Massey-Diez v. University of Iowa Community Medical Services, Inc.

826 F.3d 1149, 26 Wage & Hour Cas.2d (BNA) 991, 2016 U.S. App. LEXIS 11693, 2016 WL 3514019
CourtCourt of Appeals for the Eighth Circuit
DecidedJune 27, 2016
Docket15-2924
StatusPublished
Cited by47 cases

This text of 826 F.3d 1149 (Massey-Diez v. University of Iowa Community Medical Services, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eighth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Massey-Diez v. University of Iowa Community Medical Services, Inc., 826 F.3d 1149, 26 Wage & Hour Cas.2d (BNA) 991, 2016 U.S. App. LEXIS 11693, 2016 WL 3514019 (8th Cir. 2016).

Opinion

BEAM, Circuit Judge.

Madonna Massey-Diez, a physician assistant (PA) formerly employed by University of Iowa Community Medical Services, Inc. (UICMS), appeals the district court’s 1 adverse grant of summary judgment on claimed violations of the Family and Medical Leave Act of 1993 (FMLA). We affirm.

I. BACKGROUND

A. Massey-Diez’s Failure to Adhere to UICMS’s Charting Policies

Because this case comes to us on UICMS’s motion for summary judgment, *1153 we portray the facts in the light most favorable to Massey-Diez. Loftness Specialized Farm Equip., Inc, v. Twiestmeyer, 818 F.3d 356, 360 (8th Cir. 2016). Massey-Diez began working for UICMS at its North Liberty, Iowa, clinic as a PA in September 2009 under a year-to-year employment contract. In 2011 UICMS adopted “EPIC,” a software program used to manage patient records, track patient phone calls, review laboratory tests, and handle prescription refills. Promptly updating a patient’s medical information on EPIC after the patient’s visit (also known as “charting”) is important for billing and for presenting providers with current information about the patient. In order to .encourage prompt charting, UICMS employs nonbinding “Standards of Excellence,” which require that dictation be done within 24 hours of a patient’s visit and that once that dictation is transcribed, the transcription be reviewed and signed within the next 48 hours. The standards also require a patient’s charting generally “be completed within seven days” of a patient’s visit and that transcribed dictation in particular “be filed in the medical record within five working days of [a] visit.” 2

Apart from the Standards of Excellence, UICMS also requires that providers follow its “Completion of Documentation Policy,” enforced through a disciplinary procedure. The policy defines a provider as “noncom-pliant” if he is responsible for thirty or more unsigned records that are, on average, fourteen or more days old. If a provider is noncompliant, he is subject to “Level 1” discipline, wherein he is formally notified of his noncompliance and given seven days to complete all delinquent charting. Failure to do so within the seven-day period subjects the provider to “Level 2” discipline, which -consists of notice and paid leave until all delinquent charting is completed. Failure to complete all delinquent charting in fourteen days results in “Level 3” discipline, in which the provider’s employment is suspended pending completion of all delinquent charting.

Massey-Diez by all accounts provided excellent patient care. She had difficulty, however, with promptly updating patient records on EPIC. Providers were scheduled in back-to-back blocks of time, each allotted to a scheduled patient. Providers were expected to both attend to the patient and complete their charting within that period or to complete the charting at another time. These blocks were not long enough for Massey-Diez to do both, and apparently she was unsuccessful in having the clinic adjust her schedule to address this issue. North Liberty clinic manager Heidi Hansen advised supervisors about Massey-Diez’s issue with updating patient records in a timely fashion as early as July 2012. By that fall, Massey-Diez had over 200 delinquent records. In a November 2012 e-mail exchange Hansen wrote UICMS executive director Terry Protextor, assistant administrator Mike Hayden, and Massey-Diez’s supervising physician Dr. Powers to express her “concern! ] about Madonna and how far back her missing notes go.” Dr. Powers replied to Protextor, Hayden, and Hansen:

I was ready to address this head on today at Madonna’s review, and then it was cancelled because of her not feeling well.
I am very concerned as her supervising physician. I am almost to the point where I would not want her on my license any longer. Not only should *1154 these notes have been done, but I should have been reviewing 10% of them.
I was going to propose a probationary-period (? How long) where she MUST complete these notes, while also continuing work at the clinic. If this fails, then I would suggest work suspension.
The overlying factors are her home and family stress. Yet, those problems are now vigorously spilling over into work. Not only with incomplete work, but with many missed days or 1/2 days.
I really want to CC her on this email, but will not. Rather, Mike, Heidi, and I should complete her review ASAP. Before then, we all need to come to consensus on how SHE will handle this problem.

Massey-Diez subsequently received a “below expectations” rating on a performance evaluation for prioritizing and completing work assignments on time. She received notice of Level 1 discipline on November 30, 2012, and notice of Level 2 discipline in early December. Sometime in December, she caught up on her charting. She fell behind again the following February 2013. On March 21 she reached Level 2 discipline for the second time.

Also on March 21, 2013, Massey-Diez attended a meeting with Protextor, Hayden, arid Hansen. They discussed her tardy charting and agreed to try a new “open” scheduling method that might give Massey-Diez the opportunity to complete charting between patients. The meeting minutes describe some “Take-aways”: “1) by the end of next week notes have to be caught up so you are w/in 48 hours to current”; and “2) For 90 days stay current (gave exception for outliers). Expectation is the UICMS standard of 48 hours.” Additionally, a “Counseling & Disciplinary Action Report” signed by Massey-Diez stated: “Expectation is that charting will be current within one week and kept current for the next 90 days. If Madonna is not compliant with this then contract may not be renewed.” Massey-Diez testified that she did riot leave that meeting with the understanding that the renewal of her contract was in jeopardy and that she believed that during the 90-day period her objective was to stay in compliance with the Completion of Documentation Policy, rather than the 48-hour standard. In an April 3 email, however, Massey-Diez described her “knowing there is no intent to renew my contract in September.” In another, April 15, e-mail, she described the subjects discussed at the March 21 meeting as including “48 hour turnaround on notes, [and] intent to not renew my contract in September.” Massey-Diez caught up on her charting, but she fell behind once more in May and June of 2013.

B. Massey-Diez’s FMLA Leave and UICMS’s Decision Not to Renew Her Employment Contract

On June 17, 2013, Massey-Diez broke her foot and took FMLA leave for a serious medical condition. Her leave ran until June 30, at which point it became intermittent, and it ended on July 8. As of the date she took leave, she had as many as thirty-one incomplete charts that were five or more days old and so was in violation of the 48-hour turnaround time agreed to in the March 21 meeting. At that time, however, she was compliant under the Completion of Documentation Policy. While she was on FMLA leave, Massey-Diez was contacted for information on when she would return to work.

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826 F.3d 1149, 26 Wage & Hour Cas.2d (BNA) 991, 2016 U.S. App. LEXIS 11693, 2016 WL 3514019, Counsel Stack Legal Research, https://law.counselstack.com/opinion/massey-diez-v-university-of-iowa-community-medical-services-inc-ca8-2016.