Home care professionals and clinicians at University of Rochester Medicine Home Care (URMHC) reached a tentative three-year contract agreement on May 13, 2026, calling off a planned five-day strike that had been scheduled to begin this week. The workers are represented by 1199SEIU United Healthcare Workers East, which covers healthcare workers across seven upstate New York counties.

The tentative deal includes an 8.75% wage increase over the life of the contract, an additional floating holiday, an attendance bonus, and other provisions addressing patient caseloads and health insurance costs — the two issues that had driven more than a year of stalled negotiations.

What the Workers Were Fighting For

URMHC home care professionals had been negotiating their first union contract since May 2024 — more than a full year of stalled talks with hospital management. The primary grievances were patient caseloads they described as unsafe and health insurance costs that consumed too much of their take-home pay.

1199SEIU had previously alleged that URMHC bargained in bad faith when management failed to provide an economic counterproposal at a critical negotiating session, a charge the union documented in a formal press release. Workers responded by voting to authorize a five-day strike, with a formal strike announcement issued before negotiations resumed under a federal mediator. The mediator's involvement in the final weeks before resolution proved decisive.

Prior to the strike vote, workers held picket actions and marched to the office of URMHC President and CEO Kathy Parrinello, demanding more bargaining dates with extended hours to move the process forward. The escalation strategy — from pickets to federal mediator to strike authorization — is a textbook labor escalation ladder that eventually produced results.

What the Deal Actually Covers

The tentative agreement includes:

  • 8.75% wage increase over the three-year contract term — a meaningful raise in a sector where home care workers have historically lagged hospital counterparts in compensation growth
  • An additional floating holiday, adding flexibility to scheduling
  • An attendance bonus rewarding reliable scheduling commitment
  • Unspecified provisions on patient caseloads and health insurance coverage — the core issues that triggered the organizing drive

Workers will now review the full agreement and vote to ratify before it becomes binding. Ratification vote dates had not been announced as of publication. The contract covers home care professionals and clinicians in seven upstate New York counties served by URMHC.

Context: Home Care Nursing Under Pressure Nationwide

Home health is the fastest-growing nursing segment in the country, with demand up 12% year-over-year and employment projected to grow faster than any other care setting through 2034, according to Bureau of Labor Statistics data. An aging population increasingly preferring to age in place — rather than enter assisted living or SNF care — is the primary demand driver.

But demand growth has not consistently translated into better working conditions for home care nurses. Home health RNs nationally average $45.81–$47.49/hr ($95,285–$98,779/yr) in 2026, competitive with med-surg staff pay but below ICU or OR benchmarks in major markets. Patient caseloads at many agencies run 4–6 patients per day, plus OASIS documentation, driving, and care coordination — workloads that the UR Medicine workers specifically identified as unmanageable.

The URMHC contract fight reflects dynamics playing out across the home health sector. Agencies compete for the same licensed nurses as hospitals, travel platforms, and SNFs in a labor market with a projected 263,870-RN shortage nationally. That competition gives organized home care workers more leverage than they have historically held. The 8.75% wage win — in a sector not known for rapid compensation growth — reflects that shift.

For home care agencies watching this settlement: contract outcomes like this one set market expectations for nurse compensation in their regions. Agencies that want to compete for staff without union pressure will need to match or exceed the wage and caseload benchmarks being established in organized contracts. The URMHC settlement is likely to be cited in future negotiations across the region.