About 20 union employees of a Johnstown, PA nursing home were fired after they staged a one-day strike to protest their health insurance coverage and the home’s staffing levels.

Grane Healthcare, which runs LaurelWood, said 200 residents were neglected when the workers formed a picket line. About 70 of LaurelWood’s 110 union employees crossed the line to work. To fill the missing 40 spots, Grane found temporary workers for half and “permanently replaced” the other half.

Those who lost their jobs were mostly housekeepers, dietary and laundry workers.

Officials with the Service Employees International Union charged that Grane uses staffing levels that are 24% below the state average. Grane officials said their staffing meets state standards.