## In the



# U n ited S ta tes Co urt o f Ap p ea ls

F o rth eS e v e n th C ir cu it
N o. 09

- 3661 B R EN DA C HANEY, P laint if f-A ppell ant, v. P LA I NF I EL D H EALT HCARE C ENTE R, D efend a nt-A pp ellee.

Appeal from the United States District Court fo r the S outhernDi stricto f Indian a, Indian apolisDiv isi on. No .1:08- cv-00071- S EB-DML

— Sarah EvansBarker , Judge .
A RG UE D A PRI L 27, 2010

— D ECI DE D J UL Y 20, 2010

Befo re R OV NER, W I L L I A MS, a nd S YKES, C ircu it Judges . W I L L I A MS, Cir cu i tJudg e . Th is case p its a health-ca re wo r k e r ’ s r i g htt o a n o n- di s c r i mi na t o r y wo r k pl ace agains t a pa tient’s d em an d f or w hite-only hea lt h -c are pr o vi der s. Pl ainfi el d Hea l thca r e Cen te r i s a nur sing hom e that ho used a r esi dent w ho di d not want ass i stan c e fro m bla c k c er tifie d n u rs in g a ss ist a n ts . Pla in field c o mpl i e d wi th thi s ra c i a lp r e fe r e nc e b y t e l l i ngBr e nd a Ch aney, a bl ack nursi ng as si sta nt, i n w ri ti ng ev er yday2 N o. 09

- 3661 th at “n o black” assistan ts sh o u ld en ter this residen t’s ro om o r provi de herwith c ar e. Ch aney brought thi s a cti on under Ti tl e VI Io fthe 1964 Civi lRi ghts A ct. S he cl aim s that Pl ai nfi el d’s pract i ce o f ac ce di ng to th e r ac i al bi as es o f i ts r es i den ts i s il legal an d cre ate d a host i l e w or k envi ro nm ent. She also asser ts th atPl ainfi el d fi r ed he r b ec au se s he was b l ac k

. The Eq ual Em p loym ent Opportuni ty Com m i ssi on, as am i cus, agr ees , and t oge thertheyurg e r eve rs alo fthe dist ri ct cour t’ s g ra nt ofsum m ar y j ud gm ent to Pl ai nfi el d. Because th e r ac i al pr efer en ce po l i cy vi o l at es Ti tl e VI Iby crea ting a ho sti le w or k e nvi ro nm ent a nd bec ause i ssues o ff act r e ma i n o ve r w h e th e r r a c e mo t i v a t e d th e d i s c h a r g e , we reverse th e d istri ct cou rt’s order.

I . B AC KGR OUND Si nce Pl ai nfi el d H ealth car e Center( “Pl ai nfi el d”) prevai le d o n s um m ar y j udg m en t, we r ec o untthe f ac ts i n the l i ght m ost favor abl e t o Brenda Chaney, the non- m ova nt. Pl ainfi el d hir ed Chaney as a nurse ai de orcer ti fi ed nu r s i n ga s s i s t a n t( “ C NA” )
. As a C NA, s h e wa s r es po nsibl e form oni tor i ng pati ents, r espondi ng to thei r re q u es ts for se rv ice , an d ge n er ally as sis tin g w ith th eir d aily li ving n eed s. Plainfiel d de tailed C ha ne y’s da il y shift d u t i e s o n a n a s s i g n me n ts h e e tth a ts h e a n d o t he r e mpl o y ee s r ec ei ve d upo n a r r i vinga t wor k

. The a ss i g nm en t sh ee t list ed th e re sid en ts i n C h an ey ’s u n it a n d th eir c o r r e s p o n d i n gc a r e n e e d s . I ta l s o fe a t u r e d a c o l u mn wi thmis ce l l an eo us no te s ab o ut ea chr es i den t’ s co ndi ti o n. I n th e case of M arj orie L atsh aw , a resi d en t in Ch an ey’sN o. 09

- 3661 3

un it, the sh eet instru cted nu rse aides thatLa tsh aw “Prefers N o B lac k C N A s.” Pl ainfi el d a ckno wl edg es i ts po l i cyo f ho no r i ngthe racial p referenc es of i ts reside nt s i n a ssigning health -care provi ders. Pl ai nfi el d m ai ntai ns i t e xpe c te d i ts em plo yee s to re spect these r aci alpre fer ences because i t o ther w i se r i sked vi o l at i ngs ta te a nd fede r all aws tha t g r an t r es i den ts the r i g ht s to c hoo se pr o vi der s, t o pr i va cy, a nd to b o di l y a ut o no m y . Inde ed, i n i ts r eply b r i ef to th e d ist ric t c ou rton su m m ar y jud g m en t, P lain field ac kn ow ledged that the ass i gnm ent sheet f orC haney “banned” her fr o m a s s i s t i n gL a t s h a w. F o r fea r o fb eingfi r ed, Cha ne y wenta l o ng w i ththe po l i cy . Al th o ug h L atshaw r emai ne d o n h era ss i g nm en t sh eet, Ch a ne y rel uc tan tly r efrained from assisting her, eve n w he n s he wa s i n the b e s tp o s i t i o n t o r e s po nd

