• 530.541.3420 | 2170 South Avenue, S. Lake Tahoe, CA

Background Information

Barton Health is committed to delivering safe, high-quality care to the Lake Tahoe community and its visitors.

In November 2017, Barton Memorial Hospital Registered Nurses (RNs) voted to join the California nurses’ union. In March 2018, Barton Health and the union began negotiating a first contract. Three nurse representatives and two union representatives meet with representatives from Barton Health, including Barton’s Chief Nursing Officer, Human Resources Director and an outside labor attorney, to negotiate the many proposals that make up a contract.

This initial contract sets decisions and agreements in place for years to come, and Barton understands the importance of getting this initial contract right. We believe this contract should be fair to both our nurses and our organization. We have taken and will continue to take special care with each proposal and tentative agreement that results in the full contract.

Both parties have met at the bargaining table over 40 sessions reaching 29 Tentative Agreements (TAs) since March 2018.

Our nurses and staff provide outstanding patient care to this community, and we value their contributions.

Contract Negotiations

Status & Next Steps

  • As of August 21, 2019, 40 sessions have been held and 29 Tentative Agreements have been reached.
    • Four bargaining sessions have been attended by a representative from the Federal Mediation and Conciliation Service.
  • In April 2019 Barton Health filed an Unfair Labor Practice (ULP) charge with the National Labor Relations Board contending the union is refusing to engage in good faith collective bargaining.
  • In August 2019 the National Labor Relations Board dismissed the Unfair Labor Practice (ULP) filed by the union against Barton Health.
  • Scheduled Negotiation Dates:
    • August 27, 2019

Just the Facts

  • November 2017 - Barton Memorial Hospital nurses voted to join the California Nurse's Association (CNA).
  • March 2018 - Initial contract negotiation meeting.
  • 29 - Number of Tentative Agreements reached (as of July 24, 2019).

Nurses at Barton Health

By The Numbers

  • 182 – number of nurses in the CNA bargaining unit
  • 236 – number of nurses employed at Barton Health
  • Compensation (Benefits, ETO, Wages):

    Barton nurses and all employees are fairly compensated, receive a generous vacation package and competitive health benefits.
    • New employees receive 4.5 weeks of earned paid time off a year, and this quickly grows to 7 weeks -- almost two months -- of earned time off after 5 years for full time employees. After 10 years, full time employees accrue 8 weeks of ETO annually.
    • Barton offers a choice of three health benefit plans, where the most popular plan costs just $20-60 per pay period for medical/vision healthcare coverage depending on the size of their family.
    • Barton offers competitive wages for our nurses. We rely on an external analysis conducted by an independent research firm to build a market-based compensation program for all wages and salaries across the organization. This firm reviews salary and wage surveys for hospitals of similar size, revenue and geographical area, cost of labor, and cost of living to determine salary ranges.
    • Barton offers a 403b Retirement plan matching funds up to 5%.


  • Which nurses are included in the bargaining unit? Nurses represented by the California Nurses Association include nurses at Barton Memorial Hospital and Lake Tahoe Surgery Center. Outpatient nurses at Barton Health locations outside of the hospital or surgery center are not represented by CNA or a part of this contract negotiation.
  • What is Barton’s turnover rate for RNs? Retention for RNs working at Barton continues to outpace the state average. In 2016, RN turnover at Barton was 9.5% compared to a statewide average of 10.7%. In 2017, RN turnover at Barton dropped to 8.7%, compared to 11.4% statewide. In 2018, RN turnover was 11% compared to 10.5% statewide.
  • What is union membership (“Association Security”)? The state laws of Nevada and California are different when it comes to union membership: Nevada state law makes it unlawful to require employees to join a union while California law says an employer and union can decide together if RNs are required to join the union. Barton employs nurses in both states and wants the same rule to apply to all union nurses regardless of the state in which they work. All union nurses would have the choice to opt in or out of the union once the contract is final; and we will respect and support their decision.
  • Are staffing ratios safe? Yes, staffing ratios are set by law and Barton Health meets or exceeds California state requirements for staffing ratios. In 2017, Barton Health requested to remove the rural ratio waiver from the state to increase its required staff ratio to 1 nurse for every 5 patients in Med/Surg/Ortho (previously it was 1 to 6). Once approved, Barton began recruiting additional RNs to reach the 1:5 ratio. Additionally, since 2017, Barton has added 31 nurses to the team increasing coverage for all departments.
  • Do nurses receive adequate breaks? Many of our nurses work 12 hour shifts. Barton Health offers three 15-minute breaks per 12 hour shift in addition to a 30 minute meal period, so our nurses are rested and ready to provide exceptional care. If a nurse cannot take their third break. Barton then pays them for one additional hour based on the missed 15-minute break, in compliance with California law.

    Barton Health offers 15 minute break periods exceeding the 10 minute break periods required by California law.

       Breaks per Shift
    CA Law  3 10-minute breaks per shift
    Barton Health   3 15-minute breaks per shift
  • Does Barton send its employees to Collections? Barton treats all patients the same and utilizes common billing practices following hospital national standards. Employees, just like all other patients, are expected to pay their bills or set up a payment plan within 90 days of receiving their first statement.

    After the insurance company has paid its part of a patient’s bill, Barton sends a statement to patients every 28 days asking for payment or asking patients to set up a payment plan. After three statements, if there is no patient response, Barton sends a pre-collection letter. The pre-collection letter informs a patient that payment is expected and they are encouraged to take advantage of an interest-free payment plan, which they have 10 days to establish. If no patient response or payment plan is made only then will the account be sent to Barton’s outside collection agencies. A patient is only sent to collections after months of multiple communications and without payment in full or an interest-free payment plan set-up.
  • What does Barton do with its profits? As an independent, non-profit hospital, Barton Health reinvests all of its earnings back into the health system to provide care for the community we serve. This includes contracting quality providers, purchasing modern technology and equipment to save lives, and offering a breadth of services for our community. Over the last 5 years, Barton has invested $65 million back into the health system.
  • If nurses strike, will the hospital remain opened? All services at Barton Memorial Hospital will remain open to serve the community. We have made arrangements during the event a strike is called to hire qualified replacement nurses. The staffing agency is well known for employing nurses with experience during labor actions. Barton has made clear to the staffing agency all the necessary qualifications needed in each department. These experienced, high-quality nurses will work alongside Barton staff, leaders and physicians providing the care needed to our patients and community.

    The Lake Tahoe Surgery Center will reschedule patients during this time period to either Barton Memorial Hospital or Carson Valley Medical Center.
  • How long will replacement nurses be used? When hospitals and healthcare providers receive a strike notice from CNA – which has occurred numerous times over the years – the union knows that healthcare providers such as Barton Health are required to hire qualified replacement nurses to replace striking nurses. Barton's contract with the staffing agency requires a 5-day minimum for the replacement nurses, which is standard. The National Labor Relations Board has upheld as lawful healthcare employers' right to a 5-day replacement period for contract nurses to work.
  • Will this affect patient care? No, Barton Health will maintain the mandated amount of nursing care using qualified RNs. Patient safety is of utmost importance and safe patient-nurse ratios will not be compromised.

Consistently exceptional care isn't just our promise; it's in the proof.
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