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Question: At the home health agency where I work, one of our employees has started complaining about a patient she sees weekly in his home, alleging that he is saying inappropriate things and attempting to touch her in a way that makes her uncomfortable. He is old and frail, and she says she feels bad for him, too. We don't want to lose him as a patient, but we are concerned because our worker is making a fuss, and other employees want to know what's going on. What should our agency do?

Answer: Sexual harassment is a serious issue, and your HHA has a legal obligation to protect your employees from it.

Last September, the federal Equal Employment Opportunity Commission sued Nurse One/ Team One, a McMinnville, Tenn.-based provi-der of home care services, alleging that the company violated federal law by condoning a sexually hostile work environment in the home of one of its clients and then firing an employee for complaining about the client.

In that case, the EEOC alleged that Nurse One/Team One ignored at least 25 written reports from not just one, but a group of female certified nursing assistants of sexual harassment, inappropriate touching, and sexual requests by a male client. "Instead of taking steps to stop the harassment or removing the client from its services, Nurse One/Team One continued to place [the] CNAs at the home of the harassing client," according to the EEOC. When the lead plaintiff refused to apologize to the client for telling another CNA about the client's actions, Nurse One/Team one fired her. Avoid similar troubles at your agency with these three guidelines:

1. Make sure you review and, if necessary, update your HHA's policies and procedures concerning sexual harassment. "These should be followed, even when the harasser is a patient," says Robert Markette Jr., an employment lawyer with Gilliland & Markette in Indianapolis.

2. If an employee complains of sexual harassment by a patient, you must investigate, Markette points out in his blog. "Your efforts to follow your policies and address the problem should also be documented," he recommends.

3. Take steps to end the harassment. This can include sitting down with the patient and his or her family, which usually takes care of the problem, Markette points out. But if it doesn't, you must be prepared to terminate your care and discharge the patient. This can raise tricky patient abandonment issues, so proceed carefully, he says.

The main thing to remember is that you should never just avoid the issue, hoping it will go away. "If you ignore the problem, the EEOC will get involved," Markette says. "Like so many other regulatory areas, this is one where compliance and prevention is much, much easier than responding to a government investigation and/or lawsuit."

Patient's Son Shoots Home Care Worker

And the consequences could get even more serious than that. Take the case of a recent home care worker shooting in Tennessee. Charles James Givens, the 40-year-old son of a patient served by Innovative Home Health in Big Stone Gap, allegedly shot to death 22-year-old home nurse technician Misty Leann Garrett, according to the Kingsport Times-News. Givens had asked Garrett to be his girlfriend, the Lee County sheriff told the newspaper. When she refused, on March 5 Givens snuck up and shot her with a rifle while she was treating his mother in their living room.

Givens called 911 and told the dispatcher he shot Garrett, the newspaper says. Police arrested him and charged him with first degree murder. Givens told police he had been planning the murder for some time.

In the comments section after the story on the newspaper's Web site, numerous people saying they were home care workers reported feeling pressured to not report sexually harassing behavior.

"It is a felony to assault a health care worker,"said one commenter, "but if you file charges against a patient or family member who assaults you, your company WILL fire you for one reason or another."

"If you complain about the way a patient or family is treating you ... [management will] say you aren't an effective nurse and you need to care for the patients to which you are assigned," says another commenter. "You'll either end up losing your job or never getting a raise."

Resource: See the article and the related comments online at .