. On ce, Ch aney f ound L ats haw o n the gr ound, too weak t o sta nd

. Despi te w anti ng b ad l y t o hel p, Chaney had to sea rch the b uil din g fo r a white CN A
. Pl ai nfi el d housed at l eas t tw o other re si dents with a s i m i l ardi sta ste f or bl ac kCNA s. One r efus ed Cha ne y ’ s as si st an ce i n the sh o wer, a sk i ngf o r a di ffer en t nurse a i de i ns te ad. On a separ ate o ccasi on, a co- w or kerwa rn ed Chaney that anothe r re si dent d oes notcar e forbl acks

. Em oti onal l y, th es e r ac e-ba se d l i m i ta ti o ns de pr es se d Cha ne y, who ro u tin ely leftw or k “ te ar y e ye d .” Pl ai nfi el d’s p racti ce o fhonor i ng the r aci alpre fer ences o fr e s i d e n t s w a s a c c o mp a n i e d b y r a c i a l l y - t i n g e d c o mm en ts a nd e pi th et s fr o m c o - wor k er s. F o r i ns tance, i n the p re se n c e o f a r e s id en t, a w h ite n u rs e a id e n am ed A u d ria4 N o. 09

- 3661 cal l ed Chaney a “bl ack bi tch. ” An oth er t im e, a w hi te cowo r k e r l o o k e d d i r e c t l y a t C h a n e y a n d a s k e d wh y Pl ai nfi el d ”.

. . ke ep[s ] o n h iri ng al lo fthes e bl ack ni gge rs ? T he y’re not gon na stay an yw ay.” T he epith ets w ere r epo r te d t o the uni t su per vi so r, Lo r et ta Ask ew, who prom i sed to address them

. A l though the ep i thets ceas ed, co - w or kerA ud ri a co nti nued t o re m i nd Chaney that cer tain r esi dents were offl i m i ts because she w as bl ac k

. Cha ne y r epo r te d the se c o m m en ts to Ask ew, who re n ew ed h er p ro m ise to ta ke ca re of it. A u d ria ev en tu ally l eft Chaney al one, but Pl ainfi el d’s ra ci alpre fer ence p olic y re m ain ed in p lac e a n d co n tin u ed t o s u rfa c e in conve rs ati ons w i th o therem plo yee s. A fterChaney had worke d at Pl ai nfi eld fo r j ust three m onths, Pl ai nfi el d fi re d her. In the ear l y m or ni ng o n S ept embe r 6 , 2 00 6, a cc o r di ngt o Nurs e Cafo ur as who lod ge d th e c om p lain t t h at led to C h a n ey ’s d isc h ar ge , a re sid e n t s t r u gg lin g t o ge t o u t o f be d h ad sign ale d a c all li ght. Chaney and another CN A , C. J
. H ar t, were both posi ti oned to r espond but bo th i ni ti al l y refu se d. W hen Ch aney ult i m ate l y ca m e to the r esi dent’s r oo m , Caf oura s al l eg ed th atCha ne y us ed p rofani tywhi l e l i ftingthe r e s i de nto nt o h e r b e ds i de c o mm o de

— “s h e’s sh itt in g,” Ch a ne y s up po s e dl y s a i d. Cafo uras ’ s co m pla i nt was i nvest i gat ed concur re ntl y b y As k e w, wh o n o r ma l l y i n v e s t i g a t e d mi s c o n d u c tc o mpl a i nt s i n he r un i t, a nd J o hn Re y e s , the Di r ecto r of N ur sing . Ask ew was s k ept i ca lo fthe a l l eg at io n, ha ving ne ve r b efo r e he ar d Cha ne yus e pr o f an i tya t w ork. S he i nvest i gat ed and l earned that th e re si dent’s r oo m m ate ,N o. 09

- 3661 5 a witness to the inci dent, did n ot hearChaney use pro f an i ty
. The r ec o r d i s si l en t as t o whethe r the re si den t w ho s i gnal ed t h e ca l ll i ght he ar d C haney use pro f ani ty. A ske w rel aye d her fi nd i ngs, alo ng w i th hersk epti ci sm , to Reyes
. A l though a full day had ye t t o pass s i nce Caf oura s fi l ed herco m p lai nt, Reye s had r eso l ved to fi re Chaney. H ar t, wh o hear d the al ar m but neverr espond ed , w as not interview ed un tiltw o w eeks after the i nc iden t. H art was no t di sc i pl i ne d ev en tho ug h the r es i den t who si gnal ed the al ar m was i n heruni t, notChaney’ s. On the e ve nin g of S ept embe r 6 , 2 00 6, Cha ne y was s en t ho m e when sh e ar r i ve d t o wor kherre g ul arni g hts hi ft. The next m or ni ng, she re cei ved a s h ort phone cal lfro m Pl ainfi el d’ s human r es o ur ce s m an ag er, Do nna Gr ay, i nf or m i ng herthat she w as ter m i nated. A t a post
- ter m i nati on m ee t i n g a few d ay s la te r, C h an ey alleg es th at P lain field told Cha ne y tha t i t fi r ed he r b ec au se s he s ai d the word “s hi tt i ng ” i n the pr es en ce o fa r es i den t, an d g av e no othe r gr ou n ds f orthe fi ring. A t thi s m eet i ng, Chaney denie d the charg e and was i nvi ted to w ri te h er ve rs i on o fthe e ve nt s , b uth e r t e r mi na t i o n wa s n o to v e r t urne d. Pl ainfi el d ha s sinc e f o cus ed o n o th er, i nde pen den t g r o un d s f o r h e r d i s c h a r g e : “ b e d a l a r m a n d c a l ll i g ht in fra c tio n s” an d “n otd oin g a sh ift c h an ge .” The dist ri ct cour t enter ed sum m ar y j ud gm ent i n f avo r o fPl ainfi el d o n the cl ai m s o fho st i l e wor k pl ac e an d disc ri m i natory di schar ge. A l though the co urt re cogni zed that the c om m ents fro m Chaney’ s co- w or ker s had cr eat ed a hosti l e workenvi ro nm ent, i t co ncl ud ed that Pl ai n field av oid ed liab ility by res p on d in g p ro m p tly ea c h ti m e it6 N o. 09

