January 30, 2026

Mount Sinai Community, 

I’m writing to update you on NYSNA negotiations, as it has been a couple of days since I last wrote. Our negotiators were at the table Tuesday and Wednesday. There has been back-and- forth on a number of issues, but our progress remains slow and I share the frustration that I hear both from those of you who are working and from the nurses who have chosen to strike.

Please be reassured that our negotiating teams show up early, stay late, and continue to follow the guidance of the mediators. Don’t believe everything you hear. I’m committed to avoiding distractions, staying focused on achieving a fair settlement, and getting our teammates back to the bedside. At this point, given the slow progress at the table, we’ve extended our staffing contracts another few weeks to ensure that we won’t have an interruption in services.

Meanwhile, the Health System continues to care for the community and fulfill our mission of providing excellent care. Yesterday, our ERs saw 93 percent of expected volumes; that number was 89 percent at our ambulatory practices and 98 percent at our outpatient cancer practices, and we continue to see a high number of births—in fact, at 106 percent of our expected volumes.

Finally, we know that at some point this strike will come to an end, and I am thinking about how we repair and rebuild our culture. It’s a challenge, and I will need your help so that we can strengthen how we work together. In the meantime, I want to thank our nurse managers and nursing leaders who are doing an incredible job in a difficult time. You all are amazing and please know the entire Mount Sinai community is grateful.

As a reminder, for those of you who want to know more, we have created a website for bargaining updates. I will continue to keep you updated as there is news to share. Thank you again for your endless commitment to each other and our patients.

Thank you again,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

Negotiators from The Mount Sinai Hospital, Mount Sinai West, and Mount Sinai Morningside reconvened with NYSNA on Tuesday, January 27, and Wednesday, January 28, at the request of their mediators. 

Both parties continued to discuss a number of remaining staffing issues. As part of the mediation process and to help facilitate progress, Mount Sinai has agreed to limitations on sharing additional details.

January 24, 2026

Friends and colleagues,

I am writing with an update on our ongoing negotiations with the New York State Nurses Association (NYSNA). As you know, at the direction of our mediators, we resumed negotiations on Thursday morning. We spent Thursday and Friday negotiating, but we remain far apart on a deal, and last night NYSNA rejected our most recent proposal and left the table. As a reminder, for those of you who want to know more, we created a website for bargaining updates here.

I’m aware of the many narratives being circulated on social media. Some of you have asked why we don’t show up or why we are threatening to take away benefits. Neither of those things are true. We show up early and stay late. We have professional lawyers with national reputations representing us at the table. And with respect to benefits, we have offered lump sum increases to NYSNA so that they can allocate those funds to salary and benefits however they choose.

But even knowing all that, we have to acknowledge and respect the different perspectives that exist and the difficult decisions that need to be made. Adding emotion and blame to the situation will not help us find a path forward. We need to work together to arrive at a solution that works for our employees, the Health System, and—as I’ve explained before—the safety-net hospitals and others that will follow our lead.

Over the next few days, our operational teams will be managing two crises: one related to nurse staffing and the other related to weather, as we navigate what is expected to be the most significant winter storm to impact our area in many years. I will once again emphasize that, given our limited ability to make progress at the negotiating table, we continue to extend our commitments to staffing agencies. As we have said from the beginning, Mount Sinai’s nurses are permitted to return to work while the negotiating teams sort out a path forward. If you choose to do so, please contact your nurse manager as soon as you decide, so we can plan responsibly and add you to the schedule.

Thank you to everyone who will be working both behind the scenes and in every one of our care settings the next few days to ensure we continue to be prepared to care for our communities.

Onward,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

Today, negotiators from The Mount Sinai Hospital, Mount Sinai Morningside, and Mount Sinai West again followed the direction of their respective mediators on how to proceed with the bargaining process. They met with NYSNA from the early morning until after 8 pm, when NYSNA walked away from the bargaining table to hold a long-planned news conference after rejecting Mount Sinai’s increased economic offer—a $28,500 cumulative increase for nurses.

While Mount Sinai came to bargain in good faith to reach an agreement, NYSNA leadership violated the mediators’ rules by issuing an ultimatum to Mount Sinai negotiators and holding a press conference to again mischaracterize discussions around health care benefits. They repeated their lies claiming that Mount Sinai is holding nurses’ health care benefits hostage—despite the fact that no Mount Sinai negotiator has made any proposal about cutting or discontinuing health care benefits. 

While NYSNA provided a revised economic proposal during yesterday’s bargaining session, it only reduced base wage increases while maintaining every single other economic demand—still requesting an $80,000 increase for nurses at The Mount Sinai Hospital. Their economic proposal would cost the hospital $1.55 billion, with a 68.2 percent increase in nursing costs after the third year, down slightly from the 72.7 percent increase from NYSNA’s previous economic proposal.

