In a decision opposed by the American Hospital Association and other healthcare employers, the National Labor Relations Board has voted to overturn a 1991 policy that imposed strict limits and definitions on how union bargaining units are defined in long-term-care facilities like nursing homes.
NLRB overturns nursing home union policy
Employers-rights organizations said the NLRB's decision in Specialty Healthcare and Rehabilitation Center Mobile would encourage unions—which have been making inroads in recent years in healthcare facilities—to define ever-smaller bargaining units and make it easier to organize.
The United Steelworkers, which won the litigation against Specialty Healthcare this week, said in a statement that the decision would allow workers “to more freely exercise their rights to organize and collectively bargain.”
The steelworkers had sought to represent a unit of 53 certified nurse assistants at Specialty Healthcare in Mobile, Ala., but the company argued that under the strict rules governing nurse homes the CNAs should have to join a general nonprofessional unit that would also include 33 service and maintenance workers.
Rather than limit its ruling to the merits of the case, the NLRB solicited public comment and then voted 3-1 to overturn the 20-year-old rule that treated nursing homes differently from most other employers. The dissenting vote was from the NLRB's from lone Republican, Brian Hayes, who warned that the decision would encourage “extraordinary fragmentation of the work force.”
Healthcare has a complex history with union organizing. Not-for-profit healthcare providers were exempted in 1947 from the National Labor Relations Act, but in 1974 Congress extended the act's powers to include hospitals. Subsequent litigation led to a 1989 NLRB rule decreeing that only seven specific types of bargaining units could exist in hospitals, including one for nonprofessionals.
Two years later, the NLRB exempted nursing homes from the healthcare rule and invented another new standard that called for a specially modified version of the healthcare rules that sought to maximize employee bargaining rights against the right of employers not to have unions be unreasonably small.
This week, the NLRB tossed out that process, which was called the Park Manor approach after the 1991 nursing home litigation from which it was derived. The result is that nursing homes will have to follow typical bargaining-unit rules, under which employees are allowed to organize into units that have an “overwhelming community of interest” rather than a predefined set of job categories.
In its friend-of-the-court brief (PDF) filed in Specialty Healthcare, the AHA said the NLRB's decision to jettison the Park Manor approach would “create unnecessary friction in the workplace, impose additional costs on care providers, and impede the integration of health care delivery methods, ultimately to the detriment of patient care.”
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