Quality Health Services d/b/a Hospital San Cristobal

National Labor Relations Board - Administrative Judge Opinions

Nov 9, 2010

24-CA-011438 (N.L.R.B. Nov. 9, 2010)

JD(ATL)–24–10
Ponce, PR
UNITED STATES OF AMERICA
BEFORE THE NATIONAL LABOR RELATIONS BOARD
DIVISION OF JUDGES
ATLANTA BRANCH OFFICE
QUALITY HEALTH SERVICES
OF P.R., INC. d/b/a HOSPITAL
SAN CRISTOBAL
and
UNIDAD LABOEAL DE ENFERMERAS
Y EMPLEADOS DE LA SALUD
CASES 24–CA–11438
24–CA–11507
24–CA–11537
Jose Luis Ortiz, Esq., for the Government.1
Jose A. Oliveras, Esq., for the Hospital.2
DECISION
Statement of the Case
WILLIAM N. CATES, Administrative Law Judge. I heard this case in trial in San Juan,
Puerto Rico, on September 15 and 16, 2010.3 The case originates from multiple charges filed by
the Union against the Hospital.4 The prosecution of this case followed the issuance of a
consolidated amended complaint issued by the Regional Director for Region 24 of the National
Labor Relations Board (Board), acting in the name of the Board’s General Counsel, on August
20, 2010.
Following the presentation of the evidence, but prior to the close of the hearing, the
parties agreed to settlement of the allegations contained in subparagraphs 8(d) and (g),
subparagraphs 9(a) and (b), and paragraph 10 of the complaint.5 The foregoing settled
allegations include all conduct alleged in the charge in Case 24–CA–11549 and significant
portions of the conduct alleged in the charges in the remaining cases. Consistent with the

1 I shall refer to Counsel for the General Counsel as Government Counsel or the Government.
2 I will refer to the Respondent as the Hospital.
3 All dates are in 2010 unless otherwise indicated.
4 The charge in Case 24–CA–11438 was filed on January 22 and was amended on March 7 and June 9. The
charge in Case 24–CA–11507 was filed on April 12 and was amended on June 23. The charge in Case 24–CA–
11537 was filed on June 2 and amended on July 12 and August 19.
5 The transcript at page 254 line 8 is hereby corrected to reflect that the settled allegation related to subparagraph
8(d), not 8(b).
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settlement, I dismiss the settled allegations from the complaint, and I have deleted Case 24–CA–
11549 from the caption herein.
The unsettled portions of the complaint relate to five changes that the Hospital allegedly
made without notice to or bargaining with the Union. The complaint alleges that the Hospital, by
its actions, failed and refused to bargain collectively with the exclusive collective-bargaining
representative of its employees in violation of Section 8(a)(1) and (5) of the National Labor
Relations Act (Act).
The Hospital, in a timely manner filed an answer to the complaint, denied having violated
the Act in any manner alleged in the complaint.
The parties were given full opportunity to participate, to introduce relevant evidence, to
examine and cross-examine witnesses, and to file briefs. I have studied the whole record, the
post trial briefs, and the authorities cited therein. Based on the analysis below, I conclude and
find the Hospital violated the Act substantially as alleged in the complaint with the exception of
the assignment of consecutive shifts.
FINDINGS OF FACT
I. Jurisdiction
Quality Health Services of P.R., Inc., d/b/a Hospital San Cristobal, the Hospital, a Puerto
Rico corporation with an office and place of business in Cotto Laurel, Ponce, Puerto Rico, is
engaged in the operation of a hospital providing acute health care services. The Hospital, in
conducting its business operations, annually derives gross revenues in excess of $250,000 and
purchases and receives goods valued in excess of $50,000 directly from points outside the
Commonwealth of Puerto Rico. The Hospital admits, and I find and conclude, that it is an
employer engaged in commerce within the meaning of Section 2(2), (6), and (7) of the Act, and
is a health care institution within the meaning of Section 2(14) of the Act.
