Centralia Convalescent Center

National Labor Relations Board - Board Decisions

Jun 15, 1989

295 N.L.R.B. 42 (N.L.R.B. 1989)

42 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
Pleasant Valley Health Services Corporation d/b/a
Centralia Convalescent Center and Office and
Professional Employees International Union,
Local 23, AFL-CIO, CLC, Petitioner. Case 19-
RC-11844
June 15, 1989
DECISION ON REVIEW AND
DIRECTION OF ELECTIONS
BY CHAIRMAN STEPHENS AND MEMBERS
JOHANSEN AND HIGGINS
On October 11, 1988, the Regional Director for
Region 19 issued a Decision and Direction of Elec-
tion in the above-entitled proceeding in which he
found appropriate a unit of all employees including
registered nurses (RNs) employed by the Employer
at its 1015 Long Road, Centralia, Washington facil-
ity.
On November 9, 1988, the Board granted the
Employer's request for review solely with respect
to the Regional Director's finding that the RNs
were not professional employees within the mean-
ing of Section 2(12) of the Act, stayed the election,
and remanded the matter to the Regional Director
for further hearing on this issue and issuance of a
Supplemental Decision.
On December 6, 1988, the Regional Director
issued a Supplemental Decision and Direction of
Election, finding that the Employer's two nonsu-
pervisory RNs were not professional employees be-
cause one RN performs work similar to that of the
licensed practical nurses (LPNs) that does not in-
volve the use of professional discretion, judgment,
or intellect within the meaning of the Act, and the
other RN is not involved in direct patient care
duties . On December 29, 1988, the Board granted
the Employer's request for review of that decision
and again stayed the election.
The Board has reviewed the entire record in this
case, including the Employer's brief in support of
review, and has decided to reverse the Regional
Director 's Supplemental Decision and Direction of
Election. We conclude, for the following reasons,
that the Employer 's registered nurses are profes-
sionals within the meaning of Section 2(12) of the
Act.
The Employer operates a 96-bed, skilled, long-
term nursing facility in a 1-story building divided
into three wings. The nursing services department
employs approximately 16 licensed nurses (RNs
and LPNs) and 37 nursing assistants.'
' The parties stipulated that the LPNs were technicals and that the
outside agency substitute nurses were not unit employees.
The Board has traditionally held that registered
nurses are professional employees.2 The record es-
tablishes that the Employer's RNs are graduates of
approved nursing schools. Their course of study
leading to a nursing degree qualifies them to per-
form the same -duties as any other registered nurses,
once they have taken and passed a uniform exami-
nation as a prerequisite to being licensed as profes-
sional nurses by the State of Washington , or some
other jurisdiction. Also, based on their status as
RNs, they are allowed to draw blood and perform
veinipunctures (IVs).3 Furthermore, they are paid
a higher wage rate than LPNs because of their
higher qualifications and because they possess a
higher level of skills. Finally, Washington state law
requires that the Employer have an RN on duty at
least 16 hours per day within its facility.4 Thus,
both RNs fulfill the criteria for professional status
under the Act.
In view of the foregoing, we find that registered
nurse Robin Seroshek, who is engaged in direct pa-
tient care as an RN on the Employer's night shift,
is a professional employee under the Act.5
With respect to registered nurse Sharon Light-
foot, the record reveals that she is responsible for
certifying patients for Medicare benefits, and ren-
dering Medicare billings . In order to assess wheth-
er a patient's condition qualifies for Medicare or
continued Medicare coverage, Lightfoot must uti-
lize her higher level of education and training in
order to assess and describe the patient 's condition
accurately and to justify to Medicare why a par-
ticular patient needs skilled nursing care . Lightfoot
is also responsible for reporting to the appropriate
authorities the progress of the Medicare patients.
Thus, for about 50 percent of the time, while per-
forming these responsibilities , Lightfoot has some
type of patient contact. The record also shows that
Lightfoot uses the skills gained from her education
and training as a registered nurse when presenting
2 Mercy Hospitals of Sacramento, 217 NLRB 765 (1975) The appropri-
