Hospital San Cristobal

National Labor Relations Board - Administrative Judge Opinions

Jul 21, 2011

24-CA-011630 (N.L.R.B. Jul. 21, 2011)

JD-36-11
Ponce, PR
UNITED STATES OF AMERICA
BEFORE THE NATIONAL LABOR RELATIONS BOARD
DIVISION OF JUDGES
QUALITY HEALTH SERVICES OF P.R., INC.
d/b/a HOSPITAL SAN CRISTOBAL
and Case No. 24-CA-11630
UNIDAD LABORAL DE ENFERMERAS (OS)
Y EMPLEADOS DE LA SALUD
Ana Beatriz Ramos Fernandez, Esq., for the General Counsel.
José A. Oliveras-González, Esq., for the Respondent.
Harold Hopkins, Esq., for the Charging Party.
DECISION
Statement of the Case
GEORGE ALEMÁN, Administrative Law Judge. This case was tried in San Juan,
Puerto Rico on March 22-23, 2011, pursuant to a complaint issued on December 30, 2010,1 by
the Regional Director for Region 24 of the National Labor Relations Board (the Board) against
Quality Health Services of P.R., Inc. d/b/a Hospital San Cristobal (the Respondent).2 The
complaint alleges that the Respondent violated Section 8(a)(5) and (1) of the National Labor
Relations Act (the Act) by, on or about March 18, unilaterally changing and/or reducing the
wages of its employees without giving the Union which represents said employees prior notice
and an opportunity to bargain over the changes. On January 31, 2011, the Respondent filed an
answer to the complaint denying the commission of any unfair labor practice.
All parties at the hearing were afforded a full and fair opportunity at the hearing to
present oral and written evidence, to examine and cross-examine witnesses, and to argue orally
on the record. On the entire record, including my observation of the demeanor of the witnesses,
and after considering the briefs filed by Counsel for the General Counsel3 and the Respondent, I
make the following

1 All dates herein are in 2010, unless otherwise indicated.
2 The charge underlying the complaint was filed on September 17, 2010, and amended on
December 14, 2010, by Unidad Laboral de Enfermeras(os) y Empleados de la Salud (the
Union).
3 Counsel for the General Counsel has also filed a Motion to Correct certain grammatical
and related inaccuracies in the transcripts, and to correct General Counsel Exhibit 2(b), which is
the English version of General Counsel Exhibit 2(a), by including a page “56” which was
inadvertently omitted from the record. No objection to said corrections having been filed or
received, Counsel for the General Counsel’s Motion to Correct is hereby granted, and made a
part of the record as General Counsel Exhibit 13.
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Findings of Fact
I. Jurisdiction
The Respondent, a Puerto Rico corporation, is a health care facility in Ponce, Puerto
Rico, where it is engaged in providing acute health care services at its facility. During the past
twelve months, the Respondent, in the course and conduct of its operation, derived gross
revenues in excess of $250,000, and, during the same period, purchased and received at its
Hospital facility goods valued in excess of $50,000 directly from points outside the
Commonwealth of Puerto Rico. The Respondent admits, and I find, that it is an employer
engaged in commerce within the meaning of Section 2(2), (6), and (7) of the Act, and a health
care institution within the meaning of Section 2(14) of the Act. It further admits, and I find, that
the Union is a labor organization within the meaning of Section 2(5) of the Act.
II. Alleged Unfair Labor Practices
A. Factual Background
Since around 2002, the Union has served as exclusive collective bargaining
representative for several groups of Respondent’s employees, including two separate
bargaining units of nursing employees.4 In 2002, it entered into a collective bargaining
agreement with the Respondent, which expired on February 28, 2006, containing, among other
things, provisions describing employee salary increases and other benefits, such as incentives
and differentials, for the nursing personnel, and how such amounts were to be calculated.
