A contentious labor and patient-care struggle between unionized workers and four Windsor nursing homes in Monterey County has spilled into Salinas City Hall.

A Dec. 11 forum highlighted the battle of SEIU United Healthcare Workers West to improve conditions for the sick and elderly at Windsor facilities. In response, Windsor staff, residents and family members showed up in droves at the Dec. 16 City Council meeting to laud patient care.

Salinas City Councilwoman Jyl Lutes says she wants to schedule a public hearing about Windsor. “If the medical issues are real they need to be pursued,” she says. “If Windsor is making a huge profit on the backs of caregivers and patients, then that also needs to be exposed.”

The dueling appeal to Salinas-area elected officials is the latest rift in the conflict between UHW and Windsor Healthcare Management. Windsor operates three skilled nursing facilities in Salinas and one in Monterey: Skyline Care Center, The Ridge Rehabilitation Center, Gardens Rehabilitation Center of Salinas, and Monterey Care Center.

The centers’ 350 unionized staff have been without a contract for as long as a year and a half, says John Vellardita, UHW’s director of long term care. “These are nursing home workers that take care of the most vulnerable, frail, sick seniors,” he says. “They work in terrible conditions of employment. They are understaffed.”

The union is demanding affordable health insurance and equitable pay. Vellardita contends that health insurance premiums and pay differ at two Salinas facilities located across the street from each other. Vellardita wants a $2.33 per hour raise for caregivers spread out over three years.

Luz Maria Nuci Ramos is a certified nursing assistant at Skyline Care Center in Salinas. Ramos says she makes $11.40 an hour and can only afford a one-bedroom apartment for her two young children. She says she rents out the living room to help pay the bills. “It’s hard with that income to get another apartment,” she says.

UHW workers also want quality-of-care committees established that will allow a third-party mediator to get involved in resolving disputes.

“We want to have a voice for the patient care for our residents,” Ramos says. “Residents need to live with dignity too. It’s their second home.”

Windsor officials, however, say residents already receive excellent care.

Back in the pink-carpeted hallway, Windsor spokesman David Farrell says the union is attacking his company because they are in labor negotiations.

The union tallied more than 500 violations of health and safety regulations found by California Department of Public Health inspectors between March 2007 and May 2008 at Windsor’s 28 nursing homes. The Monterey Care Center has received 15 complaints this year, eight of them substantiated by the state, and 11 survey deficiencies. The center has been disciplined by the state five times in the past two years for such things as tying a patient to a wheelchair with a sheet, and failing to supervise a resident with a history of dementia who left the building through two alarmed exit doors.

Monte has explanations for each incident. The staff person who restrained the unruly patient was trying to protect other residents, she says, and the faulty alarm system has been replaced since the escape.

Deficiencies and complaints are a regular discovery at nursing homes. Monterey Pines nursing home, next door to Windsor’s Monterey facility, has had even more recent incidents than its neighbor– including seven state enforcement actions– this year.

“If you were to randomly select 30 nursing homes… you’d come up with 600 deficiencies,” Farrell says.

He adds that the union’s pay demands are exorbitant: “They are asking us to match what acute care hospitals pay their CNAs.”

A big sticking point between the union and Windsor, Farrell says, is that the company wants flexibility in wages in year three of the contract in case the state reduces Medi-Cal reimbursements. “We are trying to have some sort of safeguard if they cut Medi-Cal rates,” he explains.

Windsor also doesn’t think the patient care committees are necessary, since staff and supervisors already meet frequently and resolve their issues without a mediator, Farrell says.

But Vellardita says Windsor is going the opposite direction of other nursing homes across the state.

On Dec. 22, UHW announced an agreement with Kindred Healthcare, which gives CNAs the $2.33 raise and quality-of-care committees Windsor won’t agree to. The contract covers nine northern Californian facilities, including Pacific Coast Care Center in Salinas. “[Windsor] refuses to negotiate the issues we are gaining with others,” Vellardita says.