Marcia Ebbs, M.D. v. Kentucky Unemployment Insurance Commission

CourtCourt of Appeals of Kentucky
DecidedDecember 22, 2020
Docket2020 CA 000025
StatusUnknown

This text of Marcia Ebbs, M.D. v. Kentucky Unemployment Insurance Commission (Marcia Ebbs, M.D. v. Kentucky Unemployment Insurance Commission) is published on Counsel Stack Legal Research, covering Court of Appeals of Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Marcia Ebbs, M.D. v. Kentucky Unemployment Insurance Commission, (Ky. Ct. App. 2020).

Opinion

RENDERED: DECEMBER 23, 2020; 10:00 A.M. NOT TO BE PUBLISHED

Commonwealth of Kentucky Court of Appeals

NO. 2020-CA-0025-MR

MARCIA EBBS, M.D. APPELLANT

APPEAL FROM OLDHAM CIRCUIT COURT v. HONORABLE KAREN A. CONRAD, JUDGE ACTION NO. 19-CI-00184

KENTUCKY UNEMPLOYMENT INSURANCE COMMISSION AND PHYSICIANS MEDICAL CENTER, LLC APPELLEES

OPINION AFFIRMING

** ** ** ** **

BEFORE: CLAYTON, CHIEF JUDGE; DIXON AND JONES, JUDGES.

JONES, JUDGE: The Appellant, Marcia Ebbs, M.D. (“Dr. Ebbs”), appeals the

Oldham Circuit Court’s decision to affirm a decision by the Kentucky

Unemployment Insurance Commission (the “Commission”) to deny Dr. Ebbs’s

application for unemployment benefits following termination of her employment by the Appellee, Physicians Medical Center (“PMC”). Having reviewed the record

and being otherwise sufficiently advised, we likewise affirm.

I. BACKGROUND AND PROCEDURAL HISTORY

Dr. Ebbs was employed as a family practice physician at PMC from

January 1, 2017, until her termination on August 17, 2018. PMC required Dr.

Ebbs to treat approximately 225 patients per month. As part of this care, Dr. Ebbs

was to document the treatment provided within three days of each visit via

electronic medical records (“EMR”). Timely charting was essential to providing

proper patient care and PMC being paid for the care provided.

When Dr. Ebbs first applied for the position at PMC, she disclosed

that her typing skills were “not the best” and that her previous employer had

provided her scribes to input her handwritten notes into patients’ electronic charts.

Dr. Ebbs alleges that she was promised a scribe when, or shortly after, she was

hired. However, no one was available at PMC to work as Dr. Ebbs’s scribe, and

no other physicians were provided scribes at Dr. Ebbs’s location, so PMC did not

fulfill her request for a scribe.1

1 Dr. Ebbs was assisted in transcribing her notes by two members of PMC’s staff for a time, but the two staff members decided to return to their regular job duties rather than continue assisting Dr. Ebbs.

-2- According to Crystal Stroud, PMC’s human resources manager, Dr.

Ebbs had difficulty keeping up with the pace of the medical center, resulting in

charting delays and long wait times for patients.

In September 2017, Dr. Ebbs received her first non-disciplinary

corrective action for failure to complete her charting for approximately 400

patients.2 Dr. Ebbs was placed on an administrative suspension for the sole

purpose of completing her charting and ultimately did so over the span of three

weeks.

On June 14, 2018, Dr. Ebbs received a written warning and two-week

paid suspension for again failing to complete her charting. This time, Dr. Ebbs had

failed to timely complete the charts of 683 patients. PMC advised Dr. Ebbs that

her suspension would continue until she was caught up with her charting. The

written warning explicitly prohibited Dr. Ebbs from seeing patients, writing

prescriptions, or practicing medicine during the suspension period. Upon the

expiration of Dr. Ebbs’s two-week suspension, Dr. Ebbs had not completed her

charting and remained on suspension.

On June 29, 2018, Dr. Ebbs was again disciplined when it was

discovered that she had written a prescription for a patient against the express

2 At one point in the hearing record, this event was attributed to March 2018. Dr. Ebbs actually fell behind in her charting for the first time in September 2017, and eventually caught up by January 2018. Regardless, Dr. Ebbs was again behind in her charting by March 2018.

-3- terms of her suspension. Dr. Ebbs admitted to having written the prescription but

claims to have forgotten the restrictions imposed, blaming her infraction on PMC

staff not being clear on the exact terms of her suspension. At this point, Thomas

Williams, PMC’s new director, issued a written reminder to all of the PMC staff

that Dr. Ebbs was not permitted to practice medicine or write prescriptions during

her suspension.

Dr. Ebbs received her final written warning on July 13, 2018. As

other providers were seeing Dr. Ebbs’s patients during her suspension, it was

brought to Williams’s attention that, prior to her suspension, Dr. Ebbs had written

a prescription for a controlled substance for a patient being treated for ADHD

without an office visit to examine and monitor the patient’s current physical

condition.3 Although Williams testified that office visits were required for such

patients every three months, his written warning detailed Dr. Ebbs’s violation as

“prescribing an ADHD/ADD [medicine] without monthly visits; no monitoring of

patient’s health and well-being.” Record (“R.”) at 159 (emphasis added). Dr.

Ebbs contends that Drug Enforcement Agency guidelines for ADHD patients only

3 The Commission’s findings seem to note that the prescription written for Dr. Ebbs’s ADHD patient was written during the suspension period, but a review of the record indicates differently. No information was provided to the Commission as to what prescription was written by Dr. Ebbs during her suspension. The June 29, 2018, and July 13, 2018, written warnings address two separate events.

-4- recommend visits every three months rather than requiring them.4 Regardless, Dr.

Ebbs was issued her final warning and was no longer permitted to treat patients

under the age of eighteen. It was also noted that Dr. Ebbs had still not completed

her charting at this point.

Finally, in August 2018, one of the providers covering for Dr. Ebbs

during her suspension consulted with a patient for whom Dr. Ebbs had ordered a

colon cancer screening a year prior in August 2017. The provider reported that the

positive test results were in the patient’s medical records but had not been

communicated to the patient. Dr. Ebbs did not recall seeing the results of the test

in the patient’s electronic medical records but had not asked the patient if the test

had been performed as she had ordered at any of the patient’s subsequent

appointments.

Dr. Ebbs contends that she never received the test results from PMC

staff. According to Dr. Ebbs, it was PMC’s protocol to physically deliver test

results to her or her medical assistant or put the positive lab results in her

designated basket. PMC testified that its staff would directly communicate the test

results to the doctor to review them with a patient and scan the test results into its

4 According to Dr. Ebbs, there was a dispute between Williams and her as to whether the minor ADHD patient was malnourished. Dr. Ebbs averred that the child was “well-developed per his chart,” and that she had properly monitored the child by discussing the child’s progress with the child’s father when the father appeared at PMC to pick up his son’s medication.

-5- EMR system, which in turn would notify physicians of any new test results

through a system of colored “jellybeans.” According to Crystal Stroud, a red

jellybean would appear on a patient’s EMR chart any time a positive lab result was

added to a patient’s chart so as to notify the patient’s physician. Dr. Ebbs claims to

have not seen a red jellybean on this patient’s EMR chart.

As a result of this incident, on August 27, 2018, Dr. Ebbs was

dismissed for insubordination and unsatisfactory performance of duties. At that

time, over two months after she had first been placed on suspension, Dr. Ebbs had

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