Some of these incentives or pay differentials include added compensation for nurses willing to
work the apparently less desirable evening and midnight shifts, those working in the Hospital’s
high-risk departments such as intensive care, emergency room, delivery room, surgery,
recovery, and nursery, and payment for special courses taken by nursing employees to improve
their knowledge and skills in the field. (Tr. 33-34). The contract provides that the
incentive/differential amounts paid to employees were not to be calculated as part of an
employee’s base salary but rather were to be paid over and above the base salary rate. (See,
GCX-2, Art. XXIX).5
Testimony by Respondent’s Director of Human Resources, Candie Rodriguez, makes

4 One such nursing unit, identified as “Unit B-24-RC-7308” includes “All Licensed Practical
Nurses and Respiratory Therapy Technicians, Operating Room and Radiology Technicians
employed by the Employer at the Hospital located in Cotto Laurel Ward, Ponce, Puerto Rico,
excluding all other hospital employees including Executives, Administrators, Supervisors,
Administrative Employees and Managers, and Guards as defined by the National Labor
Relations Act (N.L.R.B.)”.
The other nursing unit, identified as “Unit 24-RC-8124’B’” includes “All registered nurses
employed by the Employer, excluding all other hospital employees including Executives,
Administrators, Supervisors, Administrative Employees and Managers, Guards as defined by
the Act.”
5 Testimonial evidence is referred to herein as TR (Transcript) followed by the page
number(s); GCX and RX represent, respectively, a General Counsel or Respondent Exhibit;
GCB and RB represent reference to the General Counsel or Respondent’s post-trial brief.
GCX-2[b] is an English translation of relevant portions of GCX-2[a], the 2002-2006 collective
bargaining agreement in Spanish.
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clear that the above contract provision, regarding how incentive/differential pay was to be paid,
was put into effect and, presumably, remained an established practice from at least 2002, when
the contract first went into effect, until 2010, when, as discussed below, the practice was
changed. Thus, Rodriguez testified that the incentive/differential amounts nursing employees
were earning at its Hospital were not treated as part of an employees’ base salary rate, but
rather were being paid to employees over and above, or in addition to, their basic rate of pay.
(Tr. 31).
Employee Amaritis Leon, a graduate nurse at Respondent’s Hospital, confirmed the
practice of paying incentive/differentials over and above the employees’ base salary rate. Thus,
she testified that in 2009, she received $200. monthly shift differential pay for working the
midnight (11 pm-7 am) shift, and that this amount was paid in addition to, or over and above,
her $1500 base salary rate. (Tr. 116, 120).
In July 2005, while the contract was still in effect, the Commonwealth of Puerto Rico
enacted a law, known as Law No. 27, establishing a minimum wage for nursing personnel in the
private sector. (See GCX-6[b]). Thus, under Law No. 27, the minimum wage was set as follows:
Practical Nurses -- $1,500; Nurses with an Associates Degree without experience -- $2,000;
Nurses with a Bachelor’s Degree but no experience --$2,350; Nurses with a Bachelor’s Degree
and experience -- $2,500. The above salary schedule was to be phased in over a three-year
period. Law No. 27 does make clear that “[t]he new salary schedules to be established shall
apply without impairing the terms of the different collective bargaining agreements in effect at
the time this Act becomes effective.” This provision was intended to avoid issues regarding the
“impairment of contractual obligations” from arising. (GCX-6[b], p. 2).
As its collective bargaining agreement with the Union was still in effect when Law No. 27
was enacted, the Respondent, at that time, chose not to implement the salary increases called
for by the new law. In July, 2005, the parties executed a Stipulation, to be effective from March
1, 2006 to February 28, 2010, wherein they made certain changes to employee salaries and
other provisions of the 2002-2006 collective bargaining agreement, and extended the same to
February 28, 2010. (See, GCX-3).
On March 1, the day after the parties’ collective bargaining agreement expired, the
Respondent implemented the minimum wage provisions of Law No. 27. At the same time, it
altered its existing practice regarding how certain incentives/differentials were to be paid. Thus,
on March 9, Rodriguez notified Respondent’s Finance Director, Marianita Collazo Rivera of
Respondent’s decision to implement the provisions Law No. 27, and sent her a chart containing
the names of Respondent’s nursing employees, their job classifications, the base salary earned
by each employee and the new salary they would be earning to bring them in compliance with
the minimum wage requirements of Law No. 27. (See, GCX-4[b]). On page 5 of the chart,
Rodriguez listed some of the employee incentives (rotation incentive; permanent shift incentive,
special area incentive, incentive for education courses) that were now to be included as part of
the employee’s base salary, and which of them (uniforms, stipends, Christmas bonus, years of
service) would remain excluded. Rodriguez informed Collazo that March 1, would be the
effective date for the reclassification of employee salaries, and asked her to verify the
information and to take the appropriate action.
