California Pacific Medical Center (“CPMC”) petitions for review of the final Decision and Order of the National Labor Relations Board (“the Board”) which held that CPMC violated sections 8(a)(1) and (5) of the National Labor Relation Act. CPMC had refused to recognize the California Nurses Association (“CNA”) as the bargaining representative for a bargaining unit comprised of all registered nurses at Children’s Hospital of San Francisco (“Children’s”), and unilaterally altered the employment conditions of the Children’s nurses after Children’s merged with Pacific Presbyterian Center (“Presbyterian”) to form CPMC. We affirm the Board’s final Decision and Order.
*306 I. FACTS AND PRIOR PROCEEDINGS
On June 16, 1991, Children’s and Presbyterian merged to form CPMC. The two hospitals are approximately one mile apart. After the merger, Children’s became CPMC’s “California Campus” and Presbyterian became CPMC’s “Pacific Campus.” To improve efficiency, CPMC took steps to integrate the two hospitals’ operations by eliminating duplications in staff, equipment, and services.
Before the merger, six unions represented the employees at Children’s and Presbyterian. CPMC decided to recognize only those unions which represented a majority of the employees in the combined units. Under this framework, CPMC recognized five of the unions, 1 but refused to recognize CNA. At the time of the merger, CNA represented 589 nurses at Children’s, but no union represented the 838 nurses at Presbyterian. On the day of the merger, CPMC withdrew recognition from CNA, despite the fact that CNA had represented the nurses at Children’s since 1947.
The next day, CPMC petitioned the Board for an election to allow the 1,427 nurses to decide whether they wanted representation, and invited CNA to assist with the election. Instead, CNA filed an unfair labor practices charge with the Board which precluded the election. While awaiting the Board’s response, CPMC unilaterally gave the former Children’s nurses a substantial pay raise and made other changes in their terms of employment.
Eight months after the merger, pursuant to section 10(j) of the National Labor Relations Act, the Board petitioned the U.S. District Court for Northern California for a preliminary injunction to restore the premerger status quo. Noting the unilateral withdrawal of recognition and four decades of representation, the district court granted the requested injunction, pending the Board’s final determination.
Miller ex rel. NLRB v. California Pac. Medical Ctr.,
On appeal, we vacated the preliminary injunction, holding that the District Court had applied the wrong legal standard in evaluating whether to grant a preliminary injunction.
Miller ex rel. NLRB v. California Pac. Medical Ctr.,
Subsequently, we granted the Board’s Petition for Rehearing En Banc. A majority of the en banc court reached the same result as had the panel, finding that the district court had applied the wrong standard in granting the preliminary injunction. It did not remand for application of the proper standard, but rather vacated the district court’s opinion because the district court had lost jurisdiction since the NLRB had in the interim issued its final order.
Miller ex rel. NLRB v. California Pac. Medical Ctr.,
During the pendency of the preliminary injunction appeal, an Administrative Law Judge (“the ALJ”) heard the unfair labor practice charges. On April 6, 1993, the ALJ issued a Decision and Order ruling that CPMC’s unilateral decisions to withdraw recognition from CNA and to alter the terms of the nurse’s employment violated sections 8(a)(1) and (5) of the National Labor Relations Act. 2
The ALJ made several findings indicating that CPMC had taken steps toward integrating its California and Pacific campuses. CPMC immediately centralized its management and administrative functions for the two hospitals and implemented common labor practices. CPMC took some steps to *307 ward unifying the two nursing departments: it centralized the upper levels of management; it centralized hiring and training; it distributed identical clinical and administrative manuals; it employed numerous clinical nurse specialists at both campuses; it created a voluntary cross-training program to allow any registered nurse to change campuses; and 100 float pool nurses were available on both campuses.
However, the ALJ also made several findings indicating that the nurses on the two campuses remained functionally separate. In the two months immediately after the merger, there was “almost no interchange” of nurses between the campuses. The nurses continued to use the parking lots, cafeterias, and pharmacies on their own campuses. The merger did not affect the nurses’ job titles or responsibilities. The two layers of the ehain-of-eommand immediately above the nurses — unit supervisors and nurse managers — did not have cross-campus responsibilities. In short, the merger had few day-today effects on the nurses.
The ALJ began his legal analysis with the single facility presumption, under which a single, geographically isolated facility operated by an employer which also operates other facilities is presumably the proper bargaining unit. The ALJ held that there are two ways to rebut this presumption. First, a party may demonstrate “circumstances that militate against its appropriateness, including an increased risk of work disruption....”