The Hospital admits, and I find and conclude, that Unidad Laboeal De Enfermeras y
Empleados de la Salud, the Union, is a labor organization within the meaning of Section 2(5) of
the Act.
II. Alleged Unfair Labor Practices
A. Overview
The Hospital has recognized the Union as the exclusive collective-bargaining
representative of the employees in the following appropriate units:
Unit B – 24–RC–7308: All Licensed Practical Nurses and Respiratory Therapy
Technicians, Operating Room and Radiology Technicians employed by the
Respondent, 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 Act.
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Unit – 24–RC–7315: All employees of service and maintenance including skilled
workers (“Handyman”), air conditioning refrigeration technicians, general aides,
physical plant employees, cooks and employees of food services, 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 Act.
Unit – 24–RC–8124 B: All registered nurses employed by Respondent; excluding
all other hospital employees including Executives, Administrators, Supervisors,
Administrative Employees and Managers and Guards as defined by the Act.
Unit – 24–RC–8124 A: All office clerical employees employed by Respondent in
Cotto Laurel Ward, Ponce, including those employees of different departments
and/or areas; telephone operators, medical records, laboratory, cash register, X-
ray department, E.D.P department, pre-admissions employees, accounting
department employees, control and admissions department employees, credit and
collections department, respiratory therapy department, pharmacy, operating
room, warehouse, maintenance, physical therapy, nuclear medicine and escorts;
excluding all other hospital employees including Executives, Administrators,
Supervisors, Administrative Employees, Managers and Guards as defined by the
Act.
Unit 24–RC–8035 A: All employees of Physical Therapy (physical therapy
assistant) employed by Respondent at its facility located in Cotto Laurel Ward,
Ponce, Puerto Rico; excluding all other hospital employees including Executives,
Administrators, Supervisors, Administrative Employees, Managers and Guards as
defined by the Act.
Unit 24–RC–8035 B: All medical technicians employees of Respondent at its
facility located in Cotto Laurel Ward, Ponce, Puerto Rico; excluding all other
hospital employees, including Executives, Administrators, Supervisors,
Administrative Employees, Managers and Guards as defined by the Act.
The Union and Hospital have been parties to collective-bargaining agreements, the most
recent of which, as extended by the parties, expired on February 28, 2010. Union Representative
Ariel Echevarria Martinez (Echevarria) has responsibility for administration of the contract with
the Hospital. Director of Human Resources Candie Rodriguez Ruiz (Rodriguez) is responsible
for labor relations on behalf of the Hospital. It is undisputed that, as a result of a decrease in the
number of patients in 2009, the Hospital began instituting cost cutting measures. The issues
herein relate to whether certain of those measures were unlawfully taken without notice to or
bargaining with the Union.
The Hospital, at the hearing and in its brief, argues that the allegations set forth in
subparagraphs 8(a), (b), and (c) should be deferred to the grievance-arbitration procedure in the
expired contract, noting that the failure of the Union to file grievances relating to the alleged
unilateral changes should not render deferral inappropriate. The Hospital does not dispute that
the allegations in subparagraphs 8(e) and (f) cannot be deferred because those alleged unilateral
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changes occurred after expiration of the contract. The Government points out that deferral was
inappropriate at the time the complaint issued insofar as several allegations related to the failure
of the Hospital to provide requested relevant information pertaining to the alleged changes. The
Government further notes that there are no contractual provisions relating to the restriction upon
use of sick leave alleged in subparagraph 8(c).
At the time the complaint issued, this case involved interrelated issues of unilateral
changes, refusals to provide information, and refusals to meet and bargain. “Board policy . . .
disfavors bifurcation of proceedings that entail related contractual and statutory questions.”
Avery Dennison, 330 NLRB 389, 390 (1999). The settlement into which the parties entered at
the hearing related to provision of information and a schedule for bargaining sessions. Deferral
prior to the settlement of those issues would not have been appropriate. Subparagraphs 8(e) and
(f) cannot be deferred. The settlement, which occurred immediately before the conclusion of the
hearing, does not retroactively make deferral appropriate. All of the issues herein had been fully
litigated. I deny the request for deferral.