- 3661

re cei ved a com pla i nt. T re ating the raci alp re fer ence pol i cy as a s epa r at e cl ai m o fa ho st i l e wor ke nv i r o nm ent, the co ur t co nc l ude d tha t the n o te o n Cha ne y ’ s as si g nm en t sh ee t adv i singhe r o fthe “ Pr efer s N o Black CNA s” e xcl usi on was r eas onab le g i ven Pl ai nfi el d’s goo d-f ai th b elie f th at ign or in g t h e re sid en t ’ s p re fer en c es w ou ld have vi ol ate d I nd i ana’ s pati ent- righ ts l aw s. A s for Cha ne y ’ s di sc r i m i na to r y - di sc ha r g e cl ai m , the c o ur t concl ud ed that Ch aney had f ai l ed to produ c e e vi dence fro m wh i ch an infe re nce co uld be drawn t h at r aci al an im u s m ot iva te d R ey es ’s d ec isio n to fire h er .
II. A N A L Y S IS O n ap p eal, Ch an ey an d the E E O C argu e th at Plainfiel d ’s pol i cy ofacc edi ng to the ra ci albia ses of i ts re si dents is an unlawfulem plo ym ent pr acti ce th at, al ong w i th r aci al a ni mos i t y fr o m he r c o - wo r k e r s , c r e a t e d a n un r e med i a t e d, r ac i al l y ho st i l e wor k pl ac e. The ya l so c o nt en d tha t sh e prese nted suffi ci ent e vi dence to cr eat e a tr i abl e quest i on ofwh etherr aci alani m us m ot ivat ed herfi ring. W e r evi ew th e g r an t o f su m m ar y j udg m en t de no vo , wi ththe f am ili arst andard that sum m ar y j ud gm ent s houl d be g r an te d i fthe r e i s no g enui ne i ss ue o fmate r i alf ac t an d the r eco rd s h ow s that the l aw enti tl es the m oving par ty to j u d gm en t. Chakl os v. St e ve ns , 560 F. 3d 705, 71 0 ( 7th C ir. 20 09 ).

A . R acially H ostil e W orkp lace C laim Tit l e VI Ipro hibi ts em pl o y e r s fr o m di s c r i mi nati ng ag ai nst any ind i vi du al“with re spect to hi s co m pensation , t er m s,N o. 09

- 3661 7 condi ti ons, o r pri vi l ege s o fem plo ym en t, bec ause ofsuch i nd i vi du al ’ s r ace. . . . ” 4 2 U.S
. C. § 2 000 e-2 (a) ( 1)
. In or der to i m pose Tit l e VI Ili abi l i ty f ora ra ci al l y ho sti l e work

pl ac e, a pl aint i ffmusts ho w: ( 1) th e w o r ke nv i r o nm en t w as both subj ecti vel y a nd o bj ecti vel y o ffensi ve ; ( 2) that the har ass m ent was ba sed o n m em b er sh i p i n a pr ote cted cl as s; ( 3) tha t th e co nduc t w as s ev er e o r pe r va si ve ; a nd (4) t h at th er e is a b as i s f o r e m p loy er liab ility

. M endenhall v. M ue l l e rSt r e am l i neCo. , 419 F.3d 6 8 6 , 691 (7th C ir. 20 05 ) (cit at ion s o m itt ed ). W e have no tr oubl e fi nd i ng that a re aso nable p erson w oul d find Pl ai nfi eld ’ s workenvi ro nm ent ho sti l e o r ab us ive
. In O ncale v. Sundo w nerO ff shoreSe rvic es, Inc. , the Sup r eme Co ur t emphas i ze d the i m po r ta nc e o fc o nsid er i ng the enti re co ntext o fthe w or kpl ace. 52 3 U.S
. 75 , 81 (1 998)
. H er e, o verthe cour se ofthr ee m onths, co w or kers cal l ed Chaney a “bl ack bi tch” a nd a “ni gge r” o n m u ltip le oc c as i o n s. C f. , Ro dgers v. Wes te rn- Southern Life Ins . Co. , 1 2 F
. 3d 66 8, 6 75 ( 7th Ci r . 1 99 3) ( “Perha ps no s i n g l e a c t c a n mo r e qu i c k l y a l t e r th e c o n d i t i o n s o fe mpl o y m en t an d c r ea te an abus i ve wor k i nge nv i r o nm en t than the use ofan unam bi guousl y r aci alepi thet su c h as “n igg er ” b y a su p er vi s o r inth e p re se n c e o f h is s u b or d inates
. ”) ( ci tat i ons om i tte d). A nd i n herdeposi ti on, Chaney al l ege s that m or e s ubtl e r aci alsl i ghts and com m ents co n t i n u e d e v e n a ft e r ma n a g e me n t wa s n o t i fi e d o ft he probl em . M ost i m port antl y, Pl ai nfi el d a cted to f ost er and engender a r aci al l y- charg ed envi ro nm ent thro u gh i ts ass i gnm ent s heet that u n am bi guousl y, and dai l y, re m in d ed C h an ey an d h er co -w or ke rs th at ce rt ain res idents preferre d no bl ack CN A s. U nl i ke w hi te ai des,8 N o. 09

