Usually it's a good thing when health care providers accommodate the wishes of their patients, but what happens when the patient says, “I don't want any black employees working on my case. I don't even want them in my room.” In a recent case, Chaney v. Plainfield Healthcare Center (, a nursing home was accommodating a patient's racial biases by prohibiting black assistants from entering the patient's room or providing her care. The accommodation of the patient's racial bias was explicit by way of an assignment sheet, which listed each resident and was provided to each employee upon arriving at work, that contained the notation “Prefers No Black CNAs” next to the particular patient's name.

The Seventh Circuit Court of Appeals deemed the assignment sheet to be an unambiguous and daily reminder to the employee who sued and her co-workers of the racial bias of certain residents and determined that the nursing home was fostering and engendering a racially charged environment.

The court distinguished gender preferences from racial preferences in this context. It emphasized that, although many courts have ruled that gender is a legitimate criterion for accommodating patients' privacy interests, such discrimination may not be extended to race. The court explained, “Just as the law tolerates same-sex restrooms or same-sex dressing rooms, but not white-only rooms, to accommodate privacy needs, Title VII allows an employer to respect a preference for same-sex health providers, but not same race providers.”

The rationale for this decision applies more broadly than just to nursing homes. Employers generally cannot abide by discriminatory preferences of their clients or customers. Even where the “client” was a patient, and the services provided were very intimate and personal to the patient, the law will not tolerate an employer fostering a racially discriminatory bias. In most other contexts, the law similarly will not tolerate an employer fostering a client's biases based on gender, religion, national origin, or age.