B. Allegations
1. Subparagraph 8(a)
The complaint alleges that, in or about November 2009, the Hospital “unilaterally and
contrary to its past practice, discontinued granting holiday pay to its employees when a holiday
fell on their day off.”
Article XIX of the collective-bargaining agreement relates to holidays and provides that
“[e]ach employee covered by this collective bargaining agreement will have the right to enjoy
the following holidays with pay.” The agreement then lists 12 full day holidays and 9 half day
holidays. Article XIX further provides that “any employee required to work on a holiday or the
holiday coincides with their day off” will be paid for the time they work as well as the holiday, 8
hours for full holidays and 4 hours for half day holidays. Director of Human Resources
Rodriguez acknowledged that, prior to October 2009, employees had been paid for holidays
when the holiday fell on their day off.
Rodriguez explained that the Hospital changed that policy when the former financial
director of the Hospital, Maria Rivera, “informed us that the practice was wrongly interpreted in
the collective agreement.” Rodriguez did not state the basis for the claimed erroneous
interpretation of the contract and Rivera, who is no longer employed, did not testify. Rodriguez
and Rivera met with Rodriguez’ superior and the three of them concluded that the provision had
“been wrongly interpreted.”
On October 1, 2009, Rodriguez issued an internal memorandum that addresses both
vacation days and holidays. The memorandum does not specifically state that employees will
not be paid for holidays on their day off. It states that “if that Holiday falls on a day scheduled to
be off, it is added to vacations, and in other cases, it is added as compensatory.”
The Union was not notified of the change. Union Representative Echevarria learned of
the internal memorandum from employees more than 5 days after it had issued on October 1,
2009. Employees whose day off fell on the day of the discovery of Puerto Rico, November 19,
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were not paid. They complained to Echevarria who contacted Rodriguez. Rodriguez informed
him that “any employee with a complaint about not being paid should make a claim with their
supervisor . . . [and] submit this claim to the payroll department.” After reviewing her pretrial
affidavit, Rodriguez did not deny that she also told Echevarria “that the Hospital would no longer
pay holiday pay to employees when their day off coincides with their holiday.” She testified: “I
don't recall exactly the words that I told him, but I recall that we talked about some employees
that were arguing because that holiday wasn't paid.”
The Union did not file a grievance. Union Representative Echevarria testified that
employees must file a grievance within 5 days of an alleged violation of the contract and that the
Union did not learn of the foregoing change until after the fifth day. The Hospital did not
contradict that testimony and did not offer the portion of the collective-bargaining agreement
relating to grievances as an exhibit.
Rodriguez admitted that she “did not send any written communication” to the Union that
the Hospital was “implementing this change.” The Union was presented with a fait accompli, a
decision by the Hospital, contrary to past practice, to cease paying employees for holidays that
occurred upon their scheduled days off. “[A] union does not waive its right to bargain over
unilateral changes by failing to engage in the futile act of trying to turn back the clock and
bargain over an action the employer has already taken.” Tri-Tech Services, 340 NLRB 894, 903
(2003). Holiday pay constitutes compensation similar to wages and is a mandatory subject of
bargaining. The Hospital, by altering its past practice and ceasing to pay holiday pay to
employees whose day off fell on a holiday without notice to and bargaining with the Union,
violated Section 8(a)(5) of the Act.
2. Subparagraph 8(b)
The complaint, as amended at the hearing, alleges that, in or about November 2009, the
Hospital “unilaterally and contrary to its past practice, implemented a new policy requiring its
registered nurses and licensed practical nurses to work consecutive night shifts.”
Rodriguez admitted that in December 2009 the Hospital began requiring nurses and
licensed practical nurse to work what she referred to as twin shifts, i.e., consecutive night shifts.
