A Boston skilled nursing facility (SNF) reached an agreement with the U.S. Attorney’s Office and the U.S. Department of Health and Human Service’s Office for Civil Rights to resolve an allegation of a violation of the Americans with Disabilities Act (ADA). The SNF allegedly denied admissions to individuals being treated with medications for Opioid Use Disorder (OUD), which is in violation of the ADA.
The complaint alleges that in February 2019, a hospital requested an available SNF bed for a patient. The SNF replied that it could not accept the patient because he was prescribed Suboxone, a medication that is used to treat OUD. The complaint prompted investigation (pursuant to the ADA, Section 504 of the Rehabilitation Act of 1973 and the Patient Protection and Affordable Care Act) into the SNF’s practice of denying admission to individuals who take medication prescribed to treat OUD. Individuals receiving treatment for OUD are generally considered disabled under federal civil rights laws, which prohibit private healthcare providers from discriminating on the basis of disability.
Acting United States Attorney Nathaniel R. Mendell stated, “Opioid Use Disorder is a recognized disability under the ADA, and providers who fail to treat it as such operate outside the law. This settlement is the latest demonstration of our unending commitment to vindicate the rights of disabled people – and it will not be the last.”
Lisa J. Pino, Director of the U.S. Department of Health and Human Services, Office for Civil Rights, stated, “Healthcare providers should not base decisions about patients with Opioid Use Disorder on stereotypes or misconceptions about their disability. People with OUD do not lose their civil rights because they are prescribed certain medications, and OCR is committed to ensuring that people with OUD do not face discrimination in healthcare settings or other areas of life.” Under the terms of the agreement, the Boston SNF will, among other things, adopt a non-discrimination policy, revise its admissions policy, and provide training to its admissions staff. Additionally, the SNF will pay the United States a $5,000 civil penalty.
Issue:
All nursing facilities must train their staff who screen patients for potential admission so they are knowledgeable of Title III of the ADA. Refusing an individual admission to a facility based solely on the fact that they are being treated for OUD could be seen as a violation of Title III of the ADA. Discrimination on the basis of disability is prohibited. While federal law prohibits discrimination in the workplace, most states have enacted their own additional laws regarding disability discrimination. It is essential that administration and human resources personnel are aware of their state-specific laws.
Discussion Points:
- Review your facility’s policies and procedures on discrimination and your admission policy. Ensure that these include prohibiting discrimination on the basis of disability.
- Educate appropriate staff on Title III of the ADA and how denying admission to the facility based upon OUD could be seen as discrimination. Document that the trainings occurred, and file the signed training document in each employee’s education file.
- Periodically audit to learn if any individuals were denied admission to the facility in violation of Title III of the ADA. Make corrections to the admission process if needed.
