BargainingFacts #17

Happy New Year!

We wanted to bring you a summary of where things stand at the beginning of 2015. As of today, we have been negotiating in good faith with Bill Cruice of PASNAP and the Crozer-Chester Nurses Association bargaining team for more than nine months. We are committed, as we have always been, to negotiating a fair contract with the nurses of Crozer-Chester Medical Center.

* * *

At our very first bargaining session on April 7, we identified a set of changes we “must have” in a new contract to ensure the long-term viability of Crozer-Chester Medical Center. These included the following:

  • A new and more competitive wage structure;
  • Elimination or reduction of costly and non-competitive pay premiums, such as extra-shift bonuses, “double backs,” and double-time for the first overtime shift;
  • Reduction by attrition of the Weekend Program and reduction of weekend rates that are currently $56.78 and $61.82 an hour;
  • A hard freeze of the Defined Benefit (DB) Pension Plan and transfer of participants into the Defined Contribution (DC) Plan;
  • An end of the employer match to the Tax Sheltered Annuity, beginning with employee contributions made in 2015, as well ending retiree medical, retiree life insurance, and sick leave payout on retirement for grandfathered nurses;
  • A common health plan including wellness, a smoker surcharge and an increased spousal surcharge; and
  • Priority on patient care when scheduling holidays, vacations, leaves and other time off.

We were clear up front about these needs, and we have not wavered from them because we cannot. These changes are required if the Medical Center is to meet its commitment to provide for the health needs of our community.

* * *

Our last comprehensive contract offer – our “Best Offer” – was made on Oct. 8, 2014. This “Best Offer” would have maintained the existing experience-based rates for the duration of a three-year contract dating back to June 2014, even though they are over the market and over the new proposed wage scale. However, this “Best Offer” was subject to the Union’s acceptance and ratification within a reasonable time.

The Union dismissed these concessions and did not offer any counterproposals that met the economic “must haves” we need to ensure the Medical Center’s long-term viability.

* * *

The Union recently proposed January 8 and 13 for further bargaining. We are unavailable on the 8th because we are already committed to bargaining with EMS personnel represented by PASNAP, but we have agreed to meet on January 13 if the Federal Mediator is available.

Bargaining Facts #16

On December 3 we attended another bargaining session. For this meeting, the Union requested the Federal Mediator, and we agreed. Unfortunately, the only mutually available date we could meet with the Mediator was December 3rd—a date on which we could not meet past 4 pm.

When the Mediator arrived she met with each side separately for most of the day. Her approach was to review each party’s positions and identify areas of agreement and disagreement. All communications between the parties went through the Mediator.

During our private meeting with the Mediator we told her we wanted to reach an agreement and we hoped to get a deal by the end of the day. We agreed with the Union that it might be easier to reach an agreement if we focused on a shorter contract, so we revised our proposals to fit into a contract expiring in two to three years—instead of five years.

Based on the parties’ discussions before the meeting, we felt progress could be made on important issues like the weekend program and transitioning from the defined benefit pension to the defined contribution plan. We also agreed we were very close on health insurance.

To make further progress, we conveyed through the Mediator our willingness to compromise and make our proposals more agreeable to the Union. This included some flexibility on wages, holidays, vacations and sick leave payout for “grandfathered RNs” who retired by a certain date. We felt optimistic because we had previously reached signed ‘tentative agreements’ on difficult issues, like displacement, staffing and professional development committee, monthly labor management meetings and transport team. While we were optimistic about making progress toward a deal yesterday­­—it did not turn out that way.

We found Wednesday’s meeting to be one of the most frustrating bargaining sessions we have ever had. We conveyed our ideas for compromise through the Mediator, but in response she reported rejection and inflexibility by the Union. Where we felt we were close to an agreement, new issues were raised that drove us further apart. Instead of moving toward an agreement, we seemed to be heading toward an impasse.

By the time the Mediator asked us about meeting directly with the Union, our bargaining team was very frustrated and there was no time left. Under the circumstances, we thought a joint meeting could backfire and set us further apart. In fact, neither side requested another meeting.   After the meeting ended, some of the Medical Center’s and Union’s representatives met in the hallway and discussed the awkwardness of not meeting face to face over the course of an entire day.

After the New Year, we may reach out to the Union to discuss whether it makes sense for the parties to meet again and, if so, discuss what the agenda should be.

BargainingFacts #15

Today was our first bargaining session since the nurses returned from the strike on September 26th. In this session, the Union made no new proposals, and it did not propose any further bargaining dates. By comparison, Crozer-Chester Medical Center presented a new “Best Offer” with incentives to get the Union to settle by October 17.