- 3661

A t ora l arg u m en t, cou nsel for P lain field d en ied tha t Pla infield 1 pro hibi t ed Ch ane y fro m t re at i ng La t s haw

. “Th e c har tdoe s no t say ,” he exp lain ed , “B ren d a C ha ne y , y ou can nev er trea t this p atien t.” Co u nsel’s p ro -de fend an t in t e r p reta tion of the ev idence violat es the rules of inferenc e on i ts m oti on f or s um m ary j ud gm ent, and fl a tly contradict s Plai nfie ld’ s earl ie r j ud ic ial adm is si on in i ts reply bri efon sum m ary j ud g m ent, w here Pl ain fi el d m ai nt ai ne d that“Ch ane y was no tban ne d f ro m do ing her j ob, only f rom att ending to M arj orie Latshaw.” Dk t. 35 at 8. An d coun se l’ s st atem ent als o contr adicts Plai nfie ld’ s brief on app eal, w here its im il arl y told u s th a t C haney had to keep aw ay fro m L atsh aw so tha t Pla infield cou ld c o m p ly w ith fe de r a l a n d s t a t e l a w. Cha ne y was r es tr i ct ed i n the r o o m s sh e co ul d e nt er, the c ar e t h at sh e c ou ld p ro vid e, an d th e p at ien ts sh e co u ld ass i st. 1 P lai nfi el d argues there i s no bas i s forem plo yer l i abi l i ty because i ts re sponse to the rac ialepi thets was adequate in stopping the har ass m ent a nd thatany subseque n t com m ents w er e m er e r em i nd er s o fa parti cul ar re sid en t’s p re fer en c e an d n otrac ially offe n siv e. W h ile it i s true th at Pl ainfi el d’ s ac ti o ns st o pped th e us e o fthe m o stv ul g arr aci al epi th et s, we ca nno t ag r ee tha t an y furth er com m en ts to C ha ne y abou t pa tients ’ r acial preferences w er e innocent and obj ecti vel y unoffensi ve. N or can we agre e th at Pl ai nfi el d’s pol i cy ofacc edi ng to p at ien t pr efer ence, and expecti ng Chaney t o adhere to its ins tr u c tio n s, w as rea so n ab le. P lain fiel d cla im s t h is p o l i c y wa s n e c e s s a r y t o c o mply wi th s t a t e a n d fe d e r a ll a w. I t is n ow widel y a ccepted that a co m pany’s desi re to cate r to the p erceived rac ia l p referenc es of i ts cu stom ersN o. 09

- 3661 9 i s no t a defense und erTi tl e V II f ortr eat i ng em plo yee s d iffer en tl y b as ed on rac e. Se e, e . g. , Joh nso n v . Zem a Sy s. Corp
. , 17 0 F
. 3d 734, 74 4 ( 7th Ci r. 19 99) (e vid ence ofse gr ega te d sa les forc e s u p p or te d T itle V II c laim ); Fe r r i ll v . The P arkerGroup, Inc. , 1 6 8 F
. 3 d 4 6 8 , 4 7 7( 1 1 th C i r . 1 9 9 9 ) ( e mpl o y er ’ s pr ac ti ce o fassi g ni ng“ g et
- o ut
- th e- vo te ” pho ne c alls ba se d on rac e v io lat ed T itle V II); see also Ferna nd ez v. W ynn Co. , 6 5 3 F
. 2 d 1 2 7 3 , 1 2 7 6

- 7 7( 9 th Ci r . 1 9 8 1 ) ( re j ecting custo m er prefer ence defe nse i n sex d iscr i m i natio n co n te x t a n d rely in g on E E O C h old in g t h at T i t l e V II does not perm i t the acc om m odation of the r aci al l y di scri m i natory pol i ci es of f or ei gn nati ons )
. Pl ai nfi el d argues tha tthi s we l l

