River Hills Health Care Workers Unionize in Iowa

Ottumwa clinic workers vote to join Teamsters Local 90 after over a year of organizing efforts

Apr. 1, 2026 at 8:06pm

Got story updates? Submit your updates here. ›

Health care workers at River Hills Community Health Center in Ottumwa, Iowa have voted to unionize with Teamsters Local 90, becoming the second hospital system in the state to do so. The effort was led by nurse Logan Thomas, who was inspired by the recent unionization of thousands of nurses at UnityPoint hospitals in Des Moines. After over a year of organizing and facing resistance from management, the 45 full- and part-time River Hills workers voted 27-19 to form the River Hills United union.

Why it matters

The unionization of health care workers, who are not traditionally highly unionized, is a growing trend across the country as workers seek better pay, benefits, and working conditions. The River Hills workers were motivated by issues like lack of transparency, unfair policies, and unaffordable health insurance - even though they work in the health care industry. Their victory could inspire more health care workers in Iowa to organize.

The details

Nurse Logan Thomas led the unionization effort at River Hills after seeing the success of the UnityPoint nurses' union. Thomas said workers wanted more transparency, fairness, and clear expectations from management, as well as improvements to time-off policies and health insurance affordability. The organizing process faced strong resistance from River Hills administration and outside contractors, but after over a year the workers prevailed in a 27-19 vote to join Teamsters Local 90.

  • In May 2025, River Hills Community Health Center workers announced their unionization effort.
  • In January 2026, Logan Thomas decided to try to unionize and gauge worker interest.
  • In April 2026, after five challenged ballots, the 45 full- and part-time River Hills workers voted 27-19 to form the River Hills United union.

The players

Logan Thomas

A nurse at River Hills Community Health Center in Ottumwa who led the unionization effort, inspired by the recent unionization of nurses at UnityPoint hospitals in Des Moines.

Nico Hernandez

A Teamsters Local 90 organizer who will help the newly formed River Hills United union bargain their first contract.

Teamsters Local 90

The union that will represent the 45 full- and part-time River Hills workers after their successful unionization vote.

River Hills Community Health Center

The Ottumwa, Iowa-based health care provider whose workers voted to unionize.

UnityPoint

The hospital system in Des Moines, Iowa where thousands of nurses recently unionized, inspiring the River Hills workers.

Got photos? Submit your photos here. ›

What they’re saying

“'There's a lot of unheard issues, a lot of pretend listening that happened for a long time, until it finally drove us to the point in January where I decided I'd try to unionize and just see how much interest there was. And there was a lot right away.'”

— Logan Thomas, Nurse, River Hills Community Health Center

“'People have been accultured to, especially in the healthcare industry, to just push down what they're feeling because they're told that they have to be martyrs, that they don't deserve to have safe working conditions. That this is healthcare, this is just the way things are.'”

— Nico Hernandez, Teamsters Local 90 Organizer

“'It's especially ironic being that we are healthcare workers and we have such expensive health insurance.'”

— Logan Thomas, Nurse, River Hills Community Health Center

“'Healthcare workers deserve to have dignity on the job. They deserve to have fair pay. They deserve to have respect. They deserve to have their voices taken seriously. And that hasn't been happening—not just at River Hills, but at institutions across Iowa.'”

— Nico Hernandez, Teamsters Local 90 Organizer

“'UnityPoint was a big inspiration for us here, and I hope just more and more healthcare union wins across Iowa—especially since ours is different from UnityPoint, it's not just nurses—can inspire people to unionize their workplace.'”

— Logan Thomas, Nurse, River Hills Community Health Center

What’s next

Teamsters Local 90 will now help the newly formed River Hills United union bargain their first contract with River Hills Community Health Center management.

The takeaway

The successful unionization of health care workers at River Hills Community Health Center in Ottumwa, Iowa highlights a growing trend of workers in the traditionally non-unionized health care industry seeking better pay, benefits, and working conditions. Their victory could inspire more health care workers across Iowa to organize and demand a greater voice in their workplaces.