Letter to the Editor: published July 28, 2023

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Catalina Island Medical Center

A recent letter to the editor regarding the resignation of nurses at the Catalina Island Medical Center contained misstatements and mischaracterizations that must be corrected so that the spreading of misinformation stops.

CIMC is dedicated to providing quality health care to the residents of and visitors to the Island and to providing the best possible working environment for its employees. Recently there has been significant misinformation disseminated about CIMC’s response to drastic demands made by a small group of employees.

When these demands were not satisfied, the employees resigned, they were not terminated.

As a California employer who respects state labor laws, CIMC cannot and will not respond to each mistruth or each individual claim and comment. CIMC will, however, provide the following facts to correct the record and provide important information to Island residents.

  1. CIMC response to claim that “It was not about money”

It is about the money. On June 1, 2023, the group met with and gave CIMC administration a verbal list of financial demands and operational concerns, and told CIMC that if the demands were not met by June 9th, they would resign. There was never a mention of negotiating or providing a counter proposal. It was extremely clear that all the demands had to be met in order to stop the resignation.

In response to CIMC’s request, on June 2, 2023, the group provided a written list of their demands, which included (verbatim):

  • 5% increase across the board to make it a total of 10% raise.
  • Using the lowest pay rate of a nurse after the additional 5%, a step increase chart will be implemented with that rate as Step 1.

The step increases would be based off years of experience initially and then years of service to CIMC would play a roll down the line. I have included an example from UCLA as an example. Typically, it is roughly a 2% raise per step. This step schedule will also be available to all staff to review for transparency.

  • Cost of living and market adjustment raises would be as needed and would be across the board for all RN staff.
  • Per diem RNs would receive an additional 10% raise on top of the current 10% discussed in item 1. The per diem nurses would not participate in the step increase program but would be eligible for all across the board raises as mentioned in item 3.
  • Shift bonuses for those RNs that pick up extra shifts above contracted. For Full time and Part time nurses they would receive double time for the fourth and third shift respectively.

For Per Diem they would receive time and a half for shifts picked up after the schedule is published.

Implementation of the demands would result in an increased annual expense of more than $560,000 for all employed RNs. This amount is over and above the annual increase that CIMC recently provided to all employees in the amount of $480,000, which was an average increase of 10%. If implemented, the increase in CIMC’s salaries and wages budget would exceed 20% for the coming year.

  1. CIMC response to claims that the RNs provide all patient care, are the staff that always cover, that recent employee surveys show dissatisfaction, and that because of leadership challenges, “several of our core staff of RNs resigned”

CIMC employs over 100 people. Every physician, every nurse, and every other employee is a crucial part of the team and bears responsibility for providing quality patient care from the moment a patient enters CIMC.

Two full-time and four per-diem RNs resigned (per-diem RNs provide temporary nursing care for patients that supplements full-time and part-time nursing staff). CIMC employs many RNs that also live in our community.

Of those that resigned, two individuals live permanently in Avalon. To say “core” staff resigned is to suggest that some staff are more or less important than others. This is not true. Every staff member is an essential part of the CIMC patient care team. There are many RNs other than those who were making the demands that take shifts when the ferry doesn’t run, or when there is a major rush in the ER, or when there is a late sick call.

CIMC has always and continues to appreciate the support and service of its employees. In July 2022, CIMC conducted an employee survey.

Since that time, we have been addressing issues that were presented in the survey to improve the work life of all CIMC employees. The community is invited to talk to our current employees about the working conditions at CIMC.

  1. CIMC response to claim that: “After one week and with no communication from leadership we were sent an email from the CEO denying all requests with no further discussion, which is indicative of the leadership style”

The June 1 verbal requests, which were followed up in writing on June 2, were presented by the RNs as non-negotiable.

It was made very clear that their demands were “take it or they leave,” with zero room for discussion or compromise.

The RNs never requested or indicated any desire to meet about the demands further or entertain any sort of compromise. They simply wanted a “yes to all” response on June 9.

CIMC Response on June 9

On June 9, 2023 I sent a response via email to all the RNs that work for CIMC. In full transparency, the response is repeated verbatim, except that personnel information as to specific individuals has been deleted to preserve privacy.

Good evening,

At a June 1st, 2023, meeting requested by a small group of our nursing colleagues, a number of financial requirements were made to CIMC. It was also stated that if all of the requirements were not met, then disappointingly, a number of nurses would plan to resign from our organization. To ensure that there was no miscommunication or misunderstanding, CIMC requested in writing the expectations of the group. I have copied and pasted the communication that was provided to me below: (Readers can see the list above)

CIMC has spent considerable time and effort evaluating the requirements of the staff that attended the meeting. It is important to CIMC that all staff feel valued and appreciated for their commitment to providing care for our community. We strive not only to improve the lives of residents and visitors, but also for all employees. As a Critical Access Hospital, with limited financial resources, we strive to pay our employees fairly within our organization and to have a highly competitive wage compared to other hospitals in Southern California.

Due to the high inflation of approximately 8% nationally over the past year, CIMC took extraordinary efforts to find balance between moving employee wages to be competitive with current market conditions and ensure CIMC stays financially viable. This is especially challenging as we continue to see a reduction in reimbursements from insurance companies. As part of the evaluation, it was our intent to also be as fair as possible to all employees, regardless of position, who work at CIMC.

CIMC utilizes the California Hospital Association Annual Compensation study to help determine competitive wages for all employees. The purpose of this survey is to assist health care organizations in making strategic compensation decisions by providing timely and accurate information. Over 151 hospitals, that includes over 53,000 RNs, participated in the survey.

When analyzing CIMC’s salary data and comparing it to the survey results, we found that out of 92 employees, 50 employees made less than the 50th percentile and 42 employees made more than the 50th percentile. (Explanation: The 42 employees are paid more than 50% of healthcare workers in Southern California in similar positions.) When analyzing base pay, on average, CIMC RNs are paid an average of $65.55. In Southern California, hospital RNs at the 50th percentile are paid $56.62 and the 75th percentile is currently at $60.23 per hour. 90th percentile RNs are paid on average of $67.49. We are proud to say that CIMC RNs are paid a base rate that is highly competitive compared to their hospital RN peers.

Providing fair wages to all employees is a priority for CIMC and, over time, we will have all employees paid above the 50th percentile. With the latest wage increases we were able to lower the number of employees that are paid below the 50th percentile from 50 to 34. As stated before, we plan to begin a re-evaluation process of CIMC’s current financial status and attempt to have all our employees above the 50th percentile by the end of this year.

After quantifying the requirements of the group, it became very clear that if implemented, CIMC would be put in a financially unsustainable situation with CIMC RNs being some of the highest paid nurses in the nation. The salary demands will expand CIMC’s initial annual expense by more than $560,000 for a small group of employees. This increase is larger than the total increase that was recently provided to all employees. The wage increase that was provided in April increased CIMC’s annual budget by $480,000.

[Paragraph not included to maintain employee privacy.]

We hope that you will reconsider the threat of resigning for not meeting these requirements. We will work diligently to improve staffing issues and will look for opportunities to make CIMC more competitive with other organizations’ pay methodologies. We appreciate all those who take into consideration the difficulty of implementing the above requirements and continue their employment with CIMC. We will strive to improve working conditions for all employees, including the nursing department. Currently, we do not have the ability to implement the above requirements.

Thank you for your understanding,

CIMC has an enduring commitment to the health of our community. We will continue to help our community stay healthy and grow stronger. We regret that this has become a community issue and have shared this information so our community can move forward.


Jason Paret

Chief Executive Officer