Martin v. St. Luke's Episcopal Hosp.

ROWENA MARTIN, Plaintiff, v. ST. LUKE'S EPISCOPAL HOSPITAL, et al., Defendants.

CIVIL ACTION NO. H-13-0718

UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION

September 23, 2014

MEMORANDUM AND OPINION

Rowena Martin sued her employer, St. Luke's Episcopal Hospital and its affiliated entities (collectively "St. Luke's"), after she was fired, alleging violations of the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12112, as amended by the ADA Amendments Act of 2008 ("ADAAA"), Pub. L. No. 110-325, 122 Stat. 3553 (2008). Martin claims that a new supervisor restructured her department in a way that increased her work load and made the work environment more stressful, which aggravated the effects of Martin's high blood pressure. Martin alleges that, as a result, she made errors that led St. Luke's to warn her, place her on probation, and then fire her. Martin argues that the errors resulted from "sometimes" having headaches, "moments of confusion," and "floaters" crossing her field of vision, making it hard to concentrate. She alleges that St. Luke's discriminated against her on the basis of her disability in firing her and in failing to provide a reasonable accommodation.

St. Luke's moved for summary judgment, arguing that the undisputed evidence shows that it fired Martin after repeated serious errors that persisted after warnings and probation; and that Martin's medical condition did not rise to the level of a disability and, even if it did, it was not afactor in the decision to fire her. St. Luke's also asserts that Martin never asked for the accommodations she now identifies and that they are not reasonable accommodations under the ADA. Martin responded to the motion, St. Luke's replied, and the court heard oral argument. (Docket Entry Nos. 20, 25, 26, & 31).

Based on the complaint; the motion for summary judgment, response, and reply; the oral arguments; and the relevant law, the court grants St. Luke's motion and enters final judgment by separate order. The reasons are explained in detail below.

I. Background

St. Luke's employed Martin from 1977 until April 29, 2012. (Docket Entry No. 25, Ex. A, at 2). During her 35 years at St. Luke's, Martin worked in the admitting department, which covered different hospital areas. (Docket Entry No. 20, Ex. A-1, Martin Depo. at 20-21). Around 2005, St. Luke's transferred Martin to the Pre-Admit Testing ("PAT") section of the Patient Access Services Department ("PAS") as a Senior Admitting Interviewer. (Id.).

At PAT, Martin was responsible for preregistering hospital patients before their surgeries by collecting demographic and insurance information and having them sign medical consent forms and insurance assignments. Martin collected and verified each patient's insurance information, and the patients paid their copays and other costs through Martin. (Id. at 22-23). Martin's job was to correctly input patient data and match that data to the correct patient. (Id.). Martin acknowledged in her deposition that other St. Luke's employees, including doctors, and insurance companies, relied on the information she gathered and recorded. Inaccurate information could result in a patient receiving incorrect services or prevent the patient from receiving insurance coverage. A mismatch of patient and data could cause those problems and also violate patient confidentiality and the HealthInsurance Portability and Accountability Act ("HIPAA"). Martin received training in HIPAA and knew that the law required protecting patient privacy. (Id. at 35). Martin testified that it was "never okay" to make mistakes in admitting a patient and that it was "never acceptable" to give one patient's paperwork to another. (Id. at 36).

Martin was diagnosed sometime before 2009 with hypertension. (Id. at 31, 91; Docket Entry No. 25 at 5). She has taken medication since her diagnosis but has not seen a doctor for the condition since 2009. Martin monitored her blood pressure regularly from 2009 to 2010. (Docket Entry No. 20, Ex. A-1, Martin Depo. at 56-57). Martin's blood pressure became more stable in 2010, and she stopped regularly monitoring it because she "got tired of doing it." (Id. at 57). She monitored her blood pressure only "occasionally" in 2011 and 2012. Somewhat inconsistently, Martin claims that during this period, she had "problems with [her] vision, headaches and confusion" at work that she attributes to her high blood pressure and stress. (Id. at 92). Martin has had other serious health problems in the past, including anemia, nearsightedness, and colon cancer. She does not allege any issue with St. Luke's as a result of those medical problems or the treatment they required. She testified that those medical problems were under control, and that the only time she had been physically or mentally limited was when she was being treated for cancer in 2003. (Id. at 206).

In 2011, Monica Schluer became the PAT supervisor and Martin's direct manager. (Docket Entry No. 20 at 4; Ex. A-1, Martin Depo. at 44). PAT was restructured and each employee's workload increased. Martin was not singled out; the changes applied to all PAT employees. Martin and other PAT employees were expected to admit each patient in 15 minutes or less. (Docket EntryNo. 20, Ex. A-1, Martin Depo. at 130). PAT employees were also expected to register at least 20 patients per day. (Id. at 162). Martin consistently failed to meet these goals.

