A recent decision by a Florida federal court, Equal Employment Opportunity Commission v. St. Joseph’s Hospital, Inc., serves as a reminder to employers of the need to fully explore reasonable accommodations requested by disabled employees, including reassignment. In St. Joseph’s Hospital, the district court found that the Equal Employment Opportunity Commission (EEOC) might be able to demonstrate at trial that a hospital violated the Americans with Disabilities Act (ADA) by failing to consider a disabled nurse who used a cane for two positions for which she applied. 

Plaintiff worked in the hospital’s Behavioral Health Unit (BHU), an in-patient psychiatric unit for patients who present an imminent danger to themselves or others.  In August 2009, plaintiff had hip replacement surgery, which required her to use a cane upon her return to work.  At that time, plaintiff worked as a Clinical Nurse III, which involved supervising other nurses and allowed plaintiff to spend much of her time at a desk.  On October 17, 2011, plaintiff was demoted to a Clinical Nurse II position because she had allowed patients to sleep in the hallway during staff shortages.  In her new position, plaintiff worked on the floor and had much more direct interaction with patients in hallways and in their rooms. 

Plaintiff’s supervisor observed her using the cane in the BHU and instructed her to complete a work clearance form.  Plaintiff’s physician completed the form, indicating that she needed the cane on a permanent basis to help her with a “gait dysfunction” caused by the hip replacement.  Based on the patient population with whom plaintiff worked, the hospital determined that it was unsafe to use the cane in the BHU because patients could use the cane as a weapon.  Accordingly, the hospital informed plaintiff that it could not accommodate her request to use the cane in the BHU and gave her a month to obtain another position before she would be terminated.  Plaintiff applied for seven positions, but was not hired for any of them.  Accordingly, the hospital terminated plaintiff’s employment on November 21, 2011. 

The EEOC filed suit on the plaintiff’s behalf, alleging that the hospital failed to grant her a reasonable accommodation either by letting her use the cane in the BHU or by reassigning her to another position.  The hospital moved for summary judgment on the plaintiff’s claims, which the district court granted in part and denied in part.  The district court found that the use of the cane in the BHU was not a reasonable accommodation, given the unpredictability of the patients’ behavior, plaintiff’s inability to walk even short distances, her inability to help restrain patients, and the potential use of the cane as a weapon by patients.  

By contrast, the court found that the EEOC might be able to demonstrate at trial that the hospital unreasonably failed to reassign plaintiff to an Education Specialist or Care Transition Coordinator position.  The hiring manager testified that she did not interview plaintiff for the Education Specialist position because plaintiff only had a “psychiatric background” and did not have experience with acute medical care.  It was undisputed, however, that medical experience was not a qualification for the job, but was merely the hiring manager’s preference.  The court found that such preferences “are not equivalent to essential functions of a position” and that a jury could find the hospital unreasonably failed to reassign plaintiff to the position.  With respect to the Care Transition Coordinator position, the hospital declined to interview the plaintiff, though it offered no reason for its decision.  After remaining open for several months, the position was eliminated for budgetary reasons.  Despite the elimination of the position, the court found there was evidence that the hospital would have hired a qualified individual during the application period and plaintiff met the minimum qualifications for the position.  Accordingly, the court left it to the jury to decide whether the hospital had a duty to reassign plaintiff to the Care Transition Coordinator position. 

St. Joseph’s Hospital underscores the importance of fully exploring all accommodation requests posed by healthcare workers.  Although employers are not required to grant unreasonable accommodation requests, such as where the accommodation creates a risk of harm to patients or employees, employers must at least consider the request and provide a reasoned basis for any denial.  Failure to do so leaves the employer vulnerable to attack in subsequent litigation.