In Specialty Healthcare and
Rehabilitation Center of Mobile, the National Labor Relations Board, as
expected, overruled the standard for appropriate unit determinations in the
nonacute care sector of the healthcare industry. In the process, it also, as
some had predicted, enunciated a new standard for unit determinations
generally. In this Emerging Issue Analysis, N. Peter Lareau, author of
"NLRA: Law and Practice" and numerous other books and articles in the
field of labor law, analyzes the case in considerable detail. He concludes that
the decision to overrule the standard will ultimately be upheld, but that the
new standard for unit determinations presents problems unlikely to be resolved
in the near future.
For a number of years after the passage of the Act, the primary labor law issue
for healthcare institutions was whether the Board had jurisdiction over
nonprofit hospitals. In 1943, the Board asserted jurisdiction over a nonprofit
hospital in the District of Columbia. Congress effectively undercut the impact
of that decision when it adopted the 1947 Amendments to the Act, expressly
exempting nonprofit hospitals from the Act's coverage. In 1974, however,
Congress reversed itself, adopting controversial amendments to the Act that
removed the exemption.
Once nonprofit hospitals fell under the Board's jurisdiction, the legal focus
switched from the basic issue of coverage to issues regarding the
appropriateness of bargaining units. In large part the appropriate unit issues
sprang from the legislative history of the 1974 amendments, which, in both the
Senate and the House, reflected Congressional intent that the Board guard
against proliferation of bargaining units in the healthcare field. Implementing
that intent proved to be difficult; the Board's unit determinations generated
considerable litigation. Because the Board's customary case-by-case approach
was unsuccessful in articulating an acceptable approach to unit determinations
in the health care field, the Board adopted a different method in 1987 - unit
determination through the rulemaking process.
The Board announced its
intention to engage in rulemaking in St. Vincent Hospital and issued a
proposed rule on July 2, 1987. After numerous hearings to gather empirical data
regarding the health care industry, and a second notice of proposed rulemaking
in 1988, the Board issued its final rule on April 29, 1989. The Supreme Court
upheld that rule in American Hospital Association v. NLRB [an enhanced version of this opinion is available to lexis.com subscribers
/ unenhanced version available from lexisONE Free Case Law] .
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