What to know about the looming health care workers strike at Kaiser Permanente

More than 75,000 Kaiser Permanente workers across the country are planning to strike Wednesday morning over what a coalition of unions allege are unfair labor practices.

The strike -- which will last for three days in most locations and include employees in California, Colorado, Maryland, Oregon, Virginia, Washington and Washington, D.C. -- would be the largest among health care workers in U.S. history, according to the unions.

The Coalition of Kaiser Permanente Unions, which represents more than 85,000 workers, and the health care system have been negotiating since April but were unable to come to an agreement before their contract expired on Sept. 30, officials said.

Workers allege in a release that the COVID-19 pandemic led to working conditions deteriorating and exacerbated a staffing crisis plaguing several health care systems.

The employees alleged Kaiser's bargaining in bad faith led to unsafe levels of staffing that resulted in long wait times, patient neglect and missed diagnoses. Additionally, the Coalition said it's advocating for better medical plans for retirees as well as protections against work that is outsourced and subcontracted.

Debru Carthan, lead radiologic technologist at Kaiser Permanente Modesto, told ABC News she and her colleagues are often doing the work of two to three individuals and it is affecting the quality of care, such as when she performs mammograms.

"We generally do mammograms every 15 minutes but with the Kaiser short staffing crisis, we are cut down to sometimes seven and a half minutes," she said. "So our workload is double; where I might have a regular schedule of 20, but now I have anywhere from 40 to 45 patients that were supposed to do an eight-hour period."

Carthan added, "As a frontline health care worker, we are listening to our patients and Kaiser executives are not listening to us about how mentally and physically and emotionally drained we are. Our patients feel it; they're not getting the quality care that they should be getting and it's not safe."

The Coalition also argues that despite being a nonprofit organization, Kaiser has reported more than $24 billion in profit over the last five years and $3 billion in profits in just the first six months of this year.

The strike will include hundreds of positions, including nurses, emergency department technicians, pharmacists, home health aides, dental assistants and more.

Kaiser Permanente said the strike is "not inevitable" but also "certainly not justified" and claims that it leads in total compensation in every market it operates in and that it offers "great benefits," including special benefits during the pandemic including for child care, housing and sick benefits.

"We need to keep working together to get through this. Because the reality is that we are still in a health care crisis in this country," the nonprofit said in a statement. "Access to care is stretched thin and it will take time to recover as an industry and stabilize the US health care system. We can only do that if we work together, management and labor, side-by-side, for one another, our patients, and our communities."

Carthan disagreed and said a strike is necessary due to the mental and physical exhaustion she said she and her colleagues are experiencing.

"As a 27-year-employee, I am disheartened by the bad faith bargaining that Kaiser is doing" she said. "It hurts to see that our patients can't get in for months. It hurts to know that our patients especially my mammogram patients with lumps and things of that nature have to sit at home and worry because of the Kaiser short staffing crisis. This is not okay."

Kaiser said its current offer is across-the-board wage over four years, including a proposed $21 minimum wage in Colorado, Hawaii, Maryland, Oregon, Virginia, Washington and Washington, D.C. and a $23 minimum wage in California.

In an email to ABC News, Kaiser addressed the accusations of understaffing, saying that it's hired more than 50,000 frontline employees this year and last year and said it would reach its goal of 10,000 new hires represented by the Coalition by the end of October.

The nonprofit said it has plans to take care of patients should a strike occur and that its hospitals and emergency departments remain open. Kaiser employs more than 212,000 people throughout the U.S.

However, Kaiser said it may reschedule non-emergency and elective procedures in some locations and will send some prescriptions to outpatient pharmacies to meet any demand.