NLRB Regional Director Issues Decision on Sharp Healthcare v. AFL-CIO
DECISION AND DIRECTION OF ELECTION
Sharp Professional Nurses Network,
The Petitioner claims that the petitioned-for unit, as amended, constitutes a distinct, identifiable group and the petitioned-for unit shares a community of interest with the
Both Petitioner and the Employer agree that
On
1) an
2) an SRS multi-facility unit would be appropriate because employees at the Employer's urgent-care centers and clinics share a community of interest; and
3) the petitioned-for unit, as amended, of (Primary Care) RN, RN-Triage, GI-RN, CT/MRI RN, Ophthalmology RN, and UC RN is a readily identifiable group based on classification and department, and employees in the petitioned-for unit share a community of interest. However, the excluded classifications of Case Manager RN, Diabetes Specialist Educator RN, Cardio RN, and Pacemaker Clinic RN should also be included in the petitioned-for unit because they share an overwhelming community of interest with the petitioned-for classifications, as amended, and there is no rational basis for excluding these four classifications.
I. The Employer's Operations and Hierarchy
SRS is headed by Senior Vice President and CEO
The Directors reporting to Rief include
Health/Provider Services is headed by Vice President
However, RNs working in the classifications of CT/MRI are managed by Rief since Korican lacks an RN license.
II. Employee Classifications
Petitioner petitioned for employees in the following classifications: (Primary Care) RN, RN-Triage, GI-RN, CT/MRI RN, Ophthalmology RN, and UC RN. There are four employee classifications as to which the parties disagree whether they should be included or excluded from the petitioned-for unit: Case Manager RN, Diabetes Specialist Educator RN, Cardio RN, and Pacemaker Clinic RN.4 These four employee classifications were originally included in the petition-for unit. At the hearing, Petitioner amended the petition to exclude these four employee classifications, arguing that these four employee classifications do not share a community of interest with the petitioned-for unit, as amended.
Full-time RNs working in the urgent-care centers work 12-hour shifts, three times a week, while full-time RNs working at the clinics work either an 8- or 10-hour shift. All of the RNs in the petitioned-for unit share the professional license and training requirements to be a registered nurse. SRS operates a central
The hourly wage rate of all SRS RNs is determined under the same compensation model. Seniority (based on years of service) is calculated in the same manner for all SRS RNs, and honored when employees transfer to other departments. Likewise, disciplinary rules and policies are the same for all SRS RNs. SRS RNs also attend the same orientation program dedicated to SRS general procedures, and most attend common competency training and other Employer programs. Additionally, all RNs are required to attend the same orientation program, and all employees are encouraged to attend the "Sharp Experience," an annual 2-day event.
A. Petitioned-for Employee Classifications
(Primary Care) RN is the basic classification of RN within SRS for registered nurses who do not have a specific specialization, and who work in a number of different departments providing basic nursing functions. In total, there are about 46 RNs that fall within this classification who work throughout the Employer's clinics: (
Urgent Care RNs (UC RN) are responsible for triaging the patients admitted at an urgentcare center. The UC RNs work with an urgent-care doctor in developing and implementing a patient's treatment plan. SRS employs about 90 urgent-care RNs who work in one of the five urgent-care centers (Sorrento Mesa,
Triage RNs are primarily responsible for answering telephone calls from SRS patients seeking medical advice. There are about 20 Triage RNs working at nine of the SRS clinics (
Gastroenterology RNs (GI RN) are generally divided into doctor's nurses and procedural nurses, although many of the GI RNs perform both duties. Procedural nurses assist physicians in performing a number of medical procedures, including colonoscopies, endoscopies, and PEG tube placements. As a doctor's nurse, GI RNs work with a doctor managing his/her patients, including following up with patients. In total, there are about 40 GI RNs who work at
Lastly, the Ophthalmology RNs assist ophthalmologists in the clinic with a variety of procedures. This involves things such as providing injections required for retinal pictures of the vasculature around the eye. There is only one employee in this classification, who works out of the
B. Excluded Employee Classifications from the Amended Petitioned-for Unit
1. Case Managers
Case Managers are divided across a number of specializations with four different job titles (Primary Care Case Managers, Inpatient Case Managers, Diabetes Care Management Case Managers, and Utilization Management Case Managers) and work distinctions. However, regardless of their specialization or job title, case managers' job duties are essentially the same: working as liaisons between the patient and the care team. Primary Care Case Managers (also known as Chronic Care Case Managers under the
The Inpatient Case Managers perform a similar role. While the Inpatient Case Managers do not work out of the SRS clinics or urgent-care facilities, but instead work at one of the
Likewise, Diabetes Care Management Case Managers perform a similar role to that of the Primary Care Case Managers and Inpatient Case Managers, but specifically oversee patients with diabetes. There are 14 employees in this classification.
