COMBS v. R1 RCM, INC.

CourtDistrict Court, S.D. Indiana
DecidedSeptember 24, 2021
Docket1:19-cv-04851
StatusUnknown

This text of COMBS v. R1 RCM, INC. (COMBS v. R1 RCM, INC.) is published on Counsel Stack Legal Research, covering District Court, S.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
COMBS v. R1 RCM, INC., (S.D. Ind. 2021).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF INDIANA INDIANAPOLIS DIVISION

BRENDA COMBS, ) ) Plaintiff ) ) v. ) Cause No. 1:19-CV-4851 RLM-MG ) R1 RCM, Inc., ) Defendant )

OPINION AND ORDER R1 RCM, Inc., fired Brenda Combs in March 2018. She sued, alleging that R1 violated the Americans with Disabilities Act by failing to provide reasonable accommodation and retaliating against her. R1 has moved for summary judgment on both claims and Ms. Combs has moved for partial summary judgment on the failure-to-accommodate claim. For the reasons stated below, the court GRANTS R1’s motion for summary judgment on both counts and DENIES Ms. Combs’s motion for partial summary judgment.

I. BACKGROUND St. Vincent Ascension Health (Ascension) hired Brenda Combs in 2016 as a follow-up representative in its billing department. Ms. Combs suffered from conditions such as diabetes and gastroparesis, which caused her to experience intermittent nausea, vomiting, bowel issues, and abdominal pain. Ms. Combs asked for accommodations to account for these conditions. She included a November 2016 accommodation certification in which her doctor certified that she needed frequent bathroom breaks and flexible scheduling for lunch. Ascension responded by allowing Ms. Combs to take flexible lunch breaks, take frequent trips to the restroom, and wear comfortable shoes.

R1 took over hospital billing for Ascension in 2017. R1 hired much of Ascension’s personnel and moved them to different positions. In June 2017, R1 hired Ms. Combs as a patient financial services follow-up representative. Shortly thereafter, in August 2017, Ms. Combs submitted an accommodation request to R1, seeking the same accommodations she had at Ascension and including her 2016 accommodation certification. One of R1’s human resources officers, Matt Hand, approved the accommodation request. Throughout 2018, R1 reduced the number of patient financial services

follow-up representative positions in the Indianapolis area where Ms. Combs worked. Then in November 2018, R1 informed Ms. Combs and one other patient financial services follow-up representative, Gelinda Brooks, that their positions would be eliminated, and they had twenty-four hours to accept new jobs as patient access insurance specialists, or they’d be terminated. Ms. Combs and Ms. Brooks both accepted the new positions. Their supervisors were Ebony White (their direct supervisor), Morgan Belland (Ms. White’s supervisor), and Latrenda Jones (Ms. Belland’s supervisor).

2 As a patient access insurance specialist, Ms. Combs was responsible for confirming insurance coverage for patients. To monitor employee performance, R1 tracked “adherence” (whether employees kept to their 15-minute morning

and afternoon breaks and 30-minute lunch break), quality of work, and productivity. To meet the productivity requirement, employees had to work a certain number of accounts per hour. During the first 90-day “ramp-up period,” patient access insurance specialists had to average five accounts per hour after thirty days, seven accounts per hour after sixty days, and eight accounts per hour after ninety days. Employees could work accounts on the phone or online, depending on the insurance provider, though most work was by telephone. In the days after Ms. Combs accepted the job, she corresponded with her

new human resources officer, Daniela Zdravkovski, about accommodations. R1 approved flexible bathroom and lunch breaks, as requested, and dropped the adherence requirement. R1 maintained that the productivity requirement was essential for all patient access insurance specialists so R1 didn’t drop that requirement for Ms. Combs; Ms. Combs had to meet her productivity requirement and stick to eight-hour shifts. R1 also agreed to let Ms. Combs transfer calls as needed and use the internet more than other employees, though

3 according to Ms. Combs she wasn’t adequately trained on transferring calls and never had proper access to various websites. On November 28, 2018, Ms. Combs began remote training, where she

immediately expressed concerns to Ms. Belland that she’d miss the productivity requirement if she had to drop calls to use the restroom. On December 6, Ms. Belland and other managers met with Ms. Combs over the phone to discuss concerns about Ms. Combs’s performance. According to Ms. Combs, during that call an unnamed manager laughed at her when she said she had to adjust her medication. On December 11, Ms. Combs emailed Ms. Belland to say that she felt unsettled by the December 6 meeting because she didn’t know she was going to be “belittled and laughed at,” and she accused Ms. Belland and others of

making up her performance issues. She then also emailed Ms. Zdravkovski for a transfer to another position because she “didn’t want the stress of being scrutinized.” Ms. Combs’s 90-day ramp up period officially began on December 21, 2018. On January 15, 2019, Ms. Combs filed a complaint to the R1 Ethics Point Hotline, complaining that not all her accommodations had been provided and that she had been laughed at during the December meeting.

4 Ms. Combs’s 30-day evaluation came in mid-January. On January 16, Ms. Belland emailed other supervisors to report that Ms. Combs wasn’t meeting the productivity requirement. She provided Ms. Combs with an evaluation noting

that she was behind in productivity. The two met on February 4, where Ms. Combs explained her difficulty accessing certain websites and Ms. Belland identified specific performance issues. Ms. Belland arranged for extra training on February 7, 2019, in which Ms. Combs was instructed on how to navigate insurance websites. Meanwhile, on January 17, Ms. Combs emailed Ms. Zdravkovski to report an “inappropriate comment” that Ms. Willhite made during the 30-day review. Ms. Combs’s only elaboration was that when she told Ms. Willhite that she might be rushing, Ms. Willhite asked, “why do you have stuff to

do around the house” and Ms. Combs responded, “I have bathroom issues.” Just before her 60-day evaluation, Ms. Combs emailed Ms. Zdravkovski again about a transfer, stating “I would like to be put in a different position to accommodate my health condition and not be under management that belittles me. I [saw] the doctor on [February 8] and he advised that I need to have some of this work stress eliminated.” Ms. Zdravkovski replied with the company’s transfer policy, which required twelve months’ tenure before a transfer. Ms. Combs responded with a screenshot of the company’s “Examples of Reasonable

5 Accommodations” and wrote “I should have been moved into a similar position like I had and qualify to perform.” The email thread sat dormant until March 21, after Ms. Combs’s 90-day evaluation.

Meanwhile at her 60-day evaluation, Ms. Combs was still below the productivity requirement—on February 19 she received an evaluation instructing her to apply what she learned in the extra training to help progress toward meeting the productivity requirement. Ms. Combs received extra training again on February 25. A trainer shadowed Ms. Combs, provided tips, and noted that Ms. Combs was near the goal while under observation—she reached seven accounts per hour and eight per hour was the eventual requirement. On February 21, Ms. Belland emailed others in management to report that

Ms. Combs and two other Patient Access Insurance Specialists weren’t on track to meet the production requirement. She asked, “[is it] a possibility to term[inate] prior to them having their 90 day review or do we have to wait . . . ?” On March 8, Ms. Zdravkovski responded that they could fire the other two employees at ninety days, but to wait longer to terminate Ms. Combs since Ms. Zdravkovski was waiting to hear back from the legal department since Ms. Combs had a disability.

6 Ms. Belland gave Ms.

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