The report finds that California’s integrated nursing homes have the worst organizational outcomes

FIRST ON FOX: California nursing homes with unionized staff have received lower federal quality ratings than facilities without certified union presence, according to a new report.

“The presence of a union in a home registered with a CMS certificate appears to lower its CMS rating by about 10 percent,” a new report published by the Center for Union Facts (CUF), a right-wing organization that criticizes organized labor, reviewed by Fox News Digital found.

The Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, gives nursing homes a five-star rating based on how well they perform in health screenings, the number of staff available compared to patients, how well patients are cared for and the quality of care residents receive.

A CUF analysis of CMS federal nursing home ratings found that California facilities with unionized staff received rates nearly 10% lower on average than non-union facilities, even after the study controlled for median county family income.

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Non-union facilities averaged 3.17 stars, compared to 3.02 for unionized facilities, 2.96 for SEIU-union facilities and 2.86 for facilities represented by SEIU Local 2015, which represents long-term care workers in California nursing homes and home care settings, according to the report. After calculating the income of the environment, CUF found that unionization is associated with a decrease in the average of about 0.3 stars.

CUF argued the rating gap warrants a review of the role of the Service Employees International Union (SEIU) in California long-term care, pointing to previous allegations about internal union conflicts over culture and the workplace as a possible explanation for the difference in ratings.

The report does not confirm that union representation caused the low ratings. Other studies have found that unionization in health facilities improves patient outcomes.

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“Overall, it is difficult to say for sure that unionization is the direct cause of these low rates, but this is not an isolated trend,” the CUF report said. “A previous report, like the one by the Center for Union Facts found that SEIU-affiliated hospitals had a star rating of nearly a full star (out of five stars) compared to non-union hospitals.”

CUF identified union centers by reviewing union resources, online publications and National Labor Relations Board union election records dating back to about 2006, according to the report. Institutions with no identifiable evidence of unionization were considered non-union during the analysis.

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

The report pointed to “California’s past history of labor unions” abusing their members, including Chaquan May, a former long-term care worker and plaintiff in a case supported by the Freedom Foundation against SEIU Local 2015.

In a sworn statement, May revealed that union representatives forced her and other workers in 2023 to sign membership forms, including keeping them in a room until everyone signed them.

“We’re waiting for everybody to sign … nobody’s leaving until everybody’s signed,” May quoted one union representative as saying at the time.

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

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CUF also pointed out that the possibility of union-led strikes could have a negative impact on the care of nursing home residents.

An SEIU representative speaks at the May Day march in Los Angeles, Calif., 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 can pay the price — it’s our loved ones who are most vulnerable. This new data raises an important question: can you trust your grandmother in a SEIU-organized environment?”

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

SEIU has historically been a strong supporter of the Democratic Party. During the 2024 presidential election, for example, the union spent tens of millions of dollars in private expenses and donations to help Democrats win the election, in addition to spending an estimated $200 million on internal voter mobilization efforts to support liberals that cycle.

A previous report by the Center for Union Facts found that SEIU-unionized hospitals in California also received low ratings from CMS.