Union leaders at GW Hospital have engaged in yearslong, deadlocked battles with the hospital’s owner over union recognition and bargaining in what experts say is part of an ongoing nationwide trend of union avoidance.
GW Hospital’s nurses’ union and service workers union filed unfair labor practice charges against Universal Health Services, Inc. the hospital’s owner and provider, in 2023 and 2018, respectively, alleging UHS attempted to thwart union presence by discouraging participation and engaging in bad faith bargaining. Both unions won elections among hospital employees — the nurses in 2023 and service workers more than two decades ago — but UHS doesn’t recognize either union, so officials won’t come to the bargaining table.
UHS is a for-profit Fortune 500, and one of the country’s largest hospital management companies. GW and UHS first partnered in 1998 to operate GW Hospital, and UHS became the sole owner of the hospital in May 2022 when the University sold UHS its minority stake.
The National Labor Relations Board, which enforces U.S. labor law, is taking UHS to court on Oct. 21 after escalating three of the nurses union’s unfair labor practice charges.
The board ruled in May the UHS engaged in bad-faith bargaining and ordered its leaders to resume good-faith contract negotiations with the service worker’s union.
GW Hospital spokesperson Susan LaRosa said GW Hospital is pursuing “all legal rights” related to the nurses’ union election. She said if the NLRB again certifies the election — after UHS in June appealed the regional labor board’s decision to certify the union — GW Hospital will engage in good-faith negotiations with the union.
“GW Hospital denies the allegations of any unfair labor practices and is defending against those charges vigorously,” LaRosa said in an email.
Experts in labor history said UHS’s legal moves signal union avoidance — a legal approach employed by corporations and hospitals to slow union progress by attempting to stop union election wins because they view unions as a threat to profits and management prerogatives.
“It’s a legal specialty in advising managers how to avoid bargaining with the union. That’s become kind of the norm in both the corporate world, including both for-profit and nonprofit hospitals and also in university administrations,” said William Jones, a professor of history at the University of Minnesota.
Just over a third of newly organized unions obtain a collective bargaining agreement with their employer within the first year, and about two-thirds secure a deal within three years, according to the U.S. Department of Labor.
Here’s a breakdown of union battles at GW Hospital and other UHS-owned facilities:
GW Hospital nurse’s union
Nurses initiated union organization with the D.C. Nurses Association in February 2023 after previous repeated attempts to work directly with leadership to address the hospital’s lack of staffing and a lack of “lasting systematic improvements” following the COVID-19 pandemic. GW Hospital in February also laid off 60 employees, or 3 percent of its staff.
David Zonderman, a professor of history at North Carolina State University and an expert in American labor history, said low staffing worsens working conditions in hospitals, often triggering nurses to organize unions.
“The for-profit entity wants to increase its profits,” Zonderman said. “It’ll cut staff and/or cut wages, benefits.”
Edward Smith, the DCNA’s executive director, said after nurses announced plans to unionize, UHS leaders’ anti-union practices were immediate. DCNA filed five unfair labor practice complaints in March 2023, alleging UHS officials suspended a nurse for participating in union organizing, installed surveillance cameras in staff spaces and discouraged union participation in private meetings with nurses.
UHS suspended and then fired registered nurse Angelo Estrellas in March 2023, which the nurses’ union said was due to his involvement in the union organization.
“They’re probably one of the most anti-union health care companies I’ve dealt with,” Smith said.
Smith said he believes UHS officials weren’t aware of nurses’ plan to unionize until about two weeks before DCNA launched its union campaign.
As nurses waited for the NLRB ruling that allowed them to hold a union election, union leaders said GW Hospital management removed pro-union signage and put glass frames over bulletin boards in the hospital to prevent union representatives from posting material. Union leaders also refiled two unfair labor practice complaints in April 2023, replacing four of the complaints filed the month prior.
In June 2023, the union set election dates for the end of that month, and nurses voted 310-207 to form a union. Smith said part of the reason why the association won the vote was because UHS didn’t have time to dissuade people.
UHS objected to the election results within a few weeks, contesting the union’s messaging, voter identification and brief presence of supervisors at the election. The regional NLRB director quashed the objection in June — which Smith said UHS has appealed.
