Visiting Nurse Association, Inc.

National Labor Relations Board - Board Decisions

Jan 27, 1971

188 N.L.R.B. 155 (N.L.R.B. 1971)

VISITING NURSE ASSN.
Visiting Nurse Association, Inc., and California Nurs-
es' Association , American Nurses ' Association, Peti-
tioner. Case 20-RC-9550
January 27, 1971
DECISION AND DIRECTION OF ELECTION
BY MEMBERS FANNING, BROWN , 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 Officer Philip Mounger. Fol-
lowing the hearing, and pursuant to Section 102.67 of
the National Labor Relations Board Rules and Reg-
ulations and Statements of Procedure, Series 8, as
amended, and by direction of the Regional Director
for Region 20, this case was transferred to the Nation-
al Labor Relations Board for decision. The Employer
filed a brief.
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 powers
in connection with this case to a three-member panel.
The Board has reviewed the Hearing Officer's rul-
ings made at the hearing and finds that they are free
from prejudicial error. They are hereby affirmed.
Upon the entire record in this case , including the
brief filed herein, the Board finds:
1. The Employer is a nonprofit, charitable organi-
zation which provides nursing services and is incorpo-
rated in the State of California. It provides services to
patients who reside in Santa Clara County who have
been discharged from hospitals, and are at home, but
continue to require some professional treatment and
attention. The Employer is assisted by the hospitals
and by doctors who indicate which patients to visit
and the care needed.
There are 27 members of the board of directors, a
president, vice president, secretary, and treasurer,
none of whom receive compensation. There is an ex-
ecutive director who is compensated and who admin-
isters the Employer's affairs. Other employees include
an assistant director, staff nurses with nursing super-
visors , a physical therapy supervisor, physical thera-
pist, occupational therapist, part-time speech
therapist, medical social workers, add a part-time nu-
tritionist. In addition, there are 24 registered and pub-
lic health nurses , approximately 40 home health aides,
I1 clericals , and an administrative assistant.
As part of its operation, the Employer has five pub-
lic health nursing discharge coordinators who are as-
signed to the five general hospitals in Santa Clara
County and who engage in discharge planning work
with the hospital staff and physicians to determine
whether patients can be referred to the Employer or
155
to other appropriate agencies, e.g., Cancer Society or
United Fund. The Employer also participates in the
Hospital Referral Plan, a system of outpatient care
based on an order signed by a physician setting forth
guidelines for the care required by a patient when at
home. The order often includes notes made by the
head nurse, coordinator, or dietician. After the pa-
tient 'has been visited in his home by the Employer,
the referral order is answered and copies go back to
the doctor and to the hospital for the patient's records.
Approximately half of the Employer's patients are
acquired through the Hospital Referral Plan. The re-
maining patients are referred by physicians, other
agencies , or families. The Employer treats its patients
in their own homes or apartments.
Although the Employer has no policy that would
require that its patients be residents of Santa Clara
County, most of its patients reside in that county. The
Employer receives fees from patients based on the
services it renders the patients in their homes. If a
family can afford to pay the full cost of a visit, which
is determined by cost study and policy set by the
board of directors, they are billed the full fee. Howev-
er, when a family cannot afford to pay for a visit, and
does not have other insurance sources, the visiting
nurse discusses the family's financial status and an
adjustment of the fee is made subject to approval by
the nursing supervisor.
During the year 1969 the Employer derived from its
operations approximately $761,320.80. Of this total,
$103,368 was received from United Fund; $64,025.10
from patient fees; $3,385 from the California State
Department of Public Health; and $3,900.63 from
Short-Doyle, which is the State of California mental
health program. The Employer also received income
from several private agencies such as the Multiple
Sclerosis Society, $1,250; and Congestive Heart Re-
search Program, $2,545.25. Other income received by
the Employer included $459,250.14 from Medicare;
$118,826.09 from Medi-Cal, which is partially funded
by the Federal Government; $964.25 from the Veter-
ans Administration; and $1,196.52 from other Gov-
ernment programs.
Although the Employer does not maintain any hos-
pital or nursing home facilities, it does render nursing
and related health care services and falls within the
general category of health care facilities over which
we have indicated we would assert jurisdiction.' Ac-
cordingly, as the Employer grossed over $100,000
from its operations during 1969, we find that it will
effectuate the purposes of the Act to assert jurisdic-
tion herein.2
1 See Visiting Nurses Association of Sacramento, 187 NLRB No. 88.
2 University Nursing Home, Inc., 168 NLRB 263; Drexel Home, Inc., 182
NLRB No. 151.
188 NLRB No. 21
156 DECISIONS OF NATIONAL: LABOR RELATIONS BOARD
2. The labor organization involved claims to repre-
sent certain employees of the Employer.
3. A question affecting commerce exists concerning
the representation of employees of the Employer
within the meaning of Sections 9(c)(l) and 2(6) and
(7) of the Act.
4. The parties stipulated, and we find, that the fol-
lowing 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 registered nurses and public health nurses of
the Employer, excluding all other employees, of-
fice clericals, guards and supervisors, as defined
in the Act.
[Direction of election 3 omitted from publica-
tion.)
3 In order to assure that all eligible voters may have the opportunity to be
informed of the issues in the exercise of their statutory right to vote , all parties
to the election should have access to a list of voters and their addresses which
may be used to communicate with them . Excehior Underwear Inc, 156
NLRB 1236; N L RB v. Wyman-Gordon Co., 394 U.S. 759. Accordingly, it
is hereby directed that an election eligibility list, containing She names and
addresses of all the eligible voters , must be filed by the Employer with the
Regional Director for Region 20 within 7 days of the date of this Decision
and Direction of Election. The Regional Director shall; nahe the list available
to all parties to the election No extension of time to file this list shall be
granted by the Regioast Director except in extraordinary circumstances.
Failure to comply With this iequiremebt shall be grounds for setting aside the
election whenever proper objections are filed.