The Effects Of Labor Unions On Nurse Staffing Ratios And Quality Of Care In US Nursing Homes, 2013–21 Adam Dean, Jamie McCallum, Atheendar S. Venkataramani, Paula Chatterjee, Norma B. Coe, and David Michaels

https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2025.00609?utm_campaign=march+2026+issue&utm_medium=email&_hsenc=p2ANqtz--jpXK4WMZ3EMayJ1JWJS0cP9Uh6wd3Yrq4DPD4cRxxAG2atM5iUoNvYu1DA2yisKaiCvNT2CGilPJpotEuSWXy5DO9Tw&_hsmi=410804823&utm_source=well+read&journalCode=hlthaff The study finds that when nursing home workers unionize, employers tend to use more licensed practical nurses and fewer registered nurses, but overall staffing levels and quality of care remain unchanged.