West Jersey Health System

National Labor Relations Board - Board Decisions

Apr 21, 1989

293 N.L.R.B. 749 (N.L.R.B. 1989)

WEST JERSEY HEALTH SYSTEM
West Jersey Health System and District 1199C, Na-
tional Union of Hospital and Health Care Em-
ployees, RWDSU, AFL-CIO, Petitioner Cases
4-RC-14945, 4-RC-14947, 4-RC-14948, 4-
RC-14949, and 4-RC-14950
April 21, 1989
DECISION ON REVIEW AND ORDER
BY CHAIRMAN STEPHENS AND MEMBERS
JOHANSEN AND CRACRAFr
On October 2, 1987, the Regional Director for
Region 4 issued a Supplemental Decision and Di
rection of Elections in which he found, inter alga,
that single-facility units are appropriate units in the
Employer's multidivisional system The Employer
and the Petitioner filed timely requests for review
on a number of issues On February 1, 1988, the
Board granted the Employer's request for review
concerning the appropriateness of the single-facility
units 1 The Employer and Petitioner resubmitted
briefs, previously filed with the Board or the Re-
gional Director, on the issue under review
The National Labor Relations Board has delegat-
ed its authority in this proceeding to a three-
member panel
The Board has considered the entire record in
this case with respect to the issue under review and
finds that the single facility units are not appropri-
ate For the reasons that follow, we find that the
Employer's multifacility system necessitates multi-
facility units
The Regional Director's Supplemental Decision
and Direction of Election finds2 that the Employer
operates four hospital facilities in a single nonprofit
system The four facilities, known as divisions, are
the Eastern Division located in Voorhees, New
Jersey, the Southern Division located in Berlin,
New Jersey, the Northern Division located in
Camden, New Jersey, and the Garden State Divi-
sion located in Marlton, New Jersey The distances
between the Northern and Southern Divisions,
Northern and Eastern Divisions, and Eastern and
Southern Divisions are 20 miles, 12 miles, and 9
miles , respectively The distances between the
Garden State and Northern Divisions, Garden
State and Eastern Divisions, and Garden State and
Southern Divisions are 11 miles, 2 1/2 miles, and
11 miles, respectively
' The Board at the same time placed in abeyance the Employers re
quest for review of the Regional Directors Modification of Supplemen
tal Decision and Direction of Elections which involves the issue of the
adequacy of the Petitioner s showing of interest In view of our decision
to dismiss the petitions this issue is now moot
2 We adopt the Regional Director s findings of fact unless stated other
wise in this decision
749
The Regional Director sets out the Employer's
corporate structure and notes that four members of
the corporate management team are each responsi
ble for the administration of one of the divisions 3
He finds the division administrators are responsible
not only for budget preparation and administration,
but also for the day-to-day administration of the di-
vision, including reviewing and approving evalua-
tions for employees in the division and signing ter
mination notices The Regional Director finds that
supervisors in the divisions assign and direct work,
grant overtime, approve leaves of absence, arrange
schedules and vacations, evaluate employees, initi-
ate discipline, and adjust grievances Each division
has a personnel manager who "is generally respon-
sible for employee relations at the Division," and
each division handles its own hiring or firing, al-
though a corporate personnel director located in
the Northern Division must approve these actions
All four divisions have common job classifica-
tions, wage scales, and benefits Employees at all
divisions are subject to the same personnel policies
and procedures Job vacancies are posted on a sys-
temwide basis, and employees are transferred or
promoted to jobs in other divisions without loss of
seniority Job applications submitted at one divi-
sion, where there is no opening, will be sent by the
division personnel manager to another division that
has an appropriate vacancy The Employer has a
grievance procedure providing a step 1 meeting
with the employee's immediate supervisor, a step 2
meeting with the employee's department head, a
step 3 meeting with the corporate personnel direc-
tor, and a step 4 final resolution by the system ad
ministrator
The Regional Director listed a number of func-
tions conducted by the Employer on a systemwide
basis They include transportation operations, mail
handling and materials distribution, purchasing of
supplies other than pharmaceuticals and foodstuffs,
warehousing, linen supply, data processing, print-
ing, communications, payroll preparation, commu
nity relations, and laboratory services
The Regional Director finds that each division
has its own director of nursing in charge of the
day-to day supervision of the division's nursing
staff He notes that the directors of nursing and the
division personnel managers resolve problems con-
cerning the nursing staff The directors of nursing
can set a nurse's starting wage rate above the
3 The Employer excepts to the Regional Director s use of the term
Division Administrators The Employer refers instead to Executive
Directors with the responsibility for administering a division These
terms both refer to the same corporate executives and the differing use of
terminology does not affect our decision We resolve below the differ
mg views of these executives responsibilities and authority
293 NLRB No 88
750 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
norm They are responsible for scheduling nurses
and evaluating their performance The nursing hi-
erarchy at each division is the director of nursing,
an assistant director of nursing, head nurses in
charge of units, and nurses Each director of nurs-
ing reports to the corporate director of nursing
