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Gaddis v. Brandywine Senior Care, Inc.

United States District Court, E.D. Pennsylvania

September 10, 2019

BRENDA GADDIS
v.
BRANDYWINE SENIOR CARE, INC. d/b/a BRANDYWINE SENIOR LIVING AT HAVERFORD ESTATES

          MEMORANDUM

          BARTLE, JUDGE

         Plaintiff Brenda Gaddis ("Gaddis") brings this action against her former employer, defendant Brandywine Senior Care of Haverford, LLC d/b/a Brandywine Senior Living at Haverford Estates ("Brandywine"), for violations of the Age Discrimination in Employment Act, 29 U.S.C. §§ 621 et seq., the Americans with Disabilities Act, 42 U.S.C. §§ 12101 et seq., and the Pennsylvania Human Relations Act, 43 Pa. Stat. §§ 951 et seq.[1]Before the court is the motion of Brandywine for summary judgment under Rule 56 of the Federal Rules of Civil Procedure.

         I

         Under Rule 56 of the Federal Rules of Civil Procedure, summary judgment is appropriate "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed.R.Civ.P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). A dispute is genuine if the evidence is such that a reasonable factfinder could return a verdict for the nonmoving party. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 254 (1986). We view the facts and draw all inferences in favor of the nonmoving party. See In re Flat Glass Antitrust Litig., 385 F.3d 350, 357 (3d Cir. 2004).

         Summary judgment is granted where there is insufficient record evidence for a reasonable factfinder to find for the nonmovant. See Anderson, 477 U.S. at 252. "The mere existence of a scintilla of evidence in support of the [nonmoving party]'s position will be insufficient; there must be evidence on which the jury could reasonably find for [that party]." Id. In addition, Rule 56(e) (2) provides" [i] f a party fails to properly support an assertion of fact or fails to properly address another party's assertion of fact as required by Rule 56(c), the court may . . . consider the fact undisputed for the purposes of the motion." Fed.R.Civ.P. 56(e)(2).

         II

         The following facts are undisputed. Brandywine is an assisted and independent living facility for senior citizen residents. It is licensed as a "personal care home" under Pennsylvania law. See 55 Pa. Code § 26 00.1. Brandywine is one of a group of related facilities that is overseen by a corporate parent, Brandywine Senior Living, LLC ("BSL Corporate"). The facility is divided into two units. One, called "Reflections," is designed for residents with memory impairments. All other residents live in the "Assisted Living" unit.

         Gaddis is a licensed practical nurse who began working for Brandywine in 2000 as a Wellness Nurse in the facility's Wellness Department, which provides nursing services to residents. Gaddis provided care to residents in both the Assisted Living and Reflections units. Gaddis reported to the Wellness Director, who during the relevant time period was Lisa Adoni ("Adoni"). Adoni in turn reported to the facility's Executive Director, Michael West ("West"), and the Clinical Operations Manager for BSL Corporate, Jo-Anna Reed ("Reed").

         Gaddis was diagnosed with diabetes in the 1980s. There is no dispute that her diabetes has at times been uncontrolled and that she has suffered from hypoglycemia.[2] When her blood sugar is too low, Gaddis sometimes sweats, gets hungry, and loses consciousness. She also occasionally suffers from fatigue, nausea, fast heart rate, and blood pressure issues due to her diabetes. Gaddis cannot always predict when she is about to have a hypoglycemic event.

