Nursing homes with a unionized workforce have higher compliance rates with federal safety laws making for safer environments in “one of the most dangerous workplaces in the country,” according to new research.
Unionized facilities were 31.1 percentage points more likely than nonunion buildings to report workplace injury data to the US Occupational Health and Safety Administration, according to new study results. Compliance rates during the study period hovered around 40% for all facilities, the researchers found.
“Prior studies have found that labor unions can play a crucial role in improving workplace safety,” the authors wrote. “Unions educate workers about their health and safety rights, monitor workplace hazards, and often coordinate with OSHA to increase the likelihood of safety inspections. Labor unions also often negotiate collective bargaining agreements that require employers to address workplace safety and health conditions, in some cases going beyond simply complying with health and safety laws and regulations.”
The researchers looked at the reporting rates for all 15,921 nursing homes in the 48 continental states between 2016 and 2020. During that period, they noted that 149 facilities changed their union status: 139 became unionized and 10 decertified. The authors wrote that two years after unionizing, those facilities saw a 78% increase in compliance with OSHA regulations relative to the average compliance rates throughout the study period.
The study cited the lifting of patients as a “difficult task” that is associated with back and other muscle injuries. Repetitive lifting also can increase the risk of chronic musculoskeletal disorders to the back, neck, and arms, the study said, adding that the occupation of nursing assistant was the most hazardous job in the country in 2019.
“Even before the pandemic, workers in nursing homes had higher injury and illness rates than workers in coal mines, steel and paper mills, and warehousing and trucking,” the authors wrote. “As long as the vast majority of nursing homes remain non-union, nursing homes and their regulators may continue ‘flying blind’ when it comes to preventing workplace injuries and illnesses. Worse yet, if unionized workplaces tend to be safer, then OSHA may be missing injury and illness data from many of the most dangerous workplaces in the country.”
Unionized facilities were more likely to have a higher percentage of Medicaid residents, be operated as a for-profit business, and employ nurse practitioners or physician assistants. They also were less likely to be part of a chain. Although outside of the study period, the authors noted that OSHA data from 2021 found that 7,594 non-unionized nursing homes failed to comply with reporting requirements.
In an email to McKnight’s Long-Term Care News on Friday, lead study author Adam Dean, an assistant professor in the Department of Politics at George Washington University, cited previous research published in April 2022 showing that unionization is linked to better resident outcomes. That study found that unionized facilities had a 10.8% lower resident mortality rate and a 6.8% lower worker infection rate from COVID.
“Unions fight for higher wages, better benefits, and safer working conditions for nursing home workers,” Dean said. Other researchers on the team were Jamie McCallum with Middlebury College; Atheendar S. Venkataramani with the University of Pennsylvania; and David Michaels with George Washington University. The study was published Tuesday in the journal Health Affairs.
