DJ# 202-62-458

A. Background

  1. The parties to this Settlement Agreement (“Agreement”) are the United States of America, Thomas Jefferson University Hospitals, Inc., and Outpatient Imaging Affiliates, LLC., collectively the owners and operators of Jefferson Outpatient Imaging and Radiology (hereinafter “Jefferson Outpatient”).  Jefferson Outpatient is a professional corporation with its principal place of business located at 132 S. 10th St., Philadelphia, PA 19107.
  2. This matter was initiated by a complaint filed with the United States Department of Justice (the “Department”) against Jefferson Outpatient under Title III of the Americans with Disabilities Act (“ADA”), 42 U.S.C. §§ 12181-12189.  The Attorney General is authorized under Section 308(b)(1) of the ADA, 42 U.S.C. § 12188(b)(1), to investigate complaints and bring a civil action under Title III where a pattern or practice of discrimination is believed to exist or where a matter of general public importance is raised.
  3. Jefferson Outpatient provides outpatient imaging and radiology services to members of the public, and its facilities are places of public accommodation covered by Title III of the ADA, 42 U.S.C. § 12181(7)(F), and its implementing regulation, 28 C.F.R. § 36.104.
  4. The ADA prohibits discrimination against individuals on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages and accommodations of places of public accommodation.  42 U.S.C. §12182(a); 28 C.F.R. § 36.201(a).  It is an issue of public importance to ensure that public accommodations, which own, operate, lease, or lease to medical centers or other professional offices of health care providers, do not discriminate against persons with disabilities, including persons with mobility impairments.
  5. Jefferson Outpatient operates a medical practice that provides radiology services and diagnostic imaging including, but not limited to, dual energy x-ray absorptiometry (DEXA) bone density scans, at its facilities in the greater Philadelphia, Pennsylvania area.  It provides these services both by advanced appointment and on a walk-in basis.
  6. The complainant, who has cerebral palsy, osteoporosis, and uses a wheelchair, alleges that he was denied full and equal access to the services provided by Jefferson Outpatient based on his disability, when he attempted to receive a bone density scan as a walk-in patient at Jefferson Outpatient at 850 Walnut Street, Philadelphia, PA 19103.  Because of his disability, and the height of the DEXA equipment used by Jefferson Outpatient, the complainant needed assistance to transfer from his wheelchair to the DEXA machine.  Complainant alleges that (1) the radiological technician informed him that they did not have staff available to transfer him, (2) he was not transferred, and (3) Jefferson Outpatient did not provide the DEXA scan as prescribed by his physician at that time.
  7. The parties agree that it is in their best interest, and the United States believes that it is in the public interest, to resolve this matter through a settlement agreement.  The parties have therefore voluntarily entered into this Settlement, agreeing as follows:


  1. Within 30 days of the effective date of this Agreement, Jefferson Outpatient will adopt and incorporate the Non-Discrimination Policy (attached as Exhibit 1) into its existing policies and post it in conspicuous locations in all of its offices.  Jefferson Outpatient will also post and maintain a hyperlink to the Non-Discrimination Policy on the home page of its website.
  2. Jefferson Outpatient will ensure that individuals with disabilities are afforded equal access to its facilities and services. Jefferson Outpatient will also train all staff who interact with patients on the requirements of Title III of the ADA as they apply to healthcare facilities and on techniques for safely assisting individuals with mobility disabilities to transfer to imaging equipment or examination tables.  In addition, Jefferson Outpatient will incorporate the above training into its new employee orientation for all future employees who will have contact with patients.
  3. To ensure that it provides individuals with mobility disabilities equal access to its services and facilities – whether by appointment or walk-in – Jefferson Outpatient will have staff available to safely assist individuals with mobility disabilities with transferring to imaging equipment or examination tables at all times when its facilities are accepting patients.  In addition, Jefferson Outpatient represents that it has taken steps to ensure that each of its outpatient facilities has, and will maintain, a Hoyer lift, or other patient lift designed to safely transfer a patient, to existing DEXA machines, examination tables, or other equipment.
  4. Within 14 days of the effective date of this Agreement, Thomas Jefferson University Hospitals, Inc., will offer to pay compensatory damages to the complainant in the amount of $5000.00, subject to his execution and return of a release (attached as Exhibit 2).  Within 14 days of receipt of the executed release, Thomas Jefferson University Hospitals, Inc., or Jefferson Outpatient shall send, by U.S. Mail, return receipt requested or by overnight delivery, a check for $5000.00 to the complainant.
  5. Should the complainant choose to seek treatment, testing, or any other services at Jefferson Outpatient, Jefferson Outpatient will not engage in any retaliatory conduct towards complainant as a result of his filing a complaint with the Department, participation in the investigation process, or receipt of compensatory damages.
  6. In consideration of the terms of this Agreement, the Department agrees to close its investigation of this matter, DJ# 202-62-458, except as provided in Section C, below.