She explained that “in one week that you have to make five shifts, two are going to be one day
and the other day again, consecutively. Not two shifts in the same day, but one shift one day and
the other day you're going to do the same shift.”
Registered nurse Carmen Soto was informed by her supervisor that nurses would be
required to work consecutive night shifts. She acknowledged that she had previously been
assigned night shifts twice a month, but not consecutive night shifts. She explained that the
problem with night shifts is that “[y]ou lose the night, and it's tough.” The contract, article XVI,
restricts the Hospital from assigning more than four night shifts a month except in an emergency.
There is no evidence that the Hospital violated that provision of the contract. Soto acknowledged
that she now works three or four night shifts a month including the consecutive shift.
Rodriguez informed Echevarria that the Hospital “assigned the shift as we need in order
to comply with the service of the patients.” She told him that the Hospital did not have to
“negotiate that decision” because it was “agreed in the covenant [the collective-bargaining
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agreement].”
The management-rights clause in the contract, article VII, provides, in pertinent part:
Therefore, the Hospital, will have the exclusive right to manage all its business
and direct its employees and any other right necessary to the best management of
the Hospital like, the right to plan, program, direct and to continue or not
operation and or services, to establish over time work, supervise its employees,
hire, transfer, assign employees to different shifts and/or departments . . .
[Emphasis added.]
Changes in employee shift assignments are a mandatory subject of bargaining unless a
union has waived that right. Any waiver must be clear and unmistakable. In Baptist Hospital of
East Tennessee, 351 NLRB 71, 72 (2007), the Board held that language in the management-
rights clause giving the employer the right to schedule work encompassed shift assignments.
The language herein is even clearer. The management-rights clause enumerates various rights of
the hospital including specifically the right to “assign employees to different shifts.” I find that
requiring nurses and licensed practical nurses to work twin shifts, i.e., consecutive night shifts, is
encompassed by the foregoing language. I shall recommend that this allegation be dismissed.
3. Subparagraph 8(c)
The complaint alleges that, on or about January 7, 2010, the Hospital “unilaterally
eliminated its past practice of allowing employees to use sick leave and/or annual leave for their
absences while reported to the Worker’s Insurance Compensation Fund.”
On January 7, the Hospital sent a memorandum to all employees explaining that the
Hospital’s premiums for workers compensation had “increased due to the excessive amount of
cases sent.” It informed employees that the Hospital was “implementing changes” that included
evaluating where and why accidents occurred and whether employee negligence, such as
attempting to lift patients weighing more than “x pounds,” was involved. The memorandum then
states:
Lastly, the Sick Leave will not be paid while the employee is reported to the
[State Insurance Fund]. The same [State Insurance Fund] will pay an allowance
which makes it impossible that the employee receive two payments for being out
of work.
The Hospital gave no explanation for why it was “impossible” for employees to receive
two payments as they had under the past practice which permitted employees to use leave when
receiving workers compensation. The Hospital presented no evidence that continuation of the
past practice was impossible.
Union Representative Echevarria recalled that he learned of the memorandum from
employees. He was uncertain whether he discussed this matter with Rodriguez in person or on
the telephone, but he did specifically recall that he asked why the memorandum had been
distributed to employees “without being notified or negotiated with the Union beforehand
knowing that this was a past practice at the Hospital.” Rodriguez replied that the Hospital took
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that action “based on the administrative [management] rights . . . nothing else was going to be
negotiated to that effect.”
Rodriguez claims that she sent the memorandum that had been given to employees to
Echevarria by facsimile copy on January 7. She acknowledged taking the position that the
refusal to pay sick leave when an employee was receiving workers compensation was “not a
matter to be negotiated with the Union.”
Regardless of how the Union learned of the memorandum, it is undisputed that the
restriction upon the use of sick leave constituted a change from past practice and that the Union
was not given notice of, or an opportunity to bargain about, the change. Neither the Union nor
Hospital placed into evidence the contractual provisions relating to sick leave. I am satisfied that
if the contract included the right to restrict the use of sick leave, the Hospital would have
presented that contractual provision as an exhibit. The management-rights clause does not grant
the Hospital the right to unilaterally change employees’ entitlement to sick leave.
