Cleveland Clinic Lutheran Hospital is escalating its standoff with striking workers. The hospital said Wednesday it may hire permanent replacements for workers who remain on strike, telling staff it may need the hires to support long-term staffing as the walkout continues.

Employees whose positions are filled would remain hospital employees and be placed on a preferential recall list, according to the hospital's update. Members of SEIU District 1199 went on strike Sept. 23 — about half of the nearly 200 union-represented employees are on strike — seeking higher pay, workplace protections and the right to bargain over future changes in health insurance costs.

The union says members will remain on strike until an agreement is reached. Earlier this month, some striking workers lost eligibility for active employee benefits because they had not worked their scheduled shifts, adding to the pressure on both sides as the dispute enters its third week.