- s e t t l e d r e a ding ofT i t l e V I Ido e s n o ta pp ly

— or sh ou ld n otap p ly

— i n the l ong- ter m c ar e s ett i ng. I tc o n t e n d s th a tl o n g - t e r m c a r e f a c i l i t i e s h a v e o b l i g at i o ns to thei r cl i ents that pla ce them i n a di ffer ent pos i ti on fro m m ost em plo yer s. Pl ai nfi el d i s both a m edi cal p rovider and a per m anent ho m e forhund re ds ofr esi dents. The r i g ht s o fthose res i den ts a r e se cur ed byfede r ala nd sta te l aw s a nd a vastnetworko fr egul ati ons that, acco r di ngt o Pl ainfi el d, i t m us t ho no r be f o r e co ns i der i ng i ts Tit l e VI Io bl i gat i ons to i ts em plo yee s. Forsupport, P lainfi el d ci tes a l i ne o fTi tl e VI Icas es perm i tting se x dis cri m i nati on in the heal th- car e s et tin g. S ee Je n nings v. N
. Y
. StateO ff iceof M ent al Health , 7 86 F.Sup p . 376, 383 (S. D .N .Y
. 1992); Lo ca l 56 7 Am
. Fe d’ n o f St at e, County, an d M un. Em pl oye e s v. M i ch igan , 6 3 5 F
. S up p. 10 10 , 1 01 3 (E .D . M ich . 198 6); B a ck us v. B a pti st M ed. C tr. , 51 0 F. Sup p . 1191, 1193 (E.D
. A rk. 1981); F es el v. M asonic Hom e o f D el ., Inc. , 447 F.Sup p . 1346 (D
. De l. 1978) ( aff’d by 59 1 F .2 d 11 34 (3d C ir. 19 79 )). Ta ke nto ge th er , th ey h old10 N o. 09

- 3661 that gender m ay be a l eg iti m ate cr i ter i on

— a b o na fi de occupati ona l q u al i f i cati on ( “BFOQ ”)

— f o r a c c o mmo d a t i n gp a t i e n ts ’ p r i v a c y i n t e r e s t s . I td o e s n o tf o l l o w, how eve r, that p ati ents’ p ri v a c y i nt e r e s t s e xc use d i s p a r a t e t r e a t me n tb a s e d o n r a c e . T i t l e V I If o rb i d s e mp loy er s from u sin g ra c e a s a B FO Q , R uckerv. H igherEd uc. Aids Bd. , 669 F.2d 117 9, (7th C ir. 1982), an d Plainfi eld’s case s all ow ing gen d er preferen ces in th e hea lth -care set ti ng il l ustr ate w hy. T he p ri vacyinte re st that i s o ffended when o ne undr es se s i n fr o nto fa do ct o r o r nur se o fthe op p osite sex d oes not ap p ly to race. J us t as the l aw tolerat es s ame- se x r es tr o o m s o r s ame- se x dr es singr o o m s, b ut not w hi te- onl y r oo m s, to acc om m odate pri vacynee d s, Tit l e VI Ial l ows an em plo yerto r esp ec t a pre fer ence f or sam e- sex hea th pro vi ders, but not sam e- ra ce pr ovi ders. P lain field arg u es th at ev en if T itle V II d oe s n otex p re ss ly conte m pla te a pati ent- prefer ence defen se to ra ce-base d w or k a ss ign m en ts , Pla in field ’s p olic y is a r ea so n ab le an d g o o d- f ai the ff o r t to c o m pl y wi thIndi an a l aw a nd shoul d b e excused on that basi s. U nd er I nd i ana regula

ti ons gov er ni ng l ong- ter m car e f aci l i ti es, res i dents have a r i g htt o “ ch o o se a pe r so na la tt en d ing phy si ci ana nd othe r provi ders of ser vi ces. ” 4 10 I ND . A D M IN . C ODE 16
. 2- 3. 1- 3( n)( 1)
. I fPlain fi el d’s re adingo fthe re gul ati on ( re qu iring i t to i ns tru ct its em p loyees to hon or a patien t’s ra ci alprefe rences) were cor re ct, i t would co nfl i ct with T itle V II. W h en tw o law s c on flict, on e s t a te , on e fe d er al, the S up re m acy Clause di ctat es that the federa l l aw pre va ils. U .S
. C O N ST . art . VI, cl. 2; Cros b y v . Nat ’ l Fo r e ign Trade C ouncil , 5 30 U. S
. 3 63 , 3 72 ( 20 00 )
. Had a r es i den t su ed P lain field u n d er th e p at ien t’s righ t s p ro vis ion, Tit leN o. 09

- 3661 11 V II w ou ld h av e s u p p lied an a f f irm at ive d efe n se . See Ho w lett v. R o se, 496 U .S. 35 6, 3 71 -72 (19 90 ); s e eal s o Grann v. Ci ty of M adi s on , 738 F.2d 78 6, 79 2 (7th C ir. 19 84 ). Tit le V II does not, byco ntra st, co ntai n a g oo d-f ai th “d efense” that allow s a n em plo yerto i gnor e the st atute i n f avo r o fc o n fl i c t i n gs t a t e l a w. I n an y ev e n t, I nd iana’s regu lations d o not req uire Pl ainfi el d t o i ns tructi ts em p loy ee s to a cc ede t o the r ac i alpr efer en ce s of i ts r es i den ts
. The r egul at i o ns m erel y r equi re Pl ai nfi el d to al l ow res i dents ac cess to he a l th- car e pr ovi ders ofthei r choi ce. 41 0 I ND . A D M IN . C ODE 16. 2- 3. 1- 3( n)( 1)
. I fa ra ci al l y-bi ase d resi dent w i shes to em plo y a t he r o wn e xp e ns e a whi t e a i de , I nd i a na l aw m ay req u ire P lain field to allow th e re sid en t re as on ab le a c c e s s t o tha t a i de