In September 2011, Schluer and Christine Broussard, another manager, met with Martin to discuss her low productivity. (Docket Entry No. 25, Ex. C, Schluer Depo. at 28-31). Schluer offered to give Martin a training specialist to help her increase the number of patients she registered per day. (Id.; Docket Entry No. 20, Ex. A-1, Martin Depo. at 43-44). Martin declined. (Docket Entry No. 25, Ex. C, Schluer Depo. at 28-31).

In December 2008, Martin entered the incorrect insurance code when she registered a patient. Due to the error, the patient's insurance coverage could not be verified, threatening the receipt of benefits. Martin received a written "notice of concern," a stage in St. Luke's progressive discipline, in January 2009. (Docket Entry No. 20, Ex. A-2, Martin Depo. at Ex. 6).

In October 2011, Martin incorrectly filed a "face sheet" with a patient's confidential information in another patient's file. (Docket Entry No. 20, Exs. A-1, Martin Depo. at 62; A-2, Martin Depo. at Ex. 7). The error was discovered in November 2011. Schluer gave Martin a written warning. (Docket Entry No. 20, Ex. A-1, Martin Depo. at 64). Martin admitted the error, telling Schluer that she made the mistake because she used a printer shared with other PAT employees. (Id. at 65; Docket Entry No. 20, Ex. A-2, Martin Depo. at Ex. 7). This error violated HIPAA as well as St. Luke's policies. Schluer warned Martin that any future error could lead to corrective action, including possible termination. (Id.).

In January 2012, St. Luke's discovered that in July 2011, Martin had entered one patient's information into another patient's medical file. (Docket Entry No. 20, Ex. A-1, Martin Depo. at 66-69). Martin offered no explanation for her error. (Docket Entry No. 20, Ex. A-2, Martin Depo.at Ex. 8). This error also violated HIPAA as well as St. Luke's rules. Schluer placed Martin on probation and again warned that any future error could lead to corrective action "up to and including discharge." (Id.). Schluer reminded Martin that "it is imperative to ensure the correct patient has been properly identified during each registration." (Id.).

Martin made another similar error two weeks after being placed on probation. In April 2012, St. Luke's discovered that Martin had told a patient to sign another patient's Advance Beneficiary Notice of Noncoverage Form (ABN). Medicare requires an ABN to inform a patient that it may not cover a doctor-recommended procedure. (Docket Entry No. 20 at 6; Ex. A-1, Martin Depo. at 82). After having the patient sign the wrong ABN, Martin then put the form in another patient's file. (Docket Entry No. 20, Exs. A-1, Martin Depo. at 80-86; A-2, Martin Depo. at Ex. 9). This again violated both HIPAA and St. Luke's rules. St. Luke's followed progressive discipline and placed Martin on investigative suspension. (Docket Entry No. 20, Ex. A-1, Martin Depo. at 81).

During Martin's suspension, Schluer's manager, NaToshia Joseph, and Mercedes Tang, the PAS head, considered what punishment would be appropriate. Because Martin had committed four errors in recording patient data, three of which were HIPAA violations, her supervisors considered the errors to be "extremely serious." (Docket Entry No. 20, Ex. C, Joseph Affidavit).

Amber Crawford, an Employee Relations Specialist in the Human Resources Department, initially recommended placing Martin on probation follow-up rather than firing her because of her long tenure at St. Luke's. (Docket Entry No. 25, Ex. E). Joseph and Tang disagreed, believing that Martin should be fired for her repeated serious errors, including one committed shortly after placement on probation. (Id.). Although the Human Resources Department's practice was to consider employee tenure in disciplinary termination decisions, no written St. Luke's policy statedthat tenure was a factor, much less a critical one. (Id.). To the contrary, the practice in PAS was to fire any employee who violated HIPAA while on probation, without considering that employee's length of service. (Id.; Docket Entry No. 25, Ex. C, Schluer Depo.).

Human Resources approved the decision to fire Martin. (Docket Entry No. 25, Ex. C at 53-55). On April 30, 2012, Schluer and Cynthia Okeke, another PAT manager, informed Martin that St. Luke's had decided to fire her. (Docket Entry No. 20, Exs. A-1, Martin Depo. at 81; A-2, Martin Depo. at Ex. 9). Martin filed this lawsuit on March 14, 2013.

Martin claims that "the increase in the workload and the high stress environment exacerbated [her] issues with...