Fewer Residents Died from COVID in Unionized Nursing Homes

An observational study of 13,350 nursing homes between June 8, 2020 and March 21, 2021 finds that facilities with unionized workers were associated with a 10.8% lower COVID-19 mortality rate among residents and a 6.8% lower COVID-19 infection rate among workers. 

The study, “Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020-2021,” calculates that “industry-wide unionization would have been associated with approximately 8,000 fewer resident deaths.” The researchers suggest that policies advocated for by unions – paid sick leave, access to personal protective equipment and COVID testing, and isolation of infected residents – may decrease workers’ rates of infection, thereby lowering residents’ mortality. Among the 13,350 facilities in the study, 11,108 were non-union facilities and 2,242 were union facilities.

Unionized nursing facilities had higher percentages of Medicaid residents, higher occupancy rates, and fewer white residents than non-unionized facilities. They had higher registered nurse staff-to-resident ratios, but lower licensed practical nurse and certified nurse aide staff-to-resident ratios. Unionized facilities had higher rates of for-profit ownership, but lower percentages of chain affiliation.

• For further information: Adam Dean, et al, “Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020-2021, Health Affairs (May 2022), https://www.healthaffairs.org/doi/epdf/10.1377/hlthaff.2021.01687.