🗞️ NLRB Orders Union Vote for Two More Job Classes at Sutter's Alameda Hospice

The National Labor Relations Board's Region 32 office directed an election for bereavement counselors and volunteer program coordinators at Sutter VNA and Hospice, doing business as Sutter Care at Home's Alameda Hospice, according to a decision dated August 4, 2026, and signed by Acting Regional Director Hokulani Valencia. The National Union of Healthcare Workers, which already represents a mixed unit of eight job classifications at the Alameda facility, petitioned in June to let two additional classifications, Bereavement Counselor III and Volunteer Program Specialist, vote on whether to join that existing bargaining unit.

The Alameda unit was first certified in October 2022 after an earlier NLRB-run election, and it currently covers hospice case managers, nurses, nurse practitioners, medical social workers, chaplains, bereavement counselors and hospice aides. Sutter Care at Home did not file a timely statement of position ahead of a June 24 hearing and, as a result, was barred from presenting evidence disputing the union's position that the two additional roles are similar enough to the existing unit, in areas such as supervision, job duties and contact with union-represented staff, to warrant a vote on inclusion.

The case does not involve allegations of unfair labor practices by either side; it turns on a technical question under federal labor law of whether job duties and working conditions overlap enough to place additional roles within an existing bargaining unit. It is one of several such cases NUHW has pursued at Sutter Health facilities in the Bay Area and Sacramento region since 2022, part of a broader campaign the union says is aimed at addressing understaffing and wage disputes at the nonprofit health system. Sutter Health has faced separate legal scrutiny in recent years: it paid $575 million in 2021 to settle a California antitrust suit alleging anticompetitive pricing practices, and it paid $90 million to settle federal allegations that it overbilled the Medicare Advantage program. The organizing push also coincides with new state oversight of the hospice industry: California this year became the first state to adopt hospice-specific nurse staffing ratios, a response to concerns about fraud and understaffing as for-profit hospice operators have proliferated nationally, and NUHW says its members, including at Sutter's Alameda Hospice, helped shape those rules.

The election was scheduled for August 12, 2026, at the Alameda facility. Results had not been posted on the NLRB's public case docket as of this writing.

Key Points

• The NLRB directed a self-determination election, known in labor law as an Armour-Globe election, to decide whether Bereavement Counselor III and Volunteer Program Specialist employees at Sutter Care at Home's Alameda Hospice can join the facility's existing NUHW-represented unit.
• Only one employee currently holds each of the two petitioned-for classifications, according to the decision.
• The Regional Director found the two roles share a "community of interest" with the existing unit based on factors that included common supervision and regular participation in interdisciplinary care meetings with union-represented staff, along with, in the bereavement counselor role, overlapping job duties with already-represented colleagues.
• Sutter Care at Home was precluded from contesting the union's position at the hearing after failing to file a timely statement of position, though the employer's sole witness, Hospice Administrator Grace Spencer, testified as a board witness.
• The vote uses a two-question ballot: workers first decide whether to be included with non-professional employees in a single unit, then whether they want to be represented by NUHW.
• The case follows a series of NLRB elections since 2022 in which hospice and home health workers at other Sutter Care at Home locations, including in Sacramento, San Francisco and San Mateo, voted to unionize with NUHW.

Sourcing

Primary Source Author: Hokulani Valencia, Acting Regional Director, NLRB Region 32
Primary Source: National Labor Relations Board, Decision and Direction of Election, Case 32-RC-388749
Primary Source Link: NLRB Case 32-RC-388749
Supplemental Links:

• Standing Up to Sutter, National Union of Healthcare Workers
• NUHW members helped shape groundbreaking new hospice staffing rules
• Sutter Health and Affiliates to Pay $90 Million to Settle False Claims Act Allegations, U.S. Department of Justice
• Attorney General Bonta Announces Final Approval of $575 Million Settlement of Antitrust Suit Against Sutter Health, California Department of Justice