Swedish Medical Center

National Labor Relations Board - Board Decisions

Apr 29, 1998

325 N.L.R.B. 683 (N.L.R.B. 1998)

683
325 NLRB No. 124
SWEDISH MEDICAL CENTER
1 The Petitioner also sought to clarify the unit to include the home
infusion coordinators in the bargaining unit. The Acting Regional
Director clarified the unit to include that classification. No party has
requested review with respect to the home infusion coordinators.
Swedish Medical Center and District 1199 North-
west, Hospital and Health Care Employees
Union, SEIU, AFL–CIO, Petitioner. Case 19–
UC–614
April 29, 1998
DECISION ON REVIEW AND ORDER
BY CHAIRMAN GOULD AND MEMBERS FOX AND
LIEBMAN
On April 21, 1997, the Acting Regional Director for
Region 19 issued a Decision and Order in which he
found that the Employer’s managed care home health
coordinator employed at Ballard did not share such a
community of interest with the existing bargaining unit
of registered nurses (RNs) as would compel her inclu-
sion in the unit. Accordingly, he dismissed the instant
petition with respect to that classification.1 The Peti-
tioner filed a timely request for review.
The National Labor Relations Board has delegated
its authority in this proceeding to a three-member
panel.
Having duly considered the matter, the Board grants
review and finds, contrary to the Acting Regional Di-
rector, that the managed care home health coordinator
position is, in essence, the same as the Ballard home
care coordinator position historically included in the
unit. Neither the change of title nor the alleged change
in job focus, warrants excluding the managed care
home health coordinator from the unit. We therefore
reverse the Acting Regional Director’s Decision and
clarify the unit to include that position.
In 1992, the Petitioner was certified as the collec-
tive-bargaining representative of all RNs at the Em-
ployer’s Seattle and Ballard facilities. The Petitioner
currently represents the RNs at the Employer’s acute
care hospitals (in First Hill and Ballard) and home
health nurses employed by the Employer’s home
health care service. Prior to September 1996, the Em-
ployer employed a home care coordinator at Ballard.
The Employer required the home care coordinator to
be a licensed RN, and that classification was included
in the RN unit. The basic responsibility of the Ballard
home care coordinator was to generate referrals for the
Employer’s home health services. She visited patient
floors and spoke to patients, patients’ families, physi-
cians, and staff nurses, seeking to identify patients who
would be candidates for home health care on discharge
from the hospital. She disseminated to those individ-
uals information about the Employer’s home health
services. Physicians made the actual referrals. The
Ballard home care coordinator made repeated visits to
one nursing home to generate referrals to the Employ-
er’s services, and made some visits to other nursing
homes and physicians’ offices to advertise the Employ-
er’s services.
In addition to the Ballard home care coordinator, the
Employer employs three home care coordinators at
First Hill. The First Hill home care coordinators also
are required to be RNs, and are included in the bar-
gaining unit at issue. They work within First Hill to
generate referrals to the Employer’s home health serv-
ices. The Ballard home care coordinator was com-
monly supervised with the First Hill home care coordi-
nators.
On the resignation of Ballard’s home care coordina-
tor, the Employer created the position of managed care
home health coordinator, treating this as an unrepre-
sented position. The Employer hired a licensed RN for
the position. The basic duty of the managed care home
health coordinator is to generate referrals to the Em-
ployer’s home health services. The managed care home
health coordinator seeks to identify Ballard patients for
whom home health care would be appropriate on dis-
charge. According to the Employer, she also has other
discharge planning duties. She visits four to five nurs-
ing homes each week to market the Employer’s serv-
ices. She is commonly supervised with the First Hill
home care coordinators by the Employer’s director of
planning and development.
Contrary to the Employer’s claim, we find that the
job duties and responsibilities of the Ballard managed
care home health coordinator are essentially the same
as those of the prior Ballard home care coordinator. It
is undisputed that the managed care coordinator as-
sumed the duties of her predecessor. Her basic respon-
sibility—to generate referrals for the Employer’s home
health services—remains the same. Although the man-
aged care coordinator apparently visits more outside
facilities than did her predecessor, the Employer fails
to show that her duties in this regard changed in a sub-
stantial or significant way. Nor does the Employer sub-
stantiate its claim that the Ballard managed care home
health coordinator has significant additional discharge
planning duties. It is undisputed that, as was the case
of the Ballard home care coordinator, the Ballard man-
aged care coordinator shares common supervision with
the First Hill home coordinators.
We also reject, contrary to the Acting Regional Di-
rector, the Employer’s claim that the managed care co-
ordinator position, unlike the home health coordinator
position, does not effectively require an RN license.
Although, according to the Employer, the job descrip-
tion does not expressly require an RN license, the de-
scription requires completion of an RN degree program
(associate degree or higher) or, as a substitute, 2 years
related experience and/or training, or the equivalent
combination of education and experience. This require-
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684 DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
2 Ralph K. Davies Medical Center, 256 NLRB 1113 (1981).
ment is in addition to the required 2 years of recent
home health experience or experience in coordination
of care, marketing, or community education.
Furthermore, the managed care coordinator performs
the functions of the prior Ballard home care coordina-
tor, for which an RN license had been expressly re-
quired, as well as the functions of the other home care
coordinators, for which an RN license is required. Sig-
nificantly, although the Employer contends that it con-
sidered an applicant without an RN license for the
managed care coordinator position, in fact, the Em-
ployer filled the position with a licensed RN. The fact
that the managed care coordinator does not perform di-
rect patient care is not dispositive of whether an RN
license is required, since other home care coordinators
similarly do not perform direct patient care. Inasmuch
as the Employer has failed to show that the managed
care coordinator position does not in effect require an
RN license, the case cited by the Acting Regional Di-
rector in which the Board excluded from an RN unit
positions not requiring RN licensure2 is inapposite.
In sum, we find that the newly created managed
care position is substantially the same as the Ballard
home care coordinator position which previously was
included in the bargaining unit. As such, that position
appropriately is included in the bargaining unit. See
NLRB v. Louisville Gas & Electric, 760 F.2d 99 (6th
Cir. 1985), enfg. 268 NLRB No. 149 (Feb. 17, 1984)
(Board clarified unit to include newly created position
where, inter alia, employees had been ‘‘promoted’’
from bargaining unit but performed substantially the
same work as they had in prior position in bargaining
unit); Plough, Inc., 203 NLRB 818, 819 (1973) (accre-
tion appropriate where employees in their new posi-
tions perform work similar to that formerly done by
unit employees). Accordingly, we reverse the Acting
Regional Director’s dismissal of the petition and clar-
ify the bargaining unit specifically to include the man-
aged care home health coordinator employed at
Ballard.
ORDER
The unit of all full-time, regular part-time, and inter-
mittent and per diem nurses employed as registered
nurses at the Employer’s Seattle and Ballard facilities
represented by the Petitioner is clarified to include the
classification of managed care home health coordina-
tor.
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