Sandoval v. Franciscan Alliance Inc.

CourtDistrict Court, N.D. Indiana
DecidedJanuary 29, 2024
Docket2:22-cv-00218
StatusUnknown

This text of Sandoval v. Franciscan Alliance Inc. (Sandoval v. Franciscan Alliance Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sandoval v. Franciscan Alliance Inc., (N.D. Ind. 2024).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA HAMMOND DIVISION

ESTHER SANDOVAL, ) ) Plaintiff, ) ) v. ) Case No. 2:22-cv-218 ) FRANCISCAN ALLIANCE, INC., ) ) Defendant. )

OPINION AND ORDER This matter is before the court on the Motion for Summary Judgment [DE 25] filed by the defendant, Franciscan Alliance, Inc., on September 28, 2023. For the following reasons, the Motion for Summary Judgment is GRANTED. Background The plaintiff, Esther Sandoval, initiated this lawsuit on August 1, 2022, against the defendant, Franciscan Alliance, Inc., her former employer, alleging that Franciscan violated both federal and Indiana state law when it terminated her employment as an insurance biller on July 1, 2021. Sandoval alleges that Franciscan terminated her based on her age in violation of the Age Discrimination in Employment Act of 1967 (“ADEA”) and her race in violation of Title VII of the Civil Rights Act of 1964 (“Title VII”). Sandoval brought Indiana state-law claims for intentional and negligent infliction of emotional distress as well. On September 28, 2023, Franciscan filed the instant motion for summary judgment. [DE 24]. Sandoval responded in opposition on December 15, 2023. [DE 32]. On January 15, 2024, Franciscan filed its reply. [DE 38]. The parties filed forms of consent to have this case assigned to a United States Magistrate Judge to conduct all further proceedings and to order the entry of a final judgment. As a result, this court has jurisdiction to decide this case pursuant to 28 U.S.C. § 636(c). Undisputed Material Facts Prior to her termination in 2021, Sandoval had been employed by Franciscan since 1978

and served various roles during her employment. [DE 32 at 1, ¶ 1]. At the time of her termination, Sandoval was working as an insurance biller, correcting and processing billing claims assigned to her. [DE 32 at 1, ¶ 2]. Each insurance biller received assignments according to an alphabetical split, such that each claim was assigned to a particular biller based on the last name of the patient whose claim was at issue. [DE 32 at 3, ¶ 11]. Sandoval was responsible for split A through G, while co-worker Robin Jusko was responsible for split H through L, and Julie Kolanowski was responsible for split M through Z. Id. As an insurance biller, Sandoval was expected to meet an established key performance indicator (“KPI”) of handling at least 180 accounts per day. [DE 32 at 4, ¶ 12]. To count toward

an insurance biller’s KPI, an account had to be corrected, noted, and billed, meaning that the insurance biller needed to review the account’s error code and make a correction, add a note to the account related to the review or steps taken to resolve the account, and correct the account so that it got billed to the payer on file. [DE 32 at 4, ¶ 13] To meet a KPI of 180, an insurance biller would have to, on average, correct, note, and bill 180 claims per day, so that on average at the end of the month, the insurance biller’s daily average KPI would equal 180 claims per day. [DE 32 at 4, ¶ 14]. Between October 2020 through June 2021, Sandoval continually failed to meet the expected KPI of 180, except for February 2021. [DE 32 at 5, ¶¶ 15, 17]. According to Sandoval, she struggled to meet the KPI for various reasons including the difficulties of learning to work from home because of the COVID-19 pandemic, an increased workload due to coworkers leaving the billing department, being not allowed to work overtime, and being pulled for retraining. [DE 32 at 6, ¶ 19]. In March 2020, during the pandemic, Franciscan allowed insurance billers, such as Sandoval, the opportunity to work remotely, but insurance billers still

