St. Luke's General Hospital

488 DECISIONS OF NATIONAL LABOR RELATIONS BOARD St. Luke's General Hospital and Local No. 120, Ser- vice Employees International Union, AFL-CIO, Petitioner. Case 19-RC-7419 September 22, 1975 DECISION ON REVIEW AND DIRECTION OF ELECTION BY MEMBERS FANNING, JENKINS, AND PENELLO On April 23, 1975, the Regional Director for Re- gion 19 issued a Decision and Order in the above- entitled proceeding in which he found the only ap- propriate unit to be one comprising all of the Employer's currently unrepresented nonprofessional employees. Accordingly, he dismissed the petition on the ground that Petitioner did not wish to participate in an election in such a unit. Thereafter, in accor- dance with Section 102.67 of the National Labor Re- lations Board Rules and Regulations , Series 8, as amended, the Petitioner filed a request for review of the Regional Director's decision and the Employer filed a brief in opposition. On May 21, 1975, by telegraphic order, the request for review was granted. Pursuant to the provisions of Section 3(b) of the National Labor Relations Act, as amended, the Na- tional Labor Relations Board has delegated its au- thority in this proceeding to a three-member panel. The Board has considered the entire record in this case with respect to the issues under review and makes the following findings: The Employer is a Washington corporation engaged in the operation of an independent, community-owned, nonprofit, acute care general hospital in Bellingham, Washington. It is licensed to provide for 106 regular, general, acute care beds and 6 skilled nursing facility beds. Peti- tioner seeks to represent a service and maintenance unit comprising general services employees (house- keeping aides, laundry and linen aides, seamstresses, washers, maintenance I employees, maintenance II employees), materials department employees (central supply aides, materials secretary, storeroom manag- er, and purchasing agent), nursing services depart- ment employees (nurses aides, ward clerks, also known as board secretaries, bedmakers, and operat- ing room technicians), dietary department employees (first cook, second cook, relief cook, diet assistant, diet aides, cafeteria aide, tray aides), laboratory em- ployees (lab aides and lab assistants), and respiratory therapists in the respiratory department. The Em- ployer contends that the only appropriate unit must include all its unrepresented nonprofessional em- ployees. There is no history of collective bargaining among the employees with regard to the petitioned- for unit. Currently, the Employer's laboratory tech- nologists are represented by the Petitioner in a sepa- rate unit; the registered nurses are represented by the Washington State Nurses Association; the x-ray technicians are represented by the Radiological Technicians at St. Luke's Hospital; and the licensed practical nurses are represented by the Licensed Practical Nurses Association. Petitioner stated that it is willing to represent a unit of employees including the medical records department employees or any unit smaller than the one petitioned for (composed of employees within the petitioned-for unit), but it would not agree to participate in an election which included the business office employees. The hospital employs approximately 270 employ- ees, of whom approximately 210 work full time. On the average, 60 percent of the beds are occupied, but there are times when the occupancy reaches full ca- pacity. Currently represented are approximately 50 RN's, 65 LPN's, 6 radiologic technologists, and 10 laboratory technologists. There are approximately 20 supervisors employed by the Employer. Accordingly, the petitioned-for unit encompasses approximately 81 employees. There are approximately 40 unrepre- sented nonprofessional employees who are not sought by the Petitioner. The board of trustees, a body of 40 people, is re- sponsible for major decisions as to personnel policy for the hospital. This board elects an executive com- mittee of 12 to meet on a monthly basis with the administrator of the hospital in providing direction and control over the institution. The Regional Director found that the petitioned- for unit of employees would serve only to fragment unjustifiably the Employer's employees, in the cir- cumstances of this case, since certain of the employ- ees are currently represented by various labor organi- zations in four separate units and the Petitioner seeks to establish a fifth unit comprising approximately 81 employees, but not including approximately 40 other unrepresented nonprofessional employees. The Re- gional Director dismissed the petition, finding that all the currently unrepresented nonprofessional em- ployees share similar wages, hours, working condi- tions, and benefits; regularly interchange with each other; and perform functionally integrated duties aimed at providing patient care from the time the patient enters the hospital until the patient departs and all billing and insurance functions have been completed. However, we find that the employees in the unit sought, together with the medical records department employees and certain other employees whom the Employer would exclude, but excluding business office clerical employees, is appropriate for 220 NLRB No. 86 ST. LUKE'S GENERAL HOSPITAL 489 the reasons cited in the cases which have issued sub- sequent to the 1974 amendments to the Act which expanded its coverage to nonprofit hospitals. In Newington Children's Hospital, 217 NLRB No. 134 (1975), the Board found a unit of service and maintenance employees including hospital clerical employees, but excluding, inter alia, business office clerical employees, to be appropriate. Therein, the hospital clericals (as contrasted with business office clericals) were located geographically throughout the hospital, within various departments composed of other service and maintenance employees, and shared a community of interest with the service and maintenance employees. In St. Catherine's Hospital of Dominican Sisters of Kenosha, Wisconsin, Inc., 217 NLRB No. 133 (1975), the Board found appropriate a unit limited to busi- ness office clerical employees since such employees either performed "business" office functions or had more of a community of interest with business office employees than with employees in the other voting units established in that decision. Employees in the medical records departments were not included in that office clerical unit