ateness of a separate RN unit is not an issue. See also Memorial Clinic,
220 NLRB No. 217 (Oct. 1, 1975) (inadvertently omitted from Board
bound volumes). See 91 LRRM 1029 (1975).
LPNs may perform IVs only if they obtain certification
* Unlike the Regional Director , we deem this state law to be based on
the State's perception that registered nurses are medical professionals by
virtue of their educational achievements and the level of their nursing
qualifications Although the State's view of registered nurses does not
confer on them professional status within the meaning of the Act, it
surely is a factor to be weighed in our determination . Consequently, the
Regional Director 's dismissing the Employer's hiring of RNs as nothing
more of consequence than compliance with a state requirement ignores
the significance behind the requirement that the State considers regis-
tered nurses essential to the operation of facilities like the Employer's be-
cause of their perceived professional status and what that status implies
regarding the administration of health care
S The fact that Seroshek performs duties similar to those of the Em-
ployer's LPNs is insufficient to warrant a finding that she is not a profes-
sional employee . Memorial Clinic, supra.
295 NLRB No. 7
CENTRALIA CONVALESCENT CENTER 43
and discussing her Medicare certifications at the
Employer's monthly meeting of the Utilization
Review Committee, which includes the director of
nurses as one of its members . Further, she is re-
sponsible for updating the doctors' orders for pa-
tients so that their treatment and medication
records will be current. Lastly, while Lightfoot is
performing her duties , her presence , like that of
Seroshek's, helps to fulfill the Employer's legal ob-
ligation to have a registered nurse on the premises
for 16 hours a day. Thus, although Lightfoot per-
forms predominantly nonpatient care work, we find
that by virtue of her RN status and the nature of
her job responsibilities concerning patient treat-
ment, she functions as a professional within the
meaning of the Act.6
Under the proscription of Section 9(b)(1) of the
Act, professional employees cannot be included in
a nonprofessional unit without their consent. Be-
cause Seroshek and Lightfoot are professional em-
ployees, they are entitled to the benefit of a Sono-
tone election to determine if they wish to be includ-
ed in the unit.7
Therefore, we shall direct elections in the fol-
lowing separate voting groups , one consisting of all
RNs and the other consisting of all other employ-
ees employed at the Employer's facility at 1015
Long Road, Centralia, Washington:
(a) All full-time and part-time registered
nurses employed at the Employer's facility at
6 Mercy Hospitals of Sacramento, 217 NLRB 765, 766 (1975). Samaritan
Health Services, 238 NLRB 629, 633 ( 1978). We note that no party con-
tends that Lightfoot should be excluded from the unit because of a pur-
ported lack of community of interest
7 Sonotone Corp., 90 NLRB 1236 (1950).
Centralia , Washington , but excluding all other
employees , confidential employees , guards and
supervisors as defined by the Act.
(b) All employees employed at the Employ-
er's facility at Centralia, Washington , but ex-
cluding registered nurses, confidential employ-
ees, guards , and supervisors as defined in the
Act.
The employees in voting group (a) will be asked
the following two questions on their ballots:
(1) Do you desire to be included in the same
unit of nonprofessional and technical employ-
ees?
(2) Do you desire to be represented for pur-
poses of collective bargaining by the Office
and Professional Employees International
Union , Local 23, AFL, CIO-CLC?
If a majority of the group (a) employees vote
"yes" to the first question, indicating a desire to be
included in a unit with nonprofessional employees,
they shall be so included. Their vote on the second
question will be counted with the votes of the non-
professional employees in group (b) to decide
whether to select the Petitioner as the representa-
tive for the entire combined bargaining unit. If, on
the other hand, the RNs in group (a) do not vote
for inclusion, their votes on the second question
will not be counted.
If a majority of the employees voting in group
(b) vote against the Petitioner, they will be taken
to have indicated their desire to remain unrepre-
sented and the Regional Director will issue a certi-
fication of results of election to that effect.
[Direction of Elections omitted from publica-
tion.]