West Jersey Health System

WEST JERSEY HEALTH SYSTEM West Jersey Health System and District 1199C, Na- tional Union of Hospital and Health Care Em- ployees, RWDSU, AFL-CIO, Petitioner Cases 4-RC-14945, 4-RC-14947, 4-RC-14948, 4- RC-14949, and 4-RC-14950 April 21, 1989 DECISION ON REVIEW AND ORDER BY CHAIRMAN STEPHENS AND MEMBERS JOHANSEN AND CRACRAFr On October 2, 1987, the Regional Director for Region 4 issued a Supplemental Decision and Di rection of Elections in which he found, inter alga, that single-facility units are appropriate units in the Employer's multidivisional system The Employer and the Petitioner filed timely requests for review on a number of issues On February 1, 1988, the Board granted the Employer's request for review concerning the appropriateness of the single-facility units 1 The Employer and Petitioner resubmitted briefs, previously filed with the Board or the Re- gional Director, on the issue under review The National Labor Relations Board has delegat- ed its authority in this proceeding to a three- member panel The Board has considered the entire record in this case with respect to the issue under review and finds that the single facility units are not appropri- ate For the reasons that follow, we find that the Employer's multifacility system necessitates multi- facility units The Regional Director's Supplemental Decision and Direction of Election finds2 that the Employer operates four hospital facilities in a single nonprofit system The four facilities, known as divisions, are the Eastern Division located in Voorhees, New Jersey, the Southern Division located in Berlin, New Jersey, the Northern Division located in Camden, New Jersey, and the Garden State Divi- sion located in Marlton, New Jersey The distances between the Northern and Southern Divisions, Northern and Eastern Divisions, and Eastern and Southern Divisions are 20 miles, 12 miles, and 9 miles, respectively The distances between the Garden State and Northern Divisions, Garden State and Eastern Divisions, and Garden State and Southern Divisions are 11 miles, 2 1/2 miles, and 11 miles, respectively ' The Board at the same time placed in abeyance the Employers re quest for review of the Regional Directors Modification of Supplemen tal Decision and Direction of Elections which involves the issue of the adequacy of the Petitioner s showing of interest In view of our decision to dismiss the petitions this issue is now moot 2 We adopt the Regional Director s findings of fact unless stated other wise in this decision 749 The Regional Director sets out the Employer's corporate structure and notes that four members of the corporate management team are each responsi ble for the administration of one of the divisions 3 He finds the division administrators are responsible not only for budget preparation and administration, but also for the day-to-day administration of the di- vision, including reviewing and approving evalua- tions for employees in the division and signing ter mination notices The Regional Director finds that supervisors in the divisions assign and direct work, grant overtime, approve leaves of absence, arrange schedules and vacations, evaluate employees, initi- ate discipline, and adjust grievances Each division has a personnel manager who "is generally respon- sible for employee relations at the Division," and each division handles its own hiring or firing, al- though a corporate personnel director located in the Northern Division must approve these actions All four divisions have common job classifica- tions, wage scales, and benefits Employees at all divisions are subject to the same personnel policies and procedures Job vacancies are posted on a sys- temwide basis, and employees are transferred or promoted to jobs in other divisions without loss of seniority Job applications submitted at one divi- sion, where there is no opening, will be sent by the division personnel manager to another division that has an appropriate vacancy The Employer has a grievance procedure providing a step 1 meeting with the employee's immediate supervisor, a step 2 meeting with the employee's department head, a step 3 meeting with the corporate personnel direc- tor, and a step 4 final resolution by the system ad ministrator The Regional Director listed a number of func- tions conducted by the Employer on a systemwide basis They include transportation operations, mail handling and materials distribution, purchasing of supplies other than pharmaceuticals and foodstuffs, warehousing, linen supply, data processing, print- ing, communications, payroll preparation, commu nity relations, and laboratory services The Regional Director finds that each division has its own director of nursing in charge of the day-to day supervision of the division's nursing staff He notes that the directors of nursing and the division personnel managers resolve problems con- cerning the nursing staff The directors of nursing can set a nurse's starting wage rate above the 3 The Employer excepts to the Regional Director s use of the term Division Administrators The Employer refers instead to Executive Directors with the responsibility for administering a division These terms both refer to the same corporate executives and the differing use of terminology does not affect our decision We resolve below the differ mg views of these executives responsibilities and authority 293 NLRB No 88 750 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD norm They are responsible for scheduling nurses and evaluating their performance The nursing hi- erarchy at each division is the director of nursing, an assistant director of nursing, head nurses in charge of units, and nurses Each director of nurs- ing reports to the corporate director of nursing The Regional Director finds that, in the 14 months preceding the 1982 hearing