By letter dated March 18, Rodriguez notified the nursing employees that, because the
collective bargaining agreement was no longer in effect, the Respondent was implementing the
minimum salary requirements of Law No. 27, and that employees would be seeing adjustments
to their salaries, retroactive to March 1, in paychecks being issued that day. (GCX-5[b]). She
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explained that the adjustments included “several incentives” but did not specify what those
incentives were.6
Union representative, Ariel Echevarria, first learned of the above changes on March 18,
when employees brought the memo to his attention. The following day, March 19, Echevarria
wrote to Rodriguez, asking that she provide the Union with a list of employees whose salaries
were adjusted pursuant to Respondent’s implementation of Law No. 27. There is no evidence
to indicate that the Union was, at any time prior to March 18, notified by the Respondent of its
intent to implement the provisions of Law No. 27 on March 1, or its decision, in conjunction with
said implementation, to change how the nursing employees’ earnings from incentives and
differentials were to be paid. Rodriguez, in fact, admitted that she had not notified the Union of
the changes before sending out her March 18, letter to employees.7 Rodriguez complied with
the Union’s information request by letter dated March 24, attached to which was a list containing
the names of its “Graduate and Practical Nurses” represented by the Union who received
increases pursuant to Law No. 27. (See, GCX-7; GCX-8).
Echevarria wrote again to Rodriguez on April 16, pointing out that in her March 18, letter,
Rodriguez had made reference to several incentives that were included in the wage
adjustments made to the nursing employees’ salaries, and asked Rodriguez to describe in
writing, within 5 working days, what those incentives were. Rodriguez replied by letter dated
April 28, that the incentives referenced in her March 18, letter included “area,” “special course,”
and “permanent shift” incentives, explaining that these incentives “have always” been
“allocated” to the nurses’ salary.
On November 30, Rodriguez sent Echevarria a letter, responding to the latter’s request
for additional information. Attached to the letter is a chart, reflecting the period March 11-
November 7, containing the names of unit employees, their department, the permanent shift
worked, and the “permanent shift” incentive amounts paid to employees. (GCX-11).
B. The Parties’ Contentions
While admitting that the Union was not given prior notice or an opportunity to bargain,
The Respondent nevertheless asserts that its March 1, decision to implement the minimum
wage requirements of Law No. 27, following the February 28, expiration of the parties’
agreement, was not unlawful as it was statutorily required to do so. As it was legally obligated
to carry out the mandate of Law No. 27 to raise the minimum wage rates of its nursing staff to
the amounts set forth therein, it was, the Respondent further contends, under no obligation to
notify and bargain with the Union over said changes, including the change in how
incentive/differential earnings would be paid.
Counsel for the General Counsel does not appear to quarrel with the general proposition
that the Respondent was statutorily obligated by Law No. 27, to raise the minimum wage of its
nursing employees to amounts mandated in the statute. She does, however, contend that in
seeking to comply with Law No. 27’s minimum wage requirements, the Respondent could not,
without first giving the Union notice and an opportunity to bargain, unilaterally alter or change its

6 Rodriguez’ letter does mention the incentives that are not included in the adjustment:
“Christmas Bonus, Incentive for Years of Service, Benefits, Incentives for rotating shifts, Uniform
Payments, etc.”
7 The Respondent, in its opening remarks, acknowledged that the Union first learned of the
changes on March 19, more than two weeks after the unilateral change was made. (Tr. 20).
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established practice regarding how the incentive and differential amounts earned by nursing
employees were to be calculated and paid. Thus, she argues that the Respondent’s decision to
end its long-held and contractually established practice, requiring that incentive and differential
pay earned by nursing employees be calculated separately from, and be paid over and above,
their base salary rate, and to require instead that said incentive and differential earnings be
included and calculated as part of the base salary rate, amounted to an unlawful unilateral
change in the nursing employees wages, hours, and terms and conditions of employees, and
violated Section 8(a)(5) and (1) of the Act. I find merit in Counsel for the General Counsel’s
argument.
