Workers Walk Out Across Five Facilities

On the morning of Monday, April 20, more than 300 healthcare workers with SEIU Healthcare Minnesota and Iowa walked off the job at five nursing homes across the Twin Cities. The strike continues as of Wednesday. Contract negotiations stalled, management wouldn't move, and workers decided they had run out of patience.

The demands are not unusual for 2026: higher wages that reflect the cost of living in the Twin Cities, better benefits, and staffing levels that allow workers to actually care for residents safely. Union leadership was direct about the impasse: employers have refused to respect their members and won't offer a fair contract.

The Estates at Roseville, one of the affected facilities, issued a statement saying contingency plans were in place and care would continue without interruption. That's standard management language during any labor action. The clinical reality of running a nursing home on contingency staff is a different thing entirely.

The Federal Safety Net Just Got Pulled

This strike is happening in a specific regulatory context that makes the outcome matter more than it would have two years ago. In December 2025, the Trump administration repealed the CMS minimum staffing mandate for nursing homes — the rule that would have required at minimum 0.55 RN hours per resident per day, 2.45 nurse aide hours, and a registered nurse on-site 24 hours a day, seven days a week.

That mandate is gone. It was never implemented. There are now no federal minimum staffing floors for nursing homes in the United States.

What that means in practice: union contracts are now the primary mechanism through which nursing home workers can negotiate and enforce minimum staffing standards. Without a union contract that specifies staffing ratios, there is no legal floor. Management can staff as thin as they choose — and the evidence consistently shows what they choose when given that latitude.

The workers striking in Twin Cities aren't just fighting for their own wages. The contract they negotiate is the staffing protection for the residents in those facilities.

The Wage Gap Is Structural

Long-term care workers — CNAs, nursing assistants, dietary staff, housekeeping — are consistently among the lowest-paid workers in healthcare, despite providing high-acuity hands-on care to a population that is medically complex, cognitively impaired, and often nonverbal about their needs. In the Twin Cities, wages for these roles frequently start below $20 per hour despite the physical and emotional demands of the work.

The facilities where these workers are striking are not financially distressed operations. Many nursing homes in the Twin Cities and nationwide are owned by real estate investment trusts or private equity firms that extracted significant profit margins from their properties even as they claimed financial hardship at the bargaining table. As previously documented on this site, REIT-owned nursing homes in this region have reported operating margins above 60%, while the workers inside them fight for meaningful wage increases in annual contract talks.

The gap between what facilities can pay and what they offer is a choice, not a constraint.

The Staffing Shortage They Created

SEIU leaders are explicit about the connection between poor working conditions and the workforce shortage that management routinely cites. You cannot pay workers poverty wages, refuse to invest in benefits, run skeleton-crew staffing, and then complain that you cannot find staff. The shortage in long-term care is not a mystery. It is the predictable result of a labor market where workers have better options.

The workers at these five Twin Cities facilities are on strike because they have calculated that the cost of the strike — lost wages, disruption, uncertainty — is worth the potential of a contract that makes the work sustainable. That calculation tells you something important about what these jobs are like right now.

What Comes Next

Strikes in nursing homes rarely last long. The care needs of residents create pressure on both sides to reach resolution. But quick settlements are not always good settlements. The terms that end this strike will set the baseline for staffing at these facilities for the next several years — in an environment where federal minimums no longer exist.

For nurses and CNAs considering positions in Twin Cities long-term care, the outcome of this contract fight is information worth waiting for. Facilities that genuinely resolve these disputes tend to offer better working conditions than those that wait out the strike and sign the minimum possible agreement.