United States District Court, District of Columbia
Denise Marie Clark, Clark Law Group, Washington, DC, for Plaintiff.
Brian Wayne Steinbach, Kathleen M. Williams, Epstein Becker & Green, P.C., Washington, DC, for Defendant.
ROBERT L. WILKINS, District Judge.
This matter is before the Court on the defendant's motion for summary judgment. For the reasons discussed below, the motion will be granted in part and denied in part.
The plaintiff, a registered nurse, began her employment with D.C. Chartered Health Plan, Inc. (" CHP" or " the defendant" ) on January 23, 2001. Plaintiff's First Amended Complaint (" Am. Compl." ) ¶¶ 14, 16; Def.'s Mem., Ex. 1 (Steinbach Decl.), Ex. I (Objections and Responses of Defendant D.C. Chartered Health Plan, Inc. to Plaintiff's First Set of Interrogatories (" Def.'s Interrog. Resp." ) No. 3). CHP, a managed care organization, participated in the D.C. Medicaid Managed Care Program. Statement of Material Facts As To Which There Is No Genuine Issue (" Def.'s SOMF" ) ¶ 1. CHP's Medical Director was Lavdena Orr, M.D., and Francis M. Smith was its Vice President and General Counsel. Id. In late 2004, Mr. Smith assumed duties previously assigned to Tracey Charles, the former Director of Human Resources. Plaintiff's Brief in Opposition to Defendant's Motion for Summary Judgment (" Pl.'s Opp'n" ), Ex. 2 (" Austin Aff." ) ¶ 11. Karen Morris, Director of Medical Management, Austin Aff. ¶ 15, was the plaintiff's supervisor, Def.'s SOMF ¶ 1.
The plaintiff was hired as a Utilization Management Coordinator whose " job [it] was to track Medicaid patients who were members of [CHP], to issue authorizations for medical care in hospitals and other health care facilities, and to keep timely ..., accurate and detailed records of ... members' medical treatment in CHP's computer tracking system for insurance authorization purposes." Def.'s SOMF ¶ 3. Nurses were particularly useful in
this role " because they understand medical/clinical activities," and most of CHP's utilization review (" UR" ) nurses " have hospital experience [and] understand how hospitals operate." Def.'s Mem., Ex. B (" Smith Dep." ) at 47:20-48:2. The parties do not dispute that a UR nurse was expected to input patient information in a timely manner, which CHP defined as within 24 hours. Id. The plaintiff counters that CHP had a " goal that medical records be entered within twenty-four hours of receipt from a hospital." Pl.'s Opp'n, Pl.'s Aff. ¶ 2 (emphasis added).
Over time, CHP's " business needs changed in many respects." Def.'s Interrog. Resp. No. 14. In the early years of the plaintiff's employment at CHP, UR nurses ordinarily did not make onsite visits to hospitals. Id. During the 2001-2003 time period, however, UR nurses " frequently traveled to hospitals or other health care facilities to obtain medical records and other relevant information" about CHP members and their care. Def.'s SOMF ¶ 4. By 2004, UR nurses— including the plaintiff— were required to make onsite visits to participating hospitals. Def.'s SOMF ¶ 5; Def.'s Interrog. Resp. No. 14.
The plaintiff had " difficulty walking," Def.'s Mem., Ex. A (" Pl.'s Dep." ) at 31:19, and she was unable " to [walk] to and from the parking lot," id. at 31:20, or " walk in a hospital down the long corridor[s]," id. at 31:21-22, or " go to multiple floors seeking ... patient[ ] charts," id. at 32:1-2. The plaintiff requested, and CHP approved, id. at 40:21-41:3, an arrangement such that the plaintiff " continue[d] doing the same job" from CHP's office, id. at 32:6-9. She was the only UR nurse who did not make onsite visits to hospitals. Id. at 32:16-18. Instead, she obtained patient information by telephone, fax, or computer. Id. at 32:19-33:2. Hospitals with which CHP had no contract (non-participating hospitals or " non-pars" ) did not allow onsite reviews, and the plaintiff conducted these reviews from the office for patients at those facilities. Id. at 46:11-47:4; see Am. Compl. ¶ 17.
Because the plaintiff was not conducting onsite visits, she was available in the office full time. Def.'s SOMF ¶ 6. In September 2002, the plaintiff was promoted to Team Leader of a group of three to five UR nurses. Am. Compl. ¶¶ 18-19. The " team was responsible for reviewing patient charts to confirm that continued stays in the hospital were necessary for individual patients," id. ¶ 19; see generally Pl.'s Dep. at 47:20-51:8. She was responsible for maintaining contact with nurses on her team who were working onsite and for monitoring their charts. Pl.'s Dep. at 47:20-48:7. She also monitored the patient
census, patients with long hospital stays, reinsurance, and patient transfers, and she performed UR functions for patients at non-pars. Id. at 48:21-49:11; Def.'s SOMF ¶ 6. In addition, the plaintiff was " responsible for holding weekly face-to-face meetings with UR staff to coordinate and track patient care." Def.'s SOMF ¶ 6. The plaintiff performed the duties of her Team Leader position, including daily contact with team members, from the office by telephone, fax and computer. Am. Compl. ¶ 20; Pl.'s Opp'n, Ex. 1 (" Pl.'s Aff." ) ¶ 4.
