Kaiser Foundation Hospitals

National Labor Relations Board - Board Decisions

Jul 21, 1975

219 N.L.R.B. 325 (N.L.R.B. 1975)

KAISER FOUNDATION HOSPITALS
Kaiser Foundation Hospitals and Local 5-A, Hospital
and Institutional Employees , Division of Hotel,
Restaurant Employees and Bartenders Union, Local
Union 5, Petitioner. Case 37-RC-2047
July 21, 1975
DECISION ON REVIEW AND DIRECTION OF
ELECTION
BY MEMBERS FANNING, JENKINS , AND KENNEDY
On March 7, 1975, the Acting Regional Director
for Region 20 issued a Decision and Direction of
Election in the above-entitled proceeding in which he
found appropriate a unit of all regular full-time and
part-time professional employees employed by the
Employer at its facilities on the islands of Oahu and
Maui. Thereafter, in accordance with Section 102.67
of the National Labor Relations Board Rules and
Regulations, Series 8, as amended, the Employer
filed a request for review of the Acting Regional
Director's decision on the ground that a substantial
question of law and policy is raised because of the
absence of officially reported Board precedent.
On April 3, 1975, by telegraphic order, the request
for review was granted and the election was stayed
pending a Decision on Review.
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 nonprofit corporation which
provides comprehensive medical care to all Kaiser
Foundation Health Plan members. It is one of the
four entities which comprise the Kaiser Foundation
Medical Care Program which operates in six autono-
mous geographic regions, including Hawaii. The Em-
ployer operates a medical center in Honolulu, which
is both an inpatient and outpatient facility, five other
outpatient clinics on the island of Oahu, and two out-
patient clinics on the island of Maui.
In its petition, the Petitioner requested a unit of
pharmacists on the island of Oahu. However, at the
hearing it stated that, in the event that the Board did
not find appropriate the unit specifically sought, Pe-
titioner was willing to accept any other groups in-
cluded in the appropriate unit. The Acting Regional
Director found appropriate a unit of pharmacists on
the islands of Oahu and Maui. The Employer con-
tends that a unit of pharmacists is too narrow and
that the appropriate unit must include all remaining
325
unrepresented professionals,' specifically, pharma-
cists, medical technologists, physical therapists, and
medical and psychiatric social workers.
The Employer employs approximately 800 em-
ployees, of whom slightly more than 600 are repre-
sented by collective-bargaining organizations. In ad-
dition to the Hawaiian Nurses Association, which
represents approximately 160 RN's, the International
Longshoremen's and Warehousemen's Union, Local
142, represents approximately 20 x-ray technicians
and radioisotope technicians and Petitioner currently
represents over 400 employees covered by a wide
range of classifications, including LPN's, hospital
aides, clinic assistants, orderlies, and housekeeping,
dietary, and clerical employees.
Of the 11 pharmacists in the unit sought, 6 are
employed at the medical center on Oahu and a total
of 4 pharmacists are employed at the 3 other outpa-
tient clinics on the island of Oahu. There is one phar-
macist employed on the island of Maui. Since over
half of the members of the Foundation have some
type of prepaid drug benefits, they can go to the
Employer's pharmacy and get a prescription filled
less expensively than if they went to a pharmacy not
affiliated with the Employer. The pharmacists are su-
pervised by a head pharmacist who reports to the
hospital administrator. If a patient is an inpatient,
the prescription will be part of the doctor' s general
orders, in which case the nurses will order from the
pharmacy and the pharmacy will supply the medica-
tion to the nurses working on the floor. The Health
Plan contract provides that drugs will be supplied to
inpatients at no cost.
The Regional Director found that the pharmacists
constitute a functionally distinct, identifiable, homo-
geneous group sharing a community of interest sepa-
rate from other hospital personnel and therefore
comprise an appropriate unit since the pharmacists
are physically isolated from other employees, have
virtually no contact or interchange with other em-
ployees, have separate immediate supervision, and
cannot interchange or substitute for other employees
since they have very specific training.
However, based upon the foregoing facts, we con-
clude that an appropriate unit including pharmacists
must additionally include all other nonrepresented
professional employees of the Employer in Hawaii.
In considering the composition of appropriate bar-
gaining units in the health care industry , we must
take into account the expressed desire of Congress
1 With respect to nurse anesthetists , the Employer stated at the hearing
that it would not take a "firm position" because the nurse anesthetists are
basically registered nurses who take additional training. Nurse anesthetists
are not represented by the Hawaiian Nurses Association which presently
represents the registered nurses.
326 DECISIONS OF NATIONAL LABOR RELATIONS BOARD
that the Board avoid undue proliferation of the num-
ber of bargaining units. In finding that this unit limit-
ed to pharmacists is not appropriate, we are not un-
mindful of the differences noted by the Acting Re-