Consistent with the memorandum of the Hospital announcing that it was “implementing
changes” and the testimony of Echevarria that he protested the unilateral deviation from past
practice, I find that, prior to January 7, employees were entitled to take sick leave while
receiving workers compensation. The prohibition of taking sick leave while receiving workers
compensation announced by the Hospital on January 7 was made without notice to or bargaining
with the Union. The Union was presented with a fait accompli. The inability of employees to
receive sick leave benefits while receiving workers compensation directly affected their
compensation. The Hospital, by unilaterally eliminating its past practice of allowing employees
to use sick leave when receiving workers compensation violated Section 8(a)(5) of the Act.
4. Subparagraph 8(e)
The complaint alleges that, on or about May 24, 2010, the Hospital “unilaterally
eliminated all permanent shifts in its respiratory care department, thereby implementing rotation
shifts for all its employees.”
On May 5, by a letter misdated April 5, Director of Human Resources Rodriguez wrote
Union Representative Echevarria advising that the Hospital had found it “necessary to cancel the
permanent shifts [in the department of respiratory care] so that these employees enter the rotation
program.” The letter states that, to avoid incurring overtime, the change was to be effective on
Sunday, May 16. The letter states that the affected employees can “discuss any inconvenience”
with Area Supervisor Carlos Diaz, from whom Rodriguez states she had requested “alternatives”
prior to deciding to institute the rotating shifts. In a second letter dated May 5, Rodriguez
advised that she was available to meet “regarding the effect of these changes” prior to May 16.
By letter dated May 7, Representative Echevarria protested the action of the Hospital and
requested that it “leave without effect this new change,” provide the Union with the alternatives
offered by Supervisor Diaz so that the Union could “evaluate them . . . and study what
recommendations we can offer,” and then “sit down to discuss the matter.”
More than a week later, on May 18, Rodriguez wrote Echevarria listing three alternatives
that Diaz had suggested. In the letter she explains that she rejected the first alternative, which
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involved overtime, because of the cost and overwork of the employees. The second alternative,
assignment of more night shifts, she rejected because the employees would be “overworked.”
The third, hiring more personnel, was rejected because of “finances.” Rodriguez states in the
letter that she did not “have any other alternative than to start rotating,” presumably on May 16,
and that the decision was “not the Labor Union’s decision,” it was the Hospital’s decision and
that only “the effects of this decision are negotiable, not the decision.”
The Hospital, in discussions with the Union on December 1, 2009, among various other
matters, had mentioned the possibility of eliminating permanent shifts in respiratory care and the
laboratory, but no date was proposed. An “’inchoate and imprecise’ announcement of future
plans” is insufficient to trigger an obligation to request bargaining or risk waiving the right to
bargain.” Sierra International Trucks, 319 NLRB 948, 950 (1995). In late December,
Rodriguez refused to provide the Union with requested information relating to the employees
potentially affected and explained that “we are not going to proceed with that change.”
Rodriguez recalled no further communication with the Union regarding elimination of permanent
shifts until she wrote Echevarria on May 5 stating that the decision had been made and would be
implemented on May 16.
As already discussed, the management-rights clause in the contract gave the Hospital the
right to assign shifts. That contact, however, expired on February 28. It is well settled that,
absent evidence of the parties’ intentions to the contrary, management-rights clauses and “any
waivers contained therein do not survive the expiration of the contract.” Clear Channel Outdoor,
Inc., 346 NLRB 696, 703 (2006).
Shift assignments are mandatory subjects of bargaining insofar as they directly affect the
hours and working conditions of employees. Baptist Hospital of East Tennessee, supra. The
first May 5 letter and the May 18 letter from Rodriguez confirm that labor costs were a factor in
the Hospital’s decision.
In this instance the Union was given advance notice of the Hospital’s intention.
