Hartman v. Centra Health, Inc.

550 F.Supp.3d 331

Kimberly HARTMAN, Plaintiff,

v.CENTRA HEALTH, INC., et al., Defendants.

Case No. 6:20-cv-00027

United States District Court, W.D. Virginia, Lynchburg Division.

Signed July 23, 2021

Michael Paul Valois, James River Legal Associates, Lynchburg, VA, for Plaintiff.

Joseph Walton Milam, III, Rosenwood Rose and Litwak, PLLC, Charlotte, NC, Joshua F.P. Long, Joshua Richard Treece, Charles Jesse Dickenson, Woods Rogers PLC, Roanoke, VA, for Defendants Centra Health, Inc., Stephanie East, Nathan Campbell.

MEMORANDUM OPINION

NORMAN K. MOON, SENIOR UNITED STATES DISTRICT JUDGE

In June 2019, Centra Health, Inc. terminated its employee, Kimberly Hartman, a licensed registered nurse, who managed Virginia Baptist Hospital's Child and Adolescent Psychiatric Unit. Hartman alleges that Centra retaliated against her after she reported her concerns about the unlawful denial of certain transfer patient admissions to the unit she managed. Specifically, Hartman contends that Centra violated the whistleblower protection provision of the Emergency Medical Treatment and Labor Act (Count I) and wrongfully terminated her employment in violation of public policy under Virginia law (Count IV). Dkt. 17. Hartman also claims that Centra, Centra's Vice President of Behavioral Health Stephanie East, and Centra's Director of Security Nathan Campbell made defamatory statements about her following her termination (Counts II and III). Id. Centra, East, and Campbell have moved to dismiss all claims against them under Federal Rule of Civil Procedure 12(b)(6). Dkt. 26.

For the reasons below, the Court will deny the motion to dismiss with respect to Counts I, II, and IV, but will grant the motion with respect to Count III.

I. ALLEGED FACTUAL BACKGROUND

For the purposes of ruling on the motion to dismiss, the Court is required to accept as true the following allegations set forth in the first amended complaint.

A. Hartman Manages the Child and Adolescent Psychiatric Unit

From July 2014 to June 2019, Centra Health, Inc. ("Centra") employed Hartman, a licensed registered nurse, as the unit manager of Virginia Baptist Hospital's ("VBH") Child and Adolescent Psychiatric Unit ("CAPU"). Dkt. 17 ¶¶ 13, 17. Centra owns and operates VBH. Id. ¶ 10.

VBH's CAPU is one of three secure psychiatric units in Virginia that admit children under the age of ten, and it is licensed by the Virginia Department of Behavioral Health and Developmental Services. Id. ¶¶ 24–25. The CAPU accepts transfers of child and adolescent patients from other hospitals subject to the admission, stay, and exclusion criteria provided in its Scope of Services. Id. ¶¶ 26–27; see Dkt. 17-1 (CAPU's Scope of Services). Centra's intake office applies these criteria in determining whether to accept or deny transfer requests. Dkt. 17 ¶ 28. At the same time, the Emergency Medical Treatment and Labor Act ("EMTALA"),¹ requires participating hospitals with "specialized capabilities or facilities" to accept "an appropriate transfer of an individual who requires such specialized capabilities or facilities if the hospital has the capacity to treat the individual." 42 U.S.C. § 1395dd(g) ; see Dkt. 17 ¶ 128.

As the CAPU manager, Hartman supervised the CAPU's staff and monitored the unit's daily patient census. Id. ¶¶ 19, 29. Stephanie East, Centra's Vice President of Behavioral Health, supervised Hartman. Id. During her employment with Centra, Hartman received mostly positive performance reviews and was nominated for—and received—various statewide nursing awards. Id. ¶¶ 20–21.

B. Centra's Intake Department Denies Two Transfer Requests to the CAPU

On June 1, 2019, Hartman noticed that the CAPU's patient census was lower than normal. Id. ¶ 30. After reviewing the previous day's transfer requests, Hartman discovered that the intake department denied two requests to transfer children experiencing acute psychiatric symptoms to the CAPU from hospital emergency rooms in other parts of Virginia. Id. ¶¶ 31–32. Upon further investigation, Hartman learned that Centra's intake department—at the direction of Dr. Jitendra Annapareddy, a psychiatrist and the only juvenile autism specialist in Lynchburg—had denied the transfer requests because the children had autism and lived outside the Lynchburg area, a set of circumstances that made post-discharge care arrangements difficult. Id. ¶¶ 33–36, 95. According to the CAPU's Scope of Services, "[a]lthough having an autism spectrum disorder is not [an] exclusionary criteri[on], the [CAPU's] ability to care for a child with [autism spectrum disorder] will be based on [the child's] level of functioning." Id. ¶ 35; see also Dkt. 17-1 at 3. Thus, the intake department denied the transfer requests for reasons outside of the established exclusionary criteria and even though beds were available, in violation of EMTALA. Dkt. 17 ¶¶ 35–37. Hartman took steps to determine the status of the children whose transfer requests had been denied, and although one child had already been transferred to a different hospital, she arranged for the intake department to admit the other child to the CAPU for stabilization. Id. ¶¶ 38–41.

