When Denise Hernandez and her coworkers heard that management would be transferring staff to the hospital with which they had merged, they were nervous.
It was just half a mile away. But Hernandez, 45, had been a laundry worker at Schuylkill Medical Center-South Jackson Street in Pottsville for more than 10 years. She and her coworkers — housekeepers, techs, nurses — were anxious about working in a whole new environment. And there was the union.
The workers at South had been part of SEIU Healthcare PA for as long as they could remember, dating back to the 1970s. The workers at Schuylkill Medical Center-East Norwegian Street were not.
Now they'd all be working side by side.
Hospitals across the nation — most of them struggling — are being bought up left and right, and in Philadelphia, it's no different. But in a region where "eds and meds" are among the largest employers, and where unions have represented hospital workers for decades and some are even growing at a dramatic clip, what happens when a union is part of the deal? What does it mean for workers?
Most recently, in its bid to dominate the region, Jefferson, which has just one union hospital among its 14, announced a preliminary deal to acquire Einstein Health Network. That deal would include the nearly 1,000 organized nurses at Einstein Medical Center in Olney. If the sale goes through, how will Jefferson handle the union?
Jefferson spokeswoman Gail Benner said it would be "premature" to address any questions regarding the merger because the two health systems have only just entered the due-diligence phase.
Here are some scenarios of what could happen based on how other recent mergers — between union and nonunion entities — have played out.
There were multiple failed attempts to organize nurses at Delaware County Memorial Hospital, but things changed in the fall of 2015 when workers discovered the hospital would be bought by Prospect Medical Holdings, a for-profit Los Angeles firm that owns hospitals across the country. Within months of the announcement, workers voted in favor of the union and more than 330 nurses joined the Pennsylvania Association of Staff Nurses and Allied Professionals.
Being part of a union can help combat the uncertainty that a merger will bring, said Gary Canada, a nursing assistant and vice president of the SEIU union at Chestnut Hill Hospital, which was bought last fall. "It means we're all together in this," he said.
That workers are voting to unionize at hospitals being acquired isn't surprising, as both trends — unionization and consolidation — can often stem from the fact that the hospitals are struggling.
"Nobody sells when they're doing well," said Joshua Nemzoff, a New Hope-based consultant on hospital mergers and acquisitions. And as hospital consultant Alan Zuckerman put it: "Any time you are dealing with a distressed organization, there is probably a track record of attempting to become more viable on the backs of the staff, or at least that's how the union might look at it."
The nurses' union at Pottstown Memorial Medical Center had been negotiating its first contract for four months when the nurses found out Reading Health System was going to acquire the hospital, along with four others, and create a new health system called Tower Health in September 2017. That meant the nurses would have to start bargaining again from scratch.
Since its new owner took over last fall, nurse Lori Domin, 51, says it has turned into a whole new fight — to defend the union they fought so hard to get. There have been anti-union fliers, emails from management, and meetings where nurses from Reading Hospital praised their employer in an effort to persuade Pottstown nurses they didn't need a union. There are even two new union workers who are trying to persuade others to join an effort to decertify the union.
Meanwhile, a year and a half after they voted for the union, the Pottstown nurses are still working without a contract. Domin, a 30-year veteran at the hospital, says it has been hard on the nurses: The delays make everyone angry, she said.
"We're a little more vulnerable because we don't have a contract," Domin said.
And sometimes unions have to go on strike if negotiations with their new owners break down, as they did with the nurses at Delaware County Memorial Hospital after the acquisition deal was finalized.
There's also a chance if one hospital in a health system has a union, its other hospitals might want to organize, Rutgers labor studies professor Rebecca Givan said. (Pottstown is the only hospital with a nurses' union among the six Tower hospitals.)
"We continue to make progress with all negotiations and have dates for future sessions scheduled," Tower Health spokeswoman Ann Valuch said.
Over at Schuylkill Medical Center-East, where union workers are on the floor with nonunion workers, some are in limbo. SEIU and the hospital's owner, Lehigh Valley Health Network, have been engaged in a monthslong battle, one that continues to drag on in front of the National Labor Relations Board, over whether East employees could be absorbed into the union.
"Staff members are always saying, 'Are we union or aren't we union?' " said Hernandez, a union officer who works at East.
Lehigh Valley Health Network declined to comment, citing the open NLRB case.