Highlights of the new package include the following:

  • The Medical Center proposed a new, five-year contract.
  • We offered to drop our proposal for pay cuts affecting the highest paid nurses as part of an overall contract settlement. These cuts would have saved the Medical Center almost $14 million over five years.
  • Those paid more than the new scale would be red-circled to protect their income levels for the next 5 years. On top of their salaries they also would get two percent (2%) of their salaries paid in a lump sum in 2017 and 2018.
  • Nurses covered by the new scale would get yearly increases to their step rates starting in 2015.
  • The Medical Center would delay freezing the pension plan until June of 2015. Plus, we offered the Union a choice of retirement plan contributions based on either age or seniority.
  • Weekend Program would continue and nurses would get a weekend hourly rate of $54.15 for days and $59.18 for nights. Those whose regular rates exceed the new weekend rates would get the higher rate.
  • While the Medical Center reserves the right to end the Weekend Program for substantial operational or economic reasons, nurses would be protected by the recent displacement agreement regarding notice, bumping rights, and severance if applicable.
  • The parties agreed they are not that far apart on health insurance.
  • Despite the recent strike, management will not back down on eliminating certain costly pay premiums, such as double time, double-backs, and extra shift bonuses.

If the parties do not reach a ratified agreement by October 17, however, Crozer reserves the right to pull these concessions off the table and return to its September 17th proposal. Since the Union has not even proposed bargaining before October 17th, it seems unlikely that the Union will meet this deadline.

We certainly encourage the Union to return to the bargaining table before October 17th to take advantage of this more favorable settlement opportunity. A copy of our new “Best Offer” is posted here.

The Confidence of our Community

The Pennsylvania Association of Staff Nurses and Allied Health Professionals (PASNAP) has gone on strike against Crozer-Chester Medical Center and mounted a bitter campaign of negative PR in their effort to wrest more money for nurses who already average $103,000 for full-time work – three times the per-capita income of Delaware County.

But members of the community have seen through this effort

In fact, admissions at Crozer were up 30% compared to typical levels on the first day of the strike.

Patients and physicians have chosen Crozer for such advanced services as burn and trauma.

And Crozer welcomed four new babies on Sunday. Mothers and babies are doing fine.

We deeply appreciate the confidence our community continues to place in us.

Action Speaks Louder

PASNAP complained loudly about nurse staffing levels at Wilkes-Barre General Hospital. Just like at Crozer.

PASNAP walked off the job at Wilkes-Barre General.  Just like they are doing at Crozer.

But when PASNAP overwhelmingly approved a contract with Wilkes-Barre General, it contained no staffing ratios. Just a wage increase of 7-12%.

In fact, according to, the nurses’ contract “remains silent on the issue they say is most important to their mission of patient care: mandatory staffing levels…”

The fact is that direct care staffing levels at Crozer-Chester Medical Center rank above average for hospitals nationwide – and in most cases, in the top third – when compared to benchmarks established by National Database of Nursing Quality Indicators, or NDNQI.

It’s not about staffing. It’s about more money and perks for nurses who already average $103,000 for full time work.

We call upon PASNAP to cease its negative publicity campaign and work with us in good faith to negotiate a fair contract for nurses at Crozer-Chester Medical Center.

BargainingFacts #14

With a strike only four days away, Crozer-Chester Medical Center opened yesterday’s bargaining session with a comprehensive “Best Offer,” with significant concessions, on the condition that the parties reach a ratified settlement by September 30, 2014. We also offered to make further compromises if the Union made identified concessions. Our new proposal contained the following:


  • Some steps providing modest increases for less senior nurses.
  • No step rate reductions for any nurses up through the proposed Step 15.
  • We significantly reduced our proposed step decreases for senior nurses and made them higher than Temple’s current rates.

Weekend Program

  • We offered to continue the weekend program if the Union replaced the current weekend rate with a $5 differential on top of the new proposed step rate. Top-of-scale nurses would still get of $53.12 to $55.91/hr., and with shift differentials some would get more than they do now.


  • We are considering the Union’s proposal to base DC Plan contributions on seniority rather than age. This could be a significant advantage to senior nurses.

Health Insurance

  • For the health plan we reduced our proposed spousal, smoker and income surcharges; we agreed with the Union proposal on retail pharmacy copays; and we proposed significant caps on future increases in copays, coinsurance, deductibles, and “out of pocket” maximums.


  • We offered to enhance our Staffing and Professional Development Committee agreement by adding that nursing leadership will meet with the Committee to review and discuss the budgeted HPPD model and inform the committee of any changes throughout the year.

Yesterday we signed a Tentative Agreement on “Displacement” and we have already signed TAs on a new “Staffing and Professional Development Committee,” “Monthly Union Management Meetings,” and “Transport Team.” We are making progress in the negotiations, and we are continuing to honor the expired contract as we bargain in good faith for a contract that is fair for the nurses and which the Medical Center can afford.

