LAST, BEST AND FINAL OFFER BY ST. VINCENT HOSPITAL TO MNA

August 5, 2021
  1. Tentative Agreements. All signed tentative agreements to date.
  2. Term. Ratification through December 31, 2024.
  3. Wages.
    • For all nurses (full-time, part-time and per diem), a lump-sum payment of 3% of 2021 W-2 compensation payable in June 2022. The nurse must be employed as of August 15, 2021 and remain continuously employed through June 1, 2022 to receive this payment.
    Full-time and Part-time (Both Scales)
    • Effective the start of the first full pay period following January 1, 2021; 1% across-the-board increase.1
    • Effective the start of the first pay period following August 1, 2021:
    • Each nurse will advance one step on the Step scale;2
    • Drop the Hire Step, and renumber steps (Hire Step- Step 203); and
    • 1% across the board increase.
    • For employees at the top step as of December 31, 2021, a lump sum payment of 1% calculated as follows: Base Weekly Hours as of December 31, 2021 X Base Hourly Rate as of December 31, 2021 X 52 weeks X 1%. Payment will be made in June 2022 provided the nurse remains continuously employed through June 1, 2022.
    • Effective the start of the first full pay period after June 30, 2022; 2% across-the-board increase.
    • Effective the start of the first full pay period after June 30, 2023; 2% across-the-board increase.
    • Effective the start of the first full pay period after June 30, 2024; 2% across-the-board increase.
    Per Diem Nurses
    • Effective the start of the first full pay period following August 1, 2021, increase all Per Diem rates (I and II) by 3%.
    • Effective the start of the first full pay period after January 1, 2022, increase all Per Diem rates (I and II) by 3%.
    • Effective the start of the first full pay period after January 1, 2023, increase all Per Diem rates (I and II) by 3%.
    • Effective the start of the first full pay period after January 1, 2024, increase all Per Diem rates (I and II) by 3%.
  4. Health Insurance. Effective January 1, 2022, after one (1) year of employment, the premium cost share for 24 Hour Nurses and 24-Flex nurses shall be changed to 80%/20%.
  5. Staffing. The Hospital will make a good faith effort to implement the staffing changes as soon as possible after ratification, but in any event not later than January 1, 2022.

    A. Resource Nurse. Replace Section 7.09 (Resource Nurses) in its entirety with the following:

    “7.09. Resource Nurses
    Resource nurses shall have up to a full patient assignment outside of the units and times, unless otherwise expressly provided in this Agreement. The Hospital may, if it so chooses, augment coverage based on its assessment of the unit needs. The resource nurse’s patient assignment shall be considered when determining whether the Hospital has made a good faith effort to follow the staffing guidelines.4

    In addition to providing assistance to other nurses, the Resource Nurses also assists with patient flow, e.g. facilitating admissions and discharges. Either party may seek to discuss the role of the Resource RN at the parties’ monthly Labor-Management meeting. The Resource Nurse assignments in Section 7.09 shall not result in an increase in patient assignments for other nurses inconsistent with the staffing guidelines.

    Subject to patient care needs, Resource Nurse Assignment by Units shall be as follows:5

    Subject to patient care needs, Resource Nurse Assignment by Units shall be as follows:5 Emergency Department

    No assignment

    PACU

    No assignment

    CVIL

    No assignment

    OR

    No assignment

    Endoscopy

    No assignment

    Outpatient Chemo Infusion

    0-2 patients

    36N

    No Assignment

    ICU/PCU

    No Assignment

    CWI – L&D

    No assignment6

    Psychiatry

    Days, Evenings: Reduced assignment; Nights: Up to a 5 patient assignment.

    Cardiac Telemetry 23S, 24N

    Days, Evenings: No more than 2 patients.

    Med/Surg 21S, 22S, 33S, 34N, 35N

    Days, Evenings: Resources Nurse will have no more than 2 patients.