C. Discussion
It is well settled that a unilateral and material change in employee terms and conditions
of employment regarding a mandatory subject of bargaining violates Section 8(a)(5) of the Act.
NLRB v. Katz, 369 U.S. 736 (1962). American Medical Response of Connecticut, 356 NLRB
No. 155, slip op. at 23 (2011). Mandatory subjects of bargaining are those comprised in the
phrase “wages, hours, and other terms and conditions of employment” set forth in Section 8(d)
of the Act. Incentives and differential pay are mandatory subjects of bargaining as they clearly
fall within Section 8(d)’s definition of “wages.” Waxie Sanitary Supply, 337 NLRB 303, 314
(2001); Northwest Graphics, Inc., 342 NLRB 1288, 1297 (2004); Charles Wilson Memorial
Hospital, 331 NLRB 1529,1530 (2000); Raven Government Services, Inc., 331 NLRB 651, 660
(2000); Royal Baking Co., 309 NLRB 155, 156 (1992); The Bunker Hill Co., 208 NLRB 27, 32
(1973).
The manner by which nursing employees here were being paid their incentive/differential
earnings prior to March 1, e.g., over and above their base salary rate, was also a mandatory
subject of bargaining that the Respondent was not at liberty to change unilaterally without giving
the Union prior notice and an opportunity to bargain. This particular method of payment, as
noted, was contractually established by the parties in 2002, and remained the practice until
discontinued by the Respondent on March 1, in conjunction with its implementation of Law No.
27. The payment of incentives and differentials over and above the base salary rate of
employees had, therefore, been established as a term and condition of employment both by
contract and by virtue of it having become an established past practice.8 See, Hospital San
Cristobal, 356 NLRB No. 95 (2011).
The Respondent, as noted, does not quarrel with the above facts. Still, it argues that it
had no choice but to eliminate the practice of paying employees their incentive/differential pay
over and above their base salary rate in order to comply with Law No. 27’s minimum wage
requirements, which compliance was mandatory and not optional.
Initially, I do not doubt, nor does Counsel for the General Counsel seem to question, that
the Respondent was required to comply with the minimum wage provisions of Law No. 27

8 Although the parties' agreement expired the day before the Respondent unilaterally
changed its practice on March 1, the Respondent had a continuing obligation, in the absence of
impasse, to abide by the terms and conditions of employment set out therein, including the
obligation to continue paying incentives/differential over and above the employees’ base salary
rate. . See, Acme Press, 353 NLRB No. 73, fn. 2 (2008), citing NLRB v. Katz, supra. Also, The
Pantry Restaurant, 341 NLRB 243 (2004); Convergence Communications, Inc., 339 NLRB 408,
411 (2003); Big Track Coal, 300 NLRB 951 (1990); Benjamin F. Wininger & Son, 286 NLRB
1177, 1180 (1987); Bay Area Sealers, 251 NLRB 89 (1980).
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following expiration of the contract. The language of Law No. 27, which includes a provision
calling for the imposition of fines for noncompliance, lends credence to Respondent’s assertion
that implementation of Law No. 27 was mandatory and not discretionary.
However, while compliance with Law No. 27 may have been mandatory, the statute itself
does not mandate, or in any way dictate, how employers were to achieve compliance with its
provisions. Law No. 27 did nothing more than establish minimum wage requirements for
nursing employees in Puerto Rico based on their education level and experience. It contains no
provision, nor does it explicitly or implicitly instruct, direct, or suggest to employers, on how best
to achieve compliance. Thus, a plain reading of Law No. 27 makes clear that employers, like
the Respondent here, had absolute discretion to decide what, if any, steps should be taken, or
changes made to their payroll structure, to ensure compliance with Law No. 27. Nor did Law
No. 27 preclude employers from exceeding the minimum wage rates established therein if they
chose to do so.
Thus, the Respondent here was not required to discontinue the practice of paying
employees their incentive/differential pay over and above their base salary rate in order to
comply with Law No. 27. There were other options available to it that would have allowed it to
comply with Law No. 27 without discontinuing the practice. The Respondent, for example, could
have simply raised the wages of all nursing employees in the amount needed to bring their pre-
March 1, base salary rates up to the levels called for by Law No. 27, and still kept intact its
practice of paying nurses their incentive/differential earnings over and above their newly
established post-March 1, base salary rates.