January 19, 2026

Friends and colleagues,

I am writing to provide an update as we enter the second week of NYSNA’s strike at The Mount Sinai Hospital, Mount Sinai Morningside, and Mount Sinai West. As of today, despite our best efforts to negotiate, a near-term path to an agreement is very unlikely. Over the weekend, our operational teams extended our plans to run the Health System without the support of the nurses NYSNA leadership has convinced to strike. 

As I indicated when I last wrote to you, our negotiating teams met with NYSNA’s negotiating teams on Friday. After little progress was made at either table, the mediators told the parties to break. You can continue to follow the updates here. As of now, no additional meetings are scheduled, and we will continue to follow the direction of the mediators on when to meet again.

I would once again like to thank everyone across the Health System for the incredible work that has been done to prepare for and respond to this strike. My visits with the teams working around the clock in partnership to assess, interview, onboard, and train incoming staff have been awe-inspiring. The cadence and clarity of our operational huddles inspire enormous confidence. Although I know many of you are tired and frustrated, I hope you will take a moment to reflect on all of the amazing things you have done in just the past week to deliver for our patients and each other. Everyone who has come to work—including many who have gone above and beyond to support the operational response—is helping to save lives. We have continued to deliver outstanding care to our patients, and to be present for our communities. 

Despite the staffing disruption, we have done numerous organ transplantations, nearly one dozen cardiac surgeries, and more than 100 cardiac catheterizations. And this is just part of our story—you all know the incredible work happening across the System, from surgical suites to physician offices. In fact, our outpatient practices and labor and delivery are running at full capacity. 

To ensure ongoing high-quality care, we have made additional commitments to working with our agency nurses. As we settle into this long-term cadence, it will become more difficult to add Mount Sinai nurses not already working into the schedule without advance notice. For now, we are continuing our policy to allow staff who wish to return to work to be included in upcoming schedules, and if you choose to return, you should speak with your leadership teams so that we can create a smooth transition from agency nurses back to Mount Sinai nurses. 

Because of our existing staffing commitments, even when we reach a deal, our striking nurses’ return will likely be delayed by several days or weeks depending on patient volume and specialty. These are difficult truths, but decisions that have been made in the interest of ensuring the Health System’s operational and financial health. 

I will continue to keep you up to date with any progress in negotiations. We would very much like to have our nursing partners back at the bedside as soon as possible. Thank you again for all that you have done and continue to do.

Onward,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

Negotiators from The Mount Sinai Hospital, Mount Sinai Morningside, and Mount Sinai West arrived to bargain early this morning and continued to follow the lead of their respective mediators about logistics of the bargaining process, including when to meet with NYSNA’s bargaining team.

After a meeting between NYSNA and negotiators from all three Mount Sinai hospitals, as well as negotiators from NewYork-Presbyterian and Montefiore, hospital negotiators met with their respective NYSNA bargaining units.  

NYSNA provided a revised economic proposal for all three Mount Sinai hospitals that maintained all of its previous economic demands, including differentials and staffing, but reduced its base wage increase proposal to 7 percent in the first year, 6 percent in the second year, and 5 percent in the third year.  

The union then continued to mischaracterize discussions around health care benefits, and justified the strike by falsely claiming that Mount Sinai held their health care benefits hostage, despite the fact that there have not been any prior discussions about cutting or discontinuing health care benefits.  

Mount Sinai negotiators said they would commit to a comprehensive analysis of NYSNA’s proposals, stressing the complexity of this process because of the numerous economic proposals that are impacted by the wage increases. Hospital negotiators also made clear that any counterproposal would be influenced by the fallout of the ongoing strike and significant employer expenses and lost revenue.  

The Mount Sinai Hospital, Mount Sinai Morningside, and Mount Sinai West reached tentative agreements with NYSNA on policies for employees with substance abuse disorders. 

The next bargaining session is scheduled for Friday, January 23. 

At the request of the respective mediators for both bargaining units, negotiators at The Mount Sinai Hospital, Mount Sinai West, and Mount Sinai Morningside agreed to meet with NYSNA negotiators today, with The Mount Sinai Hospital negotiators attending for 11 hours. After little progress was made at either table, the mediators told the parties to break for the evening. No additional meetings are scheduled.  

At The Mount Sinai Hospital session, the parties spent most of the day exchanging proposals on immigration, construction and renovation, and substance abuse treatments, but did not make substantial progress on any issue. 

Mount Sinai West and Mount Sinai Morningside negotiators shared two proposals that had already been agreed to at The Mount Sinai Hospital, one on artificial intelligence (AI) and the other on support for nursing mothers, and the union did not agree to either one. In the case of Mount Sinai’s AI proposal, NYSNA’s negotiators sent back a counter and said they would never agree to elements of the proposal, even though it was identical to what was already settled at Mount Sinai’s other bargaining table.  

