St. Luke's Episcopal Hospital

674 DECISIONS OF NATIONAL LABOR RELATIONS BOARD St. Luke's Episcopal Hospital, Texas Children's Hos- pital, Texas Heart Institute and Teamsters Freight, Tank Line and Automobile Industry Employees, Local No. 988, affiliated with International Brother- hood of Teamsters, Chauffeurs, Warehousemen and Helpers of America, Petitioner. Case 23-RC-4237 January 30, 1976 DECISION AND DIRECTION OF ELECTION BY CHAIRMAN MURPHY AND MEMBERS FANNING AND JENKINS Upon a petition duly filed under Section 9(c) of the National Labor Relations Act, as amended, a hearing was held before Hearing Officers Bernard D. Getto and Theodore Arter of the National Labor Re- lations Board. Following the hearing and pursuant to Section 102.67 of the National Labor Relations Board Rules and Regulations, Series 8, as amended, and by direction of the Regional Director for Region 23, this case was transferred to the National Labor Relations Board for decision. Thereafter, Employer and Petitioner filed timely briefs which have been duly considered. 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 reviewed the rulings of the Hearing Officers made at the hearing and finds that they are free from prejudicial error.' They are hereby af- firmed. Upon the entire record in this case, the Board finds: 1. St. Luke's Episcopal Hospital, Texas Children's Hospital, and Texas Heart Institute 2 are all Texas nonprofit corporations. Each hospital in the past cal- endar year has purchased goods from outside the State of Texas and each has received gross revenues i Petitioner contends that Hearing Officer Arter 's quashing of a subpoena duces tecum directed to R. J Nast, administrator of operations for the Em- ployer, was prejudicial error We do not agree The subpena sought, inter aba, the production of written job descriptions and the number of employ- ees in the job classifications in various departments of the Hospitals. How- ever, testimony was given by Barbara Nelson, the Employer's manager of wage and salary administration , and by several other Employer witnesses concerning the Employer's departmental structure , the number of employ- ees within each department, their respective duties, and the qualifications for appointment to the relevant jobs within each department . Therefore, the present record provides an adequate basis for determining the appropriate- ness of the unit sought by Petitioner and the unit placement of the classifi- cations of employees in dispute Furthermore , the additional information sought in the subpena, viz the wage rates of employees within each of the Employer's job classifications, is not necessary in order to resolve these issues 2 Herein referred to as St. Luke's, Texas Children's, and Texas Heart, respectively, and the Hospitals or Employer collectively in excess of $1 million. The parties stipulated, and we find, that they are joint employers having a common labor relations policy. Rosenberg & Singer and Lind-Milam & Associates are partnerships operating the Texas Children's and the St. Luke's pathology departments, respectively. Singleton & Associates is a professional corporation which operates the Hospitals' radiology department. Cardiopulmonary Perfusion Associates, Inc., is a wholly owned subsidiary of Texas Heart and oper- ates the perfusion technology department at Texas Children's. Baylor College of Medicine 3 is a Texas nonprofit corporation. Employees of Baylor serve in various departments at the Hospitals. The record re- veals, and the parties do not dispute, that the Hospi- tals exert extensive control over the operation of the partnerships and corporations named above and that they all have a common labor relations policy. Em- ployer argues, however, that because 77 percent of Baylor's revenues are "restricted" there is a question as to whether the Board should assert jurisdiction over those operations at the Hospitals which are funded by restricted grants. Employer does not con- tend that the "restricted" funds are not to be used for operating expenses. Furthermore, Baylor and ' the Hospitals are joint operators of various departments throughout the Hospitals and the salaries for em- ployees in these departments are centrally de- termined. We conclude that the Hospitals, Rosen- berg & Singer, Lind-Milam & Associates, Cardiopulmonary Perfusion Associates, Inc., Single- ton & Associates, and Baylor College of Medicine are joint employers, and that together they are a health care institution within the meaning of the Act. Employer annually purchases goods, materials, and supplies from outside the State of Texas having value exceeding $50,000 and the combined gross rev- enues of the Employer are clearly in excess of $250,000, the standard set for health care institutions other than nursing homes .4 Accordingly, we find that the Employer is engaged in commerce within the meaning of the Act and it will effectuate the policies of the Act to assert jurisdiction herein. 2. The Petitioner is a labor organization claiming to represent certain employees of the Employer. 