Opinion ID: 2971925
Heading Depth: 3
Heading Rank: 1

Heading: Act Swiftly… Our resource[ 2

Text: ] agrees with our assessment of high likely hood [sic] that the pivot incident[ ] is good indicator of broader, lon[g] term issue. 2. Discuss performance issues and as a SIDE part of that concern, make management referral giving individual small amount of time to make decision and first interview. Do not use the observation 2 weeks ago as primary emphasis. 1 The “resource” mentioned in the e-mail was Minderman. 2 The phrase “pivot incident” refers to the July 22, 1997 incident in which Hill perceived a smell of alcohol on Moorer’s breath. Nos. 03-5855/5965 Moorer v. Baptist Memorial Health Care System, et al. Page 4 3. Plan on minimum of 3-4 weeks of leave for the individual. 4. Plan to terminate if refuses to act on management recommendation. The e-mail concluded with a “[b]ack up plan[]” to cover for Moorer during his leave “until we get a better idea of long term situation.” Hill testified that “Mr. Minderman had given us the specific recommendations regarding how to handle Mr. Moorer’s situation.” At trial, however, Minderman denied telling Hill that Moorer had an alcohol problem or making a recommendation that Moorer might need to be terminated. He also did not recall telling Hill that the July 22 incident in which Hill smelled alcohol on Moorer’s breath was a “good indicator of [a] broader, long-term issue”; he further denied that such an incident would be a good indicator of a broader, longer-term issue. In fact, Minderman had no assessment of Moorer’s condition as of August 6, 1997. He flatly denied telling Hill that Moorer should be placed on leave for treatment or that Hill should plan a leave for him. On August 12, 1997, Hill, Robbins, and Braughton discussed Hill’s August 6, 1997 e-mail and agreed to it as the appropriate plan of action. Collectively, they decided to refer Moorer to the CONCERN program for a fitness for duty evaluation. With input from Braughton, Robbins, and legal counsel, Hill prepared a letter to Moorer that outlined alleged performance deficiencies and goals that Moorer was expected to meet. The letter was a revision of the draft letter Hill had prepared on July 22, 1997 but never gave to him. The letter noted, in part, “While I find that you have made efforts to correct the noted deficiencies and have made some improvements in some areas, there is a lack of substantial progress toward elimination of root causes and thus, limited improvements in your overall job performance and the desired outcomes in the operations at the two facilities you administer.” These purported deficiencies included inconsistent financial reporting; past due accounts receivable; improper management of a physician’s contract; lack of effort to educate his staff regarding revised budget processes; customer satisfaction issues; and symptoms of drunkenness exhibited at the July 22, 1997 meeting. The letter continued, “I have made a management referral to Concern, EAP, for fitness assessment and any resulting plan of action. This is a mandatory action and your failure to participate and cooperate by 10 am, August 20, 1997 will result in your immediate termination.” The letter further instructed Moorer “to refrain from ANY contact with ANY hospital personnel” until Robbins and Hill had “full clarification of issues and recommendations” from the fitness assessment. It also set out “additional action plans and goals” for Moorer and warned that “[f]ailure to 100% successfully adhere to or complete” them would be “a basis for immediate additional disciplinary actions up to and including termination.” Contrary to the no-contact instruction, however, some of these goals required contact with hospital personnel, including revising the BMH-Tipton’s strategic plan, which would give Moorer “the opportunity to personally interact with all levels of staff.” Id. The strategic plan was required to be submitted by August 27, 1997. Robbins and Hill met with Moorer on August 19, 1997 and presented Moorer with the letter. During the meeting, Hill told Moorer that she had a family history of alcoholism and told Hill that she thought he was an alcoholic. Hill and Robbins then assured Moorer that he would have a job when he returned from alcohol rehabilitation. To avoid termination, Moorer agreed to have an evaluation the next morning with John Houlihan of CONCERN. He met with Houlihan, who diagnosed Moore with “chemical abuse” and recommended treatment at the Anchor Hospital/Talbott Recovery Center. On August 22, 1997, Moorer flew to the recovery center in Atlanta. He was scheduled for five weeks of treatment and stayed the full five weeks. Nos. 03-5855/5965 Moorer v. Baptist Memorial Health Care System, et al. Page 5 On August 28, 1997, while