Echevarria, on May 7, requested bargaining, asking the Hospital to “leave without effect this
new change” and “sit down and discuss this matter” after providing the Union with the
alternatives offered by Supervisor Diaz so that the Union could study them and determine “what
recommendations we can offer.” On May 18, the Hospital denied any obligation to bargain with
the Union regarding its decision. Contrary to the assertion in its letter of May 18, the Hospital
was, in the absence of any waiver by the Union, obligated to give notice to and bargain with the
Union regarding its decision to make this substantial and significant change in work schedules.
By failing to do so, the Hospital violated Section 8(a)(5) of the Act.
5. Subparagraph 8(f)
The complaint alleges that, on or about May 27, 2010, the Hospital unilaterally “changed
and reduced the amount of holidays.”
The expired collective-bargaining agreement provided for 12 full day holidays and 9 half
day holidays. On May 27, the Hospital sent a memorandum to all employees explaining that it
was changing their holiday schedule by eliminating all half day holidays, three of which were
converted to full days, and changing several of the full day holidays. By way of example, Martin
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Luther King Day was eliminated and Washington’s Birthday, formerly a half day holiday, was
converted to a full day. The net result gave employees a total of 13 full day holidays and no half
day holidays. The foregoing change deprived employees of 3-1/2 days of paid holidays.
There was no notice to or bargaining with the Union. Rodriguez informed the Union of
the Hospital’s action by letter dated May 27, which states that “today we informed the
employees” of the changed holiday schedule. By letter dated June 14, Union Representative
Echevarria protested the Hospital’s action.
Although the collective-bargaining agreement had expired, the holidays provided therein
constituted the past practice of the Hospital, a practice that had been followed since at least 2002
when the collective-bargaining agreement went into effect. The Union was again presented with
a fait accompli. The foregoing change in the Hospital’s past practice that had been embodied in
the collective-bargaining agreement deprived employees not only of their half day holidays but
also resulted a net loss of 3-1/2 days of paid holidays. The foregoing changes were substantial
and had a direct effect upon the employees’ working conditions and pay. By unilaterally
changing and reducing the number of employees’ holidays, the Hospital violated Section 8(a)(5)
of the Act.
Conclusions of Law
The Hospital, by altering its past practice and ceasing to pay holiday pay to
employees whose day off fell on a holiday, by eliminating its past practice of allowing
employees to use sick leave when receiving workers compensation, by eliminating permanent
shifts in its respiratory care department thereby implementing rotation shifts for those
employees, and by changing and reducing the number of employees’ holidays, all without notice
to and bargaining with the Union, the Hospital has engaged in unfair labor practices affecting
commerce within the meaning of Section 8(a)(1) and (5) and Section 2(6) and (7) of the Act.
Remedy
Having found that the Hospital 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.
The Hospital, having unilaterally altered its past practice and ceased paying holiday pay
to employees whose day off fell on a holiday, must rescind that change, restore the past practice,
and make whole all employees who were denied holiday pay on their day off.
The Hospital, having unilaterally eliminated its past practice of allowing employees to
use sick leave when receiving workers compensation, must rescind that change, restore the past
practice, and make whole all employees who were denied sick leave.
The Hospital, having unilaterally eliminated permanent shifts in its respiratory care
department thereby implementing rotation shifts for all its employees, must rescind that change
and restore permanent shifts.
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The Hospital, having unilaterally changed and reduced the number of employees’
holidays, must rescind those changes, restore the former holidays, and make whole all employees
by paying to them the holiday pay to which they would have been entitled pursuant to the former
holiday schedule, less all amounts paid pursuant to the unlawfully changed holiday schedule.
Backpay will be computed as outlined in F. W. Woolworth Co., 90 NLRB 289 (1950)
(backpay computed on quarterly basis). Determining the applicable rate of interest will be as
outlined in New Horizons for the Retarded, 283 NLRB 1173 (1987) (adopting Internal Revenue
Service rate for underpayment of Federal taxes). Interest on all amounts due to employees shall
be compounded on a daily basis as prescribed in Kentucky River Medical Center, 356 NLRB No.
