A nursing home worker with SEIU Healthcare MN & IA on a picket line in April.
A report published in March by Columbia University’s Labor Lab finds that nursing homes in Minnesota that receive public funds through Medicare and Medicaid are more likely to use union-busting tactics, including pressure, surveillance, and discipline. The report draws from data and surveys collected over four years, and states, “We find that workers are more likely to report union avoidance tactics in facilities with larger shares of resident care financed by public funds.”
The report focuses on four Minnesota nursing homes, including one facility that is publicly owned, one for-profit facility within a larger healthcare system, one for-profit company run by a private equity chain, and one faith-based nonprofit. All four facilities were found to have engaged in union-busting tactics, including anti-union flyering, verbal pressuring of workers, and even asking residents and their families to participate in anti-union pressure. The report states that about “50% of the revenue of these companies comes from public programs like Medicare and Medicaid” and thus, “Minnesota taxpayers may be subsidizing the union avoidance activities of private employers.”
The researchers conducted interviews with workers “across a range of facilities” and found that union-busting occurs preemptively, with many workers exhibiting fear before having met with an organizer, and found that this pattern across workplaces in the industry “undermines workers’ freedom of association well before the beginning of a union drive.” The report highlights specific instances where nursing home workers from immigrant backgrounds and Black workers display fear of employer retaliation for unionization.
The report also surveyed 1,991 registered certified nursing assistants (CNA) in Minnesota, asking workers for their place of work, their assessment of unions in their workplace, and if they witnessed union-busting tactics such as employer-organized meetings and the distribution of anti-union materials. The report then states, “We find a strong, positive, and significant association between respondents’ reports of anti-union activity within a facility and that facility’s reliance on public money.”
Further, the report found that nursing home facilities “most dependent on public resources are also those in which conditions are worse for both residents and workers, and those in which workers face the most aggressive management opposition when they try to join together to push management to improve conditions.”
The findings provoked outrage among nursing home workers, concerned about public funds being used to finance anti-union tactics. “As a CNA for over 20 years, I love doing this work, but I also know that our work is underpaid and often overworked,” George Aykua, a nursing home worker in the Twin Cities, said in a March press statement. “That’s why my co-workers and I came together to form our union. We experienced many of the most common tactics from our management, including lies and misinformation about the union, promises to people if they didn’t support the union, forced meetings and sudden offers like free pizza, snacks and even management helping out in ways they never had. When we asked them how much they were spending to try to stop our union, they would never tell us.”
“But this report shows how widespread these activities are, which is horrible,” Aykua added. “We fought back against what happened to us, but this shouldn’t happen to anyone. We just want to be paid fairly and given the respect we deserve for our important work with our residents. I hope people in power look into this and find ways to make sure money is going to workers, not union busting.”
Workers say these anti-union tactics are especially troubling in light of already difficult conditions. Cassandra Thomas, a nursing home worker for more than 30 years, spoke at a Minnesota Senate Labor Committee hearing in April about an arm injury she sustained while moving a resident, an injury that resulted in a temporary lightened workload—only exacerbating issues of short staffing and a reduction in the quality of case for residents.
Photo: Courtesy of SEIU Healthcare MN & IA
Nursing home workers with SEIU Healthcare MN & IA on a picket line.In 2025, Thomas and her coworkers at Chapel View nursing home in Hopkins, Minn. formed a union in order to find solutions for the low-staffing levels and low pay. While at first the company seemed receptive and made some positive changes, Thomas witnessed a shift in the company’s attitude toward the unionization effort.
“They had a lady who came in everyday and then they had a town hall that barely anyone showed up for. They brought in food and snacks, even though no one showed up to their meetings,” Thomas says.
She took notice of someone she assumed was a representative of the company who suddenly was present in the nursing home speaking directly with workers. Thomas states, “The lady was very nice. But I kept wondering, why was she on the floor talking to us? She kept saying bad stuff about the union. She said the union won’t work for us. She said that we will pay the union’s bills. I kept wondering, who is paying her bills?”
