Friday, July 12, 2024

After big Mission Hospital vote, are unions set to roll in N.C.?

Promoting itself as the nation’s second-least unionized state is viewed by many businesspeople as a factor in North Carolina’s rapid growth. So it was a head-turner when Mission Hospital nurses in Asheville voted 965 to 411 to join the National Nurses United, a Silver Spring, Md.-based group.

The vote is viewed as the largest union election win in the South in 12 years.

So is the vote a signal for more union activity across North Carolina, a prospect raised by professors at Duke, N.C. State and other Tar Heel campuses?

It’s clear the threat is being taken seriously in the pending takeover at New Hanover Regional Medical Center. Novant Health is offering more than $3.5 billion in cash and pledged investments for the Wilmington hospital, outbidding rival networks. A final vote by the New Hanover County board next week is expected to seal the deal.

In its agreement, Novant committed to retain all of New Hanover’s employees at their current positions, titles and salaries for at least 24 months after closing. Moreover, the local hospital board must approve any job cuts after the two-year period.

That is stunning for anyone who has watched or participated in a mega-merger. Personnel is by far the biggest expense for hospitals, which constantly say they face intense pressure from insurers, payers and others to cut costs.

Nashville, Tenn.-based HCA Healthcare didn’t go that far when it bought Mission Health for $1.5 billion in February 2019. Instead, it entered western North Carolina and adjusted nursing and other patient care schedules, ticking off many employees and hospital users. HCA runs about 180 hospitals, so it presumably knows a lot about the business. It also knows how to make money, with its shares valued at more than $42 billion.

Voila, the union jumped on the opportunity with a group of motivated nurses, who delivered the union’s stunning victory.

On the same day the election results were announced, HCA CEO Sam Hazen sent an email to all company employees noting full- and part-time workers would get bonuses because of their stellar COVID-19 work. But no bonuses will go to workers at 19 HCA hospitals that belong to unions, including Mission.

Union officials say it was a swipe, but the company says the timing wasn’t related to the vote. “The company has been thoughtfully considering this for quite some time,” according to a company statement. “With more experience managing through the pandemic and the tremendous work by our colleagues, we felt we could make adjustments to those decisions and help support the financial well-being of our colleagues.”

David Mildenberg
David Mildenberg
David Mildenberg is editor of Business North Carolina. Reach him at

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