. Bu t the r e g ul a t i o ns do no t say that a pati ent’ s pre fer ence f orwh i te ai des that P lainfi el d e mplo ys tr um ps Pl ai nfi el d’s du ty to i ts em plo yee s t o abst ai n fro m r ace-base d w or k a ssi gnm ents. Pl ai nfi el d’s re ading o fInd i ana r egul ati ons i s a l so untenable b ec au se i t puts Pl ai nfi el d at r i sk ofvi ol ating duti es ofm edi calcar e that i t ow es its r esi dents. A pote nti al vi o l at i o n c o ul d ha ve o cc ur r ed when Ch an ey, a dhe r i ng to Pl ainfi el d’ s po l i cy, r eluct an tly l eft Lat sh aw o n the fl oo r so she c oul d sear ch the b uil ding f ora w hi te nurse ai de ra th erthan i m m edi ate l y a tte nd to herneeds. P l a i n fi e l d ’ s cl a i m o f“ g o o d

- f a i th ” a p p e a r s l e s s th a n c o mpel l i ng as a f actualm att eras w ell. I fPl ai nfi el d w as w or ri ed that disho nor i ng rac e-bas ed w or k pr efer ences ri ske d vi ol ating Ind i ana’ s re gul ati ons, i t coul d hav e a ske d I nd i ana’ s S tat e Depart m ent o fH eal th wh et h erst ate l aw12 N o. 09

- 3661

re quir ed Pl ai nfi el d to dir ect i ts em plo yee s t o cate r to i ts re si dents’ r aci alpre fer ences. The r eco rd does n ot sho w an at tem pt to se ek such gui dance. Pl ai nfi el d’s next ar gum ent that the r aci alpre fer ence pol i cy w as re quir ed und erfedera ll aw is a lso notper suasi ve . Pl ainfi el d r el i es pr i m ar i l y o n thr ee s ec ti o ns o fthe M edi car e Act. The fi rs t, 42 U
. S. C. § 1 39 5, sta tes that “Nothi ngi n thi s su bc ha p ter” s ha l li nt er fer e wi ththe pr ac ti ce o f m edi cine . “ [ T] hi s su bc ha pte r ” r efer s to the M edi car e Act, not, as Pl ai nfi el d sugges ts, the federa l em p loy m en t-r igh ts law . Sim ilar ly off t h e m ar k is Pl ainfi el d’s re li ance o n 42 U
. S. C. § 1 395a
. That pro vi si on m er el y r em i nd s M edi car e be nefi ci ar i es that federa ll aw does not precl ud e them fro m usi ng pro vi ders that have opted o ut o fM edi car e. Final l y, Pl ai nfi eld r el i es on 42 U .S.C
. § 13 95 i, w h ich p ro vid es th at M ed ica re be n efici ar i es i n l ong- ter m car e f aci l i ti es have a r i ght t o choos e “a pe rson al at te ndi ngphy si ci an . ” The l aw i s si l en t ab o ut a b en efi ci ar y’ s r i ght t o choos e o ther ser vi ce pr ovi ders, su cha s CN As. M o r eo ve r, a s wi ththe Indi an a r egul at i o n, ev en if th e la w ex te n d e d t o ot h er se rv ice p ro vid er s, it w oul d m er el y re quir e Pl ai nfi el d t o al l ow resi dents acces s t o them , r atherthan obli gat e Pl ai nfi el d to i nsti tute ra ce-base d w or k pr acti ces. Pl ai nfi el d al so defe nd s the r aci alpre fer ence pol i cy on a p ract i ca ll ev el : wi th o uti t, Pl ainfi el d r i sk s ex po sing bl ack em plo yee s t o raci alhar ass m ent fro m the re si dents an d , in tu rn, ex p os in g its elf t o h os tile w o r k p l ac e liab ili ty
. I t a dds, w i th o utpr o vi di nga utho r i ty, tha t di sc ha r g i ng a r aci al l y ho sti l e r esid en t to avo i d exposi ng em plo yee sN o. 09

- 3661 13 to the r esi dent i s i l l ega l

. But w i thout re so rti ng to di sch a r g i ngr e s i de nt s , a l o ng - t e r m ca r e f a c i l i t y c o nfr onte d w ith a host il e residen t has a r a n ge of op tions. I t can w arn r es i den ts b efo r e admi tt i ngthe m o f the f ac i l i ty ’ s no nd isc rim in at ion p olic y, se c u rin g t h e re sid en t’s co n se n t in w ri tin g; i t ca n att em pt to r ef or m the re si dent’s behav i or afteradm i ssi on; and i t ca n ass i gn staffbas ed on r acen eu tr al c rit er ia t h at m in im ize th e ris k of c o n flict

