Case Study: Happy Trails, LLC is a medium-sized independent living home, a for-profit facility located in a suburban environment. Due to traffic and road congestion, this eldercare facility is the most convenient independent living home near the city. Independent living homes in the city offer many of the same services as Happy Trails, but are more expensive. The elderly may go to several hospitals for acute health care issues.

In a response to the changing economy and patient access from the suburban areas to the city, Happy Trails has taken some measures to compete, become more attractive, and build on its long-term care for patients in the surrounding areas. It has reduced overtime allotments of its seasoned patient care staff, and has terminated several registered nurses. As the registered nurses leave Happy Trails, they are replaced by Licensed Practical Nurses (LPNs), who receive lower compensation and fewer benefits.

The health care facilities in the city are unionized and are well represented by an experienced union business agent. The union has recently negotiated superior wages and benefits at the independent living homes in the city.

In terms of the health care professionals employed there, Happy Trails is not so happy now because the union representing the other facilities has received the attention of the Happy Trails LPNs.