Racial preferences for caregivers don’t hold up

By | 2021-05-07T15:13:20-04:00 July 19th, 2017|Tags: |0 Comments

A reader asked about a situation in which an African-American patient wanted only African-American nurses to care for her. The employer went along with this request. Nursing staff of other races were hindered in their ability to care for this and other African-American patients.

However, as the following case illustrates, discrimination of this kind is not protected under Title VII of the 1964 Civil Rights Act.

Brenda Chaney, a black certified nursing assistant, was hired by Plainfield Healthcare Center, which is a nursing home. Her daily shift requirements were included on an assignment sheet that all employees received when they came to work. Among other things, the sheet included a comments column for miscellaneous notes on the residents. Chaney’s assignment sheet noted that a resident on her unit “prefers no black CNAs,” (Brenda Chaney v. Plainfield Healthcare Center, 612 F.3d 908 (2010)).

The nursing home had a policy of honoring such racial preferences for caregivers so residents retained the right to select their providers, the right to privacy and the right to bodily autonomy. Plainfield based its policy on its concern that not supporting these rights would risk violations of state and federal laws. Chaney adhered to Plainfield’s policy, since she was concerned she would lose her job if she didn’t do so. It was difficult to do, especially when she discovered a resident on the floor who was too weak to stand. She had to hunt for a nonblack staff member to help the resident return to her bed.

Other residents in the facility had similar restrictions on nonwhite staff caring for them and verbalized the restriction to Chaney on a regular basis. These comments left Chaney depressed, and she often left work “teary eyed,” according to court documents.

Racial epithets compound problem

In addition to supporting residents’ preferences for white-only caregivers, white staff at Plainfield used “racially tinged” comments and epithets toward Chaney. She reported these incidents to her unit supervisor, who said she would address them but never really resolved these issues, Chaney alleged, according to court documents.

On one morning, a resident who was struggling to get out of bed pushed her call light for help. Chaney and another CNA were able to respond but initially refused, court documents showed. Chaney finally did help another staff member assist the resident, but that staff member reported to the unit supervisor that Chaney used profanity when helping with the resident.

The unit supervisor and the director of nursing investigated the complaint. The unit supervisor was skeptical of the complaint, since she had never heard Chaney use profanity. In addition, the resident’s roommate, who had observed the incident, said she heard no profanity from Chaney.

Nonetheless, the DON decided to terminate Chaney. During a post-termination meeting a few days later, Chaney was told she was terminated for using profanity in front of a resident. Chaney denied the allegations and was allowed to give her written version of the event. Plainfield did not overturn her termination, however, and later added other allegations, including “bed alarm and call-light infractions” and “not doing a shift change,” according to court reports.

Chaney filed a lawsuit under Title VII of the Civil Rights Act of 1964 in a federal District Court alleging that the nursing facility’s practice of adhering to residents’ racial biases was illegal and created a hostile work environment. The Equal Employment Opportunity Commission, in a brief supporting Chaney’s allegations, agreed.

However, the District Court ruled for the nursing home in judging allegations to be without merit. Chaney appealed that decision to the 7th U.S. Circuit Court of Appeals, which reversed the previous judgment and sent the case back to the district court for further proceedings. In doing so, the Court of Appeals analyzed Title VII’s prohibition of discriminating against a worker due to his or her race. The court held that it “found no trouble” finding that a reasonable person would find Chaney’s work environment hostile or abusive. Moreover, the court did not find Plainfield’s effort to stop the staff’s hostile or abusive conduct to be adequate.

In addition, citing other case law, the court struck down Plainfield’s arguments, saying “a company’s desire to cater to the perceived racial preferences of its customers is not a defense under Title VII for treating employees differently based on race.”

While the court acknowledged that previous judgments upheld patient preferences regarding the gender of their caregivers, it stated that “Title VII allows an employer to respect a preference for same-sex health providers, but not same-race providers.”

Chaney and Plainfield Healthcare Center subsequently settled the case, with Chaney receiving $150,000, according to AHC Media.

To read more about Title VII’s protections against discrimination on the basis of race at: “Facts About Race/Color Discrimination”.


Courses Related to ‘Cultural Competence’

CE255-60: An Action Plan for Cultural Competence
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The American population, now more than 323 million people, continues to grow in its diversity while shifting in its ethnic makeup. The lack of minority representation among healthcare professionals may further limit their access to those who might provide information about the cultural or ethnic groups they represent and can negatively impact patient outcomes. This educational activity will present a definition of cultural competence, discuss barriers to provision of culturally competent care, and suggest components of a personal plan for becoming culturally competent.

CE570: Mind Your Manners … Multiculturally
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About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

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