The Respondent, however, chose a different option. It decided instead to give wage
increases only to those employees not receiving incentive/differential pay, thereby raising their
pre-March 1, base salary rate to the minimum wage levels mandated by Law No. 27.
Employees receiving incentive and differential pay, however, did not fare as well. Thus, rather
than grant the latter the same wage increase needed to also bring their base salary rate up to
Law No. 27 level, as it did with other employees, the Respondent instead used the
incentive/differential pay these employees were already entitled to and earning, in place of a
wage increase, to bring their base salary rate to Law No. 27’s minimum wage requirements.
The Board has held that when an employer has discretion over how to implement certain
changes in employee wages, hours, or other terms and condition of employment mandated or
imposed on it by statute or regulation, it has a duty to notify and bargain with the collective
bargaining representative of its employees over how such changes should be implemented
before making any such changes. See, Sheltering Pines Convalescent Hospital, 255 NLRB
1195 (1981); also, United Parcel Service, 336 NLRB 1134, 1135 (2001); Armour & Co., 280
NLRB 824, 827 (1986). The Respondent here, as noted, had, and indeed, did exercise, such
discretion when it chose to end the practice of paying employees their incentive/differential pay
over and above their base salary rate as a way of complying with Law No. 27’s minimum wage
requirements. As this particular practice was a mandatory subject of bargaining, the
Respondent was not at liberty to unilaterally discontinue or end it without first giving the Union
notice and an opportunity to bargain over that decision.
The Respondent nevertheless argues, implicitly, that it did not have to bargain with the
Union over its decision to end the practice because the decision had little or no impact on
employee wages, or on any other term and condition of employment. It claims that elimination
of the practice did not result in a reduction in pay because employees still receive their
incentive/differential pay, albeit, now as part of their base salary rate rather than in addition or
as a supplement to their base rate. The Board has, indeed, held that an employer is not
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required to bargain over changes so minimal as to have little or no impact on employee wages,
or terms and conditions of employment. The Toledo Blade Co., Inc., 343 NLRB 385, 388
(2004); W-I Forest Products Co., 304 NLRB 957, 959 (1991). However, the Respondent’s claim
that its decision had little or no impact on employee wages is simply wrong and belied by the
facts.
First, employees receiving incentive/differential pay effectively had their wages reduced
when the Respondent, as noted, opted not to increase their base salary rate, while increasing
that of other employees, in connection with its implementation of Law No. 27’s minimum wage
requirements. Second, and more importantly, these employees also saw their wages reduced
as a result of Respondent’s March 1, decision to end its longstanding practice of paying them
their incentive/differential pay over and above their base salary rate. Prior to March 1, these
employees, while earning the same base salary rate as other employees not receiving
incentive/differential pay, nevertheless received higher wages because their
incentive/differential earnings were paid to them over and above their base salary rate, while the
wages of employees not entitled to such perquisites were limited to their base salary rate.
Following the Respondent’s March 1, discontinuance of the above practice, all employees,
whether or not receiving incentive/differential pay, were, as readily admitted by Rodriguez,
earning the same wages. Clearly, the Respondent’s decision not to grant a wage increase to
employees receiving incentive/differential pay, as it did with other employees, and to instead
use the incentive/differential pay they were already entitled to and receiving as a way of raising
their base salary rate to minimum wage levels called for by Law No. 27, resulted in a net loss in
pay for these employees in an amount equal to their incentive/differential earnings.
The Respondent’s assertion, therefore, that its discontinuance of the practice of paying
employees their incentive/differential earnings over and above their base salary rate, had no
impact whatsoever on their wages, is clearly without merit. Rather, the facts, as discussed
above, make patently clear that employees receiving incentive/differential pay sustained a real
and substantial reduction in their wages as a result of the discontinuance of the practice. The
Respondent’s claim that no harm was done here because employees continue to receive
incentive/differential pay is somewhat disingenuous, for, clearly, from the perspective of
employees entitled to such perquisites for having chosen to work less desirable shifts or in high
risks area of the Hospital, the concept of incentive/differential pay now exists in name only. For
all practical purposes, these employees no longer receive incentive/differential pay, as their
wages now, with the so-called incentive/differential compensation included as part of their base
salary rate are, as readily admitted by Rodriguez, no different from that of other employees.
