St. Luke's General Hospital

National Labor Relations Board - Board Decisions

Sep 22, 1975

220 N.L.R.B. 488 (N.L.R.B. 1975)

488 DECISIONS OF NATIONAL LABOR RELATIONS BOARD
St. Luke's General Hospital and Local No. 120, Ser-
vice Employees International Union , AFL-CIO,
Petitioner. Case 19-RC-7419
September 22, 1975
DECISION ON REVIEW AND DIRECTION OF
ELECTION
BY MEMBERS FANNING, JENKINS, AND PENELLO
On April 23, 1975, the Regional Director for Re-
gion 19 issued a Decision and Order in the above-
entitled proceeding in which he found the only ap-
propriate unit to be one comprising all of the
Employer's currently unrepresented nonprofessional
employees. Accordingly, he dismissed the petition on
the ground that Petitioner did not wish to participate
in an election in such a unit. Thereafter, in accor-
dance with Section 102.67 of the National Labor Re-
lations Board Rules and Regulations , Series 8, as
amended, the Petitioner filed a request for review of
the Regional Director's decision and the Employer
filed a brief in opposition.
On May 21, 1975, by telegraphic order, the request
for review was granted.
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
Washington corporation engaged in the operation of
an independent, community-owned, nonprofit, acute
care general hospital in Bellingham , Washington. It
is licensed to provide for 106 regular, general, acute
care beds and 6 skilled nursing facility beds. Peti-
tioner seeks to represent a service and maintenance
unit comprising general services employees (house-
keeping aides, laundry and linen aides, seamstresses,
washers , maintenance I employees , maintenance II
employees), materials department employees (central
supply aides, materials secretary, storeroom manag-
er, and purchasing agent), nursing services depart-
ment employees (nurses aides, ward clerks, also
known as board secretaries, bedmakers, and operat-
ing room technicians), dietary department employees
(first cook, second cook, relief cook, diet assistant,
diet aides, cafeteria aide, tray aides), laboratory em-
ployees (lab aides and lab assistants), and respiratory
therapists in the respiratory department. The Em-
ployer contends that the only appropriate unit must
include all its unrepresented nonprofessional em-
ployees. There is no history of collective bargaining
among the employees with regard to the petitioned-
for unit. Currently, the Employer's laboratory tech-
nologists are represented by the Petitioner in a sepa-
rate unit; the registered nurses are represented by the
Washington State Nurses Association; the x-ray
technicians are represented by the Radiological
Technicians at St. Luke's Hospital; and the licensed
practical nurses are represented by the Licensed
Practical Nurses Association. Petitioner stated that it
is willing to represent a unit of employees including
the medical records department employees or any
unit smaller than the one petitioned for (composed of
employees within the petitioned-for unit), but it
would not agree to participate in an election which
included the business office employees.
The hospital employs approximately 270 employ-
ees, of whom approximately 210 work full time. On
the average, 60 percent of the beds are occupied, but
there are times when the occupancy reaches full ca-
pacity. Currently represented are approximately 50
RN's, 65 LPN's, 6 radiologic technologists, and 10
laboratory technologists. There are approximately 20
supervisors employed by the Employer. Accordingly,
the petitioned-for unit encompasses approximately
81 employees. There are approximately 40 unrepre-
sented nonprofessional employees who are not
sought by the Petitioner.
The board of trustees , a body of 40 people, is re-
sponsible for major decisions as to personnel policy
for the hospital. This board elects an executive com-
mittee of 12 to meet on a monthly basis with the
administrator of the hospital in providing direction
and control over the institution.
The Regional Director found that the petitioned-
for unit of employees would serve only to fragment
unjustifiably the Employer's employees, in the cir-
cumstances of this case, since certain of the employ-
ees are currently represented by various labor organi-
zations in four separate units and the Petitioner seeks
to establish a fifth unit comprising approximately 81
employees, but not including approximately 40 other
unrepresented nonprofessional employees. The Re-
gional Director dismissed the petition, finding that
all the currently unrepresented nonprofessional em-
ployees share similar wages, hours, working condi-
tions, and benefits; regularly interchange with each
other; and perform functionally integrated duties
aimed at providing patient care from the time the
patient enters the hospital until the patient departs
and all billing and insurance functions have been
completed. However, we find that the employees in
the unit sought, together with the medical records
department employees and certain other employees
whom the Employer would exclude, but excluding
business office clerical employees, is appropriate for
220 NLRB No. 86
ST. LUKE'S GENERAL HOSPITAL 489
the reasons cited in the cases which have issued sub-
sequent to the 1974 amendments to the Act which
expanded its coverage to nonprofit hospitals.
In Newington Children's Hospital, 217 NLRB No.
134 (1975), the Board found a unit of service and
maintenance employees including hospital clerical
employees , but excluding , inter alia, business office
clerical employees, to be appropriate. Therein, the
hospital clericals (as contrasted with business office
clericals) were located geographically throughout the
hospital, within various departments composed of
other service and maintenance employees, and
shared a community of interest with the service and
maintenance employees.
In St. Catherine's Hospital of Dominican Sisters of
Kenosha, Wisconsin, Inc., 217 NLRB No. 133 (1975),
the Board found appropriate a unit limited to busi-
ness office clerical employees since such employees
either performed "business" office functions or had
more of a community of interest with business office
employees than with employees in the other voting
units established in that decision. Employees in the
medical records departments were not included in
that office clerical unit because they had more of a
community of interest with employees in the service
and maintenance unit.'