gional Director. However, as we stated in Mercy Hos-
pitals of Sacramento, Inc., 217 NLRB No. 131 (1975),
"Thus, although there is a diversity of skills between
each of these professional groups, their skills, inter-
ests, and working conditions are, in many respects,
no more diverse than those of employees in a pro-
duction and maintenance unit in the industrial
sphere or in the overall service and maintenance unit
in the health care industry. Despite these differences,
we note that all of the employees here under consid-
eration possess a commonality of professionalism
which sets them apart from other employees in the
Employer's operations." Clearly, such "commonality
of professionalism" exists herein. In particular, the
job descriptions and job analysis questionnaires re-
veal that each of the alleged professionals is required
to have a college education, and an internship and
certification are frequently required. Although it is
obvious that each of the professional employees,
herein, has a different job function and limited con-
tact with the other professionals, we find that the
professional employees basically share a community
of interest because they are basically the same type
of employee, viz, professionals who have undergone
the same type of academic training, receive compara-
ble wages (particularly in comparison to the other
employees), and usually work a 40-hour week, most
often during the day. These professional employees
constitute a readily identifiable unit. Although the
pharmacists obviously share a greater community of
interest with each other than they do with the other
professional employees, we do not consider that they
possess interests evidencing community of interest
with each other separate from that shared with the
other employees in the health care industry. These 11
pharmacists are employed at 5 different locations
and have no reason to deal with each other except on
occasional circumstances. Moreover, the record does
not indicate that pharmacists possess the history of
separate representation in collective bargaining that
we found in Mercy Hospitals, supra, to be of the
"greatest significance" in establishing the separate
interests of registered nurses. Accordingly, for the
aforementioned reasons and based on the record in
the instant case , we conclude that a unit consisting of
all professional employees,2 including physical thera-
2 Although the record indicates that the nurse anesthetists are profession-
pists, dietitians, nutritionists, social workers-psychi-
atric and medical, and medical technologists, is ap-
propriate for the purposes of collective bargaining.
Since Petitioner stated at the hearing that it desired
to represent employees and any other groups that the
Board finds must be included in the appropriate unit,
we shall direct an election in the aforementioned
unit.
[Direction of Election omitted from publication.]3
MEMBER KENNEDY, concurring in part and dissenting
in part:
I concur in my colleagues' finding that a unit limit-
ed to the pharmacists is inappropriate. I would find
that a unit of all unrepresented professional employ-
ees constitutes the appropriate unit. I disagree with
my colleagues' exclusion of the unrepresented nurse
anesthetists from the unit. If a certification issues in
the unit found appropriate by my colleagues, the
nurse anesthetists would be the only unrepresented
professional employees. As such, under Board deci-
sions they would then constitute an appropriate "re-
sidual" unit.4 I find unacceptable a decision which
denies separate representation to the unrepresented
pharmacists but which may result in separate repre-
sentation of unrepresented nurse anesthetists.
The unit in which the election is directed is four
times the size of the unit in which Petitioner made a
sufficient showing of interest. For the reasons stated
in my dissent in Mercy Hospitals of Sacramento, 217
NLRB No. 131 (1975), I would dismiss the petition
rather than direct an election in a unit which is sub-
stantially different in size and composition from that
sought. Such dismissal should be without prejudice
to the filing of a new petition when supported by an
adequate showing of interest. Such dismissal would
permit the filing of a petition or orderly intervention
by any other labor organization having an interest in
representing those employees not previously sought
by the Petitioner but now included in the unit found
appropriate.
al employees, we shall not include them in this unit . They must possess a
license as an RN as well as certification as a nurse anesthetist . They are
required to possess I year of practical experience as an RN or RNA. As the
Employer stated at the hearing , the nurse anesthetists are basically regis-
tered nurses who take additional training . The Employer took no position as
to the nurse anesthetists, but admitted that this classification was in doubt.
We consider the nurse anesthetists to have a sufficient community of inter-
est with the other RN's that we will not include them in the professional unit
herein . They share a community of interest not only with the professional
employees , but with the other RN' s who are currently represented by the
Hawaiian Nurses Association
[Excelsior footnote omitted from publication.]
See Weber Aircraft, Division of Walter Kidde & Company, 191 NLRB 10
(1971); Roston Corporation, 196 NLRB 467 (1972).