This decision addresses a petition filed by Service Employees International Union, United Healthcare Workers-West (Petitioner) seeking to represent a unit of radiation therapists employed by City of Hope National Medical Center (Employer) at its acute care medical center in Duarte, California. The Petitioner requested a Sonotone and Armour-Globe self-determination election to add these professional employees to an existing bargaining unit of service employees.

The Regional Director dismissed the petition, finding that the Petitioner failed to meet its burden of establishing a sufficient community of interest between the petitioned-for radiation therapists and the existing service unit. This decision was based on two primary legal grounds: the National Labor Relations Board's (NLRB) Healthcare Rule and the established Armour-Globe doctrine for community of interest analysis.

First, the Regional Director examined the NLRB's Healthcare Rule (29 CFR § 103.30), which delineates eight presumptively appropriate bargaining units for acute care hospitals to prevent the proliferation of bargaining units. The Rule generally prohibits the formation of new units that do not conform to these eight classifications, except in extraordinary circumstances or where existing non-conforming units are present. The decision noted that the existing service unit, which already includes some professional radiation therapists from outpatient clinics, is a non-conforming unit. The petition to add more professional radiation therapists to this unit would exacerbate the non-conformity, potentially leading to further fragmentation of representation efforts, and therefore, runs contrary to the Rule's intent.

Second, the Regional Director analyzed the Petitioner's attempt to establish a sufficient community of interest under the Armour-Globe doctrine. While Armour-Globe elections are permissible in situations with existing non-conforming units to allow employees to vote on joining an existing unit, the Petitioner must still demonstrate a community of interest. The Regional Director applied several factors to assess this:

• Identifiable Distinct Segment: The Duarte radiation therapists were found to constitute an identifiable and distinct voting group.
• Organized Under a Separate Department: This factor weighed against a community of interest, as the therapists work in entirely different locations and report to different supervisors, despite having the same departmental classification.
• Distinct Skills, Training, and Job Functions: This factor favored the Petitioner, as the therapists share similar educational backgrounds, licensure, and core job functions, although Duarte therapists have more advanced training.
• Functional Integration: This factor weighed against a community of interest, as the therapists perform their tasks in different locations with different patients and under different leadership.
• Frequent Contact and Interchange: This factor also weighed against a community of interest. While Duarte therapists occasionally substitute at outpatient sites, the evidence did not demonstrate frequent interchange or contact between the groups, and there was no evidence of outpatient therapists working at Duarte. The physical separation and different types of facilities also contributed to this.
• Common Supervision: Although upper management is shared, day-to-day supervision is through facility-specific leads, and even common upper management alone is insufficient to establish a community of interest without other integrating factors.
• Terms and Conditions of Employment: The record was not sufficiently detailed to establish similarity, although one instance of a pay cut upon transfer suggested differences. Even if terms and conditions were similar, it would not be determinative in the absence of other integrating factors like interchange or functional integration.

The Regional Director concluded that the lack of frequent contact, interchange, functional integration, and distinct day-to-day supervision, combined with the operational differences between the acute care hospital and the outpatient clinics, failed to demonstrate a sufficient community of interest with the existing service unit. Therefore, the petition was dismissed. However, the decision noted that the Union could still seek to represent the Duarte radiation therapists by forming a unit that complies with the NLRB's Healthcare Rule.

Significant Cases Cited

• Sonotone Corp., 90 NLRB 1236 (1950): This case established the principle that professional employees should have the opportunity to vote in a self-determination election to decide whether they wish to be included in a unit with non-professional employees.
• Globe Machine and Stamping Co., 3 NLRB 294 (1937) and Armour and Company, 40 NLRB 1333 (1942): These cases established the "Globe" election doctrine, which allows employees in an appropriate unit to vote on their choice of bargaining representative, and were foundational for the concept of self-determination elections.
• St. Vincent Charity Medical Center, 357 NLRB 854 (2011): This case clarified that Armour-Globe self-determination elections do not violate the Healthcare Rule because they do not create new units but allow existing unrepresented employees to join an existing unit, thereby avoiding proliferation.
• Rush University Medical Center v. NLRB, 833 F.3d 202 (D.C. Cir. 2016): This court decision affirmed that Section 103.30(c) of the Healthcare Rule, concerning petitions for additional units, does not preclude Armour-Globe elections.
• West Virginia University Hospitals, 2024 WL 726191 (NLRB): This decision affirmed a regional director's direction of a self-determination election for shuttle drivers, finding they shared a community of interest with other nonprofessional employees in an existing non-conforming unit, and that the Board can rely on its appropriate unit determinations under the Healthcare Rule even if the existing unit doesn't strictly conform.

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