The Respondent’s March 1, decision here to change how employees’
incentive/differential pay was to be paid can best be described by the phrase, “robbing Peter to
pay Paul,” for, in seeking to comply with Law No. 27, the Respondent simply changed the
nature of the additional compensation employees were receiving for working less desirable
shifts or in high risk areas from an incentive/differential benefit to a wage increase. The net
result of its decision is that, while employees entitled to incentive/differential pay had their
wages increased to bring them in line with Law No. 27’s minimum wage levels, said increase
came at the expense of their incentive/differential benefits, and, as noted, resulted in a net loss
in wages for them in an amount equal to their incentive/differential earnings.
Accordingly, I find that the Respondent’s unilateral decision to end the practice of paying
employees their incentive/differential earnings over and above their base salary rate, which is a
mandatory subject of bargaining, had a real, substantial, material, and adverse effect on
employee wages and other terms and conditions of employment. Consequently, I further find
that the Respondent’s admitted failure to give the Union prior notice and an opportunity to
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bargain over that decision was unlawful, and violated Section 8(a)(5) and (1) of the Act, as
alleged.
Conclusions of Law
By unilaterally discontinuing, as of March 1, the practice of paying incentives and
differentials earned by nursing employees over and above their base salary rate without giving
the Union prior notice or an opportunity to bargain over this change in its employees’ terms and
conditions of employment, the Respondent has engaged in an unfair labor practice affecting
commerce within the meaning of Section 8(a)(5) and (1) and 2(6) and (7) of the Act.
Remedy
Having found that the Respondent has engaged in certain unfair labor practices, I find
that it must be ordered to cease and desist and to take certain affirmative action designed to
effectuate the policies of the Act.
Having unilaterally and unlawfully discontinued its practice of paying the
incentive/differential compensation earned by nursing employees over and above their base
salary rate, the Respondent shall be ordered to reinstate the practice, and to make whole all
employees for any loss in wages they may have sustained as a result of the Respondent’s
unlawful unilateral discontinuance of the practice.
Backpay will be computed as set forth in F.W. Woolworth Co., 90 NLRB 289 (1950).
Interest on the amounts due will be determined in the manner described in New Horizons for the
Retarded, 283 NLRB 1173 (1987), with said interest being compounded on a daily basis as
prescribed in Kentucky River Medical Center, 356 NLRB No. 8 (2010).
The Respondent shall also be required to post, in English and in Spanish, a notice to
employees.
On these findings of fact and conclusions of law and on the entire record, I issue the
following recommended9
ORDER
The Respondent, Quality Health Services of P.R., Inc. d/b/a Hospital San Cristobal.
Ponce, Puerto Rico, its officers, agents, successors and assigns, shall
1. Cease and desist from
(a) Refusing to bargain with the Union, Unidad Laboral de Enfermeras(os) y Empleados
de la Salud, which is the exclusive bargaining representative of its nursing employees in
appropriate units, by failing to give it notice and an opportunity to bargain before changing the
practice of paying nursing employees their incentive/differential earnings over and above their
base salary rate, or making other unilateral changes in the unit employees terms and conditions

9 If no exceptions are filed as provided by Sec. 102.46 of the Board’s Rules and
Regulations, the findings, conclusions, and recommended Order shall, as provided in Sec.
102.48 of the Rules, be adopted by the Board and all objections to them shall be deemed
waived for all purposes.
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of employment.
(b) In any like or related manner interfering with, restraining, or coercing employees in
the exercise of the rights guaranteed them by Section 7 of the Act.
2. Take the following affirmative action necessary to effectuate the policies of the Act.
(a) Reinstate the practice of paying nursing employees their incentive/differential
earnings over and above their base salary rate.
(b) Make whole all nursing employees for any loss in wages or other losses they may
have sustained, with interest, as a result of its unlawful March 1, decision to discontinue the
practice of paying nursing employees their incentive/differential earnings over and above their
base salary rate, as set forth in the remedy section of the decision.
