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East MarketAdvanced Practice Providers

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Update Sept. 13, 2024

Today we share an update on the status of the Minnesota Nurses Association’s (MNA) petition to represent our advanced practice providers (APPs) in collective bargaining. The MNA has requested to initiate bargaining and has filed a request for information on behalf of our East Market APPs.

Essentia Health is currently seeking National Labor Relations Board (NLRB) review of the Regional Director’s Decision and Direction of Election as it relates to the composition of the bargaining unit. That review is still pending, so the Union’s request to start bargaining is premature. We are following the processes of the NLRB, and we appreciate the continued patience of our APPs.


At Essentia, we’re grateful for the role our APPs play in delivering exceptional care, and we appreciate their patience as we follow NLRB processes.

Our Advanced Practice Providers (APPs) are important professionals who provide thousands of clinic visits and hospital care for our patients. East Market APPs offer primary, surgical and specialty care to patients throughout east and central Minnesota and northwest Wisconsin.

In June, the National Labor Relations Board (NLRB) issued a ruling that allowed roughly 400 East Market APPs to vote as a single bargaining unit on the subject of APP unionization.

Since the ruling, we’ve expressed serious concerns with the NLRB Regional Director’s decision. We view the Regional Director’s decision as a major departure from the NLRB’s long-standing application of its own Health Care Rule[1] which separates hospital and clinic staff for the purposes of collective bargaining. The NLRB’s Health Care Rule is intended – in part – to protect patients’ access to care.

A single bargaining unit covering such a large geographic footprint and wide variety of practice areas could negatively impact our ability to care for our patients. We continue to strongly believe that the Health Care Rule does apply in this case, and we are appealing the NLRB Regional Director’s decision.

Throughout this process, our care teams remain focused on providing high-quality patient care and excellent service. We appreciate our APPs and all our care team members for their dedication to our patients and communities.


[1] https://www.nlrb.gov/about-nlrb/who-we-are/our-history/1974-health-care-amendments



Background information about APP unionization.

Rights and realities of union representation.

Answers to top questions.