Dive Brief:
- Unionized nursing homes were more likely to comply with federal regulations and report workplace injury and illness data to the Occupational Safety and Health Administration, according to a study published this week in Health Affairs.
- Only 40% of nursing homes nationwide complied with reporting requirements between 2016 and 2021, despite nursing homes being among the most dangerous workplaces in America. Nursing home employees experience higher injury and illness rates than coal mines, steel and paper mills and trucking.
- Nursing home unionization was associated with a 78% increase in compliance with reporting requirements compared to the industry average, offering employees and patients increased transparency into individual facilities’ safety data, the study found.
Dive Insight:
The nursing home industry has been one of the most dangerous places to work in the U.S. for decades, according to the study. Workers routinely lift heavy patients and may experience muscle sprains, strains, and tears or back injuries.
Since the onset of the COVID-19 pandemic, nursing homes have been short-staffed and have experienced higher patient volumes and increased workplace risks. In 2020, working as a nursing home certified nursing assistant became one of the deadliest jobs in America, according to data from the the CMS and the Bureau of Labor Statistics.
OSHA has required certain employers to report summary illness and injury data since 2016, hoping increased transparency may help decrease future adverse events by incentivizing employers to proactively address risk.
However, compliance has lagged. Fewer than 50% of employers report required data and OSHA has limited resources to penalize offenders, according to a report from the U.S. Government Accountability Office.
In the nursing home industry, unions can play a “critical role” in improving workplace safety, according to the study. Unions can negotiate compliance into contract terms or serve as a whistleblower for noncompliance.
Should the nursing home industry broadly adopt unions, researchers project compliance would increase 31.1%, causing an additional 2,361 nursing homes to report data on workplace injuries and illnesses to federal regulators.
Jessie Martin, executive vice president of the New England Health Care Employees Union District 1199NE, a union that represents nursing home workers, told researchers that most of the union agreements he helps negotiate include clauses dictating that employers have to follow health and safety laws.
“...Nonunion workers simply don’t have the same opportunity,” Martin said.
Unions have previously been associated with better patient and employee safety in nursing homes. In an analysis of COVID-19 death rates, unionized facilities experienced lower resident mortality rates and worker infection rates than non-unionized nursing homes.
Unionized workplaces may experience better safety outcomes because unions educate workers about health and safety rights, monitor the workplace for hazards and coordinate with OSHA to increase safety inspections, researchers noted.
However, unions are not common across the industry. Researchers found unions in 16.3% of nursing homes between 2016 and 2021. Unions were more common in for-profit facilities and those with a higher percentage of residents primarily supported by Medicaid.
