Mercy Health Services North

National Labor Relations Board - Board Decisions

Jun 28, 1993

311 N.L.R.B. 1091 (N.L.R.B. 1993)

1091
311 NLRB No. 98
MERCY HEALTH SERVICES NORTH
1 Review was requested of the Regional Director’s findings that
the following employees were not technical employees: biomedical
engineers I and II; renal dialysis technician; physical therapy techni-
cians; and health information technicians.
3 The stipulated classifications are set forth in the appropriate unit
described below.
Mercy Health Services North, Mercy Hospital-Cad-
illac and Local 79, Service Employees Inter-
national Union, AFL–CIO, Petitioner. Case 7–
RC–19970
June 28, 1993
ORDER DENYING REVIEW
BY CHAIRMAN STEPHENS AND MEMBERS
RAUDABAUGH AND DEVANEY
The National Labor Relations Board has considered
the Employer’s request for review of the Regional Di-
rector’s Decision and Direction of Election (pertinent
portions of are attached). The request for review is de-
nied as it raises no substantial issues warranting re-
view.1
MEMBER DEVANEY, dissenting in part.
I would permit the biomedical technicians to vote
under challenge.
APPENDIX
DECISION AND DIRECTION OF ELECTION
The Employer is an acute care hospital located in Cadillac,
Michigan. The only employees represented for purposes of
collective bargaining are the registered nurses who are rep-
resented by Petitioner. The Petitioner seeks to represent a
unit of all full-time and regular part-time technical employ-
ees employed by the Employer at its 400 Hobart Street, Cad-
illac, Michigan facility. The Employer does not dispute that
the unit is appropriate. The parties stipulated to the inclusion
of various classifications encompassing about 105 employ-
ees,3 but the Petitioner disagrees with the Employer’s conten-
tion that the following job classifications are technical em-
ployees and therefore included within the appropriate unit:
1. Biomedical Engineering Technician I
2. Biomedical Engineering Technician II
. . .
4. Renal Dialysis Technician
. . .
7. Health Information Tech
. . .
9. Physical Therapy Tech
Biomedical Engineering Technicians I and II
Biomedical Engineering Technicians (BET) I and II repair
and maintain medical equipment involved in patient care,
such as IVAC controllers and defibrillators and assist the
nursing staff in the operation and use of such equipment. The
BETs are involved in routine preventative maintenance on
medical equipment and troubleshooting problems in such
equipment that arise. About 20 percent of the preventative
maintenance performed by BETs is routine, while the re-
mainder requires subjective use of judgment, education, and
skills.
A BET I or II is required to have a minimum educational
level of an associate’s degree; a BET I is required to have
3 to 5 years of experience, and a BET II is required to have
5 to 7 years of experience. BETs I and II perform the same
job duties except that a BET II also maintains and repairs
the Employer’s computer cable system and the internal tele-
phone system; a BET I may assist in these functions but does
not perform such duties independently. The current job de-
scriptions for BET I and II both require certification in addi-
tion to the educational and experience requirements. Certifi-
cation is available through the American Association of
Medical Instrumentation. There are currently two employees
working as BETs, neither of whom are certified although the
record reflects that they are currently studying for the certifi-
cation exam.
The BETs work out of an office and shop in the main hos-
pital area which is adjacent to an area utilized by the envi-
ronmental services or housekeeping employees. The BETs
are supervised by the environmental services manager who
also supervises housekeeping employees and maintenance
employees, such as painters, electricians, and carpenters, who
work in garages separate from the main hospital building.
BETs work from 7 a.m. to 3:30 p.m. and from 8 a.m. to 4:30
p.m. unlike maintenance employees who work three shifts.
All employees are eligible to receive benefits on the same
basis, which are dependent on whether the employee is con-
sidered full time, part time, or casual. Hourly wage rates of
BET I are at pay grade level 20, ranging from $10.60 to
$14.03, while those of a BET II are at pay grade level 22,
ranging from $11.68 to $15.48.
