Health systems increasingly link hospitals to outpatient clinics under one roof, and the legal rules written for a single type of facility do not always fit that structure.
How the board resolves that mismatch could reshape organizing strategy across entire health systems.
In Law360 Employment Authority's "Changes In Healthcare Industry Shape NLRB Unit Question", the publication reported on a call for briefs from the National Labor Relations Board over whether its 1989 Health Care Rule should govern bargaining units that mix acute and nonacute care workers. James S. Frank, Member of the Firm in the Employment, Labor & Workforce Management practice of Epstein Becker Green, weighed in on how the board should approach the question.
The rule sets out eight standard bargaining units for acute care hospitals. The board is now weighing whether a similar bright-line approach makes sense once outpatient clinics enter the picture. The dispute grew out of an Essentia Health election involving nurse practitioners, physician assistants, and other advanced practice providers split between hospitals and outlying clinics. A regional director found that a general standard, not the Health Care Rule, controlled the case, and the board's Republican majority granted review.
Frank argued against replacing that case-by-case approach with a single fixed rule, pointing to how much facility structures vary across the industry.
"It's important for the board to decide cases by the facts of the situation rather than trying to come up with a rule that fits all situations without regard to what the facts are," Frank said.
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To discuss this perspective, contact James Frank at jfrank@ebglaw.com.
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