TY - JOUR AU - Sojourner,Aaron J. AU - Town,Robert J. AU - Grabowski,David C. AU - Chen,Michelle M. TI - Impacts of Unionization on Employment, Product Quality and Productivity: Regression Discontinuity Evidence From Nursing Homes JF - National Bureau of Economic Research Working Paper Series VL - No. 17733 PY - 2012 Y2 - January 2012 UR - http://www.nber.org/papers/w17733 L1 - http://www.nber.org/papers/w17733.pdf N1 - Author contact info: Aaron Sojourner University of Minnesota Carlson School of Management 321 19th Ave S, 3-300 Minneapolis, MN 55455 E-Mail: asojourn@umn.edu Robert Town Health Care Management Department The Wharton School University of Pennsylvania 3641 Locust Walk Philadelphia, PA 19104 E-Mail: rtown@wharton.upenn.edu David Grabowski Harvard University Department of Health Care Policy Harvard Medical School 180 Longwood Avenue Boston, MA 02115 E-Mail: grabowski@med.harvard.edu Min Chen Department of Finance and Real Estate The College of Business Administration Florida International University 11200 S.W. 8th Street Miami, Florida 33199 Tel: (305) 348-4201 E-Mail: min.chen2@fiu.edu AB - This paper studies the effects of unions in private-sector nursing homes on a broad range of labor, firm, and consumer outcomes. We link national data on nursing home characteristics from the Centers for Medicare and Medicaid Services to records on establishment-level unionization from federal labor agencies, and employ a regression discontinuity design to identify union effects by contrasting outcomes in nursing homes where unions closely won representation elections to outcomes in facilities where unions closely lost such elections. After showing that these two sets of homes are similar leading up to the election, we estimate union effects on staffing levels, care quality, and other outcomes. We find negative effects of unions on staffing levels and no decline in care quality, suggesting positive productivity effects. Consistent with these results, supplementary analysis shows significant increases in wages for some classes of nursing labor. Some evidence suggests that nursing homes in local product markets that were less competitive and had lower union density at the time of election experienced stronger union employment effects. We find no impact of unionization on facility survival. By combining credible identification of union effects, a comprehensive set of outcomes over time with measures of market-level characteristics, this study generates some of the best evidence available on many controversial questions in the economics of unions. Furthermore, it generates evidence from the service sector, which has grown in importance and where evidence on these questions has been thin. ER -