As many as 70 clinical and support workers at Essentia Health's hospital and nursing home in Deer River are set to go on strike indefinitely if their pay and staffing demands aren't met, according to their union.

The walkout would start Monday and involve the hospital's nursing assistants, medical and lab technicians, and workers involved in everything from blood draws to laundry to food preparation. Union officials said workers at the affiliated nursing home are prepared to strike as well.

The workers represented by SEIU Healthcare Minnesota & Iowa said they are seeking the same wage increases granted recently at other Minnesota health care facilities, and protection from nonunion float workers taking over their jobs.

"We've seen such a reduction in staffing levels and are so overworked. It is unacceptable that we are so undervalued," said Sarah Roberts, a surgical tech at Essentia Deer River who participated in a five-day protest strike earlier this year.

Contract talks have been ongoing since August but failed to produce a deal. Essentia negotiators had offered a 9% wage increase phased in over three years, before receiving a counterproposal that they were evaluating on Friday. Unless an agreement is reached this weekend, the hospital is prepared to reduce inpatient admissions and surgeries for the duration of the strike while maintaining its emergency room, outpatient clinics and nursing home.

"These are difficult but necessary steps to take as we prepare for the possibility of another SEIU strike," Essentia said in a statement. "Our highest priority is the safety and well-being of the patients we serve."

The hospital, 15 miles west of Grand Rapids in northern Minnesota, has experienced many of the pressures of rural health care over the past decade. Childbirths declined from 78 in 2018 to 18 in 2020 and now aren't scheduled at the hospital. Acute inpatient admissions also have declined from 372 in 2018 to 237 in 2022, the most recent year for which public hospital data is available.

Essentia Deer River has nonetheless remained financially healthy, posting a 7% operating margin in 2022. Among all hospital providers in Minnesota, 43 reported operating losses that year.