3. A question affecting commerce exists concern- ing the representation of certain employees of the Employer within the meaning of Sections 9(c)(1) and 2(6) and (7) of the Act. 4. Petitioner seeks to represent a unit of all service and maintenance employees, including nurses assis- 3 Herein referred to as Baylor East Oakland Community Health Alliance, Inc, 218 NLRB No. 193 (1975) Member Fanning, for the reasons stated in his dissent in East Oak- land, concurs in the assertion of jurisdiction over the Employer because its gross annual revenues exceed $100,000 222 NLRB No. 109 ST. LUKE'S EPISCOPAL HOSPITAL 675 tants, dietary employees, housekeeping employees, ward clerks, supply clerks, division clerks, medical records clerks, and orderlies; excluding all profes- sional employees, office clerical employees, technical employees, licensed vocational nurses, guards, and supervisors as defined in the Act. Employer contends that the appropriate unit consists of employees with- in all its departments other than its central business office and security, and would exclude professionals, confidential and managerial employees, and supervi- sors. Employer would thus include technical employ- ees and all clerical employees except those in its busi- ness office and computer operations. Petitioner would include only those clericals performing non- business office functions. The Board has, in cases involving health care insti- tutions, recently indicated that it will not normally compel the inclusion of technical employees in a unit composed of service and maintenance employees.' We see no reason herein to deviate from precedent and require the inclusion of the technical employees in the service and maintenance unit. In addition, we have found that the interests of business office cleri- cals differ markedly from those hospital clerical em- ployees whose functions are more closely related to the functions performed by the service and mainte- nance employees 6 Consistent with our decisional guidelines in that area, we shall exclude the business office clericals from the service and maintenance unit sought by Petitioner. Having determined that technical employees and business office clericals shall be excluded, there re- mains only the issue of unit placement, i.e., whether specific classifications of employees are properly characterized as technicals or as business office cleri- cals or whether some other reason exists for the in- clusion or exclusion of particular classifications of employees? Technical Employees The parties stipulated that employees who work in the following classifications are technicals without stipulating as to their inclusion in or exclusion from the unit: licensed vocational nurses (LVN's), voca- tional nurse I and vocational nurse II, electroence- 5 Newington Children's Hospital, 217 NLRB No 134 (1975), Nathan and Miriam Barnert Memorial Hospital Association d/b/a Barnert Memorial Hos- pital Center, 217 NLRB No. 132 (1975), Mercy Hospitals of Sacramento, Inc. 217 NLRB No. 131 (1975), Trumbull Memorial Hospital, 218 NLRB No. 122 (1975) 6 Mercy Hospitals of Sacramento, supra; St Catherine's Hospital of Donuni- can Sisters of Kenosha, Wisconsin, Inc., 217 NLRB No 133 (1975), William W Backus Hospital, 220 NLRB No 107 (1975) 7 The parties entered into stipulations as to the professional and/or super- visory status of numerous classifications of employees We accept their stip- ulations. Thus, the status of those individuals is not discussed herein phalogram (EEG) technician I and senior EEG tech- nician, nuclear medicine technologist, physical thera- py assistant, respiratory technician III, technical edu- ation coordinatory, respiratory care specialist, blood collection department supervisor, histology depart- ment supervisor, histotechnologist, cytology supervi- sor, histology technician, medical laboratory techni- cian, cytotechnologist, clinical laboratory assistant, ultrasound technician, and patient coordinator. Ac- cordingly, based on the stipulations that the occu- pants of the above classifications are technical em- ployees, and since we have found that technicals are to be excluded, we shall exclude them from the. unit. Petitioner would exclude employees in the follow- ing classifications as technical employees while Em- ployer contends they should be included even if a service and maintenance unit is found appropriate: EEG Technicians II: There are an unspecified number of employees in the neurophysiology labora- tory classified as EEG technicians. The parties stipu- lated that EEG technicians I and senior EEG techni- cians have "advanced training in their work and .. . a registry or certification available" to them, and that they are technical employees. With respect to the re- maining classification, EEG technician II, the parties stipulated that employees in that classification, hav- ing been employed before any registry became avail- able, are not certified, licensed, registered, or en- rolled in any formal training program. The parties, however, also stipulated that EEG technicians II per- form the same duties and have the same responsibili- ties as the other EEG technicians. Because the EEG technicians II have a close functional relationship with the other EEG technicians, we shall exclude them from the service and maintenance unit.' Senior Nuclear Medicine Technician: Within the department of nuclear medicine there is an employee classified as senior nuclear medicine technician. The occupant of this position has only a high school edu- cation but had worked in a nuclear medicine lab prior to her employment in nuclear medicine at the Hospitals. The occupant is not certified, licensed, or registered. She has apparently chosen to attempt to achieve certification as a nuclear medicine technolo- gist (a classification which the parties stipulated to be technical) through 5 years of on-the-job training. She had, however, at the time of the hearing, received only 1 year of that training. The record does not re- veal the nature of her training to date. Her duties appear