8 (2010).
The Hospital must also post an appropriate notice.
On these findings of fact and conclusions of law and on the entire record, I issue the
following recommended6
ORDER
Quality Health Services of P.R., Inc., d/b/a Hospital San Cristobal, Ponto, Puerto Rico, its
officers, agents, successors, and assigns, shall
1. Cease and desist from
(a) Refusing to bargain with Unidad Laboeal De Enfermeras y Empleados de
la Salud as the exclusive representative of all employees in the units by failing to give notice to
and bargain with the Union before making changes in the wages, hours, and working conditions
of unit employees.
(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) Rescind the alteration of the past practice of paying holiday pay to
employees whose day off falls on a holiday, restore the past practice, and make whole all
employees who were denied holiday pay on their day off, with interest, as set forth in the remedy
section of the decision.
(b) Rescind the elimination of the past practice of allowing employees to use
sick leave when receiving workers compensation, restore the past practice, and make whole all
employees who were denied sick leave, with interest, as set forth in the remedy section of the
decision.

6 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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(c) Rescind the elimination of permanent shifts in its respiratory care
department thereby implementing rotation shifts for all its employees and restore permanent
shifts.
(d) Rescind the changed holiday schedule, restore the former holidays, and
make whole all employees for the holiday pay to which they would have been entitled pursuant
to the former holiday schedule, with interest, as set forth in the remedy section of the decision.
(e) Within 14 days after service by the Region, post at its facility in Ponto,
Puerto Rico, copies of the attached notice in English and Spanish marked “Appendix.”7 Copies
of the notice, on forms provided by the Regional Director for Region 24, after being signed by
the Hospital’s authorized representative, shall be posted by the Hospital and maintained for 60
consecutive days in conspicuous places including all places where notices to employees are
customarily posted. In addition to physical posting of paper notices, notices shall be distributed
electronically, such as by email, posting on an intranet or an internet site, or other electronic
means, if the Hospital customarily communicates with its employees by such means.
Reasonable steps shall be taken by the Hospital 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
Hospital has gone out of business or closed the facility involved in these proceedings, the
Hospital shall duplicate and mail, at its own expense, a copy of the notice to all current
employees and former employees employed by the Hospital at any time since October 1, 2009.
(f) 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 Hospital has taken to comply.
IT IS FURTHER ORDERED that the complaint is dismissed insofar as it alleges
violations of the Act not specifically found.
Dated, Washington, D.C. November 9, 2010
________________________________
William N. Cates
Administrative Law Judge

7 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.”
JD(ATL)–24–10
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 had 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 Laboeal De Enfermeras y Empleados de la Salud
as your exclusive representative in the appropriate units by failing to give notice to and bargain
with the Union before making changes in your wages, hours, and working conditions.
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 rescind the alteration of the past practice of paying holiday pay to those of you whose
day off falls on a holiday, restore the past practice, and make whole all of you who were denied
holiday pay on your day off, with interest.
WE WILL rescind the elimination of the past practice of allowing you to use sick leave when
receiving workers compensation, restore the past practice, and make whole all of you who were
denied sick leave, with interest.
WE WILL rescind the elimination of permanent shifts in our respiratory care department thereby
implementing rotation shifts and restore permanent shifts.
WE WILL rescind the changed holiday schedule, restore the former holidays, and make whole
all of you for the holiday pay to which you would have been entitled pursuant to the former
holiday schedule, with interest.
Quality Health Services Of P.R., Inc.,
d/b/a Hospital San Cristobal
(Employer)
Dated By
(Representative) (Title)
JD(ATL)–24–04
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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.
La Torre de Plaza, Suite 1002, 525 F. D. Roosevelt Ave.; San Juan, PR 00918–1002
(787) 766–5347, Hours: 8:30 a.m. to 5:00 p.m.
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