“I was 100 percent positive they would fight,” Smith said. “It’s not rocket science. No, all you need to do is look at this company’s history with labor unions.”
The regional NLRB in late May ruled to dismiss one of UHS’s charges, which alleged that Estrellas was a supervisor — a position that labor laws bar from participating in union efforts. The NLRB’s decision affirmed that Estrellas was not a supervisor and couldn’t have coerced nurses into joining. UHS has since appealed the decision.
“It affected me finding work, emotionally, psychologically and financially,” Estrellas, who worked at GW Hospital for more than a decade, said in June.
The NLRB regional director ordered a court hearing for Oct. 21 over three unfair labor practice charges, including Estrellas’ termination.
GW Hospital service workers’ union
The 1199 Service Employees International Union had represented more than 150 GW Hospital cleaning, ambulatory and food service workers for more than two decades before the hospital received a decertification petition in October 2018 — which 81 of the 156 employees in the bargaining unit signed.
UHS officials notified the union that they were immediately withdrawing recognition of the union, claiming it had lost support of a majority of employees in the bargaining unit. UHS officials then canceled all future bargaining sessions and implemented a new compensation structure and employee wage rates.
In response, union workers filed a complaint with the NLRB that month, alleging UHS bargained with the union in bad faith by opening negotiations with a “wish list, throw-in-the-kitchen-sink” proposal — a form of hard bargaining — and claimed for this reason the hospital could not legally withdraw their recognition of the union.
An administrative law judge ruled in favor of the union in September 2019 before the NLRB overturned the ruling in May 2021, determining the hospital was engaging in “hard bargaining” but didn’t violate labor law because the union had allegedly insisted on maintaining the terms in the expired agreement instead of negotiating with the hospital to form a new one.
“1199’s position has stayed the same since GW Hospital workers were unfairly stripped of their union in 2018: workers have the right to organize, and Universal Health Services should respect that right,” Carrietta Hiers, 1199 vice president for D.C., said in an email.
Joseph McCartin, the executive director of Georgetown University’s Kalmanovitz Initiative for Labor and the Working Poor, said hospital managers like UHS are often against unions because they want to make decisions without input from employees.
“That is fundamentally a problem in so many labor relations, power even more than money,” McCartin said.
In May, the NLRB ruled GW Hospital’s contract negotiations with the union unlawful because it “failed” and “refused” to bargain with the union in good faith from 2016 to 2018 before ceasing recognition of the union.
After reviewing the union’s unfair labor charges, the NLRB in May also ordered UHS to recognize and bargain with the union in good faith, rescind changes the hospital made to employment terms and conditions unilaterally after October 2018 and compensate employees for any lost benefits, earnings and all adverse tax consequences and expenses.
Other UHS-owned hospitals
Union efforts at UHS-owned hospitals in Pennsylvania, California and Nevada have also failed in the past few years.
Tamara Kraynak — a former nurse supervisor at The Meadows Psychiatric Center, a UHS-owned mental health facility in Centre Hall, Pennsylvania — said she and another nurse attempted to organize a union because hospital owners understaffed the center, which made working conditions dangerous. She said she used to work in the center’s management and knew that UHS leaders didn’t want unions.
“Everyone knew, you say that word, you better watch your back,” Kraynak said, referencing unions.
Kraynak said she filed the union election at the end of February 2022 and faced termination in March 2022. UHS said in her termination letter that officials fired her because of her role in attempting to organize a union.
In response, the Service Employees International Union, which worked with the center’s employees, filed in 2022 unfair labor practice charges with the NLRB and Kryanak said the NLRB escalated the charge related to her termination. Instead of going to court, she said she reached a monetary settlement with UHS but didn’t specify how much compensation she received in the settlement.
“The fines are a joke, if you’re talking about this corporation who’s a multibillion dollar, I mean, this whole conglomerate is so massive, this stuff is a drop in the bucket,” Kraynak said of the settlement.
Kraynak said nurses at the center never unionized, which she attributes to fears of termination. She said officials fired seven nurses while they were attempting to organize in 2022. She added that she believes UHS doesn’t want unions at its hospital because it wants to maintain control of the facilities.
“They don’t want to bargain, they don’t,” Kraynak said. “They definitely like to be in control.”
