United States of America v. Genesis Healthcare System - Settlement Agreement

ACTIONS TO BE TAKEN BY GENESIS

15. Genesis, including its hospitals, employed physicians, outpatient health care centers, and other medical facilities in which Genesis has a controlling interest, will not discriminate against any individual on the basis of disability, including HIV or AIDS, in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations offered at any of its current or future locations, in violation of title III of the ADA, 42 U.S.C. § 12182, and its implementing regulation, 28 C.F.R. Part 36.

16. For each person who is not accepted as a patient for any reason, and who (i) discloses to the Genesis provider a diagnosis of, (ii) is regarded by the Genesis provider as having, or (iii) is otherwise identified by the Genesis provider at or before the time of non-acceptance as potentially having HIV or AIDS, Genesis will create an electronic file and will maintain the electronic file for at least two years from the date the final decision is made to not accept the person as a patient.  Each file must include, at minimum: (i) the person's name if known or a unique identifier if the person's name is unknown (i.e., date of call, time of call, person receiving call), (ii) the date of initial contact with the person, (iii) the date the final decision is made to not accept the person as a patient, (iv) the names and titles of all persons involved in the decision, (v) the reasons for the decision, and (vi) all written documentation supporting the reasons for the decision.  The requirement does not apply if a person was not accepted as a patient because the Genesis provider was not accepting new patients at the time of the non-acceptance.  Copies of such files shall be provided to counsel for the United States quarterly (i.e., files created in calendar months January, February and March to be provided by April 30, and so on) throughout the duration of this Agreement and within 21 days of any written request for them.

17. For each person who is discharged from treatment for any reason other than the conclusion of treatment, and who (i) discloses to the Genesis provider a diagnosis of, (ii) is diagnosed by the Genesis provider as having, (iii) is regarded by the Genesis provider as having, or (iv) is otherwise identified by the Genesis provider at or before the time of discharge from treatment as potentially having HIV or AIDS, Genesis will create an electronic file and will maintain the electronic file for at least two years from the date the final decision is made to discharge the patient from treatment other than at the conclusion of the treatment.  Each file must include, at minimum: (i) the patient's name if known or a unique identifier if the patient's name is unknown (i.e., date of call, time of call, person receiving call), (ii) the date of initial contact with the patient, (iii) the date the final decision is made to discharge the patient, (iv) the names and titles of all persons involved in the decision, (v) the reasons for the decision, and (vi) all written documentation supporting the reasons for the decision.  Copies of such files shall be provided to counsel for the United States quarterly (i.e., files created in calendar months January, February and March to be provided by April 30, and so on) throughout the duration of this Agreement and within 21 days of any written request for them.

18. Within 21 days of receipt of any written or oral complaint made to Genesis's Patient Experience department (aka customer service) or Corporate Integrity hotline related to any alleged violations of title III of the ADA arising from or relating to Genesis's (a) non-acceptance of a person as a patient for which Genesis must create a file under paragraph 16 above or (b) discharge of a patient from treatment other than at the conclusion of the treatment for which Genesis must create a file under paragraph 17 above, Genesis shall send written notification to counsel for the United States with a copy of any such written complaint (or, if an oral complaint was made in the manner described in this paragraph 18, a description of the oral complaint) and a complete copy of Genesis's response.

19. Within 30 days of the effective date of this Agreement, Genesis will submit a draft non-discrimination policy to the United States for its review and approval.  The non-discrimination policy will state that it does not discriminate in the provision of services to persons with disabilities, including persons who have HIV or AIDS.  The non-discrimination policy will also direct those with questions, concerns, or complaints about the provision of services to contact Genesis’s Patient Experience department or Corporate Integrity hotline.  Within 21 days of approval by the United States, Genesis will adopt and implement the non-discrimination policy, and Genesis will maintain and enforce the non-discrimination policy for the duration of this Agreement.  Genesis will conspicuously post the non-discrimination policy in the reception area of each current and future Genesis hospital, outpatient health care center, and other medical facility in which Genesis has a controlling interest, and as a link on the company’s main webpage or “homepage,” currently located at http://www.genesishcs.org/, as well as on the homepage of any current or future Genesis website, for the duration of this Agreement.

20. Within 120 days of the date Genesis receives written approval by counsel for the United States under paragraph 23 of this Agreement, and in 2016 and 2017, Genesis will provide training on title III of the ADA to all Genesis employees and contractors who are involved with admissions or treatment of patients, including training about HIV/AIDS and discrimination in general.  Genesis is required to provide the training required by this Agreement only to such contractors who on the effective date of this Agreement are under a contract by which Genesis may require compliance with this training obligation.  The format of such training may be provided by electronic means and must include an interactive component.

21. In addition, Genesis will ensure that all new employees and contractors who are involved with admissions or treatment of patients receive the training referenced in paragraph 20 as a component of new employee training and orientation through the duration of this Agreement.  Genesis is required to provide the training required by this Agreement only to such contractors who on the effective date of this Agreement are under a contract by which Genesis may require compliance with this training obligation.  Genesis will ensure that any new contracts executed with new contractors while this Agreement is in effect shall give Genesis authority to require all new contractors to comply with this training obligation.  Genesis shall provide the training to such new employees and contractors within 45 days of their start date.  The format of such training may be provided by electronic means and must include an interactive component.

22. Employees whose duties will involve the record-keeping provisions set forth in paragraphs 16 and 17 shall be trained on how to implement those provisions.

23. All training manuals or written or electronic materials dealing with Genesis's policies and practices used in the trainings required in paragraphs 20 and 21 or created or substantively revised after the effective date of this Agreement shall be consistent with the provisions of this Agreement, and approved in advance by counsel for the United States.

24. Genesis shall create and maintain a log that documents the name of each individual who participates in the trainings required in paragraphs 20 and 21, his or her title, and the date he or she participated in the training(s).  This log may be kept in electronic format.  Copies of such log shall be provided to the United States within 21 days of any written request for it.

25. Within the later of 30 days of the effective date of this Agreement and the date the Complainant provides Genesis with an IRS Form W-9, Genesis will pay $25,000 to the Complainant to compensate her for the alleged harm she has endured (including, but not limited to, emotional distress, pain, and suffering) as a result of Genesis's failure to accept her as a new patient.  Genesis will issue an IRS Form 1099 to Complainant for this payment.  Genesis shall provide written notification to counsel for the United States, including a copy of the check, when it has completed the actions described in this paragraph.

26. Within 30 days of the effective date of this Agreement, Genesis will pay a civil penalty in the amount of $9,000 as authorized by 42 U.S.C. § 12188(b)(2)(C) and 28 C.F.R. § 36.504(a)(3), as amended, in order to vindicate the public interest.

27. Genesis will notify the United States in writing when it has completed the actions described in paragraphs 19–22.  This notification need only be provided when all of Genesis's hospitals, employed physicians, outpatient health care centers, and other medical facilities in which Genesis has a controlling interest, have completed the action required in the relevant paragraph(s).  Notification of Genesis's completion of the training described in paragraph 21 will be provided to the United States on an annual basis within 60 days of the end of each calendar year covered by this Agreement.  If any issues arise that affect the anticipated completion dates set forth in paragraphs 16-26, Genesis will immediately notify the United States of the issue(s), and the parties will attempt to resolve those issues in good faith.