in this matter, there were 147 permanent transfers of employees and supervisors between divisions During the same time, 250 employees and supervisors regularly ro- tated or were assigned between the divisions The 250 figure includes Mobile Intensive Care Unit (MICU) employees, nursing pool employees, and 50 supervisors The Regional Director, citing Manor Healthcare Corp, 285 NLRB 224 (1987), notes the Board's re- buttable presumption that single-facility units are appropriate in the health care industry He then concludes that each division operates essentially as an independent, autono- mous hospital, the day-to day activities and operations of which are directed by the mana- gerial and supervisory hierarchy of the Divi- sion Thus, each Division has its own Adminis- trator, Personnel Manager, and Director of Nursing who exercise substantial authority over the operations and personnel of the Divi- sion Significantly, the Divisions have substan- tial autonomy in day to-day labor relations matters The supervisors at each Division de- termine employee work schedules and assign- ments and prepare employee evaluations Dis- ciplinary actions, including discharges, and grievances are initiated at the Division in- volved and hiring decisions are made by Divi- sion management Although some of these de cisions are subject to review or approval of the corporate Personnel Director, this does not destroy the effective autonomy exercised at each facility The Regional Director states that the system- wide functions previously noted do not establish that single facility units are inappropriate Citing National G South Inc, 230 NLRB 976 (1977), he additionally finds that the number of interdivision transfers, the common personnel policies and pro- cedures, and the common job classifications, wage scales, and fringe benefits do not make single-facili- ty units inappropriate The Regional Director notes that many of the 250 employees regularly rotated between divisions are supervisors, MICU employ- ees, or nursing pool employees, all of whom he finds are outside the units at issue The Regional Director finds no increased risk of work stoppages or other adverse consequences from single-facility units He finds the single-facility units are justified by a "sufficiently separate and distinct community of interest" among employees at each division The Employer excepts to some of the Regional Director's findings of fact and conclusions We agree with the Employer as set forth below Although the Employer runs four facilities, its system is incorporated, accredited, and licensed as one system Separate accreditation is not possible because some element required for accreditation is missing at each division All four divisions are overseen by one system administrator Each divi- sion has its own executive director (whom the Re- gional Director called "Division Administrator"), but this individual is responsible only for general implementation of policy and budget oversight within his own division The day-to day operation of the system is handled not by the division admin- istrators, but by the departmental directors, who are based in one division and travel to the others on a regular, frequent basis Departmental directors include the corporate personnel director, the cor porate director of nursing, director of materials management, director of communications, director of admissions, director of medical records and qual- ity assurance, and director of central food services An employee in any division is responsible to his or her supervisor and the departmental director Departmental directors are responsible for hiring, firing, evaluations, scheduling, discipline, and grievances Job evaluations are done by an employ ee's direct supervisor and the departmental direc tor The division administrator and personnel man- ager are not responsible for the actual evaluations although they play a role in the processing of the paperwork For example, the corporate director of nursing is involved in the evaluation of each nurs- ing employee in the entire system Moreover, the departmental directors prepare the budgets for their departments on a systemwide basis The amounts are allocated to specific divisions once the budget is completed, but departmental directors have the authority to and do transfer funds from one division to another as needed to cover costs Departmental directors report directly to the system administrator rather than the division ad- ministrators In addition to departments such as nursing being centralized in policy, practice, and supervision, the Employer's personnel system is highly centralized As stated above, all four divisions use a common application form, and applicants are cross-referred between divisions about two to three times each week When job openings are posted on a system- wide basis, there is no preference for employees in the division where the opening exists Employees WEST JERSEY HEALTH SYSTEM may bump employees at other divisions based on seniority The personnel managers at the divisions, who report to the corporate personnel director, are not responsible for the creation of the Employer's personnel policies and practices More significantly, the personnel managers are not involved in the ulti- mate decision to hire or fire employees That is handled by the corporate director of personnel for the entire system Similarly, personnel managers play no substantive role in the grievance proce- dure, the corporate director of personnel has the final word of step 3 of the grievance procedure, and can be overruled at step 4 only by the system administrator The corporate director of personnel hears one grievance at step 3 about every 3 weeks The Regional Director correctly notes that many of the rotating employees in the system are outside the units 4 Nonetheless, employees