January 16, 2025

Friends and colleagues,

The mediators at The Mount Sinai Hospital, Mount Sinai West, and Mount Sinai Morningside asked both parties to reconvene at the bargaining table, and our teams on both sides of the park are scheduled to meet today. 

While we continue to work toward a deal, we also continue to make progress toward getting our hospitals operating at full capacity. We have extended our contracts for agency nurses to ensure we have a workforce willing to provide care to our patients. We are onboarding an additional complement of agency nurses focused on specialty areas so that we can rapidly bring our scheduled surgical volumes back to normal.  

I had the privilege of visiting with some of our teams from Finance and Digital and Technology Partners yesterday. I plan to spend some time with our amazing Human Resources team today. These teams have worked incredibly hard to rapidly onboard a large number of new employees over the last few weeks, and although much of their work may not always be visible on the front lines, they are incredibly important to our mission. 

Thank you everyone at the bedside and behind the scenes for the amazing work. Our patients and your colleagues thank you.  

Onward,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

January 14, 2026

Friends and colleagues,

As we are now three days into NYSNA’s strike at The Mount Sinai Hospital, Mount Sinai Morningside and Mount Sinai West, I again want to share my deepest gratitude to the thousands of people across our system who worked so hard to prepare us for this moment. I’ve spent a lot of time in all three of our affected hospitals over the last few days and am happy to report that our hospitals are running smoothly.  

On Monday, we saw 20 percent of our scheduled NYSNA nurses decide not to participate in NYSNA’s strike, and yesterday we saw similar numbers—hundreds of nurses joining their teams at the bedside. I remain grateful to our nurses who have come to work, to the traveling nurses who came to help us, to nursing leaders who have been working around the clock, and to the many other individuals who are working incredibly hard to make up for their absent colleagues. We have continued to provide extraordinary care at all three hospitals. Yesterday I visited a number of teams across the Health System, and although we aren’t yet at full capacity, you can feel the tempo accelerating.  

Our goal continues to be an agreement that balances the amazing contributions of our nurses with the long-term financial realities. Unfortunately, we’ve made no progress over the last two days. To support ongoing safe operations, we’ve now extended our nonrefundable contract to ensure we have a workforce willing to provide care to our patients. This investment consumes limited resources that I would have preferred to direct to our nurses. Our negotiators are ready when NYSNA is ready to bargain, and will continue to follow the lead of the mediators to help us reach a deal. As I’ve said before, it is my responsibility to reach an agreement that benefits our nurses without limiting our ability to invest in the whole of our workforce or compromising our mission.  

I have been made aware that NYSNA is bullying and intimidating our nurses who have come to work. This is incredibly destructive to the collaborative culture that makes health care special and Mount Sinai great. Our nurses deserve better, and we will continue to provide resources to protect our nurses from this sort of behavior.

I hope we will be back at the negotiating table working towards a resolution soon, and will keep you updated. 

Onward,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

January 12, 2026

Friends and colleagues,

I want to start by saying thank you. I heard from so many of you in the hallways, on the front line, and in the command centers today. Your compassion and dedication to our patients—and each other—is remarkable. Onboarding 1,400 qualified and specialized nurses, safely transferring patients, rescheduling appointments, and making sure that we can meet the needs of our communities takes a coordinated effort, and it is incredible what you are doing.

You’ve probably heard by now that 20 percent of our scheduled nurses came to work today to join their teams at the bedside. This showing was a testament to the culture that we’re building, even though it still felt like key members of our teams were missing. I’m grateful that so many of you showed up today to care for our patients, and anyone else who chooses to do so will be welcome here. I commit to all of you that we will work tirelessly to come to an agreement that balances the incredible value you bring to our teams with the financial crisis facing health care today.

The last few updates have been long and difficult, so I’ll keep today short.  You can see a brief update here on our Instagram page. 

Onward,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

January 11, 2026

Friends and colleagues,

I’m writing again to provide an update on our negotiations with the New York State Nursing Association (NYSNA) and their plans to strike beginning Monday morning at 6 am. Our negotiating teams from The Mount Sinai Hospital, Mount Sinai West, and Mount Sinai Morningside continue to meet, but no substantial economic items have been decided in recent days. In truth, the list of items left to resolve is long. Beyond wages and compensation, NYSNA includes proposals to change vacation/PTO, staffing models, and shift differentials. All have significant costs both operationally and economically, and they will need to be resolved in addition to agreeing on base wage increases.

Preparations on the Health System side are nearing completion. Our Clinical Command Center has been working with clinical and administrative leadership 24/7 to prepare. Significant progress has been made on identifying patients who can safely be discharged. They’ve been helping to transfer patients between Mount Sinai hospitals to better balance the load, reschedule appointments and operations, and review and adjust staffing projections. We are ready to begin running our hospitals with the temporary replacement nurses who have been recruited and onboarded.

