St. Luke's Episcopal Hospital

National Labor Relations Board - Board Decisions

Jan 30, 1976

222 N.L.R.B. 674 (N.L.R.B. 1976)

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.]