were expected to meet the standard KPI of 180. [DE 32 at 9, ¶ 23]. Employees who failed to meet the required KPI were provided a coaching session, and if there was no improvement, the employee was instructed to return to working in the office. [DE 32 at 9, ¶ 24]. In March 2020, Sandoval’s KPI was 119, below the 180 standards. [DE 32 at 9, ¶ 25]. Franciscan assigned Sandoval to a re-training period in April 2020, where she reviewed claims with supervisors between 2:00 p.m. and 3:30 p.m. each day for five days. [DE 32 at 10, ¶ 26]. On April 23, 2020, Sandoval’s supervisors held another training call with her. [DE 32 at 10, ¶ 27]. After retraining Sandoval, Franciscan provided her with additional time to increase her productivity to meet the expected KPI of 180. [DE 32 at 10, ¶ 28]. Sandoval’s KPI was 43 for

April 2020 and 68 for May 2020. [DE 32 at 11, ¶¶ 30, 31]. On June 5, 2020, Franciscan issued Sandoval a first Corrective Action for unsatisfactory work performance for May 2020. [DE 32 at 11, ¶ 32]. On July 6, 2020, Sandoval was issued a second Corrective Action for unsatisfactory work performance during June 2020, for her KPI of 106. [DE 32 at 12, ¶ 35]. In May 2020, Sandoval emailed her supervisors to argue that the workload was not fair and explained that she was falling behind because older accounts, as well as neurotransmitter accounts, took longer to process. [DE 32 at 26, ¶ 81]. However, Franciscan’s protocol was for all insurance billers to work the older accounts in the insurance biller’s assigned work queue first. [DE 39 at 33, ¶ 81]. According to Franciscan, older accounts were not necessarily more complex or more time-consuming than newer accounts and such protocol was necessary because there were specific timeframes within which claims must be submitted to be timely and eligible for payment. Id. On July 31, 2020, Franciscan management met with Sandoval and discussed how she should focus her time when working accounts, recommended that Sandoval document responses

to questions asked because she tended to ask the same questions, as well as other recommendations to improve her efficiency to meet the KPI of 180. [DE 32 at 12, ¶ 37]. Nevertheless, Sandoval received a KPI of 125 during July 2020 and was issued a third Corrective Action for unsatisfactory work performance in September 2020. [DE 31 at 13, ¶ 40]. After Sandoval’s third Corrective Action, she was placed on a performance improvement plan due to her low KPI. [DE 32 at 14, ¶ 42]. In April 2021, Sandoval was issued a fourth Corrective Action for unsatisfactory work performance for a KPI of 159 in January 2021 and a KPI of 162 in March 2021. [DE 32 at 15, ¶ 45]. Following her fourth Corrective Action, Sandoval again failed to meet the expected KPI of

180 in April (155), May (162), and June (157) of 2021. [DE 32 at 15, ¶ 46]. Franciscan’s corrective action process for a billing department employee who does not meet the expected KPI is as follows: 1. The 1st month an employee does not meet their KPI standards; the employee will receive a verbal warning. 2. On the 2nd month (not necessarily consecutively) of not meeting the KPI the employee will receive a 1st written warning. 3. On the 3rd month of not meeting KPI standards the employee will receive a 2nd written warning and will be placed on a 30- day probationary plan with an action plan. 4. At the end of the 30-day probationary period if the KPI standard is not met the final step will be termination of employment. 5. If staff is working a special project outside the normal daily duties management will take those hours into consideration when calculating the KPI results. 6. The results will be based on a 12 month rolling period starting with the 1st occurrence.

[DE 32 at 15-16, ¶ 48]. On July 1, 2021, Franciscan terminated Sandoval for her continued failure to meet the expected KPI. [DE 32 at 16, ¶ 50]. Sandoval, who is Hispanic, was 63 years old at the time of her termination. [DE 32 at 16, ¶ 51]. Four other employees in the collections department were terminated between 2019 and 2022 for failing to meet the expected KPI. [DE 32 at 17, ¶ 54].

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Sandoval v. Franciscan Alliance Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/sandoval-v-franciscan-alliance-inc-innd-2024.