         Gaddis maintains a "Medication Administration" policy to ensure the safe storage, handling, and administration of medication. That policy provides in relevant part:

A. All medication that is administered by the staff of Brandywine Assisted Living Community will be given by a licensed nurse.
......
D. Residents that are unable to self-administer their medication . . . will be given their medication by the [nurse] on duty.
F. Nursing Personnel that are administering medication will refer to the resident's [Medication Administration Record ("MAR")] for orders and a resident photo.
G. All personnel will verify the medication orders on the MAR with the orders in the resident record.
H. All personnel will follow the five medication rights.[3]

         Brandywine also maintains a "Disciplinary Procedures" policy. That policy provides for progressive discipline with the following steps: (1) informal counseling; (2) verbal warning; (3) written warning; (4) final written warning; (5) suspension pending investigation; and (6) discharge.[4] Most discipline should be provided in writing on a "performance improvement notice" form. However, "the company retains the right to bypass progressive discipline steps based on responsibility at the time, scope and severity of the issue" and the policy further provides that"[r]epeated violations of the same rule, violation of more than one rule in a single act, or violations of different rules at different times are considered just cause for accelerated or more serious disciplinary action up to and including termination." Termination of employment requires the approval of both the employee's manager and the administrator or executive director. If the employee has eight years of service or more with the company, BSL Corporate must also approve any termination before it may occur.

         Under Pennsylvania regulations, the Pennsylvania Department of Health ("DOH") is required to perform unannounced inspections of facilities such as Brandywine. During an inspection, representations from the DOH will observe nurses administer medications for potential errors. The DOH has the authority to cite and fine Brandywine for each medication error it observes. As a result, it is critical that Brandywine be prepared for state inspections. In April 2015, the DOH inspected Brandywine and issued several citations for deficiencies regarding medication administration observed during an inspection.

         To assist with preparation for state inspections, Brandywine contracts with Innovative Pharmaceutical Packaging Corporation ("IPPC"). IPPC is an independent entity that provides nursing consulting services to clients such as Brandywine, including helping the clients to prepare for state inspections, providing m-service education to clients' nursing staff, and performing regular "Medical Administration Observations" ("MAOs") of the clients' nurses. IPPC performed multiple MAOS of Brandywine per year, with visits lasting approximately two to three hours.

         In March 2015, Gaddis had a hypoglycemic incident while at home in which she lost consciousness and was taken to the hospital via ambulance. Gaddis was admitted for two days and discharged on March 12, 2015. She returned to work on March 18, 2015 with a note from her physician clearing her to work without any restrictions.

         On April 2, 2015, Gaddis was observed by Reed passing medication to a resident without a MAR, that is, a Medication Administration Record, in hand. The MAR is a piece of paper that lists the medications a patient has been prescribed and is used to record when medications are administered. Referring to the MAR while administering medications helps nurses adhere to Brandywine's Medication Administration policy and decreases the likelihood of errors. Gaddis received an oral warning for her failure to have a MAR in hand. She was instructed to follow Brandywine policy and was warned that further infractions would result in progressive disciplinary action up to and including termination. Gaddis does not dispute that she was required to have the MAR with her when administering medication and that she failed to do so on this occasion.

         On May 14, 2015, Gaddis received a final written warning after she left medication in a cup with a resident seated at a dining room table with other residents. The final written warning stated that leaving medication unattended was detrimental to the safety and well-being of residents. Gaddis explains that she was distracted by a new nurse she was training and that nurse was the one who left the medication unattended. However, Gaddis does not dispute that she was responsible for the trainee and her actions.

         On June 4, 2015, Gaddis suffered a hypoglycemic event at work. Toward the end of her shift around 2:45 p.m., Gaddis began to feel "a little shaky." She went to the breakroom to purchase candy from the vending machine to raise her glucose level. Unfortunately, Gaddis lost consciousness as she was about to put money into the machine. Gaddis was observed by other employees with coins in her mouth. West was called to the scene and witnessed Gaddis slurring her speech and speaking incomprehensibly. Paramedics were called to the scene and Gaddis regained consciousness after approximately fifteen minutes. Gaddis declined to be taken to the hospital and was instead picked up by her husband. The next day, Gaddis went to the emergency room. She was cleared by the emergency room physician to return to work but advised to follow up with her primary care physician, an endocrinologist, and an ophthalmologist.

         In the meantime, on June 4, 2015, West and Adoni emailed Reed and Deborah Stine, the Chief Nursing Officer of ...


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