Although BETs work different hours than others who may
be termed skilled maintenance employees, similar employees
described by the Board as ‘‘highly skilled employees who re-
pair and calibrate sophisticated hospital equipment’’ have
been included in a skilled maintenance unit rather than a
technical unit. In San Juan Medical Center, 307 NLRB 117
(1992), the Board rejected the contention that biomedical
technicians were technical employees because of their high
skill level and stated that the Board had contemplated that
skilled maintenance units would include employees of vary-
ing degrees of skills. Like the biomedical technicians dis-
cussed in San Juan Medical, the BETs at issue have no di-
rect patient care duties and have skills more similar to those
traditionally included in skilled maintenance units. They
share common supervision with other maintenance employ-
ees. Accordingly, I conclude that BET I and II are not prop-
erly included in the technical unit.
Chief Service Technician and Renal Dialysis Technician
There are approximately 15 employees in the renal dialysis
unit including 1 social worker, 1 clerk, 1 chief service tech-
nician (CST), 1 renal dialysis technician (RDT), 1 nurse ex-
tern, 5 licensed practical nurses (LPN), and 5 registered
nurses (RN). In performing patient care duties, the employ-
ees work under the supervision and direction of an RN.
The chief service technician inspects and tests equipment
in the dialysis unit, calibrates such equipment, and performs
1092 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
preventative maintenance and repairs as needed; the CST
also trains staff in the use of equipment. The CST learns to
monitor and fix equipment through the vendors of such
equipment. The CST also performs direct patient care duties
in initiating the dialysis procedure and monitoring patients
through the procedure. About 50 percent of the chief service
technician’s time is spent in patient care duties in the dialysis
unit. The CST performs all the duties performed by LPNs
except initiating intravenous medication, although he can ini-
tiate other intravenous procedures. The CST assists the nurs-
ing staff in terms of choices of kidney dialysis machinery.
The CST job description requires 2 years’ prior experience
with renal dialysis equipment or a biomedical license. The
Employer testified that it required a high school education
with dialysis experience or a 2-year degree. According to the
Employer, certification exists for the CST position, although
the person currently in this position has no certification. The
wages for this position are at pay grade 16, which range
from $8.72 to $11.54 per hour.
The renal dialysis technician (RDT) assists in providing
patient care during the dialysis procedure. The RDT sets up
the various machines used in dialysis, and monitors patients
during the procedure by measuring vital signs and visually
and verbally monitoring the well being of patients. The RDT
may terminate the dialysis procedure by removing the intra-
venous needle but may not initiate the procedure. Both the
CST and the RDT make chart entries as to their patient ob-
servations and treatment. A high school diploma is required
for the RDT and on-the-job training is provided, although
nursing or other health care experience is preferred. There is
no certification or licensing available for this position. The
wages for this classification are at pay grade 8, and range
from $5.90 to $7.81 per hour.
Technical employees are defined as those ‘‘who do not
meet the strict requirements of the term ‘professional em-
ployee’ as defined in the Act but whose work is of a tech-
nical nature involving the use of independent judgment and
requiring the exercise of specialized training usually acquired
in colleges or technical schools or through special courses.’’
Barnert Memorial Hospital Center, 217 NLRB 775, 777
(1975), quoting Litton Industries of Maryland, 125 NLRB
722, 724–725 (1959). Technical employees are those whose
specialized training, skills, education, and job requirements
establish a community of interest not shared by other service
and maintenance employees. Such a separate community of
interest is frequently evidenced by the fact that the employee
is certified, licensed, or registered although employees may
meet the standards of technical employee without such cer-
tification. Barnert, supra at 776.
On the basis of the foregoing, I conclude that the CST is
a technical employee. The Employer requires 2 years of spe-
cialized experience, a 2-year degree, or a biomedical license
for this position. It appears that the CST is responsible for
a broad level of knowledge in the field of dialysis including
both machinery and patient care. The CST wage rate is at
pay grade 16 which is at the same level as respiratory ther-
apy technicians and cytology technicians, both of which are
stipulated to be within the technical unit. William W. Backus
Hospital, 220 NLRB 414, 419 (1975); St. Elizabeth’s Hos-
pital of Boston, 220 NLRB 325, 327 (1975). Accordingly,
the CST is included in the technical unit.
I reach a contrary conclusion, however, with respect to the
RDT whose patient care duties in the dialysis unit are more
circumscribed than those of LPNs or the CST. The RDT is
only required to have a high school education, is trained in
job duties on the job, and is paid in the lower ranges of
wages discussed here. Accordingly, I conclude that the RDTs
are not technical employees and they are excluded from the
unit.