in many job classifications in the units either routinely rotate be- tween divisions or regularly work on a temporary basis at divisions other than their permanent place- ment Ultrasound technicians, nuclear medicine technicians, and x ray technicians regularly move from division to division Some nurses, other than pool nurses, will work on a temporary basis in an- other division to provide necessary coverage in their specialty areas, e g , obstetrics Maintenance employees are assigned to different divisions tem porarily as specific projects require additional as sistance Central supply room employees, who work on processing and distributing medically re- lated supplies throughout the system, are moved between divisions to provide coverage needed due to vacations, sickness, or emergencies The medical records department has one permanently floating employee and routinely transfers clerks from one division to another for temporary coverage The Regional Director's ultimate finding on the appropriateness of single-facility units is based, in part, on the conclusion that there would be no ad- verse consequences caused by that determination The record, however, discloses that certain radiol- ogy and nuclear medicine equipment is available only in some divisions and that in some instances, the employees who operate the equipment regular ly rotate from division to division The Southern Division has no EEG department and must send patients in need of that testing to another division More significantly, all hot food served to patients and employees at the Southern Division is pre- pared at the Northern Division and transported to 4 The Employer excepts to the Regional Director s exclusion of MICU employees and pool nurses from the appropriate units The Petitioner offers arguments unrelated to the constant rotation of these employees to justify their exclusion We find it unnecessary to resolve this issue as we find a systemwide unit is necessary even in the absence of these rotating employees in the units 751 Southern 5 These all present situations where a labor disruption at one division, where some func- tion is centralized, would adversely affect the health care available at other divisions in the Em- ployer's system In Manor Healthcare, supra, 285 NLRB 224, the Board not only reaffirmed the rebuttable presump- tion of single-facility appropriateness in the health care industry, but also stated it would continue to weigh traditional factors in deciding whether the presumption has been overcome Those factors in elude geographic proximity, employee interchange and transfer, functional integration, administrative centralization, common supervision, and bargaining history Based on the above facts, we conclude the Employer has rebutted the presumption of single- facility appropriateness We note that the four divisions are located rela- tively close to one another There has been a sig- nificant degree of permanent transfers of employees among divisions, as well as a steady temporary interchange of employees on a nonnegligible basis Functional integration is apparent based on the sys temwide accreditation, as well as the numerous centralized departments, including the lab, trans- portation, and accounting departments Personnel policies and procedures are centrally determined and enforced Each department is centrally con trolled by a department director who oversees hiring, firing, and work procedures and directly participates in employee evaluations and griev ances The amount of money allocated to a particu- lar department in a division may be moved by the department director to another division when needed, without permission of the division adminis- trators involved All these factors, combined with the potential for adverse consequences ensuing from a labor disruption at a single facility unit, demonstrate the necessity for a systemwide unit in this matter The cases cited by the Regional Director in sup- port of his decision are distinguishable National G South, supra, 230 NLRB 976, which the Regional Director notes involved a higher degree of em- ployee transfers than the instant matter, involved nursing homes spread throughout the State of Texas The Board found there that hiring, firing, and grievance adjustment were done at the local level and that the administrator of the petitioned- for single facility exercised significant control over the direction of employees at that facility Al- though there may be a slightly lower degree of em 5 We note that contrary to the Regional Directors finding the record shows that the Employers purchase of foodstuffs and pharmaceuticals is done on a centralized basis 752 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD ployee transfer here, the combination of all the fac tors presents a basis for finding a systemwide unit in this case but not in National G South Similarly, Pomona Golden Age Convalescent, 265 NLRB 1313 (1982), and Manor Healthcare, supra, 285 NLRB 224, involved health care facilities whose adminis- trators were responsible for hiring and firing of em ployees as well as grievance adjustment As found above, this case involves much more than central ization of limited functions Accordingly, we find that single-facility units are inappropriate in this case and that systemwide units are required In its posthearing brief, the Petitioner stated that ` it does not intend to seek to represent the employ- ees at Northern Division, and will not agree at this time to amend its petition to cover those employ ees, if the Board finds that unit to be the only ap propriate unit " As we find systemwide units to be the only appropriate units and the Petitioner has in dicated its unwillingness to proceed to elections in those units, we will dismiss the petitions ORDER It is ordered that the petitions for elections are dismissed