(c) Preserve and, within 14 days of a request, or such additional time as the Regional
Director may allow for good cause shown, provide at a reasonable place designated by the
Board or its agents, all payroll records, social security payment records, timecards, personnel
records and reports, and all other records, including an electronic copy of such records if stored
in electronic form, necessary to analyze the amount of backpay due under the terms of this
Order.
(d) Within 14 days after service by the Region, post at its facility in Ponce, Puerto Rico,
in English and in Spanish, copies of the attached notice marked “Appendix.”10 Copies of the
notice, on forms provided by the Regional Director for Region 24, after being signed by the
Respondent’s authorized representative, shall be posted by the Respondent and maintained for
60 consecutive days in conspicuous places, including all places where notices to employees are
customarily posted. Reasonable steps shall be taken by the Respondent to ensure that the
notices are not altered, defaced, or covered by any other material. In the event that, during the
pendency of these proceedings, the Respondent has gone out of business or closed the facility
involved in these proceedings, the Respondent shall duplicate and mail, at its own expense, a
copy of the notice to all current employees and former employees employed by the Respondent
at any time since March 18, 2010.
(e) Within 21 days after service by the Region, file with the Regional Director a
sworn certification of a responsible official on a form provided by the Region attesting to the
steps that the Respondent has taken to comply.
Dated, Washington, D.C. July 21, 2011.
____________________
George Alemán
Administrative Law Judge

10 If this Order is enforced by a judgment of a United States court of appeals, the words in
the notice reading “Posted by Order of the National Labor Relations Board” shall read “Posted
Pursuant to a Judgment of the United States Court of Appeals Enforcing an Order of the
National Labor Relations Board.”
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APPENDIX
NOTICE TO EMPLOYEES
Posted by Order of the
National Labor Relations Board
An Agency of the United States Government
The National Labor Relations Board has found that we violated Federal labor law and has
ordered us to post and obey this Notice.
FEDERAL LAW GIVES YOU THE RIGHT TO
Form, join, or assist a union
Choose representatives to bargain with us on your behalf
Act together with other employees for your benefit and protection
Choose not to engage in any of these protected activities
WE WILL NOT refuse to bargain with Unidad Laboral de Enfermeras(os) y Empleados de la
Salud, which is the exclusive bargaining representative of our employees in appropriate units,
by failing to give it notice and opportunity to bargain over any decision involving how the
payment of incentives and differentials to employees should be made, or as to any other matter
affecting their wages, hours, or terms and conditions of employment.
WE WILL NOT in any like or related manner interfere with, restrain, or coerce you in the
exercise of the rights guaranteed you by Section 7 of the Act.
WE WILL reinstate the practice of paying employees their incentive/differential pay over and
above their base salary rate.
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WE WILL make employees whole, with interest, for any loss in wages or other losses they may
have sustained as a result of our unlawful decision to discontinue the practice of paying
employees their incentive/differential earnings over and above their base salary rate.
QUALITY HEALTH SERVICES OF P.R., INC.
d/b/a HOSPITAL SAN CRISTOBAL
(Employer)
Dated By
(Representative) (Title)
The National Labor Relations Board is an independent Federal agency created in 1935 to enforce the National Labor
Relations Act. It conducts secret-ballot elections to determine whether employees want union representation and it
investigates and remedies unfair labor practices by employers and unions. To find out more about your rights under
the Act and how to file a charge or election petition, you may speak confidentially to any agent with the Board’s
Regional Office set forth below. You may also obtain information from the Board’s website: www.nlrb.gov.
525 F. D. Roosevelt Avenue, La Torre de Plaza, Suite 1002
San Juan, Puerto Rico 00918-1002
Hours: 8:30 a.m. to 5 p.m.
787-766-5347
THIS IS AN OFFICIAL NOTICE AND MUST NOT BE DEFACED BY ANYONE
THIS NOTICE MUST REMAIN POSTED FOR 60 CONSECUTIVE DAYS FROM THE DATE OF POSTING AND MUST
NOT BE ALTERED, DEFACED, OR COVERED BY ANY OTHER MATERIAL. ANY QUESTIONS CONCERNING THIS
NOTICE OR COMPLIANCE WITH ITS PROVISIONS MAY BE DIRECTED TO THE ABOVE REGIONAL OFFICE’S
COMPLIANCE OFFICER, 787-766-5377.