In Sisters of St. Joseph of Peace, 217 NLRB No.
135 (1975), medical records employees and ward
clerks were found to be properly excluded from a
unit limited to business office clerical employees de-
spite their performance of clerical functions because
they worked with different people on different types
of records for different immediate objectives; they
were not located in the central business office com-
plex, did not share common supervision with the
business office employees, and did not appear to
share close working relationships sufficient to estab-
lish a significant community of interest with the busi-
ness office clerical employees.
In Mercy Hospitals of Sacramento, Inc., 217 NLRB
No. 131 (1975), the Board found that "[u]pon due
consideration, we have decided that in the health
care field, as in the industrial sphere, we shall contin-
ue to recognize a distinction between business office
clerical employees, who perform mainly business-
type functions, and other types of clerical employees
whose work is more related to the function per-
formed by personnel in the service and maintenance
unit and who have, in the past, been traditionally
1 In agreeing with the unit determination made herein, Member Penello
does not rely on the decisions in Newington Children's Hospital and in St
Catherine's Hospital of Dominican Sisters of Kenosha, Wisconsin, Inc, supra.
In Newington, Member Penello dissented based on the exclusion therein of
technical employees including LPN's from a service and maintenance unit.
Likewise, in St. Catherine's, he dissented in part based on a separate unit
finding for technical employees including LPN's.
excluded by the Board from bargaining units of busi-
ness office clerical employees. Thus, the Board has
consistently recognized that the interests. of business
office clerical employees differ markedly from the in-
terests of clerical employees who work in the produc-
tion area and has declined to establish bargaining
units composed of the two clerical groups."
After a careful reading of the record, it is clear to
us that the business office clerical employees herein,
who are located in a separate office, apparently are
hired and fired by the hospital's controller who man-
ages the business office, and who do not share super-
vision with any other employees, share a community
of interest as set out in the above-mentioned cases
which sets them apart from the service and mainte-
nance employees. Accordingly, we find that the unit
petitioned for appropriately excludes the business of-
fice clerical employees, but that the medical record
employees, herein, consistant with Sisters of St. Jo-
seph of Peace, must be included with the other em-
ployees in the service and maintenance unit sought.
We note that Petitioner stated that it is willing to
represent the medical records department employees
in such a unit.
The parties also apparently disagree as to the sta-
tus of the laboratory secretary (laboratory depart-
ment); the medical stenographer (x-ray department);
the EEG technician (EEG department); and the
medicare coordinator and patient service coordina-
tor (both under the administrative assistant). The
laboratory secretary is a recent position which re-
placed the medical stenographer or transcriptionist.
The classification no longer requires skills pertaining
to the transcription of medical terminology or rec-
ords. Apparently, however, the laboratory secretary
is still located in the laboratory, next to the
pathologist's office and the duties continue to con-
cern typing reports dictated by the pathologist and
answering questions regarding the pathologist's bill-
ings . The medical stenographer, whose desk and typ-
ing station is located in the x-ray department adja-
cent to one of the radiological rooms, types the
radiological diagnoses dictated by the radiologist.
We conclude that both the laboratory secretary and
the medical stenographer are hospital office clericals
and shall include them in the unit.
The EEG technician records on a graph the electri-
cal impulses from the different parts of the brain.
The associate administrator of the hospital testified
that the technician does not exercise independent
discretion of judgment in administering the test since
it was standardized, does not require a certification,
and requires a formal training of only I week to a
month. Accordingly, we find that the EEG techni-
cian is not a technical employee but must be includ-
490 DECISIONS OF NATIONAL LABOR RELATIONS BOARD
ed in the service and maintenance unit sought?
The patient service coordinator, who is under the
supervision of the administrative assistant, takes pa-
tients' inventory (inquires as to the patients' opinion
of the hospital's services), assists in the daily occupa-
tional therapy needs of extended care facility pa-
tients, and primarily completes certain forms. Much
of this work is done with the medicare coordinator,
also under the administrative assistant's supervision,
who maintains charts assuring that the hospital meets
the guidelines for providing health care to medicare
patients. There is no indication in the record of any
unique education or licensing requirements or that
2 Member Penello finds it unnecessary to pass on whether or not the EEG
technician is a "technical" employee since, in any event, he would include
him in the service and maintenance unit. See the dissenting opinion in Na-
than and Miriam Barnert Memorial Hospital Association d/bla Barnert Me-
morial Hospital Center, 217 NLRB No. 132 (1975).
these employees utilize independent judgment or dis-
cretion. Accordingly, we conclude that these employ-
ees are hospital office clerical employees and we shall
include them in the unit.
On the basis of the foregoing, we find that a unit of
service and maintenance employees including ward
clerks, respiratory therapists, operating room aides,
nurses aides , maintenance employees, housekeeping
employees, linen department employees, dietary em-
ployees, central supply-storeroom employees, hospi-
tal clerical employees, and medical records depart-
ment employees; but excluding office clerical
employees, guards, supervisors as defined in the Act,
and all other employees constitute a unit appropriate
for purposes of collective bargaining within the
meaning of Section 9(b) of the Act.
[Direction of Election and Excelsior footnote omit-
ted from publication.]