The U.S. Court of Appeals for the District of Columbia today upheld a National Labor Relations Board decision permitting an incumbent union of a hospital to organize only a small portion of the unrepresented employees in a partially organized bargaining unit. At issue was application of the Health Care Bargaining Rule, which was intended to prevent undue proliferation of collective bargaining units in health care facilities. The question in the case was whether a union that already represents some employees in a designated bargaining unit under the Health Care Bargaining Rule must seek to add all of the remaining employees in that bargaining unit. The union sought to represent only a portion of the unrepresented employees in the designated bargaining unit and to add those employees to the existing bargaining unit. The court upheld the NLRB’s position that the addition of employees to an existing unit did not have to meet the same requirements that would apply if a union was seeking to organize employees into a new bargaining unit in an acute care hospital. The AHA and Federation of American Hospitals filed a friend-of-the-court brief urging the court to overturn the NLRB’s decision, arguing that the board's decision casts “long-standing principles aside,” permitting piecemeal organization that subjects hospitals to “serial organizing and bargaining, and all of the attendant disruption that brings.” The case is Rush University Medical Center v. National Labor Relation Board.