. See P a t r ick G av in& JoA n n e L ax , Whe n Re s i de n t s a n d F ami ly Ha rass S ta

ff: The Tigh trop e betw een R egu la to ry C o m pli a nc e, R is k M ana gem entand E m ploym entLiabi li ty, L ONG T ERM C ARE AND THE L AW 16- 18 ( Feb. 27, 2 008) ( A m er i can H ea l thLa wye r s Asso ci at i o n, S emi na r M at er i al s)
. Pl ainf i el d c o ul d h a v e , f o r i ns t a nc e , a dv i s e d i t s e mpl o y e e s that th eyc o ul d a skf o r pr o te ct i o n fr o m r ac i al l y ha r as sing r es i d en ts
. Tha t way, Pl ainfi el d woul d no t be i m po sing an u n w anted, r ace- consci ous workl i m i tat i on o n i ts b l a c ke m p l o y e e s ; r a th e r, i tw o u l d b e a l l o w i n ga l le mp loyees to w ork i n a race -neu tral, non -haras sing w ork en v i r on m en t, as is co m m on ly ex p ec te d of em p loy er s. C f. P ort er v. E ri e Foo ds Int’l, Inc. , 576 F.3d 629 , 636 (7th C ir. 20 09 ); He r r on v. D ai m l e r Chrys l e rCorp. , 38 8 F. 3d 293, 302 ( 7th Ci r. 20 05)
. A nd ev en i fal lthes e e ffor ts do not guar antee fu l lr aci alhar m ony, theyexem pli fy r easonab l e m eas ures thatan e m plo yercan u n d er tak e t o av oid liab ility for kn ow n w or kp lac e h ar as sm en t
. See, e.g., C o o per-S hu t v. Visteon A uto m o tiv e Sy s., 361 F. 3d 421, 426 (7th C ir. 2004). Pl a i nfi e l d, h o we v e r, ch o s e n o ne o fthe s e o pt i o ns . Ins t e a d, Pl ainfi el d tol d Ch aney that i t was excl ud i ng herfro m w or k a re as and res i dents so l el y o n acco unt ofherr ace,14 N o. 09

- 3661 th er eb y c re at in g a rac ially -c h ar ge d w or kp lac e t h at p oisone d the w or k envi ro nm ent. I n l ess than thre e m onths, Ch aney re port ed at l eas t three speci fi c i nci dents o fhar ass men t, two o fwh i c h ( i
. e . , “ Bl a c kb i t c h” a nd “ whydo they kee p hir i ng the se bl ack ni gge rs ?”) i nvol ved rac ial sl urs dir ecte d tow ar d her. A l though the di re ct e pithets stop p ed after Plai n fi e ld learned of th em , the record d oes not show w he th er the lulls in h a r assm en t w ere for tu ito u s o r th e re su lt of re m ed ial a c tio n . Se eSm i t h v
. S he han , 18 9 F
. 3d 529, 53 5 ( 7th Ci r. 19 99)
. M or e fund am ental l y, Pl ai nfi el d never c orre cted the princi ple so urce ofthe ra ci al h os til i ty i n the w or kpl ace

— i ts w i l l i ngness to accede to a p ati ent’ s r aci alpre fer ences. The hos ti l i ty that Ch aney described cam e fro m daily re m i nd er s t hat Pl ainfi el d was e m pl o y i nghe r o n mat er i al l y di ffer en t t e r m s tha n h er w hite co-w orkers. Fu eli ng this pa ttern w as the r aci alp re fer ence pol i cy, bo th a sour ce o fhum i l i ati o n fo r Cha ne y a nd f o dder for herc o - wor k er s, who in vo ke d it reg u lar ly. It w as , in sh or t, a ra c ially h os tile en vironm en t, an d the evid en ce p resen ted at sum m ary j ud gm ent a l l ows a j ury to conclude thatPl ai nfi el d too k i nsuffi ci ent m eas ures to address i t.

B. D iscrim ina tory D isch arge Claim Ch an ey re new s herar gum ent that herdi schar ge w as ra ci al l y m oti vate d. She proce eds und erthe dir ect m etho d ofpro of, wh i ch m ay i ncl ud e di re ct o r ci rcum stanti al ev id en c e t h at rac e m ot iva te d P lain fiel d ’s d ec isio n . See Henry v. Jon es , 50 7 F. 3d 558, 56 6 ( 7th Ci r. 20 07)
. The thr ust ofChaney’ s cl ai m i s th at R eye s’ s cur sor y invest i gat i onN o. 09

- 3661 15 i nto her al l ege d m i sco nd uct ca sts d ou b t on the si ncer i ty of th e re aso n that he o ffer ed f orfi ring her

. Evi dence of prete xt, byits el f, m ay not al w ays be enough t o defe at su m m ar y jud gm en t u n d e r th e d ire c t m et h od

