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Catholic Healthcare West

chw_web.jpg The largest not-for-profit hospital care provider in California has improved working conditions by partnering with employees and their unions to advance patient care.


Advancing patient care by improving working conditions

At a Glance

Founded in 1986, Catholic Healthcare West is the largest not-for-profit provider of hospital care in California, and the 8th largest hospital system in the United States.

San Francisco, CA



Union Employees
26,000 healthcare workers and support staff

Total Employees

Annual Revenues
$5.3 billion

40 hospitals and medical centers in AZ, CA, and NV

4 million patients seen annually

As the largest not-for-profit hospital care provider in California and the 8th largest healthcare system in the United States, Catholic Healthcare West’s (CHW) labor practices can influence the industry. CHW initially resisted its workers’ efforts to form unions. But in 2001, employees, the Service Employees International Union (SEIU), and the company reached a pivotal cooperative agreement covering healthcare institutions in California and Nevada. As a result, CHW banned one-on-one meetings with supervisors, a tactic often used by employers to intimidate employees and dissuade them from voting for a union. The company went one step further and decided to not oppose its employees’ efforts to form a union.

Last year, CHW agreed to a four-year contract with SEIU covering 14,000 employees at 28 California facilities. This agreement goes above and beyond the usual pay-and-benefits provisions to include joint labor-management committees to solve staffing issues; shared goals to improve patient care; a $4 million training fund; and wage and benefit increases to recruit, retain, and develop a highly-skilled workforce.

A similar agreement was reached with the California Nurses Association in 2005, which covers approximately 4,700 nurses at 12 CHW hospitals in Northern and Central California. The contract provides a 26 percent increase in wages and benefits over the next four years, and establishes an oversight committee to evaluate the nurses’ pension plan. CHW also agreed to adopt a nurse-to-patient ratio with a maximum of five patients for each registered nurse in general medical units, even though a California state law requiring safe staffing level ratios was being challenged during contract negotiations.

The positive work environment that results from such collaboration between management and employees may very well be one of the reasons that CHW’s 2004 satisfaction survey showed a 32 percent increase in employee confidence from the previous four years.

Selection Criteria

> Free and fair choice to form a union

> Collaborating as equal partners with workers and their unions to craft innovative strategies on compensation, performance, and productivity to meet business goals and address challenges

> Providing sustainable wages or increases and worker-friendly benefits

> Creating new jobs and implementing employee retention strategies

> Fostering diversity and inclusion in the workforce

> Offering training and professional development opportunities

> Contributing positively to the broader community