The Regional Director finds that, in the 14
months preceding the 1982 hearing in this matter,
there were 147 permanent transfers of employees
and supervisors between divisions During the same
time, 250 employees and supervisors regularly ro-
tated or were assigned between the divisions The
250 figure includes Mobile Intensive Care Unit
(MICU) employees, nursing pool employees, and
50 supervisors
The Regional Director, citing Manor Healthcare
Corp, 285 NLRB 224 (1987), notes the Board's re-
buttable presumption that single-facility units are
appropriate in the health care industry He then
concludes that each division
operates essentially as an independent, autono-
mous hospital, the day-to day activities and
operations of which are directed by the mana-
gerial and supervisory hierarchy of the Divi-
sion Thus, each Division has its own Adminis-
trator, Personnel Manager, and Director of
Nursing who exercise substantial authority
over the operations and personnel of the Divi-
sion Significantly, the Divisions have substan-
tial autonomy in day to-day labor relations
matters The supervisors at each Division de-
termine employee work schedules and assign-
ments and prepare employee evaluations Dis-
ciplinary actions, including discharges, and
grievances are initiated at the Division in-
volved and hiring decisions are made by Divi-
sion management Although some of these de
cisions are subject to review or approval of
the corporate Personnel Director, this does
not destroy the effective autonomy exercised
at each facility
The Regional Director states that the system-
wide functions previously noted do not establish
that single facility units are inappropriate Citing
National G South Inc, 230 NLRB 976 (1977), he
additionally finds that the number of interdivision
transfers, the common personnel policies and pro-
cedures, and the common job classifications, wage
scales, and fringe benefits do not make single-facili-
ty units inappropriate The Regional Director notes
that many of the 250 employees regularly rotated
between divisions are supervisors, MICU employ-
ees, or nursing pool employees, all of whom he
finds are outside the units at issue The Regional
Director finds no increased risk of work stoppages
or other adverse consequences from single-facility
units He finds the single-facility units are justified
by a "sufficiently separate and distinct community
of interest" among employees at each division
The Employer excepts to some of the Regional
Director's findings of fact and conclusions We
agree with the Employer as set forth below
Although the Employer runs four facilities, its
system is incorporated, accredited, and licensed as
one system Separate accreditation is not possible
because some element required for accreditation is
missing at each division All four divisions are
overseen by one system administrator Each divi-
sion has its own executive director (whom the Re-
gional Director called "Division Administrator"),
but this individual is responsible only for general
implementation of policy and budget oversight
within his own division The day-to day operation
of the system is handled not by the division admin-
istrators, but by the departmental directors, who
are based in one division and travel to the others
on a regular, frequent basis Departmental directors
include the corporate personnel director, the cor
porate director of nursing, director of materials
management , director of communications, director
of admissions, director of medical records and qual-
ity assurance, and director of central food services
An employee in any division is responsible to his
or her supervisor and the departmental director
Departmental directors are responsible for hiring,
firing, evaluations, scheduling, discipline, and
grievances Job evaluations are done by an employ
ee's direct supervisor and the departmental direc
tor The division administrator and personnel man-
ager are not responsible for the actual evaluations
although they play a role in the processing of the
paperwork For example, the corporate director of
nursing is involved in the evaluation of each nurs-
ing employee in the entire system Moreover, the
departmental directors prepare the budgets for
their departments on a systemwide basis The
amounts are allocated to specific divisions once the
budget is completed, but departmental directors
have the authority to and do transfer funds from
one division to another as needed to cover costs
Departmental directors report directly to the
system administrator rather than the division ad-
ministrators
In addition to departments such as nursing being
centralized in policy, practice, and supervision, the
Employer's personnel system is highly centralized
As stated above, all four divisions use a common
application form, and applicants are cross-referred
between divisions about two to three times each
week When job openings are posted on a system-
wide basis, there is no preference for employees in
the division where the opening exists Employees
WEST JERSEY HEALTH SYSTEM
may bump employees at other divisions based on
seniority The personnel managers at the divisions,
who report to the corporate personnel director, are
not responsible for the creation of the Employer's
personnel policies and practices More significantly,
the personnel managers are not involved in the ulti-
mate decision to hire or fire employees That is
handled by the corporate director of personnel for
the entire system Similarly, personnel managers
play no substantive role in the grievance proce-
dure, the corporate director of personnel has the
final word of step 3 of the grievance procedure,
and can be overruled at step 4 only by the system
administrator The corporate director of personnel
hears one grievance at step 3 about every 3 weeks
The Regional Director correctly notes that many
of the rotating employees in the system are outside
