Report finds unionized California nursing homes get worse federal scores

FIRST ON FOX: Nursing homes in California with unionized staff received lower average federal quality scores than facilities without confirmed union presence, according to a new report.

A new report published by the Center for Union Facts (CUF), a center-right organization critical of organized labor, reviewed by Fox News Digital, found that “union presence in a registered CMS-certified home appears to reduce its CMS rating by almost 10 percent.”

The Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, rates nursing homes on a five-star scale based on how well they perform on health inspections, the number of staff available relative to patients, how much care is provided to patients and the overall quality of care residents receive.

A CUF analysis of federal CMS nursing home ratings found that, even after the study controlled for median county household income, California facilities with union staff received ratings that were approximately 10% lower, on average, than facilities without a union presence.

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According to the report, non-union facilities received an average rating of 3.17 stars, compared to 3.02 stars for unionized facilities, 2.96 stars for SEIU unionized facilities, and 2.86 stars for facilities represented by SEIU Local 2015, which represents long-term care workers in California nursing homes and home care settings. CUF found that unionization corresponded to a rating drop of about 0.3 stars after accounting for the surrounding area’s income.

CUF argued that the difference in ratings warranted an examination of the Service Employees International Union’s (SEIU) role in long-term care in California, pointing to previous allegations about the union’s internal culture and workplace disputes as a possible explanation for the discrepancy in ratings.

The report does not find that union representation caused the low ratings. Some studies show that unionization in healthcare institutions to develop patient outcomes.

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“Overall, it is difficult to say with certainty that unionization is the direct cause of these low scores, but it is not a single trend,” the CUF report said. “A previous similar report by the Center for Union Facts found that hospitals unionized with the SEIU had a lower star rating of nearly a full star (out of five stars) than non-union hospitals.”

CUF identified unionized facilities by reviewing union materials, online publications and National Labor Relations Board union election records dating back to approximately 2006, according to the report. Facilities with no evidence of unionization at the time of analysis were considered non-union.

Union workers march during the 2012 Toronto Labor Day Parade on September 3, 2012 in Toronto, Canada. (Getty Images)

The report noted the past “history of abuse of members” of labor unions in California; among them was Chaquan May, a former long-term care worker and plaintiff in a Freedom Foundation-backed lawsuit against SEIU. Local 2015.

May alleged in a sworn affidavit that union representatives forced her and other workers to sign membership forms in 2023, including holding them in a room until everyone signed.

“We expect everyone to sign… no one will leave until everyone signs,” May said, a union representative said at the time.

SEIU did not respond to a request for comment reached by Fox News Digital. Fox News Digital has also reached out to May’s lawyers and CMS for additional comment.

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CUF also argued that the potential for a union-led strike could negatively impact the care of nursing home residents.

An SEIU representative speaks at the May Day march in Los Angeles, California, on May 1, 2026. (LB for Fox News Digital)

“Bad policy ideas and bad leadership are a dangerous combination,” CUF communications director Charlyce Bozzello told Fox News Digital. “It’s not just workers who may pay the price; it’s our most vulnerable loved ones, too. This new data raises a serious question: Would you trust your grandmother in an SEIU-organized facility?”

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The report comes as California’s long-term care system is under federal scrutiny. CMS deferred more than $1 billion in Medicaid funding tied to the state’s in-home support services program; It’s a move that California officials have condemned as illegal and harmful to vulnerable residents but that federal officials see as necessary to root out the fraud.

SEIU has historically been a big supporter of the Democratic Party. During the 2024 presidential election, for example, the union spent tens of millions of dollars in independent expenses and contributions to help Democrats win the election; in addition, he purportedly spent $200 million on domestic voter mobilization efforts to support liberal candidates for this cycle.

Previous Union Facts Center report to create SEIU unionized hospitals in California also receive lower scores from CMS.