Similarly, the Utilization Management Case Managers perform the same tasks as the other case managers, but specifically work with patients who require either high-cost services or services required outside of
The Primary Care Case Managers and the Utilization Management Case Managers work 8-hour shifts, Monday through Friday (excluding holidays). The Inpatient Case Management Managers work 7-days a week, including holidays. As to the Diabetes Care Management Managers, they work 8-hour days, 5-days a week, or 9-hour days, 4 1/2-days a week.
2. Diabetes Specialist Educator RN
Diabetes Specialist Educator RNs focus on educating patients diagnosed with diabetes, and work almost exclusively with patients who have been recently diagnosed with diabetes or recently experienced a change in their medical condition. Diabetes Specialist Educator RNs require a certified specialist education.5 There are three employees in this classification, who all report to
The complete text of the report is available at (https://apps.nlrb.gov/link/document.aspx/09031d45823b1ec8).
* * *
1 The Petitioner's name appears as amended at the hearing.
2 At the hearing, the Hearing Officer instructed the parties that the issue of whether the
3 The current Sharp Healthcare Unit is defined as follows: All full-time and regular part-time Registered Nurses, including per diem Registered Nurses, employed in classifications for which a Registered Nurse license is required and who work at the following facilities:
4The petitioned-for unit, as amended, consists of approximately 200 SRS RNs. The Employer argues that approximately 270 SRS RNs are included in the appropriate unit, which includes the petitioned-for unit classifications and the four classifications at issue here.
5 However, the record and evidence suggest that at least one employee in the
6 There was no evidence presented as to these employees' work schedules other than that two are full-time employees and one is a part-time employee.
7 There was no evidence presented as to this employee's work schedule other than that she is a full-time employee.
8 The Employer contends that Child's
9 The Employer argues that the Petitioner is barred from representing the petitioned-for unit of employees, as amended. In support, the Employer cites the parties' collective-bargaining agreement (CBA) which states the following: Excluding: All other professional employees (emphasis added), physicians, nonprofessional employees, technical employees, business office clerical employees, skilled maintenance employees, guards, and supervisors as defined in the Act. Additionally, the CBA between the parties states that All Bargaining Unit employees, hereinafter called "employees" or "Bargaining Unit," shall be covered by this Agreement. RNs working at clinics shall not be covered by this Agreement (emphasis added).
In
Here, in looking at the contractual language alone, the evidence does not support a finding that Petitioner made an express promise that it would refrain from representing registered nurses working at the SRS facilities. Rather, the language appears to be nothing more than the parties' understanding as to whom the CBA would and would not apply. This language cannot be interpreted as Petitioner's express promise that it would not represent SRS nurses in the future. UMass Mem'l Med. Ctr., 349
10 At the hearing, there was some testimony regarding the RNs under the
11
12 Because this is a mail ballot election, the undersigned requests that one copy of the list be furnished in the form of mailing labels, if possible, for use by the Regional Office in mailing the voting kit to employees. While the Employer is not required to comply with this request, its cooperation in doing so will assist in promptly sending mail ballots to each employee's correct address and maximize employee participation in the election.
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