Moorer was at the recovery center, Hill telephoned Moorer’s wife at home and said, “I know an awful lot about alcoholism and alcoholics.” She told Mrs. Moorer that her father was an alcoholic, as was her brother, who had killed himself. She also said that “alcoholism is an incurable disease and your husband will never be cured, and it is a deadly disease.”3 On August 21, 1997, Dr. Jesse Cannon, Chief of the Medical Staff at BMH-Tipton, sent a letter to the President of Baptist, with copies to Hill and Moorer, as well as to Anita Vantries of the Tennessee Health Care Facilities Commission (“THFC”), the state licensing agency for hospitals. Cannon’s letter forwarded a list of problems and deficiencies at the hospital that had come to light over the past three to five years and attached complaints of other physicians as well. Cannon attributed these problems to management’s requirement that the system must “decrease cost at all cost.” The problems included the decision of Moorer to close restroom facilities in the south doctor’s office building because a patient had sued the hospital after slipping on the wet floor; the poor maintenance of the hospital’s facilities and unsanitary conditions; leaking ceilings (including in the operating rooms); a fire hazard in an operating room due to a lack of storage space for supplies; too few nurses; and shortages of supplies. Hill confirmed many of these complaints through her own investigation and was required to spend $200,000 to address them. Other issues purportedly came to Hill’s attention in this time-frame. First, Hill could not locate the leases signed by the physicians for the office space in the physician office buildings at BMH-Tipton; she also allegedly learned via verbal reports from Joe Hunsucker, an internal auditor, that physicians were obtaining medical supplies and pharmaceuticals from the hospital, as well as using labor from the hospital’s business office, without compensating the hospital. Second, Hill received complaints from employees at BMH-Tipton about certain employee relations issues, including an accusation that Moorer did not respect employees, especially women, and the results of a survey showing that employees had rated the administrative leadership below national norms. Third, on September 2, 1997, Hill learned about high accounts receivable balances for the hospitals that Moorer managed, apparently due to a backlog of claims and an inordinately high error rate in claims processing. Fourth, during the first week of September, 1997, Hill discovered that certain home health care employees on the home health agency payroll actually were working at the hospital, raising the potential of fraud because Medicare provides a larger reimbursement for home health care workers who work for the agency as opposed to the hospital. Between August 19, 1997 and September 12, 1997, Hill had regular contact with Robbins regarding Moorer. She recommended that Moorer not be permitted to come back to work at BMHTipton because of his performance problems. Robbins took Hill’s recommendation under advisement, and later decided to terminate Moorer because he had lost confidence in Moorer’s ability to run an independent facility. According to Hill, the decision to terminate Moorer’s employment was made during the week prior to September 12, 1997. Robbins and Braughton developed a script with the human resources department that Hill was to follow when terminating Moorer’s employment. After consulting with Houlihan at CONCERN and with Moorer’s therapist, Braughton determined that it would be best to relay the termination decision in person and that the most therapeutically appropriate day to relay this information was September 18, 1997. Robbins and Hill traveled to Atlanta on that day and met with Moorer and his primary therapist. Hill read primarily from the termination script. Moorer recalls little from the meeting except that Hill told him that his work problems were caused by his disease. 3 At trial, Hill confirmed that she had personal family experiences that caused her to be interested in alcoholism. She explained that both her father and brother had abused alcohol, and her brother committed suicide after a long battle to cope with a brain injury he had suffered in an alcohol-related automobile accident. According to Hill, her personal experience enabled her to have a “greater insight” into alcoholism. Nos. 03-5855/5965 Moorer v. Baptist Memorial Health Care System, et al. Page 6 Moorer completed the five-week treatment period, but his doctors recommended that he remain in treatment for a few additional weeks. Moorer elected to leave the treatment program against medical advice. Moorer admits he is an alcoholic, but testified that he has not had a drink since August 22, 1997.