to have some similarity to that of the techni- cal assistants in nuclear medicine who are not deemed to be technical employees because they are not certified, registered, or licensed, and have no for- mal training, and whose work experience is acquired 8 Cf Trumbull Memorial Hospital, 218 NLRB No. 122 (1975) 676 DECISIONS OF NATIONAL LABOR RELATIONS BOARD exclusively on the job. Accordingly, as the current state of the record indicates her duties lie somewhere between those of the nuclear technologist and those of the technical assistants and in the absence of any evidence that she does or does not exercise any inde- pendent judgment, we shall permit the senior nuclear medicine technician to vote subject to challenge. Radiology Technologist: Radiology technologists are in the radiology department. They perform X-ray examinations of patients. They must have a mini- mum of 2 years' training in a hospital accredited by a joint accreditation committee composed of the American Medical Association, the American Col- lege of Radiology, and the National Board of X-Ray Technology. Those who have completed the requisite training program are eligible for an examination which, if passed, results in their certification as ra- diology technologists. Employer maintains the fol- lowing classifications as part of its progression for radiology technologists: radiology technologist I, ra- diology technologist II, and senior radiology technol- ogist. Occupants of the latter two classifications have been certified as radiology technologists. Based on their training, certification, and job duties, which re- quire the use of independent judgment, we find that radiology technologists II and senior radiology tech- nologist are technical employees. Because radiology technologists I perform the same job duties and have the same training as other radiology technologists, we find they are also technical employees whose community of interest is separate and distinct from unit employees. We shall therefore exclude radiology technologists from the unit. Graduate' Vocational Nurses: Within the depart- ment of nursing are graduate vocational nurses who have graduated, from an approved school of voca- tional nursing, and who are eligible to take the state licensing examination. Graduate vocational nurses work under state permits until they have passed the examination. They perform essentially the same functions and have the same duties as licensed voca- tional nurses who are technicals. We find that gradu- ate vocational nurses, because of their training and functions, are technical employees and we shall ex- clude them from the unit. Disputed Clericals Business Office Clericals: As noted above, the par- ties agree that those employees performing service and maintenance functions should be in the unit. They also agree that clericals in the business office and computer operations should be excluded. There are several classifications of clerical employees, how- ever, which Petitioner would exclude and which Em- ployer would include. The guidelines for determining whether clerical employees are business office clericals or are hospital clericals have been established by the recently issued hospital cases.' Business office clericals are those clerical employees who, because they perform busi- ness office functions, have minimal contact with unit employees or patients, work in geographic areas of the hospital, or perform functions , separate and apart from service and maintenance employees , and thus do not share a community of interest with the service and maintenance unit employees. Clerical employees in the following departments possess the characteristics of business office clericals described above and are accordingly excluded from the unit: The administration department, as its name implies, houses the Hospitals' administrators. The planning and development department's function is to contact organizations for possible philanthropic con- tributions. Public relations collects data for publica- tion in the Hospitals' employee newspaper . Personnel serves all departments of the Hospitals , retains data with respect to employees' hire, fire, advancement, and training. This department conducts salary sur- veys and handles questions concerning employee benefits. Accounting maintains payroll records for employees of the Hospitals, processes payment of in- voices submitted by vendors who deal with the Hos- pitals, and insures that governmental reporting re- quirements are met. The management engineering department conducts workflow and efficiency stud- ies of the Hospitals' operations. Internal audit per- forms certain accounting-related functions for the Hospitals. The pastoral care and education depart- ment houses the chaplains present within the Hospi- tals. Communications, including the switchboard, as its name implies , provides communications between the various departments. Medical education coordi- nates the rotation of interns and residents throughout the Hospitals. The office of Texas Children's physi- cian-in-chief shares some of the responsibilities of the medical education department in that it is also con- cerned with the training and instruction of interns and residents within Texas Children's Hospital. Tex- as Children's community affairs department deals with the community which the Hospitals serve and informs the community of the facilities and services available at Texas Children's. The credit union per- forms functions normally associated with credit unions. Purchasing handles the acquisition and deliv- ery of supplies to the various departments within the Hospitals. 