Unionization in the nursing home space may decrease staff turnover, and help employers meet proposed staffing minimums – especially in counties where most nursing homes are unionized.

The presence of a union is associated with a 1.7 percentage point decrease in staff turnover, according to a study published on Friday in JAMA Network Open. This association was “significantly larger” when the county-level proportion of nursing homes that were unionized was high, researchers noted.

Specifically, when more than 75% of nursing homes in a county were unionized, facility-level presence of a union was associated with a 9% decrease in staff turnover.

“Such industry-wide unionization enables management to meet union demands without worrying about competition from nonunion facilities with lower labor costs,” researchers said.

In terms of the proposed minimum staffing proposal, the American Health Care Association (AHCA) points to turnover as a main challenge to meeting such a requirement.

When 75% or fewer nursing homes in a county were unionized, researchers saw a 1.2 percentage point decrease in turnover.

About 12,633 nursing homes had total nursing staff turnover data available, and the mean staff turnover rate was 52.6%.

Labor unions have argued that their presence can decrease turnover by improving job quality, and in turn helping to maintain a stable workforce and improve resident care, according to the study. And, unionized health care workers earn higher incomes than nonunionized peers, researchers said.