Prior to her employment with CHP, the plaintiff sustained " a back injury that impacted her ability to lift and walk, as well as her overall mobility." Am. Compl. ¶ 15. In late December 2003 while the plaintiff was at the CHP office, her " back injury became severely aggravated." Id. ¶ 22. The plaintiff explained that her " back had locked up," Pl.'s Dep. at 76:14, causing " excruciating pain ... down [her] leg and ... buttocks," such that she " had great difficulty walking[ ] and ... couldn't stand at all," id. at 77:19-22. The plaintiff was out of the office on sick leave for six weeks. Def.'s Interrog. Resp. No. 6; Pl.'s Dep. at 82:5-10, 261:2-5, 262:13-15.
The plaintiff's condition allegedly " resulted in several impairments that substantially affect several major life activities, including but not limited to walking, standing, and lifting," and " prevented her from working on the floor of any hospital." Am. Compl. ¶ 24. In January 2004, the plaintiff requested " that she be allowed to continue her employment from home." Id. ¶ 25; Def.'s Mem., Ex. J (Responses to Defendant's Interrogatories (" Pl.'s Interrog. Resp." ) No. 4). CHP approved her request. Am. Compl. ¶ 26; Def.'s Interrog. Resp. No. 4; Pl.'s Dep. at 262:10. The plaintiff thus was excused not only from attending weekly meetings in the office, but also from making onsite visits to hospitals. Def.'s Interrog. Resp. No. 14. While working from home, the plaintiff allegedly " was able to complete the essential tasks of her employment." Am. Compl. ¶ 27. Although the plaintiff believed that the work-from-home arrangement " would be short term," Pl.'s Dep. at 83:9-10; 97:17-22, she did not return to the office, id. at 83:14-16.
According to the plaintiff's treating physician, Dr. Smith S. Ho, as of March 3, 2004, the plaintiff was partially incapacitated and could continue light duty work, provided that she take frequent breaks to lie down. Pl.'s Dep., Ex. 5 (Disability Certificate dated March 3, 2004). Dr. Ho made the same recommendation for the remainder of 2004. See Pl.'s Opp'n, Ex. 3 (Disability Certificates dated April 1, 2004 and June 17, 2004).
Apparently with the understanding that the plaintiff could return to the office with accommodations, CHP offered to provide the plaintiff a chair and a sofa for her use during breaks, Pl.'s Dep. at 98:22-101:19, and a handicapped parking space, Plaintiff's Response to Defendant's Requests for Admission (" Pl.'s Resp. to Def.'s Req. for Admis." ) No. 3. The plaintiff rejected the offers because, in her opinion, " these accommodations were not sufficient to accommodate her medical condition." Id. She explained that she could not " lie on a couch" because it would be " extremely painful" to do so on such an " uneven" surface. Pl.'s Dep. at 84:4-6. Furthermore, the only spaces for a couch were a kitchenette and the front lobby, Austin Aff.
¶¶ 24-25, and presumably neither area was conducive to rest. The plaintiff " preferred to continue to work from home." Pl.'s Resp. to Def.'s Req. for Admis. No. 3. According to CHP, on several occasions it " requested that it be provided a diagnosis, prognosis and expected date of return to work, but such was never provided, and Plaintiff apparently viewed such ... requests for information to be hostile and harassing." Def.'s Interrog. Resp. No. 14. According to the plaintiff, she " supplied regular information about her prognosis and diagnosis to Tracey Charles." Pl.'s Resp. to Def.'s Req. for Admis. No. 5.
On July 1, 2004, Ms. Morris conducted the plaintiff's performance review. See Def.'s Mem., Smith Decl., Ex. A (Annual Performance Appraisal dated July 1, 2004). The report generally was favorable, noting, for example, that the plaintiff's " job skill and knowledge about rehab[ilitation]" was " untouchable." Id., Ex. A at 2. Ms. Morris " rated Plaintiff's performance as ‘ meeting’ to ‘ exceeding’ expectations in a vast majority of categories and as ‘ needs improvement’ in four categories." Id. ¶ 4 & Ex. A at 3. It was noted, however, that the plaintiff received verbal counseling regarding her lack of attention to detail and " the importance of communicating with her staff on a daily bases [sic]." See id., Ex. A at 2. The review comments indicated that the plaintiff was " working on" submitting timely documentation and meeting other performance measures. See id., Ex. A at 2-3.
