Contract talks between management and nurses at the Martha's Vineyard Hospital are now at a bitter standoff, and hospital chief executive officer Kevin Burchill said this week that he is prepared for the possibility of a strike.
"Everything is now off the table. We're prepared for the worst but we expect the best," he said.
Mr. Burchill said some 33 registered nurses at the Vineyard hospital are now officially working without a contract. He said the contract was extended once, from Sept. 22 to Nov. 3. The nurses have asked for another extension, but Mr. Burchill said yesterday that the answer is no. "I do not intend to grant this request for an extension. That is absolutely clear," he said.
Only one side of the story has been made fully public; spokesmen for the local nurses' union said they were unable to make detailed statements until after a meeting scheduled for Monday next week.
"We are not looking to escalate this, and their approach to this has obviously not been helpful," said Eamon Hogan, associate director of the labor relations program for the Massachusetts Nurses Association (MNA). Mr. Hogan has represented the Vineyard nurses for 23 years.
Relations between hospital management and the nurses are believed to be at a low point unlike anything seen in recent memory.
Mr. Burchill said he first sat down with union spokesmen on Sept. 13. He said a Sept. 21 meeting was canceled by the union. He said both sides agreed to voluntary federal mediation; one session was held last Friday. There is disagreement between the two sides over the date of the next meeting.
"Right now they are working without a contract and to my knowledge there have been no strike votes and no information picket votes," Mr. Burchill said.
Mr. Burchill said he has retained the services of a company in Colorado to provide replacement nurses in the event of a strike. He reported that at the end of the session on Friday he waved the check he had written to the replacement company in front of the group of Vineyard nurses.
"This was destined for a collision course. This is just like Brockton - and if they want it to be like Brockton, it can be like that," Mr. Burchill said, referring to a 103-day nurses' strike that rocked the Brockton hospital this year.
Mr. Burchill said the hospital offered the nurses a three-year contract with a four per cent salary increase each year, plus a two-tiered "clinical ladder" that would offer salary increases in connection with clinical performance. He said the hospital offer also included a proposal to increase per diem rates for nurses every year.
He said the nurses want a package that includes a five per cent cost of living salary increase in the first year and six per cent in the second year, plus step increases that would amount to three and a half per cent for each step. He said the nurses also want early retirement benefits at age 58 and a more liberal prescription drug plan. He described a philosophical difference between the two sides. "We were looking for recruitment and retention. We're talking about raising the bar of clinical performance and rewarding people for it. There is a marked difference between rewarding people for longevity and for performance," he said.
Mr. Hogan said the early retirement request has been dropped. "We were prepared to drop most of our proposal; the remaining issue is the salary issue, and we are prepared to work on that," he said. He said hospital management has proposed a nearly complete gutting of the contract - an unprecedented move. He described other hardball tactics, including the elimination of a longstanding practice that allows nurses who are on the negotiating team to be paid for their time if a negotiating session takes place during regularly scheduled work hours.
"We may or may not be on a collision course. They have broken tradition," Mr. Hogan said. He agreed with Mr. Burchill that there is a philosophical difference, but he took another view about the solution. "I think there is a philosophical difference - but when they are talking about recruitment and rewarding seniority - those two things don't need to be mutually exclusive," he said.
The quality of the nursing care at the Vineyard hospital has drawn accolades over the years. Two years ago, one Island resident was so impressed with the nursing care while he was a patient that he gave $100,000 to the hospital.
The labor news is much better at the Windemere Nursing Home and Rehabilitation Center. Mr. Burchill and hospital chief financial officer Tim Walsh said there is now a memorandum of understanding for a contract with Windemere workers. Mr. Walsh is also the acting administrator at Windemere. The worker contract is the result of two sessions with a federal mediator. The two-year contract will include a four per cent salary increase each year, plus 10 paid holidays with an agreement to go to 11 paid holidays after the contract runs out. Also at the end of two years, differentials (pay for night and weekend shifts) for Windemere workers will be increased to the same level as at the hospital. Housekeepers will be paid an additional 25 cents an hour.
Mr. Walsh also reported that operating losses at the nursing home fell sharply in August and September, thanks to the elimination of "travelers," expensive nursing assistants from outside agencies. He said overtime pay has also been reduced as the nursing home gradually replaces an employee schedule built around part-time workers with a schedule built around full-time workers who put in 40 hours a week. Windemere is now projected to end the fiscal year with an operating loss of about $450,000. Most of the loss derives from the months before August, when the cost of outside labor soared. Losses in August and September were $26,640 and $6,272, respectively.
"I think the August and September numbers are what we should be able to run it at - conceivably we could run at a loss of $150,000," Mr. Walsh said.
He said an aggressive training course for certified nursing assistants has begun to pay dividends in the form of trained full-time workers; he said the home plans to continue to offer courses and to recruit workers from the Island community.
The Windemere fiscal year ends Dec. 31. The corporate name of Windemere is WNR Inc.; the nursing home is a subsidiary of the hospital and the hospital is carrying a $2.5 million mortgage on the home.
Financial news at the hospital is far worse. Second quarter financial statements show a year-to-date operating gain of $772,964, but this is a time of year when the hospital usually makes money and the number is in fact some $478,000 under budget. Mr. Burchill and Mr. Walsh said the hospital is now on target to post a $1.1 million operating loss at the close of its fiscal year on March 31. As is now the ongoing practice, the blow will be softened by using some $1.3 million in projected gift money to offset the loss.
There is more bad news. Mr. Burchill and Mr. Walsh confirmed that the hospital lost about $250,000 in the stock market this year. About 40 per cent of hospital endowment money is invested in the stock market. Another interesting fact also emerged: The bull market of recent years allowed the hospital to raid its unrestricted donor money for cash, thanks to an accounting practice permitted for charities in Massachusetts. Under the provision, the hospital can take seven per cent of appreciated assets in cash each year. The hospital has been taking advantage of the loophole at the maximum rate, but there is also another provision: The money must be returned if the withdrawal causes the base cost of the investment to drop.
Mr. Burchill and Mr. Walsh said this year is a close call, so the money will not be withdrawn.
"It's hit us twice - once on the balance sheet side and once on the revenue side, where we obviously cannot take the appreciation. All in all about $450,000," Mr. Burchill concluded.