    CWI – Mother/Baby7

    Days, Evenings: Resource Nurse will have no more than 2 Couplets.8

    CWI-Nursery

    Days, Evenings and Nights: Resource Nurse included in the RN staffing

    B. Staffing Article 28.01.
    Revise current language and add the following NEW paragraph:
    “Section 7.09 (Resource Nurse) and these Guidelines are an addendum to the Agreement and subject to all provisions of this Agreement, including the management rights clause and grievance procedure. The Hospital will make good faith effort to follow these Guidelines in staffing. If there is a dispute as to the staffing under these Guidelines, then the Association will take the matter up with the Hospital Staffing Committee. Failing to resolve the dispute with the Staffing Committee, the Association will take the matter to the contractual grievance procedure, subject to an arbitrator’s determination as to whether the Hospital has made good faith effort to follow the Guidelines (See Appendix I).

    “Article VII Section 7.09 in combination with the staffing guidelines will set forth the patient assignments; The Med/Surg (21,22,33,34,35) and Cardiac Telemetry (23,24) units shall be a mix of 4 and 5 patient assignments; The Post Cardiac Surgery Floor 36 shall be no more than 4 patients; Inpatient psychiatry (32) shall be no more than 5 patients.”

  6. See Staffing Guidelines Attached (same as guidelines proposed by Hospital on July 6, 2021).
  7. MNA #24 – Differentials. Effective the start of the first pay period after ratification:
    • Increase evening shift differential from $2.75 to $3.00;
    • Increase night shift differential from $4.00 to $5.00; and
    • Increase on-call rate from $4.50 to $5.00.
  8. MNA #12 – Health and Safety.
    Add the following as a side letter:
    “The parties share a mutual interest in a healthy and safe work environment for all employees. As part of the parties’ mutual commitment to a healthy and safety work environment, the Association may designate two bargaining unit members to join the existing Workplace Safety Committee, or its successor. In addition, the Hospital will take the following steps as soon as practicable:
    • The Hospital will staff the ED with a Special Police Officer detail during the night shift (7 days per week), on weekends (all three shifts) and holidays (all three shifts). The Workplace Violence Committee will discuss whether the Special Police Officer will be armed.
    • The Hospital will implement an updated Visitor Management System, which will require visitors to be registered and badged during designated hours and at designated entrances, to be determined by the Hospital after discussion with the Workplace Safety Committee. Visitors entering through the Emergency Department will be required to be registered 24 hours per day/7 days per week.
    • As part of its responsibilities, the Workplace Safety Committee will:
      • review options and make recommendations with respect to the Visitor Management System;
      • review options and make recommendations for identifying in the medical record or through some other means patients with a history of violence; and
      • review options and make recommendations for additional locations for panic buttons.
    • Security personnel will engage in enhanced rounding in areas identified by the Workplace Safety Committee.”
    • The Hospital will continue to maintain and staff a metal detector in the hospital’s emergency department for screening all patients and visitors entering the Hospital’s emergency department.”
  9. MNA #2 – Assault Pay.
    Add NEW Section 14.08, effective upon ratification:
    “Any nurse who receives workers compensation benefits as a result of a workplace assault by a patient or visitor, and who uses vacation or sick time as the result of the assault during the first five (5) calendar days after the assault prior to receiving workers compensation benefits shall be credited with the vacation or sick hours used during such five (5) day period.
  10. H6 – Sick Time. Add NEW Section 14.08: “Hospital earned sick time accruals include Massachusetts Earned Sick time and are not in addition to Massachusetts Earned Sick Time.”
  11. Flex Nurse. Modify first sentence of second paragraph of Section 10.01 as follows:
    “The flex nurse has the option to refuse a maximum of two flex shifts (up or down or one of each) in a schedule cycle.”

All other proposals of both parties withdrawn without prejudice and all side letters and other terms of the agreement continue in accordance with their terms.

