Article
Where things stand
Members of the New York State Nurses Association walked out on Jan. 12 at Mount Sinai’s main campus, Mount Sinai Morningside and West, Montefiore and NewYork-Presbyterian. The union calls it the largest nurse strike in the city’s history. Several city-run hospitals and three Northwell Health facilities settled before the deadline, which left the three private systems carrying the dispute alone.
Bargaining sessions with federal mediators on Jan. 15 and 16 ran past midnight but produced little. Talks broke down again over the weekend, and as of Jan. 20 no new sessions were on the calendar. After pressure from Gov. Kathy Hochul and Mayor Zohran Mamdani, the union said all three systems would return to the table on Jan. 22.
What is actually in dispute
Pay matters, but it is not the only issue. The union’s list centers on enforceable staffing ratios, workplace violence protections, preserving health coverage and pensions without cuts. It also says the hospitals want to weaken staffing enforcement mechanisms won in the 2023 strike, which ended with raises of 19.2% over three years. The systems describe the demands as unaffordable; Montefiore has put their cost at $3.6 billion. The union counters that the hospitals have already spent about $100 million on replacement nurses.
The positions also differ by system. Montefiore has offered counterproposals focused on workplace violence, while the union says NewYork-Presbyterian rejected its revised proposals without countering. Mount Sinai says it extended plans to keep operating without striking staff and has 1,400 replacement nurses available.
Questions for leadership teams elsewhere
Few systems face a union this large, but the dynamics are portable:
- Staffing enforcement is the new battleground. Once ratios or enforcement language enter a contract, unions defend them hard. Know what your current commitments cost and how compliance is measured.
- Benefits redesign carries labor risk. Changes to health plans or pensions, even when financially justified, can unify a workforce faster than wage offers can divide it.
- Strike costs compound. Replacement staffing, closed beds, diverted volume and recruitment damage add up quickly. Build a realistic multi-week cost model before negotiations stall.
- Politics now shapes bargaining. Elected officials took visible roles here within days. Board members and community partners should be briefed early.
Archive entry for Jan 22, 2026, added Nov. 11, 2026.