Hospice Care in Crisis: Sonoma County Workers Strike for Patient Care

LISTEN UP, EVERYONE! The hospice care industry is in the midst of a MAJOR CRISIS, and it's happening right now in Sonoma County. More than 100 National Union of Healthcare Workers (NUHW)-represented hospice workers have taken to the streets, holding a two-day strike to demand a contract that enshrines current patient care practices. They're fighting to preserve the quality of care that their community has relied on for decades, and they're doing it against a backdrop of corporate greed and private equity takeover.

The workers, who are employed by Providence, the largest hospice care provider in Sonoma County, are up against a formidable foe: Compassus, a private equity-owned firm with a track record of providing poor services. Providence has announced that it’s forming a 50-50 joint venture with Compassus to jointly own Providence’s hospice, home health, and long-term care businesses, with Compassus as the operator. The agreement is expected to go into effect later this year, and the workers are terrified of what this means for their patients.

“Providence is often seeking to save money at the expense of patient care, and we’re worried that our services will be greatly reduced under a new private equity operator, unless we can enshrine protections in our union contract,” said Tim Johnson, a social worker at Memorial Hospice in Santa Rosa. “Hospice care is at a crossroads in Sonoma County, and we’re fighting to preserve the patient-focused care residents in our community have counted on for decades.”

The workers have been negotiating their first contract with Providence since 2023, when they joined NUHW. But Providence has refused to bargain in good faith, leaving the workers increasingly concerned that the nonprofit healthcare giant wants to give Compassus a free hand to gut existing patient care protocols, increase caseloads, and leave caregivers with far less time for individual patients and their families.

“It’s a profound honor to serve hospice families,” said Kristina Nauheimer, a nurse at Hospice of Petaluma. “Hospice work is a calling, and to watch it turned into a big money-making machine like every other facet of health care is painful. I’m deeply committed to protecting our patients, and that requires winning a contract that honors the work we do.”

The strike was covered by the Santa Rosa Press Democrat and Petaluma Argus Courier, and the workers held signs that read “Support Your Hospice Angels,” “Unfair Labor Practice Strike,” and “Support Hospice of Petaluma,” as passing cars honked and people waved. The workers are fighting for their patients, and they're fighting for their community.



The hospice care industry is a $23 billion industry, accounting for one-fourth of Medicare spending. Since the Medicare Hospice Benefit (MHB) was introduced in 1982, for-profit hospices have gradually taken over the market from non-profit hospices. Private equity (PE) firms have recently acquired and sold some of the largest hospice chains in the country, significantly increasing their share of the hospice market. PE firms raise capital from institutions and wealthy individuals to acquire and manage companies in the short term. They often leverage debt and restructure operations to maximize returns for investors, with the ultimate goal of selling companies at a profit. PE interest in the hospice sector is unsurprising, given the opportunity to consolidate fragmented agency networks, the expected increase in demand for services, and the reliability of Medicare hospice payments.

But the workers are fighting back, and they're not going down without a fight. They're demanding a contract that enshrines current patient care practices, including caseload limits, before Providence closes a deal to turn over operations of its two local hospices to Compassus. They're fighting for their patients, and they're fighting for their community.

“Providence is bargaining in bad faith so that it can run out the clock on negotiations,” said Sabrina Hearst, a nurse with Hospice of Petaluma. “With no contract in place with us, Providence and its new private equity partner, Compassus, would have a free hand to continue their focus on profit-making to the detriment of patient care. We formed a union so that we’d have the power to advocate for the families we serve, and we are determined to secure a contract that includes strong patient care standards.”

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