The tribal health organization that runs Dillingham’s hospital and serves 27 other communities across the Bristol Bay region slashed the pay of its roughly 50-person nursing staff this month — and it’s considering a second, equally deep cut.
The Bristol Bay Area Health Corp.’s March 9 pay cuts came as a surprise to nurses. And because of housing entanglements and the possibility of needing to repay certain bonuses, some nurses say they feel like they’re being held hostage to stay on.
A letter to the nurses announcing the pay cut came on the last day of January. In it, the organization’s Chief Human Resources Officer Frank Mazzocco told the nurses that their wages were being cut by $500 a week – which nurses say is between 11 and 15% of their pay.
In the letter, the pay being cut was described as a pandemic-related “retention bonus program” to help Kanakanak Hospital recruit nurses during a nationwide shortage.
The letter says that now that the health crisis is over, and due to “changes in staffing and economic considerations since the inception of the program, BBAHC has decided to modify the program.”
The national COVID-19 crisis ended in 2023 but in email correspondence with KDLG, the organization's Public Relations Director Cynthia Rogers said the timing of the cut coincides with “associated Covid-19 funding being fully expended.”
The program was offered to all permanently employed nurses recruited from out of state, the vast majority of the organization's nursing staff. Five nurses who spoke to
KDLG say their original offer letters never mentioned COVID-19, nor did they stipulate that the bonus was temporary.
In at least one of the original three-year sign-on agreements, the pay was categorized as “Additional Registered Nurses Benefits” with a retention bonus amount of $1,000 paid to employees each week. The reduction cut that in half.
As for the second half? The HR letter says it is under review.
“This program may be modified or eliminated at any time at BBAHC’s sole discretion,” the HR director wrote in the letter. "BBAHC intends to reevaluate this bonus program later this year and make additional changes to the program.”
KDLG spoke with five nurses who declined to be recorded or named for fear of retaliation from their employer. The nurses say that during a Q&A forum addressing the pay cut, BBAHC executives reminded them that they were at-will employees, meaning they can be fired without cause.
And, many of the nurses live in hospital-provided housing. The nurses say losing their job could also mean losing their housing, at the organization’s discretion.
In an email to KDLG, one of the nurses wrote, “Many nurses were recruited under a three-year agreement, leaving behind stable jobs and uprooting their families based on promises of financial stability and professional opportunity.”
The letter goes on to say that less than a year after relocating to Bristol Bay, the nurses were seeing their “promised retention bonuses” cut in half.
Recruiting registered nurses from out-of-state tracks with statewide trends. According to the Alaska Beacon, the number of nurses being trained in Alaska this year only accounts for a quarter of the nurses the state is projected to need. That means the Alaska health organizations need to recruit three-quarters of their new hires from out of state — and competitive pay is one way to do that.
“BBAHC uses recruitment and retention bonuses to reduce attrition and improve retention rates,” Public Relations Director Cynthia Rogers said in an email correspondence with KDLG.
BBAHC officials declined interview requests but would answer questions by email.
Rogers goes on to say that employment is at-will and because nurses signed an agreement, not a contract, they can change the pay at their discretion.
“At-will employment includes the employer’s ability to prospectively change compensation (and other terms and conditions of employment) at any time,” Rogers said.
The organization says they followed Alaska state law requiring that employers make employees aware of any change to their rate of pay the payday before the time of the change.
“In this case, BBAHC provided employees more notice than was required by law,” Rogers said.
But, in addition to the pay cut, the nurses say that they were told if they break their side of the agreement by resigning before the end of their term, they will be required to pay back relocation and sign-on bonuses.
“This is essentially holding nurses hostage,” nurses wrote in an unsigned letter addressed to the BBAHC board of directors. The nurses say the letter was submitted through the organization's compliance line, but KDLG could not verify that the board received the letter for their meeting this month.
All policy changes go through the organization's board of directors. Its 28 members each represent a Bristol Bay community the organization serves, from Platinum to Port Heiden. KDLG contacted five board members for this story but was told by
Public Relations Director Cynthia Rogers that board members do not respond to media inquiries and that board meeting dates, agendas, and minutes are not public.
According to Rogers, at least one nurse has resigned because of the pay cut.
The nursing staff says they anticipate more and are concerned about what this would mean for the region's health care.
“Hospitals keep the doors open because of nursing. If there are no nurses, there is no hospital. There are no alternatives for people in the region to receive hospital care in their region,” the letter addressed to the board said.
According to the Alaska Hospital and Healthcare Association’s 2024 Healthcare Workforce Analysis report, nurse vacancy rates across the state are 22% and it takes an average of 138 days to fill a vacant position.
In their statement to KDLG, Rogers said BBAHC is not currently concerned about staffing changes.
“Staffing level changes are to be expected and BBAHC utilizes various strategies to ensure coverage for patient care,” Rogers said. The specifics of the strategies were not made clear.
Nurses told KDLG that during the Q&A forum addressing the pay cut, temporary traveling nurses were proposed by the organization as a replacement if the nursing staff resigns.
“Administration and HR have made it abundantly clear; they feel that staff here are easily replaced by travelers,” one nurse said in an email to KDLG.
The Alaska Hospital and Healthcare Association’s report says that travel nurses can fill vacancies, but it comes at a cost. According to the 2024 data, travel nurses earn 56% more than their nontraveling counterparts.
The standard contract for traveling nurses is 13 weeks in a location, while regular nurses usually commit to three years to start. The nurses say that continuity makes a difference.
“I just want the communities we serve to be aware, you currently have a hospital nursing staff full of committed nurses, nurses who live here, work here and care about you. Nurses who have come to Dillingham with the idea that they are committed to 3-5 years, who are now having to make decisions about leaving. Not based on their love or hate of our region, but based on financial commitments made prior to moving here,” a nurse said in a letter to KDLG.
The HR letter to nurses requested that each nurse sign an acknowledgment of its receipt. So far, sources say only one nurse has. The HR request was later modified to state that continuing work would be considered acknowledgment.
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