'Mercy Hospitals of Sacramento, supra, St. Catherine 's Hospital, supra, Backus Hospital, supra ST. LUKE'S EPISCOPAL HOSPITAL 677 Because of the nonbusiness office nature of their functions and their intimate contact with employees in the service and maintenance unit, we conclude that those bookkeepers, secretaries, clerks, clerk typ- ists, unit clerks, medical transcription typists, medi- cal services clerks, stores clerks, and billing clerks in the following departments share a sufficient commu- nity of interest with service and maintenance em- ployees to be included in that unit: nursing, Texas Heart out-patient clinic, family practice center, Good Shepard clinic, psychiatric services, psychological services, opthomology, otolaryncology, speech pa- thology, and Junior League out-patient clinic.10 Petitioner would exclude those secretarial and cler- ical employees in those departments which may be described as being predominantly engaged in re- search." Employer would include them and Peti- tioner does not offer any reasons why they should be excluded. We can perceive no reasons for their exclu- sion other than the fact that they may not be directly involved in patient care. It is clear, however, that the functions and duties of these clerical employees in the research departments are connected and related to patient care. Additionally, the clericals in the re- search departments perform functions similar to those performed by their counterparts in the patient care areas of the Hospitals. Furthermore, they come in frequent contact with the unit employees sought, and do not perform tasks related to the clericals in the business offices. Finding no justifiable reason to exclude them we shall include the secretarial and clerical employees in the Hospitals' research depart- ments in the unit. Medical Records Department Employees: The medi- cal records department is located near the Employer's central business offices. It gathers vital statistics from other departments which are then used for maintaining hospital records and in dealing with other hospitals. Petitioner made it clear during the course of the hearing that it does not seek inclu- sion of those clericals in the medical records depart- ment but that it seeks the inclusion of only those "medical records clericals" employed elsewehere in the Hospitals who exhibit a community of interest with the service and maintenance employees." The clericals in the medical records department handle medical records, transcribe physicians' notes and in- structions concerning patients' medical histories, and relay this information to other areas of the Hospitals upon request. None of the 65 clerical employees in the department have any daily physical contact with employees in the patient care areas. The clericals here, unlike the medical records employees in Bac- kus Hospital, supra, do not generally leave their office nor is there any evidence that nursing unit personnel regularly come to the medical records department. We find that in the circumstances of this case the medical records department clericals do not share a significant community of interest with the service and maintenance employees. We shall therefore ex- clude them from the unit.13 Admitting and Addressograph Clericals: Employer would include those clericals in admitting and ad- dressograph, a division of the nursing department. Petitioner has not indicated its desires with respect to the inclusion or exclusion of these employees. Admit- ting clerks collate information obtained from newly admitted patients and place it on cards which record the patients' medical histories. They spend most of their time in the admitting office. Patients are nor- mally escorted to their rooms by patient escorts, who report to the supervisor of transportation in the nurs- ing department, rather than by admitting clerks. The only substantial contact between admitting clerks and a patient comes when an admitting clerk initiates a patient's medical record forms. Addressograph op- erators prepare the identification plate worn by each patient. They also prepare data "cards" which are used in the Hospitals. There is no evidence that either the admitting clerks or the addressograph op- erators have any substantial contact with patients or with any employees in the unit. The mere fact that admitting and addressograph is part of the depart- ment of nursing does not warrant a finding that the clericals in those divisions are to be included in the service and maintenance unit in the face of evidence that they perform duties which would qualify them as business office clericals. We shall exclude them from the unit.14 Other Clerical Employees: Employer would include those clerical employees working in the mail and ")The parties stipulated that at the Junior League out-patient clinic, lo- cated on the ground floor of Texas Children's, there are certain classifica- tions of employees common to the business services offices of the Hospitals and that those classifications are: clinic records supervisor, insurance ana- lysts, financial counselor, and senior financial counselor. We shall exclude them from the unit. 11 The departments so characterized by Petitioner are. reproductive re- search, birth defects center, clinical research center, hematology and oncol- ogy, heart sounds laboratory, computer application research, Texas Heart office of research , office of medical director, cardiovascular research lab, cardiovascular anesthesia research , and infectious