Two nursing home chains in Washington resolved allegations that they violated the Americans with Disabilities Act (ADA) by denying admission to prospective residents because of their Substance Use Disorder (SUD), according to an October 26, 2023, press release from the US Attorney’s Office. One of the nursing home chains resolved a second ADA complaint that it failed to provide a sign-language interpreter for a patient who is deaf.
Chain 1 manages three nursing homes in western Washington. An investigation by the US Attorney’s Office determined that their facility in Avalon engaged in discrimination by denying admission to individuals with SUD. The US Attorney’s Office found that in some instances, patients were denied admission because they were prescribed FDA-approved medication for Opioid Use Disorder (OUD).
As part of the settlement, the facility will submit a draft non-discrimination policy to the US Attorney’s Office for review. After approval, it will post the policy and will train its employees and contractors on the policy and on medications to treat SUD. The facility will keep training and admission logs for review by the government and will alert government investigators to any ADA complaints.
Chain 1 will pay the government $12,000. However, $10,000 of the penalty is suspended pending successful compliance with the requirements of the settlement.
Chain 2 operates four nursing homes in western Washington. The US Attorney’s Office investigation determined that individuals were denied admission to their facilities because of their SUD. The chain agrees to update its policies and not discriminate against persons who have been prescribed medication for their OUD. The chain will undertake new training and keep logs of training and patient admissions. Any ADA complaints will be forwarded to the US Attorney’s Office. Company 2 will also pay the government $12,000. However, $10,000 of the penalty is suspended pending successful compliance with the requirements of the settlement.
Finally, in a different settlement, Chain 1’s Avalon facility has agreed to pay a patient who is deaf $20,500, for violating the ADA by failing to provide the patient with a qualified sign-language interpreter while the patient was recovering from back surgery. The patient was in the facility from February 18, 2021, to March 11, 2021. The facility did not act on the patient’s requests for a sign-language interpreter so the patient could not communicate with staff about her treatment plan or physical therapy.
The facility disputes many of the government findings, but to avoid the cost and uncertainty of litigation, is choosing to resolve the matter. The settlement requires the facility to put training, policies, and procedures in place to ensure staff do not violate the ADA and provide appropriate communication devices or services to the patients who need such assistance. The settlement lists a number of required improvements regarding evaluations, contracting, dissemination of policies and complaint tracking. The government will review the compliance for 18 months.
Compliance Perspective
Issue
Under Title III of the ADA, no individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation. Specifically, discrimination includes the imposition or application of eligibility criteria that screen out or tend to screen out an individual with a disability or any class of individuals with disabilities from fully and equally enjoying any goods, services, facilities, privileges, advantages, or accommodations, unless such criteria can be shown to be necessary. A public accommodation may impose legitimate safety requirements that are necessary for safe operation, but safety requirements must be based on actual risks and not on mere speculation, stereotypes, or generalizations about individuals with disabilities. Refusing an individual admission to a facility based solely on the fact that they have an SUD or are being treated for OUD could be seen as a violation of Title III of the ADA. The ADA also requires places of public accommodation to provide the necessary auxiliary aids and services to ensure that communication is effective. Such aids and services can include American Sign Language interpreters for individuals who are deaf or hard of hearing and must be paid for by the place of public accommodation.
Discussion Points
- Review policies and procedures on discrimination and admission screening. Ensure that facility policies include prohibiting discrimination on the basis of any disability. Also review your policies and procedures for communicating effectively with residents who are hearing, sight, or speech impaired.
- Educate appropriate staff on Title III of the ADA and how denying admission to the facility based upon SUD or OUD could be seen as discrimination. Provide training for staff on effective communication techniques for all residents, including those with hearing, sight, or speech disabilities. Document that these trainings occurred and file each signed document in the employee’s individual education file.
- Periodically audit for individuals who were denied admission to the facility to ensure that their denial was not in violation of Title III of the ADA. Also periodically survey staff to ensure that they are aware of resources that are available at the facility for residents who are hard of hearing or deaf, or who have sight or speech disabilities. In addition, ensure that staff are aware of how to report any concerns of discrimination or retaliation.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