The plaintiff's absence from the office meant that she did not attend weekly meetings in person; instead she participated by telephone. Pl.'s Opp'n, Pl.'s Aff. ¶ 3; Def.'s Interrog. Resp. No. 11. According to the plaintiff, Ms. Morris would " put [her] on the spot sometimes on teleconferencing, asking: ‘ When are you coming back to the office?’ " Pl.'s Dep. at 64:13-14. Ms. Morris " seemed angry with [the plaintiff] on the phone" when the plaintiff was speaking, id. at 64:20-21, and " she would interrogate [the plaintiff by] asking [her] the same question" repeatedly, id. at 65:3-4. The plaintiff was told that Ms. Morris was " making all these faces and rolling her eyes up and sighing" as the plaintiff spoke. Id. at 66:16-18. At least one other employee thought that Ms. Morris " was perceived as very mean, her condescension and mean behavior were directed particularly towards [the plaintiff and another employee]." Austin Aff. ¶ 17. Ms Morris also called the plaintiff " an air head," Pl.'s Dep. at 231:4, and suggested that the plaintiff was dyslexic, id. at 230:9-10.
According to the plaintiff, Ms. Morris " demanded that Plaintiff's accommodation of working from home cease and that she report to work in the office, while other employees on Plaintiff's team, who did not have disabilities, were permitted to work from home." Am. Compl. ¶ 29. She " frequently" would tell the plaintiff that she needed the plaintiff to return to the office. Pl.'s Dep. at 106:8-107:8. Ms. Morris allegedly " harassed Plaintiff because of her disability," Am. Compl. ¶ 30, and this behavior " was so pervasive and severe that it prompted Plaintiff to call [CHP's] ‘ Employee Hot Line,’ " id. ¶ 31, on September 8, 2004, Smith Decl. ¶ 5. " The subject of
the call was ‘ work environment issues,’ and the sub-category was ‘ unfair treatment.’ " Smith Decl. ¶ 5. The report of the call stated:
Caller, Valerie Parks, employee, stated that " for months and months" [did not provide exact dates]," Karen Morris, director of medical management, has spoken to her in a " degrading manner." Ms. Parks stated that Ms. Morris often calls her an " airhead." Ms. Morris also claimed that Ms. Parks is dyslexic, which Ms. Parks stated is untrue. Ms. Parks feels that Ms. Morris is very unprofessional and needs to be reviewed by compliance. Caller stated, " The manner in which [Ms. Morris] speaks to me is not fair and equal. [Ms. Morris] degrades me in front of everyone during case round meetings [in which employees discuss the nature of healthcare received at different facilities]. You don't do that. I want fair and equal treatment."
There came a time when CHP officials developed " substantial privacy concerns with regard to employees who worked from home," particularly with respect to the handling of patient records containing protected health information. Def.'s SOMF ¶ 15; Pl.'s Resp. to Def.'s SOMF ¶ 15. Issues also arose with respect to the plaintiff's working from home, her absence from weekly meetings, and her inability " to participate fully in the interactive communication process with regard to member care." Def.'s SOMF ¶ 16; Def.'s Interrog. Resp. No. 11. For example, the plaintiff's former supervisor had never met the plaintiff, did not know the plaintiff's work hours, and noticed that sensitive patient information was being sent to the plaintiff from hospitals by fax. Def.'s Mem., Ex D (" Dodoo Dep." ) at 55:7-13. Mr. Smith also was quite concerned about employee productivity and complaints he had received from hospitals regarding the timeliness of authorizations for hospital stays. See Smith Dep. at 15:7-18:22, 38:1-41:17.
" By 2004, [CHP] required UR employees to go onsite, a requirement from which Plaintiff initially was excused." Def.'s Interrog. Resp. 14. It was determined that, " [t]o effectively handle Team Lead duties, ... onsite travel and oversight" were required. Id. In addition, CHP had become " increasingly concerned with privacy protocols," and therefore urged all employees who worked from home to return to the office, " simply to insure quality of work and effective communication." Id. It was in this context that, in October 2004, CHP officials were evaluating job descriptions. See Am. Compl. ¶ 32.
On October 27, 2004, Ms. Charles sent a letter to Dr. Ho which in relevant part stated:
I understand that [the plaintiff] is a patient of yours. Since January 2004, we have been receiving regular physician notes from your office regarding [the plaintiff's] ability to perform her current position .... Based on the physician notes from your office, for the past 10 months, we have accommodated [the plaintiff] by allowing her to work
from home. We are currently evaluating our job descriptions and need to make determinations regarding expectations of work environment for her position as Team Leader overseeing five nurses. This position requires the incumbent to be able to travel to different sights [sic] to oversee staff. With her current medical condition, we need your assessment as to whether or not [the plaintiff] can be onsite in the office and travel, as her position requires.
Pl.'s Dep., Ex. 4 (Letter from Tracey A. Charles, Director of Human Resources, CHP, to Dr. Smith S. Ho dated October 27, 2004). Dr. Ho responded:
[The plaintiff] has been under my professional care for the treatment of adult onset diabetes, hypertension, as well as osteoarthritis, specifically involving her hip and knees, as well as her back for the past several years. Since January[ ] 2004, she has been performing her duties at home[ ] due to her medical condition. Recently she has had a fall and sustained a tear ...