Thomas alleges that the union busting ramped up during the union election including anti-union signs, workers being called into one-on-one meetings with management, and continued verbal condemnation of unions and union dues. The Columbia University Labor Lab report includes photos of similar anti-union flyers. Thomas adds, “This all happened when we were working short. They could have spent that money on staff to care for our residents. How is this okay?”
Minnesota nursing homes are funded in part by Medicare and Medicaid, and workers and researchers are sounding the alarm that some of these taxpayer resources may have gone towards costly union-busting efforts, rather than increasing staffing and pay for workers.
In May, the Minnesota Legislature passed a Nursing Facility Wage Increase Back Pay effort with bipartisan support, which included a one-time direct payment to nursing home workers. The payment still hinges on federal approval before being dispersed to workers.
According to a press release from SEIU Healthcare MN & IA, Dr. Rasha Ahmad Sharif, executive vice president with SEIU Healthcare MN & IA and director of the nursing home sector, said, “We are relieved that nursing home workers are getting this bonus.” However, she continued, “While this deal barely scratches the surface of what our workers deserve, it is a step closer in that direction and it is a long time coming to get money in the pockets of these essential workers.”
The victory comes amid a slurry of attacks against nursing home workers organizing efforts—including a recent lawsuit aimed at dismantling the Nursing Home Workforce Standards Board. In 2023, Minnesota nursing home workers won a Nursing Home Workforce Standards Board, established in order to address short staffing, low pay, and improved conditions for workers and residents in nursing homes.
According to a press release from SEIU Healthcare MN & IA in May 2025, a judge dismissed a lawsuit brought by nursing home lobby groups LeadingAge Minnesota and Care Providers of Minnesota that asked for the court to roll back paid holiday rules and end the Nursing Home Workforce Standards Board.
In a statement from Chapel View nursing home submitted to Workday Magazine, Angela Brown, chief human resources officer, states, “Our focus is—and always will be—high-quality resident care and supporting our team members. We are proud of our strong staffing ratings and competitive wages, and we are committed to open communication and continuous improvement in line with our mission.”
The statement continues, “At Chapel View, we are proud that our staffing levels have received the highest possible rating—five stars—from the Centers for Medicare & Medicaid Services (CMS),” and that during the unionization drive, the nursing home “offered voluntary meetings, optional one-on-one conversations, and written materials to help clarify the process—including aspects such as union dues and the role of negotiation in establishing workplace policies.”
In response, Dr. Rasha Ahmad Sharif told Workday Magazine, “When your workers come to you and they tell you that they are tired, they are exhausted, they got injured because of being short-staffed, your answer isn’t that we are great on staffing. You don’t get to decide that. Your people get to decide that.”
She continues, “At least a little bit of recognition of what their workers are going through would make me feel better, but the fact that there’s a complete denial, it’s a very, very dangerous place.” Dr. Ahmad Sharif adds that this isn’t just about Thomas’ individual experience as a worker, but that Chapel View must contend with the Columbia University report’s findings as well. “They’re battling with a case study that was done with so much focus from two extremely credible scholars.”
Teresa Brees, a nursing home worker and member of SEIU Healthcare MN & IA, reacted to the lawsuit’s dismissal in a May 2025 press release, saying, “I am so excited to hear that a judge has dismissed this attack on the Standards Board that we worked so hard to make a reality. It was frustrating that the people who run this industry so often tell us we can’t have better wages or benefits, yet they had enough money to sue to try to stop the rule that says we get time-and-a-half when people have to work on holidays.”
While nursing workers are relieved by the dismissal of the lawsuit and Minnesota Legislature’s passing of the one-time payment for nursing home workers, many are still concerned about the staffing shortage and public funds not used for increased staffing and pay.
Thomas ended her testimony stating that short staffing causes workers to have to rush and an inability to take the time to speak with their residents. She concludes stating: “Someone you love, or maybe you, will be placed into a nursing home. We want there to be enough staff. You want money going to the workers who make sure your loved ones have dignity.”
Regarding the money spent on materials and resources to deter workers from unionizing, Dr. Ahmad Sharif says, “It shows absolutely that it’s not about money, it’s not about staffing, it’s about control. It’s about controlling this marginalized group, even when numbers and scholarly numbers come and tell you this is the truth.”