1 In order to receive a retroactive payment, a nurse must be employed on the date payment is made.
2 This is in addition to regular step movement. For example, a nurse with an anniversary date of June 1 that moved from Step 2 to Step 3 on June 1, 2021, will move to Step 4 effective the first pay period following August 1, 2021, and then move to renumbered Step 4 (currently Step 5) on June 1, 2022.
3 Hire Step through Step 19 for the Clinical Specialist/Nurse Educator Scale.
4 Italics indicate areas where this proposal is consistent with the MNA’s last proposal.
5 Delete * from grids and statement “Add a resource nurse when applicable” as there will be a resource nurse at all census points. Also delete from grids, “Reasonable attempts will be made for resource nurse to enter shift without an assignment.”
6 Delete “Subject to patient care needs, Resource Nurse shall not have an assignment” from existing L&D staffing grid.
7 Delete Resource Nurse reference from current grid.
8 Delete Resource Nurse reference on Mother-Baby grid.

ATTACHMENT TO AUGUST 5 LAST, BEST AND FINAL OFFER

August 5, 2021
Appendix I: Staffing Guidelines9
Modify - see below.

ICU Staff Per Shift

PROPOSED GUIDELINES

CENSUS

DAY RN

PCA/CCT

EVE RN

PCA/CCT

NIGHT RN

PCA/CCT

24

14

4

14

4

14

4

23

14

4

14

4

14

4

22

13

4

13

4

13

4

21

13

4

13

4

13

4

20

12

4

12

4

12

4

19

12

4

12

4

12

4

18

11

3

11

3

11

3

17

11

3

11

3

11

3

16

10

3

10

3

10

3

15

10

3

10

3

10

3

14

9

3

9

3

9

3

13

9

3

9

3

9

3

12

7

2

7

2

7

2

11

7

2

7

2

7

2

10

6

2

6

2

6

2

9

6

2

6

2

6

2

8

5

2

5

2

5

2

7

5

2

5

2

5

2

6

5

1

5

1

5

1

5

4

1

4

1

4

1

4

4

1

4

1

4

1

3

3

1

3

1

3

l

2

3

I

3

1

3

1

1

2

1

2

1

2

1

The assignment of critical care patients will be based on critical care admission criteria with input from physicians and nursing leadership. AACN guidelines shall be a factor in the setting of such admission criteria. Critical care patients will receive the same level of care regardless of their location in the Hospital.

Resource nurse included in the guidelines and subject to Article VII Section 7.09. pp.

PCU Staff Per Shift

PROPOSED GUIDELINES

CENSUS

DAY RN

PCA/CCT

NIGHT RN

PCA/CCT

12

5

2

5

2

11

5

2

5

2

IO

5

2

5

2

9

4

2

4

2

8

4

2

4

2

7

4

1

4

1

6

3

1

3

1

5

3

1

3

1

4

3

0

3

0

3

2

0

2

0

2

2

0

2

0

l

2

0

2

0

Resource nurse included in the guidelines and subject to Article VII Section 7.09. pp.

Med/Surg/Telemetry Units (21, 22, 33, 34, 35) Staff Per Shift

PROPOSED GUIDELINES

CENSUS

DAY RN

PCA/CCT

EVE RN

PCA/CCT

NIGHT RN

PCA/CCT

26

7

4

7

4

6

4

25

7

3

7

3

5

3

24

6

3

6

3

5

3

23

6

3

6

3

5

3

22

6

3

6

3

5

3

21

6

3

6

3

5

2

20

5

3

5

3

4

2

19

5

3

5

3

4

2

18

5

2

5

2

4

2

17

5

2

5

2

4

2

16

5

2

5

2

4

2

15

4

2

4

2

3

2

14

4

2

4

2

3

2

13

4

2

4

2

3

1

12

4

2

4

2

3

1

11

4

2

4

2

3

I

10

3

2

3

2

3

I

9

3

 

3

 

3

 

8

3

 

3

 

3

 

7

3

 

3

 

2

 

6

2

 

2

 

2

 

5

2

 

2

 

2

 

4

2

 

2

 

2

 

3

2

 

2

 

2

 

2

2

 

