When considering whether to accommodate a patient’s request regarding caregivers of a particular race, gender, or religion, the case that comes closest to setting a precedent for healthcare providers is Chaney v. Plainfield Healthcare Center, which involves a Plainfield, IN-based nursing home that forbade black nurses from treating certain patients.

In a 2010 decision, the Indiana Seventh Circuit Court of Appeals determined that Title VII of the Civil Rights Act bars nursing homes from acceding to their residents’ racially discriminatory requests with respect to certified nursing assistants. (See the case at http://tinyurl.com/pnpfzu9.) Plainfield Healthcare Center is a nursing home that housed a resident who did not want assistance from black certified nursing assistants (CNAs). Plainfield complied with this racial preference by noting in each day’s duty sheets that “no black” assistants should enter this resident’s room or provide her with care. Brenda Chaney, a black CNA, filed a lawsuit claiming the nursing home created a hostile work environment.

Chaney reluctantly refrained from assisting the patient, even when she was in the best position to respond. Once, according to the lawsuit, Chaney found the woman on the ground, too weak to stand. Despite wanting badly to help, Chaney had to search the building for a white CNA. Plainfield housed at least two other residents with a similar distaste for black CNAs.

The district court ruled in favor of the nursing home and accepted its argument that failure to comply with her request might have violated the state’s patients’ right laws. The Seventh Circuit Court of Appeals in Indiana disagreed and concluded that the nursing home “told Chaney that it was excluding her from work areas and residents solely on account of her race, thereby creating a racially-charged workplace that poisoned the work environment.”

By accommodating the race-based request, the employer encouraged racial abuse toward the black CNA, the court determined.

“The hostility that Chaney described came from daily reminders that Plainfield was employing her on materially different terms than her white co-workers. Fueling this pattern was the racial preference policy, both a source of humiliation for Chaney and fodder for her co-workers, who invoked it regularly,” the court wrote. “It was, in short, a racially hostile environment.”

Plainfield later settled the case for $150,000, according to court records.