Manor Healthcare Corp.,
The ALJ then ruled that CPMC failed to rebut the single facility presumption. The ALJ rejected a Manor Healthcare rebuttal because CPMC offered no evidence of a risk of work disruptions. The ALJ also rejected a Wesi Jersey rebuttal because CNA had a four-decade bargaining history and because of the lack of interchange between the nurses of the two campuses.
Accordingly, the ALJ held that CPMC’s withdrawal of recognition from CNA and its unilateral changes in the nurses’ conditions of employment violated the National Labor Relations Act. As a remedy, the ALJ recommended that the Board order CPMC to allow CNA to choose which unilateral changes to keep and which to reject. On September 30, 1993, the Board issued a final Decision and Order affirming the ALJ’s findings and conclusions and adopting his recommended Order.
See Children’s Hospital,
II. JURISDICTION
The Board had jurisdiction over the unfair labor practices alleged by CNA against CPMC under section 10(a) of the National Labor Relations Act, 29 U.S.C. 160(a). We have jurisdiction over the Board’s final Decision and Order under section 10(f) of the Act, 29 U.S.C. 160(f).
III. STANDARD OF REVIEW
Courts of appeals may overturn Board decisions only if the Board’s findings of fact are not supported by substantial evidence, or if the Board has incorrectly applied the law.
NLRB v. General Truck Drivers, Local No. 315,
In addition, there is a substantial overlay of deference to the Board. Courts of appeals may overturn the Board’s interpretations of.the National Labor Relations Act only if they are not “reasonably defensible.”
Id.
(quoting
NLRB v. United Union of Roofers, Waterproofers & Allied Workers, Local 81,
*308
The determination of appropriate bargaining units is uniquely the Board’s function — we overturn only an “abuse of discretion.”
NLRB v. HMO Int’l/Cal. Medical Health Plan, Inc.,
Courts of appeals may overturn the Board’s remedial orders only for a “clear abuse of discretion.”
NLRB v. C.E. Wylie Constr. Co.,
TV. DISCUSSION
This appeal presents two questions. First, was CNA an appropriate bargaining unit? This turns on whether the single facility presumption is applicable and properly applied. Second, was the Board’s remedy proper?
A. THE SINGLE FACILITY PRESUMPTION
CPMC argues that the Board should have applied the disparity of interest test and not the single facility presumption. We disagree.
The linchpin of this case is whether, after the merger, CNA remained an appropriate bargaining unit. After a merger, an employer has no duty to negotiate with a pre-merger bargaining unit that has become inappropriate.
See, e.g., Border Steel Rolling Mills, Inc.,
The Board held that the single facility presumption applies to the California campus, making the nurses of that campus an appropriate bargaining unit.
See, e.g., Spring City Knitting Co. v. NLRB,
Before 1974, the NLRA did not cover employees in the nonprofit health care industry. 29 U.S.C. § 152(2) (1973) (repealed, 1974). In 1974, Congress amended the Act to cover them. S. 3203, 93d Cong., 2d Sess. (1974); H.R. 13678, 93d Cong., 2d Sess. (1974); see generally S.Rep. No. 93-766, 93d Cong., 2d Sess. 1 (1974), reprinted in 1974 U.S.C.C.A.N. 3946. Apparently, because some legislators feared this amendment could cause disruptions in patient care, the following language was inserted in the Senate Report: “due consideration should be given by the Board to preventing the proliferation of bargaining units in the healthcare industry.” S.Rep. No. 93-766, 93d Cong., 2d Sess. 5 (1974), reprinted in 1974 U.S.C.C.A.N. 3946, 3950.
On its face, it is not clear whether this language was meant to discourage proliferation in unit composition
(i.e.
different units for different occupations), or unit scope
(i.e.
different units for different facilities), or both. At least two circuits have applied this language to unit scope decisions in the health field. In
Presbyterian/St. Luke’s Medical Ctr. v. NLRB,
The Second Circuit reached the same conclusion in
Long Island Jewish-Hillside Medical Ctr. v. NLRB,
We have discouraged proliferation in unit
composition
decisions. In
St. Francis Hospital,
we rejected the Board’s irrebuttable presumption that registered nurses had unique interests that set them apart from other professional employees and were thus entitled to their own unit.
However, unlike the Second and Tenth Circuits, we have never held that the Board must apply the disparity of interests test and not the single facility presumption to unit scope decisions. The issue is new to us.