2

 

2

 

1

2

 

2

 

2

 

Resource nurse included in the guidelines and subject to Article VII Section 7.09.pp ___
On 22 South OBS Unit - Dedicated Resource Nurse - 7 days a week, days and evenings
On 22 South OBS Unit only, add 1 PCA at census of 18 days and evenings

Cardiac telemetry Units 23 and 24 Staff Per Shift

PROPOSED GUIDELINES

CENSUS

DAY RN

PCA/CCT

EVE RN

PCA/CCT

NIGHT RN

PCA/CCT

26

8

4

8

4

7

4

25

7

3

7

3

6

3

24

7

3

7

3

6

3

23

7

3

7

3

6

3

22

6

3

6

3

5

3

21

6

3

6

3

5

2

20

6

3

6

3

5

2

19

6

3

6

3

5

2

18

5

2

5

2

4

2

17

5

2

5

2

4

2

16

5

2

5

2

4

2

15

5

2

5

2

4

2

14

4

2

4

2

3

2

13

4

2

4

2

3

1

12

4

2

4

2

3

1

11

4

2

4

2

3

1

10

3

2

3

2

3

1

9

3

 

3

 

3

 

8

3

 

3

 

3

 

7

3

 

3

 

2

 

6

2

 

2

 

2

 

5

2

 

2

 

2

 

4

2

 

2

 

2

 

3

2

 

2

 

2

 

2

2

 

2

 

2

 

1

2

 

2

 

2

 

Resource nurse included in the guidelines and subject to Article VII Section 7.09.

Post Cardiac Surgery Floor* Unit 36 -- Staff Per Shift

PROPOSED GUIDELINES

CENSUS

DAYRN

PCA/CCT

EVE RN

PCA/CCT

NIGHT RN

PCA/CCT

32

9

4

9

4

9

4

31

9

4

9

4

9

4

30

9

4

9

4

9

4

29

9

4

9

4

9

4

28

8

4

8

4

8

4

27

8

4

8

4

8

4

26

8

3

8

3

8

3

25

8

3

8

3

8

3

24

7

3

7

3

7

3

23

7

3

7

3

7

2

22

7

3

7

3

7

2

21

7

3

7

3

7

2

20

6

3

6

2

6

2

19

6

3

6

2

6

2

18

6

2

6

2

6

2

17

6

2

6

2

6

2

16

5

2

5

2

5

2

15

5

2

5

2

5

2

14

5

2

5

2

5

2

13

5

2

5

2

5

1

12

4

1

4

1

4

1

11

4

1

4

1

4

1

10

4

1

4

1

4

1

9

4

 

4

 

4

 

8

3

 

3

 

3

 

7

3

 

3

 

3

 

6

3

 

3

 

3

 

5

3

 

3

 

3

 

4

3

 

3

 

3

 

3

2

 

2

 

2

 

2

2

 

2

 

2

 

1

2

 

2

 

2

 

Resource nurse included in the guideline and subject to Article VII Section 7.09. pp. ___

Psych Staff Per Shift

PROPOSED GUIDELINES

CENSUS

DAY RN

MHW/MHC

EVE RN

MHW/MHC

NIGHT RN

MHW/MHC

20

5

2

5

2

4

2

19

4

2

4

2

4

2

18

4

2

4

2

4

2

17

4

2

4

2

4

2

16

4

2

4

2

4

2

15

4

2

4

2

3

2

14

3

2

3

2

3

2

13

3

2

3

2

3

2

12

3

1

3

1

3

1

11

3

1

3

1

3

1

10

3

1

3

1

2

1

9

2

1

2

1

2

1

8

2

1

2

1

2

1

7

2

1

2

1

2

1

6

2

1

2

1

2

1

5

2

1

2

1

2

1

4

2

1

2

1

2

1

3

2

1

2

1

2

1

2

2

1

2

1

2

1

1

2

1

2

1

2

1


Resource nurse included in the grid and subject to Article VII Section 7.09. pp.