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Nelson v. Marymount Hospital8/17/2000
assist her.
The appellant overheard a meeting between Ms. Brenner, Ms. Herbert, and three Caucasian coders. Two of the coders threatened to quit rather than train the appellant. Ms. Herbert informed the coders that they had no choice. Once training began, the coders would only assist her on the days to which they had been assigned. Even if the assigned person was away from her desk, another coder would not answer a question. As a result of the coders' complaints, the appellant was told not to disturb them until she had completed a task.
As to the training schedule itself, the appellant stated that it was not always followed precisely. The appellant attended some seminars regarding coding. The appellant used Code 3 programming, the ICD-9 and CPT coding. The three coders with whom the appellant worked all had previous coding experience at other facilities prior to being hired by Marymount. The appellant was told that she had to be 90% proficient on all of the charts after 90 days. While this was the standard in the department, no other coder was held to this standard in such a short time.
The appellant was unhappy because one week after she began her training as a coder, she was told by Ms. Brenner that she was not to ask the other coders questions. The coders complained that they could not finish their own work when they had to answer her questions. Every time she asked a question, the coders went to Ms. Brenner to report her questions. The appellant felt like she was under a microscope and that she was made to feel very stupid.
The appellant acknowledged that she was lent text books to assist her with her training and that there were books on a neighboring desk to which she had access.
Eventually, Ms. Brenner and a woman from human resources met with her regarding her sixty-day evaluation. The appellant did not agree with the evaluation. On her evaluation the appellant received the following marks:
ability to follow and understand directions poor
quality of work fair
quantity of work poor
ability to fulfill job requirements poor
attitude and cooperation good
potentialities fair
limitations fair
A separate sheet was attached to the evaluation setting forth specific comments under each category. Under the category of quality of work, the evaluation is separated into different types of charts the appellant was required to code. Of the seven types of charts listed, the appellant was rated on seven different types of charts as follows: 1) on the admissions list the appellant was rated satisfactory; 2) on the ROP list the appellant was rated satisfactory; 3) on the ED charts the appellant was rated as fair because she had obtained a 65% accuracy when an accuracy of 95% was expected; 4) on the AMS charts the appellant was rated as poor because she had obtained a 17% accuracy when 95% was expected; 5) on the Inpatient, Obstetric & Newborn the appellant was rated as poor because her accuracy on the principal diagnosis was 64%, on the secondary diagnosis 15%, on the procedure code 44%, and only two charts of 39 were entirely correct, an accuracy rating of 95% was expected; 6) on Inpatient, Surgery the appellant was rated as poor because her principal diagnosis was correct in 67% of the cases, the secondary diagnosis was incorrect in some aspect in all of the cases, the procedure code was correct in 44% of the cases, the accuracy rate expected is 95% and none of the nine cases coded by the appellant were correct; and, 7) on Abstracting the appellant was rated as fair because errors continued to occur in areas the appellant had been previously as
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