A Baltimore hospital’s workers union earned the right to unionize after a federal appeals court backed its bargaining order and said the hospital had to enforce it despite its objections.

The U.S. Court of Appeals for the Fourth Circuit, in a May 10 ruling, affirmed and granted enforcement for a bargaining order from Sinai Hospital of Baltimore’s Vocational Program after it said the hospital did not fully establish that the employer relationship was “primarily rehabilitative.”

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