposals around a number of topics, including non-nursing duties, disciplinary history, and break coverage.  

Much of the conversation centered on questions about disciplinary history. NYSNA shared concerns about what they claimed was the perception of a punitive culture, but the facts show that this perception is unfounded. Mount Sinai negotiators summarized data that showed that over the past year there had only been two suspensions, and one termination, out of more than 2,000 nurses across the Mount Sinai Morningside and Mount Sinai West campuses.   

During the discussion, NYSNA negotiators agreed with Mount Sinai negotiators that clinical errors should always be addressed, but then questioned why an employee failing to show up for a shift without providing advance notice warranted a final warning. Mount Sinai negotiators responded that Mount Sinai has a longstanding practice that a “no call, no show” warrants appropriate discipline, because ensuring adequate staffing is such a critical issue for patient care. In any event, Mount Sinai reiterated that nurses always have the ability to challenge the discipline through the established grievance procedure.  

NYSNA requested that the Mount Sinai bargaining team bring counterproposals for some of their proposals, specifically around discipline and the grievance process; however, the Mount Sinai negotiators said that the protections that NYSNA is requesting are already provided in the current collective bargaining agreement and Mount Sinai policies. 

The two sides are scheduled to meet again on Friday, November 7. 

During the third bargaining session with negotiators from Mount Sinai Morningside and Mount Sinai West, NYSNA finally presented its complete economic proposals, including wages and hiring.  

After caucusing, the Mount Sinai bargaining team came back and said that they will need to take time to estimate the total cost of the proposals, but that after the initial review, the three-year cost appeared to be exceptionally high. Mount Sinai negotiators asked NYSNA if they had conducted a cost analysis of their proposal or estimated the number of new nurses that would need to be hired to meet their demands, and NYSNA’s bargaining team said they had not.  

The remainder of the session was spent with Mount Sinai negotiators asking questions about approximately 30 pages of proposals that NYSNA had presented at the previous session, on September 29, including proposals related to per diem employees, discipline history, and staffing.  

Mount Sinai negotiators concluded the session by stating they would conduct a thorough cost analysis of the comprehensive economic proposals and come prepared to ask additional questions at the next bargaining session.  

After two completed bargaining sessions, NYSNA has yet to present its core economic demands on wages to the Mount Sinai Morningside and Mount Sinai West bargaining team.

While the union did present a range of other demands, it is delaying the process through its continued insistence that bargaining take place on hospital premises. Mount Sinai negotiators reiterated that this was not a viable option and again offered to meet at NYSNA’s headquarters or somewhere centrally located—as the parties have historically done.

The Mount Sinai Morningside and Mount Sinai West bargaining team said it would begin to consider the proposals that were made, but underscored that it cannot respond fully until the union puts forward its complete economic proposals. NYSNA agreed to present these demands at our next meeting on Monday, October 13.

Both parties agreed to schedule additional bargaining sessions for the following dates: Monday, October 20; Friday, November 7; Friday, November 14; Friday, November 21; Monday, December 1; and Tuesday, December 9.

Negotiators for Mount Sinai Morningside and Mount Sinai West had their first official bargaining session with NYSNA at Mount Sinai’s offices on 42nd Street. At NYSNA’s request, a large part of the conversation focused on future bargaining locations.

NYSNA requested that sessions take place within the hospital. Mount Sinai negotiators explained that it was preferable for meetings to take place at a location that was not also used for patient care. In previous years, bargaining has routinely taken place at Mount Sinai offices on 42nd Street, so our request was that we continue to meet at this location, which offers multiple large conference rooms to accommodate bargaining and breakout spaces. Mount Sinai also has offered to meet at NYSNA’s headquarters in addition to 42nd Street, as the parties have done in previous rounds of negotiation.

Additionally, there is no reliable space at the hospitals where negotiations can take place without interfering with patient, student, or employee activities. For example, there were systemwide annual mass casualty exercises taking place that required the use of conference room facilities in hospitals across the system today.

There was no final determination made on future locations. The Union declined to provide any contract proposals at this time. We are set to meet again on Monday, September 29, and Monday, October 13.