Whatever Congress may have intended,
4
a recent opinion of the United States Supreme Court,
American Hospital v. NLRB,
Shortly after this decision, one legal scholar wrote, “[t]he Court’s declaration effectively razed the actions of several courts of appeals.” Terry A. Bethel,
Recent Supreme Court Employment Law Decisions, 1990-91,
17 Dayton L.Rev. 33, 42 (1991). Time has proved this assessment to be correct. As discussed above, the Second Circuit previously had held that the Board should not apply the single facility presumption to the health care industry.
See Long Island Jewish-Hillside,
Similarly, the Third Circuit reversed itself. Prior to
American Hospital,
the Third Circuit interpreted the 1974 legislative history as requiring the Board to abandon the single facility presumption.
See St. Vincent’s Hosp. v. NLRB,
Petitioner’s proposal that we create new law in this circuit by prohibiting the Board from using the single facility presumption in unit scope determinations ignores the teaching of American Hospital and would put us at odds with other circuits that have considered the impact of American Hospital. We decline to do so.
B. THE BOARD’S APPLICATION OF THE PRESUMPTION
The petitioner’s fallback position is that even if the single facility presumption applies, the Board misapplied it here since CPMC successfully rebutted the presumption that the California campus nurses comprise an appropriate bargaining unit. As discussed above, we must affirm the Board’s bargaining unit determination unless there is an “abuse of discretion.”
HMO Int’l,
In
Spring City,
For nearly half a century CNA has represented the nurses at the California campus. The Pacific campus has an entirely different history — it has never had a nurses’ union.
See, e.g., Bay Medical Ctr., Inc. v. NLRB,
Moreover, the Board found a “lack of significant interchange between nurses on the two campuses.”
Children’s Hospital,
CPMC urges that it has centralized management and administration of the two campuses, that the nurse directors of the separate campuses have little autonomy, that the power to hire and fire rests with centralized management, and that working conditions are nearly identical. All this may be true.
If the Board had less discretion in the unique and discrete function of determining the appropriate bargaining unit, our decision *311 might be different. But our role is not to reweigh the factors or second-guess the Board’s expertise. We affirm the Board’s determination of the bargaining unit.
C. THE REMEDY
To remedy CPMC’s unilateral changes in the nurses’ employment conditions, the Board issued a “status quo ante restoration order” that allowed CNA to choose which changes to reject and which to keep. Some changes were clearly beneficial, others not.
Under section 10(c) of the National Labor Relations Act (29 U.S.C. § 160(c)), the Board has broad discretion to impose remedies for unfair labor practices. We may overturn the Board’s remedial order only if there is “clear abuse of discretion.”
Wylie Constr.,
The Board’s remedy is well grounded in law. The Seventh Circuit has approved the Board’s policy “in cases of combined favorable and' unfavorable unilateral changes,” which is “to order a return to the status quo ante with regard to the unfavorable changes, but to not penalize employees by ordering revocation of the favorable changes.”
NLRB v. Keystone Steel & Wire,
CPMC argues that the Board’s remedy is appropriate only if the employer commits “a particularly egregious” violation of the Act. For an example of such a violation, it points to
Peat Mfg. Co.,
The Board did not clearly abuse its discretion. We affirm.
V. CONCLUSION
We enforce the Board’s order.
Notes
. These five unions represented 600 of CPMC's 4100 non-nurse employees.
. Section 8(a)(1) of the Act (29 U.S.C. § 158(a)(1)) makes it an unfair labor practice for an employer to “interfere with, restrain, or coerce employees in the exercise of ... the right to bargain collectively through representatives of their own choosing____” Section 8(a)(5) of the Act (29 U.S.C. § 158(a)(5)) makes it an unfair labor practice for an employer "to refuse to bargain collectively with the representatives of his employees....”
. In
Presbyterian,
the Tenth Circuit also rejected the Board’s unit composition decision, which granted the registered nurses an independent union. It held that application of the Board's presumption in favor of separate units violated the Federal Rules of Evidence.
. There is reason to doubt in any event that the comments were aimed at determinations as to scope. Immediately after the language discouraging proliferation of bargaining units, the Senate Report goes on to cite approvingly three Board unit decisions in the health industry. S.Rep. No. 93-766, 93d Cong., 2d Sess. 5 (1974),
reprinted in
1974 U.S.C.C.A.N. 3946, 3950. All three involved unit composition.
See Four Seasons Nursing Center,