diseases department 12 The record does not reveal whether there are in fact any "medical records clericals" outside the medical records department 13 Chairman Murphy dissents from this finding She believes that there is no meaningful distinction between the clerical employees in the medical records department and the medical records employees in Backus Hospital, supra Here, as in Backus, the medical records department employees deal with patient records which must be collected from the patient care areas and which are used to describe the history of an individual patient's treatment received at the Hospitals The fact that the clericals here do not regularly leave their department does not, in her opinion , warrant a different result from that reached in Backus She would include them in the unit. 14 Trumbull Memorial Hospital, supra, St Catherine's Hospital, supra. 678 DECISIONS OF NATIONAL LABOR RELATIONS BOARD messenger department. There are five individuals employed in that department, one of whom is a su- pervisor. The other four employees, classified as mail clerks, sort mail as it comes into the Hospitals and deliver it to the various departments. We conclude that the messengers share a community of interest with the employees in the service and maintenance unit and shall include them in the unit. 15 Petitioner would exclude the blood bank secretary who works in St. Luke's pathology department. The blood bank secretary works alongside other secre- taries and medical transcription typists within St. Luke's pathology department who are included with- in the service and maintenance unit. Because the blood bank secretary performs functions related to and intimately bound with the functioning of St. Luke's pathology department we shall include the employee in the service and maintenance unit. Miscellaneous Classifications The parties stipulated that volunteers in the St. Luke's auxiliary department are not employees with- in the meaning of the Act. We shall exclude them from the unit. The parties stipulated that full-time students em- ployed during the summer have no reasonable expec- tation of continued employment. Based on the above stipulation, we shall exclude summer students as tem- porary employees. The parties stipulated that student assistants are regular part-time employees and that their tenure as employees and their terms and conditions of employ- ment do not depend on their status as students. We shall include them in the unit as regular part-time employees. The parties stipulated that pharmacy externs are college students who have exhibited an interest in pursuing pharmacy as a career. They work on a regu- lar basis and remain on the Hospitals' payroll even if they drop out of school. Their status as employees does not depend on their status as students. We find pharmacy externs are regular part-time employees and shall include them in the unit. Petitioner would exclude and Employer would in- clude the assistant blood donor coordinator at St. Luke's pathology department. The assistant blood donor coordinator sometimes referred to as assistant 15 Cf. Alextan Brothers of Elizabeth, Inc d/b/a A lexian Brothers Hospital, 219 NLRB No. 179 (1975) blood donor recruiter recruits donors to participate in the volunteer blood donor program, visits patients in the Hospitals to inform them about this program, and solicits their assistance in obtaining additional donors. Based on the above facts, we find that the assistant blood donor coordinator shares a commu- nity of interest with the other employees in the pa- thology department who are properly included in the service and maintenance unit. We shall include her in the unit. Petitioner would also exclude part-time blood col- lectors. The record reveals these employees work on the average between 5 and 25-hours per week and that their hours are scheduled in -advance. They per- form the same type of functions as blood donor col- lectors and blood collectors. We find that part-time blood donor collectors are regular part-time employ- ees and shall include them in the unit. We therefore find the following unit appropriate for the purposes of collective bargaining within the meaning of Section 9(b) of the Act: All-regular full-time and part-time service and maintenance employees, including nurses' assis- tants, dietary employees, housekeeping employ- ees, ward clerks, division clerks, medical records clerks, messengers, orderlies and those book- keepers, secretaries, clerks, clerk-typists, unit clerks, medical transcription typists, medical services clerks, stores clerks, and billing clerks other than those excluded below as business clericals employed by the Employer at its hospi- tal facilities located at 6720 Bertner St., Hous- ton, Texas, but excluding all professional em- ployees, technical employees, and business clerical employees, including those employed in administration, business services, computer op- erations, planning and development, public rela- tions, personnel, accounting, management engi- neering, internal audit, pastoral care and education, communications, admitting and ad- dressograph, medical education, office of Texas Children's Hospital's physician-in-chief, Texas Children's Hospital's community affairs office, medical records department, credit union and purchasing department, volunteers in St. Luke's Episcopal Hospital's auxilliary department, tem- porary employees, confidential employees, guards, and supervisors as defined in the Act. [Direction of Election and Excelsior footnote omit- ted from publication.]