Our next bargaining session is already scheduled for September 23rd, but yesterday the Union indicated it may cancel. We believe it would be unreasonable and irresponsible for the Union to walk away from the bargaining table while at the same time subjecting the Medical Center, its employees, and the community to a job action. Having a strike solves nothing, but it will cost significant resources and put a settlement further out of reach.

A Message to the Community from Crozer-Keystone Health System Physicians

We are all practicing physicians in the Crozer-Keystone Health System, the county’s largest employer and healthcare provider, and we are extremely proud of that fact. We consider ourselves to be very “pro-nursing” and many of us are involved in activities to further nursing education. We know nurses as friends and family, and as health care providers, we understand the importance of nursing and their relationship with patients.

We were disappointed in the recent articles in the Delaware County Daily Times concerning the current nursing union negotiations. We feel that the articles were very one-sided and portrayed Crozer-Keystone as a system that does not care about its nurses or its patients. There is nothing that can be further from the truth. Crozer-Keystone Health System is a forward-thinking health system that continually works to adjust to the major changes in healthcare. The system is not asking anyone to do anything more than is necessary so that we all can continue to fulfill our mission – which is to continue to provide the best possible care for the residents of Delaware County.

Crozer-Keystone has not (and has never) asked anyone to do anything that is unsafe for patients or bad for patient care. Our staffing levels are safe for patients and are better than national averages. We all would love for a nurse to be able to sit for hours holding one patient’s hand. For better or worse, there is no hospital in the world that would be able to stay in business if they were staffed to that level. Each day, the health system is faced with situations – such as call-outs from staff – and our leaders and managers respond in a way to maintain the care and safety of the patients.

Many of us are residents of Delaware County. We receive our healthcare in the Crozer-Keystone Health System. We have never felt like our care was sub-standard in any way. We have entrusted Crozer and our nurses with our care and with the care of our family members. We have witnessed the dedication to service and quality of care that the system and our nurses have demonstrated.

We come to work each day knowing that we work in a place where we can practice cutting-edge, appropriate medicine regardless of the patient’s background or insurance status. We end each day feeling good knowing we were able to care for our patients in the way that we feel is best for them. We feel that we are lucky to work with great nurses that work hard for each and every patient they encounter every day of the week. The work conditions are not “deplorable” and not unsafe for patients.

The hospitals in the system are constantly being inspected and reviewed by numerous certifying committees, such as the Joint Commission. Crozer-Keystone and its hospitals have won regional and national awards for quality and patient safety, as well as for the services we provide to our community.

We would like to tell the residents of Delaware County to feel confident that Crozer-Keystone will continue to provide outstanding medical care in a safe environment.


Thomas J. Bader, MD, MGA,FACOG
Chair of Obstetrics & Gynecology

Douglas Brunner, M.D.
Chairman, Physical Medicine and Rehabilitation

Dina Capalongo, D.O.
Director, Transitional Residency Program

Kevin Caputo, M.D.
Chairman, Psychiatry

John Colombo, M.D.
Chief, Hospitalists

Gregory Cuculino , MD, FACEP
Chairman, Emergency Medicine

Eric Dobkin, M.D.
Chief Quality Officer and VP, Quality and Patient Safety

Christine Donohue-Henry, M.D.
Director, Primary Care

Daniel DuPont, D.O.
Chief, Pulmonary Diseases

Hugh Ehrenberg, M.D.
Director, Maternal Fetal Medicine

Albert El-Roeiy, M.D.
Director, Reproductive Endocrinology and Fertility

Sarah Falgowski, M.D.
Medical Director, Community Hospital

Alan Graham, M.D., FACS
Chair, Surgery

David Hadley, M.D.
Director, OB/GYN Residency Program

Guy Hewlett, M.D.
Director, Medical Education

Marcin Jankowski, D.O.
Medical Director, Trauma

Tamika King, M.D.
Emergency Medicine

Joby Kolsun, M.D.
Asst. Vice President, Quality and Patient Safety

David Lainoff, M.D.
Medical Director, Population Health Management

Jeffrey Loose, M.D.
Acting Chair, Pathology

William Mannella, M.D.
Medical Director, Wound Care

Bruce Nisbet, M.D.
Chairman, Emergency Medicine

Nathan Okechukwu, M.D.
Chair, Medicine

Karen Scoles, M.D.
Medical Director, Information Systems

Christopher Stenberg, M.B.Ch.B., FAAP
Chair, Pediatrics

Joseph Stock, M.D.
Chair, Radiology

Susan Williams, M.D.
Senior Physician, Network Affairs

Updates on contract negotiations between Crozer-Chester Medical Center and CCNA/PASNAP.


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