the units 4 Nonetheless, employees in many job
classifications in the units either routinely rotate be-
tween divisions or regularly work on a temporary
basis at divisions other than their permanent place-
ment Ultrasound technicians, nuclear medicine
technicians, and x ray technicians regularly move
from division to division Some nurses, other than
pool nurses, will work on a temporary basis in an-
other division to provide necessary coverage in
their specialty areas, e g , obstetrics Maintenance
employees are assigned to different divisions tem
porarily as specific projects require additional as
sistance Central supply room employees, who
work on processing and distributing medically re-
lated supplies throughout the system, are moved
between divisions to provide coverage needed due
to vacations, sickness, or emergencies The medical
records department has one permanently floating
employee and routinely transfers clerks from one
division to another for temporary coverage
The Regional Director's ultimate finding on the
appropriateness of single-facility units is based, in
part, on the conclusion that there would be no ad-
verse consequences caused by that determination
The record, however, discloses that certain radiol-
ogy and nuclear medicine equipment is available
only in some divisions and that in some instances,
the employees who operate the equipment regular
ly rotate from division to division The Southern
Division has no EEG department and must send
patients in need of that testing to another division
More significantly, all hot food served to patients
and employees at the Southern Division is pre-
pared at the Northern Division and transported to
4 The Employer excepts to the Regional Director s exclusion of MICU
employees and pool nurses from the appropriate units The Petitioner
offers arguments unrelated to the constant rotation of these employees to
justify their exclusion We find it unnecessary to resolve this issue as we
find a systemwide unit is necessary even in the absence of these rotating
employees in the units
751
Southern 5 These all present situations where a
labor disruption at one division, where some func-
tion is centralized, would adversely affect the
health care available at other divisions in the Em-
ployer's system
In Manor Healthcare, supra, 285 NLRB 224, the
Board not only reaffirmed the rebuttable presump-
tion of single-facility appropriateness in the health
care industry, but also stated it would continue to
weigh traditional factors in deciding whether the
presumption has been overcome Those factors in
elude geographic proximity, employee interchange
and transfer, functional integration, administrative
centralization, common supervision, and bargaining
history Based on the above facts, we conclude the
Employer has rebutted the presumption of single-
facility appropriateness
We note that the four divisions are located rela-
tively close to one another There has been a sig-
nificant degree of permanent transfers of employees
among divisions, as well as a steady temporary
interchange of employees on a nonnegligible basis
Functional integration is apparent based on the sys
temwide accreditation, as well as the numerous
centralized departments, including the lab, trans-
portation, and accounting departments Personnel
policies and procedures are centrally determined
and enforced Each department is centrally con
trolled by a department director who oversees
hiring, firing, and work procedures and directly
participates in employee evaluations and griev
ances The amount of money allocated to a particu-
lar department in a division may be moved by the
department director to another division when
needed, without permission of the division adminis-
trators involved All these factors, combined with
the potential for adverse consequences ensuing
from a labor disruption at a single facility unit,
demonstrate the necessity for a systemwide unit in
this matter
The cases cited by the Regional Director in sup-
port of his decision are distinguishable National G
South, supra, 230 NLRB 976, which the Regional
Director notes involved a higher degree of em-
ployee transfers than the instant matter, involved
nursing homes spread throughout the State of
Texas The Board found there that hiring, firing,
and grievance adjustment were done at the local
level and that the administrator of the petitioned-
for single facility exercised significant control over
the direction of employees at that facility Al-
though there may be a slightly lower degree of em
5 We note that contrary to the Regional Directors finding the record
shows that the Employers purchase of foodstuffs and pharmaceuticals is
done on a centralized basis
752 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
ployee transfer here , the combination of all the fac
tors presents a basis for finding a systemwide unit
in this case but not in National G South Similarly,
Pomona Golden Age Convalescent , 265 NLRB 1313
(1982), and Manor Healthcare , supra, 285 NLRB
224, involved health care facilities whose adminis-
trators were responsible for hiring and firing of em
ployees as well as grievance adjustment As found
above , this case involves much more than central
ization of limited functions Accordingly , we find
that single -facility units are inappropriate in this
case and that systemwide units are required
In its posthearing brief , the Petitioner stated that
` it does not intend to seek to represent the employ-
ees at Northern Division , and will not agree at this
time to amend its petition to cover those employ
ees, if the Board finds that unit to be the only ap
propriate unit " As we find systemwide units to be
the only appropriate units and the Petitioner has in
dicated its unwillingness to proceed to elections in
those units , we will dismiss the petitions
ORDER
It is ordered that the petitions for elections are
dismissed