Health Information Tech
Health information techs (HIT), also referred to as medical
records technicians, review the entire patient record at the
time of discharge and assign diagnostic and procedure codes
to such records for reimbursement purposes. Such employees
are required to research and analyze patient charts to obtain
correct diagnoses. They also examine patient charts for dis-
crepancies and errors relative to such procedures and diag-
noses.
Although the previous job description required a nursing
or associated medical degree, or accreditation as a record
technician, the current job description only requires a high
school education with previous related training and experi-
ence. A representative of the Employer testified that it was
the hospital’s practice to require a 2-year program or related
education. No certification is currently required, although it
is preferred. One of the four current HITs is certified. The
hourly pay rate is grade 5, which ranges from $8.30 to
$10.99.
On the basis of the foregoing, I am unable to conclude
that HITs are technical employees. Faribault Clinic, 308
NLRB 131 (1992); Levine Hospital of Hayward, 219 NLRB
327 (1975). The educational requirements have been reduced
from the previous job description. Although certification is
available, it is not a condition of employment and only one
of four current employees possesses such certification. Al-
though the wages of such employees are comparable to oth-
ers stipulated to be technical employees, their education and
skill level do not rise to that of medical records employees
found by the Board to be technical. Jewish Hospital of Cin-
cinnati, 223 NLRB 614, 619 (1976). Accordingly, they are
excluded from the unit.
Physical Therapy Aide and Physical Therapy
Technician
Physical therapy technicians (PTT) work in the physical
therapy department with physical therapists, physical thera-
pist assistants, and physical therapy aides (PTA). PTTs are
responsible for providing various treatments to patients, ac-
cording to a treatment plan formulated by a physical therapist
under a physician’s order. The PTT is also responsible for
cleaning and maintaining equipment and transporting pa-
tients, when directed. PTTs work Monday through Friday at
pay grade 11, at an hourly rate ranging from $6.83 to $9.05.
PTAs prepare treatment areas, assist in preparing patients
for treatment, and assist others in providing treatments. PTAs
work part time and only on weekends at pay grade 7, an
hourly rate ranging from $5.62 to $7.45.
Both PTTs and PTAs are required to have a high school
education and training in cardiopulmonary resuscitation.
PTTs are also required to have a year’s experience as a PTA.
There is no licensing or certification requirement for such
1093MERCY HEALTH SERVICES NORTH
positions, although two of those currently classified as PTTs
have completed the college educational requirements for the
physical therapist program. Training for PTT positions is re-
ceived on the job. PTTs perform their job duties under the
supervision of a physical therapist, but generally not in their
presence. The majority of the job duties performed by PTAs
is done in the presence of another person. PTTs spend the
majority of their time working with outpatients, while PTAs
work mainly with hospital patients.
Neither the PTTs nor the PTAs possess the skills and
training sufficient to permit a finding that they are technical
employees. They are not required to have any education be-
yond high school and receive training on the job for their du-
ties. No licensing or certification is available for such posi-
tions and their wages are on the lower end of those whose
status is at issue here. Accordingly, I conclude that PTTs and
PTAs are not technical employees and they are excluded
from the unit. Trinity Memorial Hospital of Cudahy, 219
NLRB 215, 219 (1975).
5. In view of the foregoing, the following employees of
the Employer constitute a unit appropriate for the purposes
of collective bargaining within the meaning of Section 9(b)
of the Act:
All full-time and regular part-time technical employees
employed by the Employer at its facility located at 400
Hobart Street, Cadillac, Michigan, including Respiratory
Therapy Technicians II/LPN, Certified Respiratory
Therapy Technicians, Registered Respiratory Therapists,
Computerized Tomography Technologists, Cytology
Technicians, Echo Technologists, Registered Histology
Technicians, Medical Laboratory Technicians, Medical
Technologists, Nuclear Medicine Technologists, Sur-
gical Technicians, Pharmacy Technicians II, Psychiatric
Technicians, Radiology Technologists, Ultrasound
Technologists, Licensed Practical Nurses, Respiratory
Therapy Assistants, Employee Health Specialists, Chief
Service Technicians (Renal Dialysis Unit), and on-call
technical employees who have worked a minimum of
120 hours in either of two 3-month periods immediately
preceding the date of the issuance of the Decision and
Direction of Election but excluding all other nonprofes-
sional employees, professional employees, guards and
supervisors as defined in the Act.