. See Ven t ure l l iv. Ar c Cm ty. Se r v. , 350 F. 3d 592, 601 ( 7 t h C ir. 2 0 0 2 )
. B u tC h a n e y h a s a l s o p r e s e n t e d o th e r c i r c u mst an tia l ev id en c e o f m or e fa vo ra b le tre at m en t of a s im ilar ly si tuate d co- w or kersugg est i ng tha t r ace fi gured i nto P l a i n fi e l d ’ s d e c i s i o n t o fi r e h e r . T a k e n t o g ethe r, th e t wo thre ads ofev i dence cr eat e a tr i abl e i ss u e w hetherr ace m ot iva te d C h an ey ’s d isc h ar ge . First, the r e c o rd cont ains evid en ce th at Plainfiel d ’s gr ounds f orfi ring herwere i nsi ncer e. Reye s had r eso l ved to fi re Ch an ey w ithin 24 h ou rs of receiving C afouras ’s compl a i nt, a de c i s i o n he r e a c he d in a n un us ua lway. A ske w o rdi nari l y invest i ga ted char ges o fm i sco nd uct i n heruni t, but Reyes co nd ucted hi s o w n i nvest i gat i on an d d ecid ed to fire C ha ne y w ithou t con side ring A skew ’s evi dence thatthe c om p lai nt was unfo und ed. Reye s coul d hav e eas i l y i nter vi ew ed Ch aney about the inci dent, as w el las co - w or kerH ar t, wh o w as prese nt wh en Ch aney’ s a l l ege d m i sco nd uct o ccurred . W hat i s m or e, C h an ey s ta te s t h at atth e t er m in at ion m ee tin g, th e o n ly re aso n she w as gi ven for her disc harg e was the al l ege d u se of pr ofa n ity
. D u rin g l itig at ion h ow ev er , P l ain field has focuse d atte nti on o n ot h erpote nti algr ounds f or fi r i ngCha ne y s ucha s ch ar ges of i g no r i ngthe c al ll i g ht and refusi ng a shi ft chang e. A shi fti ng j usti ficati on f or an em plo ym ent a cti on ca n itsel fbe ci rcum sta nti al ev id en c e o f an u n law fu l m ot ive
. See Rudi n v . Li nc ol n L and C m ty. Co ll
. , 42 0 F
. 3d 712, 72 3- 24 ( 7th Ci r. 20 05)
. Pl ai nfi eld16 N o. 09

- 3661 counter s that Rey es’ s deci si on t o fi re Chaney s houl d be aff o r ded a “pr es um pti o n o fl eg i ti m ac y ” sinc e he was the offi ci althathi re d h er . Th i s a rgum ent was f or fei ted b ec au se P lain field m ad e it on ly o n a p p e al. Se eAr e ndtv. V et ta S p orts, Inc. , 9 9 F
. 3 d 2 3 1 , 2 3 7( 7 th C i r . 1 9 9 6 )
. In a ny case , the “p resu m p tion” is j us t pa rt of th e evide nt iary m ix
. He r r nre i t e rv. Chi
. Hous . Aut h. , 315 F. 3d742, 747 (7t h C ir. 20 02 ). Ch aney has a l so pres en ted ci rcum sta nti alev i dence of a d isp ar ity in t re at m e n t b et w ee n h er an d a c om p ar ab le wh i t e n u r s e a i d e . E v i de nc e th a ts i mi l a r l y s i t u a t e d e mplo yee s o utsi de the p ro tected cl ass r ecei ved bet tertr eat
m ent c an h elp support a ci rcum sta nti alsho w i ng o fdi sc rim in at ion
. See Henry, 50 7 F
. 3d at 566. H er fi rs t co m parabl e white CN A i s Au dri a, wh o l i ke Chaney w as re port ed f orswearing i n the prese nce of a re si dent. This com pari son woul d be apt i f Cha ne y ha d ev i den ce th atthe com pl aint wenthi g h e r u p th e c h a i n o fc o mma n d th a n As k e w, h e r i mme d i a t e s u p e r v i s o r . S i nc e sh e d o e s n o t, th e c o mpari son i s unhel pful, as the deci si on to di schar ge C h an ey be lon ge d to R ey es , no t A sk ew . Cha ne y ha s a m o r e pr o m i singc o m par at or in H ar t, the CN A w ho se pa ti en t Cha ne y was a ss i st i ngwhens he al l ege dlyused pro f anity
. Both Chaney and H ar t were at th e nur se s ta ti on w he n Ca f o ur as a sk ed f o r he l p. The re si dent w ho nee ded hel p w as i n H ar t’ s uni t, ye t i t was C h an ey , no t H ar t, w h o u lti m at ely res p on d ed to th e c all. Tr ue , unl i k e Cha ne y, H ar t was no t ac cus ed o fus i ng prof ani ty i n fro nt o f a r esi dent. But the si m i l ar l y s i tuate d co- w or keri nquiry i s a se ar ch f ora substa nti al l y s i m i l arN o. 09

- 3661 17

em p loy ee , no t fo r a c lon e. Argyropol ous v. Ci ty of Al t on , 53 9 F. 3 d 72 4 , 7 3 5 ( 7 th Ci r . 2 0 0 8 )
. I f, a s P l a i nfi e l d no w conte nd s, f ai l i ng to r es p on d to a bed al ar m i s a se parat e, ter m i nabl e o ffense, i t i s s uspici ous that H ar t was not que st i o ne d ab o ut he r i na ct i o n unt i l two wee k s afte r the i nc i den t an d tha t, de spi te he r r efus alt o r es po nd t o the ca l ll i g htfr o m a resi den t i n h eruni t, s he g o t o ffwi th o ut so much a s a war ni ng . W he n con sider ed i n l i g hto fthe fullacc ount o fReye s’ s unusual an d lim i ted i nvest i gation, a reason able j ury co uld conc lud e f r om this record th at Pl ainfi el d’ s g r o unds f o r fi r i ngCha ne y c l o ak ed th e f orbi dd en m oti vati on o fr ace.

I I I . C ONC L US I ON Th e j ud g men t o f the di s t r i c t c o ur t i s R EV ER S ED a nd R EMAND ED f orfurtherpro ceedings.

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