An appeals court on Tuesday denied a review of a case between a South Carolina nursing home and its nursing staff, effectively upholding a decision by the National Labor Relations Board.

Registered nurses and licensed practical nurses at Prince George Healthcare Center in Georgetown, SC, sought to unionize and begin the collective bargaining process. Prince George officials argued that the nurses counted as supervisors since they have the authority to direct and discipline the certified nursing assistants who work under them, and therefore did not have collective bargaining rights.

Prince George was ordered by the NLRB to bargain with the nurses’ union. The facility resisted, and petitioned the Fourth Circuit Court of Appeals to review the case.

In her opinion Judge Diana Gribbon Motz sided with the NLRB, citing “substantial evidence” that backs up the board’s decision that the nurses don’t qualify as supervisors since their jobs do not require them to exercise “independent judgment,” or “effectively recommend action, free of the control of others.”

“The record offers abundant evidence supporting the Board’s finding that Palmetto failed to establish that the Nurses use independent judgment in disciplining and directing the work of CNAs,” Motz wrote. “Accordingly, we must deny Palmetto’s petition for review and grant the Board’s cross-petition for enforcement of its order.”