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

TITLE III COVERAGE AND FINDINGS

4. The Attorney General is responsible for administering and enforcing title III of the ADA, 42 U.S.C. §§ 12181-12189, and the relevant regulation implementing title III, 28 C.F.R. Part 36.

5. The Complainant, an individual with HIV, has a physical impairment that substantially limits one or more major life activities, including the functions of the immune system, which is a major bodily function.  Accordingly, she has a disability within the meaning of 42 U.S.C. § 12102 and 28 C.F.R. § 36.104.

6. Genesis is an Ohio not-for-profit corporation, with its principal location at 2951 Maple Avenue, Zanesville, OH 43701.  Genesis owns and operates an integrated health care system that includes a not-for-profit hospital that operates at two Zanesville sites, a network of more than 300 physicians (of which approximately 120 are employed by Genesis), and multiple outpatient health care centers throughout its six-county region of southeastern Ohio. 

7. Among its approximately 47 locations in Ohio, Genesis has a medical facility that provides general family medicine services located at 1 East Main Street, Suite 200A, New Concord, OH 43762, known as the Genesis Health Center – New Concord or New Concord Family Practice (“New Concord”). 

8. Genesis owns, leases (or leases to), or operates places of public accommodation within the meaning of 42 U.S.C. § 12182(a); is a private entity within the meaning of 42 U.S.C. § 12181(6); and is a place of public accommodation within the meaning of 42 U.S.C. § 12181(7), because it affects commerce and operates a professional office of a health care provider.  See also 28 C.F.R. § 36.104.

9. Under title III of the ADA, no person who owns, leases (or leases to), or operates a place of public accommodation may discriminate against an individual on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation.  42 U.S.C. § 12182(a); 28 C.F.R. § 36.201(a).

10. Ensuring that medical care providers do not discriminate on the basis of disability is an issue of general public importance.  The United States is authorized to investigate alleged violations of title III of the ADA and to bring a civil action in federal court in any case that involves a pattern or practice of discrimination or that raises issues of general public importance.  42 U.S.C. § 12188(b).

11. As a result of its investigation, the United States has determined:

• a. In April 2013, Genesis employed one primary care physician at New Concord.

• b. On April 10, 2013, the Complainant called New Concord to obtain a primary care physician and spoke with the receptionist. 

• c. During the initial call with the New Concord receptionist, the Complainant stated that she was currently taking medications for anxiety and HIV.  The Complainant explained to the receptionist that the HIV medicine was prescribed by her HIV specialist. 

• d. The Complainant was told by the receptionist that the receptionist did not believe that New Concord would accept her as a patient.  The receptionist informed the Complainant that she would speak with the New Concord physician and would call her back.

• e. New Concord confirms that the receptionist recalls speaking with the New Concord physician about treating a patient with HIV, and that the physician indicated that she was not equipped to treat a patient with HIV and the patient should remain with her treating physician in Columbus, Ohio.  New Concord further confirms that it is the physician's practice to refer any patient with HIV to an infectious disease specialist.

• f. In April 2013, the Complainant lived in Cambridge, Ohio.  The commute between Cambridge and Columbus is approximately 80 miles.  New Concord is approximately 10 miles from the Complainant's Cambridge home.

• g. The Complainant did not receive a follow-up call after her initial conversation with the New Concord receptionist.  On April 11, 2013, the Complainant called New Concord and the receptionist informed her that the physician would not accept her as a patient because of her HIV diagnosis.  The Complainant reminded the receptionist that she only needed a general practitioner for medical care unrelated to HIV, and that she would continue to see an infectious disease practice for her HIV treatment.  Nonetheless, the receptionist told the Complainant that the New Concord physician would not accept her as a patient because she had HIV.

• h. In evaluating the Complainant as a potential new patient, the New Concord physician never examined the Complainant, nor did she review any of the Complainant's medical records. 

• i. After New Concord refused to accept her as a new patient in April 2013, the Complainant continued to search for a primary care physician for approximately five months, but was unable to find one who would accept her as a new patient in the local Cambridge area. 

• j. In September 2013, the Complainant finally located a primary care physician at a medical practice over 25 miles away from her Cambridge, Ohio home.  In addition to receiving treatment from this primary care physician, the Complainant continues to see her infectious disease doctor in Columbus for treatment of her HIV. 

• k. During this five month period from April 2013, when New Concord refused to accept the Complainant as a new patient because of her HIV, until she located her current primary care physician in September 2013, the Complainant had to seek medical treatment at the local emergency room for non-emergent health issues because she did not have a primary care physician.  Because the Complainant reports that she had to wait in the emergency room for several hours on some occasions before seeing a doctor, she would only seek medical treatment from the emergency room when she was very ill or had immediate medical needs.

12. A healthcare provider cannot refer a patient with HIV or AIDS to another provider simply because the patient has HIV or AIDS.  The referral must be based on the fact that the treatment the patient is seeking is outside the expertise of the provider, not the patient's HIV status alone.  See Questions and Answers: The Americans with Disabilities Act and Persons with HIV/AIDS, available at http://www.ada.gov/aids/ada_q&a_aids.htm. 

13. The United States has determined that Genesis discriminated against the Complainant by denying her the opportunity to participate in or benefit from the goods, services, facilities, privileges, advantages, or accommodations of Genesis on the basis of HIV, in violation of 42 U.S.C. § 12182 and 28 C.F.R. § 36.201.  Genesis disclaims any liability for any wrongdoing against Complainant and denies any wrongdoing against Complainant.  Genesis agrees to enter into this Agreement solely in the interest of compromise.

14. The Complainant is an aggrieved person pursuant to 42 U.S.C. § 12188(b)(2)(B).