  1. Within twelve (12) months of the effective date of this Agreement, Jefferson Outpatient or Thomas Jefferson University Hospitals, Inc. shall send a report, by email to the undersigned counsel, documenting its compliance with the actions described in Section B, above.  The report shall include identification of the make, model, and pictures of any purchased or leased equipment for lifting or transferring.
  2. During the term of this Agreement, Jefferson Outpatient and/or Thomas Jefferson University Hospitals, Inc. will notify the Department if any individual brings any lawsuit, complaint, charge, or grievance alleging that it failed to provide any aid or service to an individual with a disability at a Jefferson Outpatient Imaging clinic.  Such notification must be provided in writing within thirty (30) days of the day when either entity has received notice of the allegation and will include, at a minimum, the nature of the allegation, the name of the individual making the allegation, and any documentation possessed by Jefferson Outpatient and/or Thomas Jefferson University Hospitals Inc., or any of its agents or representatives relevant to the allegation.
  3. The Department may review compliance with this Agreement at any time during the term of this Agreement.  If the Department believes that this Agreement or any of its requirements has been violated, it may institute a civil action in federal district court to enforce this Agreement or the requirements of Title III, following written notice to Jefferson Outpatient of possible violations, and, a period of 30 days in which Jefferson Outpatient has the opportunity to cure the alleged violations.
  4. Failure by the Department to enforce this entire Agreement or any of its provisions or deadlines shall not be construed as a waiver of the Department’s right to enforce other deadlines and provisions of this Agreement.
  5. This Agreement shall be binding on the agents, employees and successors of Jefferson Outpatient, including agents and employees of affiliated outpatient clinics.  In the event that Thomas Jefferson University Hospitals, Inc., or Outpatient Imaging Affiliates, LLC, seeks to transfer or assign all or part of its interest in the outpatient services, and the successor or assign intends on carrying on the same or similar use of the practice, as a condition of sale, and shall obtain the written accession of the successor or assign to any obligations remaining under this Agreement for the remaining term of this Agreement.
  6. This Agreement constitutes the entire agreement between the parties on the matters raised here, and no other statement, promise, or agreement, either written or oral, made by either party or agents of either party, that is not contained in this written agreement, shall be enforceable.  This Agreement does not purport to remedy any other potential violations of the ADA or any other federal law.  This Agreement does not affect, amend, or decrease the continuing responsibility borne by Jefferson Outpatient, or any other hospital, clinic, or treatment center affiliated with Thomas Jefferson University Hospitals, Inc. to comply with all aspects of the ADA.
  7. If any term of this Agreement is determined by any court to be unenforceable, the other terms of this Agreement shall nonetheless remain in full force and effect, provided, however, that if the severance of any such provision materially alters the rights or obligations of the parties, the Department and Jefferson Outpatient and/or Thomas Jefferson University Hospitals, Inc. shall engage in good faith negotiations in order to adopt mutually agreeable amendments to this Agreement as may be necessary to restore the parties as closely as possible to the initially agreed upon relative rights and obligations.
  8. This Agreement will remain in effect for two (2) years from its effective date.
  9. The person signing this Agreement for Thomas Jefferson University Hospitals, Inc., and for Outpatient Imaging Affiliates LLC., represents that he/she is authorized to bind Jefferson Outpatient, its named affiliates, and employees to this Agreement.
  10. The effective date of this Agreement is the date of the last signature below.

United States Attorney



Assistant United States Attorney
Chief, Civil Division
Eastern District of Pennsylvania



__/s/ Deborah Frey_________
Assistant United States Attorney
Eastern District of Pennsylvania

Assistant Attorney General
Civil Rights Division


Section Chief
Special Litigation Counsel
Disability Rights Section
Civil Rights Division

_/s/ Alyse Bass___________
Senior Trial Attorney
Disability Rights Section
Civil Rights Division
U.S. Department of Justice
950 Pennsylvania Avenue, N.W. – NYA
Washington, D.C. 20530

Dated:  _April 18, 2019________


Executive Vice President and General Counsel
Thomas Jefferson University

__/s/ Cristina Cavalieri_________



_/s/ W. Cannon King________





Dated: 4/16/19





Dated: 4/16/19


In accordance with Title III of the Americans with Disabilities Act (ADA), Jefferson Outpatient Imaging and Radiology (“Jefferson Outpatient”) does not discriminate on the basis of disability in the provision of its medical services.  To ensure that individuals with a disability are provided equivalent service, whether by appointment or on a walk-in basis, Jefferson Outpatient will make reasonable modifications to its policies, practices, or procedures when necessary to provide its medical services to individuals with disabilities, unless such modifications would fundamentally alter the nature of its medical services. 

When a patient with a mobility impairment or other disability seeks assistance with transferring to imaging equipment or examination tables, Jefferson Outpatient will safely assist the patient to transfer.  Jefferson Outpatient staff will first ask the patient exactly what type of assistance he or she needs, and how he or she prefers to be assisted in order to provide a safe and effective transfer.

Jefferson Outpatient staff have been and will continue to be trained in proper transfer techniques, and will use staff, adjustable equipment (where available), or patient lifts, when appropriate, to assist an individual with a mobility impairment or other disability to transfer to imaging equipment or examination tables.