We have secured almost 1,400 qualified and specialized agency nurses to join our care teams, many of whom have already been integrated into units across our hospitals. Thank you to those who have come to support Mount Sinai and our patients during a difficult time. And thank you to our incredible care and support teams who are making sure that patients come first every step of the way. The planning and personnel costs required to responsibly run our hospitals for what we anticipate could be a long strike are substantial, but we are prepared to maintain these operations. We have explained to NYSNA that given the extreme financial pressures facing health care, we have a fixed budget that can be used either for nurse wages and benefits or to prepare and operate during a strike. I feel urgency to make progress in our negotiation so that we can spend the remainder of our budgeted funds on our nurses rather than on the strike.

To ensure the health and safety of the population, a State of Emergency has been declared in New York State and the Department of Health has issued guidance to allow hospitals to plan for the staffing disruption. This declaration and the guidance give us greater flexibility to manage during the strike. We are now able to use out-of-state providers and to transfer patients to alleviate the strain on stressed hospitals. These flexibilities will help us to ensure safety during the staffing disruption. There are patients who need our services, and I’m optimistic that after a few days of transition, we will be able to use our alternative staffing solution to fulfill our obligation to our patients to provide quality health care for the duration of any strike.

We will continue to bargain in good faith with NYSNA over the course of the day and through the night as necessary, but from my perspective, a labor disruption continues to appear to be very likely. I thank you all for your ongoing work to keep our patients safe during this incredibly difficult time.

I’ll be back in touch tomorrow and a systemwide broadcast is also being prepared so that we can communicate details and logistics as they emerge during this dynamic situation.

With respect and gratitude,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System

January 10, 2026

Friends and colleagues,

With just two days before a possible strike by the New York State Nurses Association (NYSNA) at The Mount Sinai Hospital, Mount Sinai West, and Mount Sinai Morningside, I want to update you on where things stand and how we are preparing as we start the weekend. 

The negotiating teams from both Mount Sinai and NYSNA remain at the bargaining tables and are working hard to try to find a solution. I continue to hope that we will be able to reach agreements on both the East and West Sides, but the reality is that we are still very far apart on terms. As I have tried to do consistently over the last two years, I will communicate regularly with you even if I only have short updates, to ensure you know where things stand and how we are navigating these challenges. There are already a few things circulating that I’ll try to provide clarity on today. 

First, many of you have asked me about the news reports about settlements at other hospitals in the region and why we have not also settled. The truth is that these are tentative agreements being reported at smaller providers (Maimonides, Richmond University Medical Center, Wyckoff Heights Medical Center, One Brooklyn, etc.) that do not contain actual terms. They are essentially an agreement to accept the terms that are set by the larger three academic medical centers (Mount Sinai, NewYork-Presbyterian, and Montefiore). Whatever terms we reach, the rest will follow. 

This is an incredibly important point to understand. The terms we agree to will directly impact these safety-net hospitals, and our agreements will also set a framework that will influence the public hospitals (NYC Health + Hospitals) when their contract negotiations take place. It’s all connected, and if we agree to a deal we cannot afford, it won’t just be Mount Sinai that is affected; it will be virtually all the hospitals in New York. Our terms will impact not only our budget, but the state and city budgets as well, given that these hospitals all require public funds to stay open. The issues of affordability that are top of mind across the city and the looming federal cuts to health care programs are colliding.  

I know there are a lot of perspectives on this issue. I’m also aware that there is a lot of misinformation and negativity circulating in the press and on social media. As things get more complicated over the next few days and weeks, I’d like us all to try to remember that nurses, nonprofit health systems, and unions are not enemies. The separation being created between teams that work together every day is damaging to our organization and to our shared priority of taking care of patients. I will continue to work to align us in the interest of our organizational mission. 

At this point I think it is highly likely that we will not have an agreement before Monday morning. We will, of course, respect the decision of our employees who choose to strike. We will also make accommodations to allow those of you who choose not to strike to continue to work. Everyone needs to make the decision that is right for them and their families. Nurses who want to keep working and not strike should continue to speak to their nurse managers about the process. 

I just signed off from an operational check-in. We have made extensive plans to prepare for any staffing disruptions, including the expense of hiring replacement nurses to ensure continuity of safe patient care. We owe an enormous debt to our operational teams who have been working tirelessly to coordinate discharges, reschedule elective appointments, and coordinate staffing schedules so we can balance our volume and the needs of our patients with our resources. 

I wish I had better news and will keep everyone up to date as things progress.

With respect and gratitude,

Brendan

Brendan G. Carr, MD, MA, MS
Chief Executive Officer
Mount Sinai Health System