The next day, Hartman reported the denial of the two transfer requests to her superiors. Id. ¶ 42. In an email to Dr. Michael Judd, Centra's Medical Director of Psychiatric Services, Sylvia Gallagher, Centra's Director of Psychiatric Emergency Services, and East, Hartman wrote, "We cannot de[n]y kids with autism based on being out of the area. This is a[n] injustice to the children and frankly an EMTALA violation. We could face two [$]50,000 fines over this." Dkt. 17-2 at 2; see also Dkt. 17 ¶ 42. In text messages that same day, East warned Hartman to "[b]e careful about admitting ‘fault’ " in communications with the emergency rooms that had requested the transfers, noting that the hospital "could be opening up a larger can of worms and indicting" itself. Id. ¶ 45; see also Dkt. 17-3 at 2.

C. Hartman Organizes Meetings Regarding Transfer Request Denials

On June 5, Hartman organized a meeting with East and other staff members to address and correct the problems that led to the transfer request denials. Id. ¶¶ 44, 46. At the meeting, Hartman again described the transfer request denials as EMTALA violations. Id. ¶ 47.

Immediately after that meeting, East asked Hartman to meet with her and Judd. Id. ¶¶ 48–50. During this second meeting, Judd warned Hartman that her email messages referencing the purported EMTALA violations "could get circulated" and were "over the top." Id. ¶ 51. East told Hartman that her email was "manic and pressured." Id. ¶ 54. Hartman stated that she needed to stop the meeting because she would not participate in a cover-up of the EMTALA violations and that she wanted a human resources department representative present. Id. ¶ 55. East then directed Hartman to leave the hospital. Id. ¶ 56. As she walked to her car, Hartman received a text message from East—intended for the human resources department—asking whether she could take Hartman's keys and badge. Id. ¶ 58.

After leaving the hospital that day, Hartman compiled and preserved evidence of the EMTALA violations, including the intake logs documenting the transfer request denials. Id. ¶ 63. She also reported the EMTALA violations to the Virginia Department of Health's Office of Licensure and Certification ("OLC"), a state agency responsible for investigating hospitals’ compliance with federal laws and regulations. Id. ¶¶ 68–69.

D. Centra Terminates Hartman's Employment

On June 6, the day after her meetings with East, Judd, and other staff members, and only four days after first notifying her supervisors about the purported EMTALA violations, Centra terminated Hartman. Id. ¶ 60. In an email, Centra's Human Resources Director, Shannon Meadows, wrote, "At this point, we believe that it is in everyone's best interest to end our working relationship." Id. ¶ 61; see Dkt. 17-4 at 2. Meadows also wrote that Hartman and "[her] family are always welcome to receive patient services as appropriate from Centra providers," and thanked Hartman "for all [her] concerns regarding potential EMTALA violations." Dkt. 17-4 at 2.

The same day, three armed Centra security officers showed up to Hartman's house and pounded on her front door for more than 30 minutes, demanding that she return "Centra property." Dkt. 17 ¶ 64.

E. OLC Investigates Hartman's Report of EMTALA Violations

The OLC investigated Hartman's report of EMTALA violations and released its findings in a "Statement of Deficiencies and Plan of Correction" on July 25. Id. ¶ 70; see Dkt. 17-5. According to the OLC's findings, Centra's staff "denied requests from two transferring hospitals[ ] for admissions to the [CAPU]" for children "who required specialized behavioral health care services offered by the facility," "failed to provide evidence [that the CAPU] lacked capacity and/or capability to accept the two requests for admission," and "altered" the intake logs that explained the reasons for denying the two transfer requests. Dkt. 17 ¶¶ 71–72; see Dkt. 17-5 at 3. The OLC further found that a Centra intake specialist made the alterations "on or about the time" Hartman reported her concern that the denials violated the EMTALA. Dkt. 17 ¶¶ 71–72; see Dkt. 17-5 at 3–4.

F. East's Statements About Hartman

On June 10, East emailed Denise Konrad, Director of Strategic Initiatives and Policy at the Virginia Health Care Foundation ("VHCF"), about a scholarship application for further professional nursing education that Hartman had pending with VHCF. Dkt. 17 ¶¶ 76–77. Unsolicited, East informed Konrad that Hartman "is no longer with our organization" and wrote, "Wasn't sure if you needed an update before distributing scholarship funds." Id. ¶ 77. At some point in the two weeks after East sent this email to Konrad, East called Konrad to specify that Centra had terminated Hartman's employment "for cause." Id. at ¶ 79. Soon after, Konrad called Hartman to discuss what East shared with...