Unit determination: National Labor Relations Board rule making in the health care industry

This article reviews the events leading up to the National Labor Relations Board's (NLRB) historic decision to engage in substantive rule making over appropriate bargaining units in the health care industry. It describes the rule-making process and outcomes, and the reaction of hospital unions and management to the rules. Finally, the potential for the use of rule making for other issues facing the NLRB is analyzed. This analysis uses a cost/benefit framework from the agency's perspective to predict the likelihood of future rule making. The article concludes that rule making is sufficiently costly to make extensive use in other situations unlikely.The order of the author's names was determined randomly and should not be interpreted as implying an unequal contribution.