Hospice Employees May Turn to Unions if Feeling Unheard

Listening to hospice employees and addressing their needs and concerns is essential to staff recruitment and retention. Failing to do this could also motivate staff to pursue unionization, according to lawyers from the firm Husch Blackwell. 

Unionization is uncommon in hospice, but local media reports in some communities show that the movement has gained some ground. Hospices that are affiliated with larger health systems may be more likely to see staff participate in labor unions.

“I think that even though the unions are kind of on the decline throughout our country. Back in the 50s people in unions were 30% of the workforce was unionized. Now it’s less than 10%, but the one area where it’s growing is hidden health care,” said Jon Anderson with Husch Blackwell in a JD Supra podcast. “It’s growing because people are getting older. Health care is a growing industry because of that. It’s an economic mainstay, even in a recession. There’s lots of job opportunities compared to the rest of the private sector. There’s a strong need for workers. Every health care employer is an opportunity or a union and all it takes is one disgruntled employee to try to get other employees to join.”


Of  the nation’s nearly 10,000 health care workers about 14% were represented by unions in 2019, according to the U.S. Bureau of Labor Statistics. This includes clinical and technical employees, but does not include support occupations.  

One factor that could influence employment and labor trends is ongoing staff shortages among hospice and palliative care clinicians.

Hospice leaders identified staffing shortages as their top concern moving into 2020 on a Hospice News survey in collaboration with Dallas-based tech company Homecare Homebase. More than 26% of 300 respondents anticipated staffing as their greatest challenge, outweighing concerns over increased competition in the hospice space and new payment models.


A culture of safety in which staff can bring concerns to management and feel heard and that some action would be considered.

“If the unsatisfied employee knows that they can go to management — with their concerns, with their questions, with their issues —  and the employee knows that they’ll be listened to, and that action may be taken to address or correct or at least try and better understand the issue, I think that helps avoid unions entering the workplace,” Tom O’Day, also a lawyer with Husch Blackwell. “It’s the work environment where employees feel like they aren’t being listened to where unions organize.”

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