because they had more of a community of interest with employees in the service and maintenance unit.' In Sisters of St. Joseph of Peace, 217 NLRB No. 135 (1975), medical records employees and ward clerks were found to be properly excluded from a unit limited to business office clerical employees de- spite their performance of clerical functions because they worked with different people on different types of records for different immediate objectives; they were not located in the central business office com- plex, did not share common supervision with the business office employees, and did not appear to share close working relationships sufficient to estab- lish a significant community of interest with the busi- ness office clerical employees. In Mercy Hospitals of Sacramento, Inc., 217 NLRB No. 131 (1975), the Board found that "[u]pon due consideration, we have decided that in the health care field, as in the industrial sphere, we shall contin- ue to recognize a distinction between business office clerical employees, who perform mainly business- type functions, and other types of clerical employees whose work is more related to the function per- formed by personnel in the service and maintenance unit and who have, in the past, been traditionally 1 In agreeing with the unit determination made herein, Member Penello does not rely on the decisions in Newington Children's Hospital and in St Catherine's Hospital of Dominican Sisters of Kenosha, Wisconsin, Inc, supra. In Newington, Member Penello dissented based on the exclusion therein of technical employees including LPN's from a service and maintenance unit. Likewise, in St. Catherine's, he dissented in part based on a separate unit finding for technical employees including LPN's. excluded by the Board from bargaining units of busi- ness office clerical employees. Thus, the Board has consistently recognized that the interests. of business office clerical employees differ markedly from the in- terests of clerical employees who work in the produc- tion area and has declined to establish bargaining units composed of the two clerical groups." After a careful reading of the record, it is clear to us that the business office clerical employees herein, who are located in a separate office, apparently are hired and fired by the hospital's controller who man- ages the business office, and who do not share super- vision with any other employees, share a community of interest as set out in the above-mentioned cases which sets them apart from the service and mainte- nance employees. Accordingly, we find that the unit petitioned for appropriately excludes the business of- fice clerical employees, but that the medical record employees, herein, consistant with Sisters of St. Jo- seph of Peace, must be included with the other em- ployees in the service and maintenance unit sought. We note that Petitioner stated that it is willing to represent the medical records department employees in such a unit. The parties also apparently disagree as to the sta- tus of the laboratory secretary (laboratory depart- ment); the medical stenographer (x-ray department); the EEG technician (EEG department); and the medicare coordinator and patient service coordina- tor (both under the administrative assistant). The laboratory secretary is a recent position which re- placed the medical stenographer or transcriptionist. The classification no longer requires skills pertaining to the transcription of medical terminology or rec- ords. Apparently, however, the laboratory secretary is still located in the laboratory, next to the pathologist's office and the duties continue to con- cern typing reports dictated by the pathologist and answering questions regarding the pathologist's bill- ings. The medical stenographer, whose desk and typ- ing station is located in the x-ray department adja- cent to one of the radiological rooms, types the radiological diagnoses dictated by the radiologist. We conclude that both the laboratory secretary and the medical stenographer are hospital office clericals and shall include them in the unit. The EEG technician records on a graph the electri- cal impulses from the different parts of the brain. The associate administrator of the hospital testified that the technician does not exercise independent discretion of judgment in administering the test since it was standardized, does not require a certification, and requires a formal training of only I week to a month. Accordingly, we find that the EEG techni- cian is not a technical employee but must be includ- 490 DECISIONS OF NATIONAL LABOR RELATIONS BOARD ed in the service and maintenance unit sought? The patient service coordinator, who is under the supervision of the administrative assistant, takes pa- tients' inventory (inquires as to the patients' opinion of the hospital's services), assists in the daily occupa- tional therapy needs of extended care facility pa- tients, and primarily completes certain forms. Much of this work is done with the medicare coordinator, also under the administrative assistant's supervision, who maintains charts assuring that the hospital meets the guidelines for providing health care to medicare patients. There is no indication in the record of any unique education or licensing requirements or that 2 Member Penello finds it unnecessary to pass on whether or not the EEG technician is a "technical" employee since, in any event, he would include him in the service and maintenance unit. See the dissenting opinion in Na- than and Miriam Barnert Memorial Hospital Association d/bla Barnert Me- morial Hospital Center, 217 NLRB No. 132 (1975). these employees utilize independent judgment or dis- cretion. Accordingly, we conclude that these employ- ees are hospital office clerical employees and we shall include them in the unit. On the basis of the foregoing, we find that a unit of service and maintenance employees including ward clerks, respiratory therapists, operating room aides, nurses aides , maintenance employees, housekeeping employees, linen department employees, dietary em- ployees, central supply-storeroom employees, hospi- tal clerical employees, and medical records depart- ment employees; but excluding office clerical employees, guards, supervisors as defined in the Act, and all other employees constitute a unit appropriate for purposes of collective bargaining within the meaning of Section 9(b) of the Act. [Direction of Election and Excelsior footnote omit- ted from publication.]