The opinion
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by Reporter of
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Appellate Court Date: 2022.01.04
09:44:42 -06'00'
Oommen v. Glen Health & Home Management Inc., 2020 IL App (1st) 190854
Appellate Court BINO OOMMEN, M.D., Plaintiff-Appellant, v. GLEN HEALTH
Caption AND HOME MANAGEMENT INC.; BRENTWOOD NORTH
HEALTHCARE AND REHABILITATION CENTRE, INC.;
SIDNEY GLENNER; JOSHUA RAY; and PHILIP THOMPSON,
Defendants-Appellees.
District & No. First District, Sixth Division
No. 1-19-0854
Filed November 20, 2020
Decision Under Appeal from the Circuit Court of Cook County, No. 18-L-4985; the
Review Hon. Jerry A. Esrig, Judge, presiding.
Judgment Affirmed in part and reversed in part.
Cause remanded.
Counsel on Brian J. Spencer, of Spencer Law Offices, P.C., of Chicago, for
Appeal appellant.
Kevin M. O’Hagan and Elizabeth M. Bartolucci, of O’Hagan Meyer
LLC, of Chicago, for appellees.
Neal Gainsberg, of Gainsberg Law, P.C., of Chicago, for amicus
curiae Illinois Trial Lawyers Association.
Panel PRESIDING JUSTICE MIKVA delivered the judgment of the court,
with opinion.
Justice Harris concurred in the judgment and opinion.
Justice Griffin specially concurred, with opinion.
OPINION
¶1 Dr. Bino Oommen’s privileges to practice medicine at defendants’ nursing facility were
terminated following his cooperation in the investigation of the death of one of the facility’s
residents. We are asked to decide in this case whether the doctor has legal recourse under the
Whistleblower Act (Whistleblower Act or Act) (740 ILCS 174/1 et seq. (West 2014)) or has
the ability to assert common law claims for retaliatory discharge against the nursing home, its
parent company, and the individuals he claims were responsible for terminating his privileges.
The circuit court granted summary judgment in defendants’ favor on all counts. For the reasons
that follow, we affirm in part and reverse in part.
¶2 I. BACKGROUND
¶3 Defendants in this case are Brentwood North Healthcare and Rehabilitation Centre, Inc.
(Brentwood North)—a nursing and rehabilitation facility located in Riverwoods, Illinois;
Brentwood North’s administrator, Philip Thompson; Brentwood North’s parent company,
Glen Health and Home Management Inc. (Glen Health); Glen Health’s president, Sidney
Glenner; and Glen Health’s director of operations, Joshua Ray. The plaintiff, Dr. Oommen, is
a physician licensed to practice medicine in the State of Illinois who, prior to July 8, 2015, had
privileges to treat patients at Brentwood North. Pursuant to a consulting agreement, Dr.
Oommen also served as a corporate medical advisor to Glen Health.
¶4 Although defendants object to, and disagree with, many of the purported facts set out in
Dr. Oommen’s appellate brief, they have elected not to file an opposing statement of facts
because, in their view, the issues on appeal present questions of law not directly bearing on the
circumstances surrounding the death of Dr. Oommen’s patient, the ensuing investigation, or
defendants’ motivations for terminating the doctor’s privileges at Brentwood North. We agree
and, for purposes of this opinion, take Dr. Oommen’s allegations regarding those matters as
true. Because many of the facts recited by Dr. Oommen are also only relevant to his attempts
to pierce the corporate veil, a theory we have no need to consider, those facts are omitted here.
¶5 Dr. Oommen alleged that one of his patients at Brentwood North, Harry Cavicchioni, was
assessed by him as a “high fall risk,” a finding that, according to the doctor, should have
prompted Brentwood North’s employees to create and follow a care plan to minimize that risk.
On June 21, 2015, however, Mr. Cavicchioni suffered a fall in the nursing home’s common
area. Dr. Oommen instructed Brentwood North’s staff by text message to “Send [Mr.
Cavicchioni] to ER stat for evaluation.” He claimed that, “[a]fter an initial delay,” the nursing
home’s staff “eventually” and “reluctantly” transferred Mr. Cavicchioni to a nearby hospital
“by a private ambulance and not 911,” where Mr. Cavicchioni was diagnosed with an acute
subdural hematoma (a blood clot between the surface of the brain and its outer covering).
According to Dr. Oommen, following this incident, Mr. Cavicchioni’s “quality of life quickly
declined[,] and he remained in hospice care until his eventual death on July 6, 2015.”
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¶6 Dr. Oommen further alleged that Brentwood North’s administrator, Mr. Thompson, caused
the Lake County Coroner’s office to be told that Mr. Cavicchioni’s “sole diagnosis at death
was dementia” and knowingly omitted any information about the patient’s fall, even when
specifically asked by the deputy coroner about recent falls, fractures, or trauma. Upon learning
of this, Dr. Oommen informed the coroner’s office that the correct cause of death was “an acute
subdural hematoma secondary to a fall.”
¶7 A subsequent investigation into the matter by the Illinois Department of Public Health
(IDPH) resulted in a $25,000 fine against Brentwood North, and the nursing home agreed to
pay Mr. Cavicchioni’s family $175,000 in exchange for a release of their claims against the
facility. Dr. Oommen cooperated with the IDPH’s investigation, telling the agency that, in his
opinion, the proximate cause of Mr. Cavicchioni’s fall and death was the failure of Brentwood
North’s employees to properly supervise him.
¶8 According to Dr. Oommen, on the day after Mr. Cavicchioni’s death, Mr. Thompson
promised the doctor that “ ‘more patients will be coming your way’ ” if he agreed to help the
nursing home conceal the true cause of Mr. Cavicchioni’s death. Dr. Oommen ended that
conversation, telling Mr. Thompson that what he proposed was “unethical, immoral, and
criminal.” In the days that followed, Mr. Thompson confronted Dr. Oommen via text message
about what the doctor had told the coroner’s office and finally asked the doctor for a meeting.
When Dr. Oommen asked what the meeting would concern, Mr. Thompson wrote,
“Credentials at Brentwood.” Dr. Oommen agreed to meet “with a third party present for legal
purposes,” prompting the following response from Mr. Thompson:
“This is why we have to part ways. On [August] 10th I am removing your
credentialing and all privileges there in [sic] for brentwood north. I will be sending
you a patient list so that you can approach family members and residents to transfer
to a facility you are credentialed at. Please [let] me know if there is anyway [sic] I
can assist. After [August] 10th, you will not be permitted to practice here. I wish
you well.”
¶9 Dr. Oommen alleged that Mr. Thompson acted “in concert with” Mr. Glenner and Mr. Ray
to terminate his privileges to see patients at Brentwood North and that Mr. Glenner and Mr.
Ray also terminated Dr. Oommen from his position as Glen Health’s corporate medical
advisor. Dr. Oommen brought claims against defendants under the Whistleblower Act and for
common law retaliatory discharge.
¶ 10 On August 29, 2018, the circuit court granted defendants’ motion to dismiss the complaint,
in part, on the basis that Dr. Oommen had failed to state a claim for retaliatory discharge against
the individual defendants. The court agreed with defendants that the only proper party to such
a claim is a plaintiff’s former employer, not the agents who may have acted on the employer’s
behalf.
¶ 11 The court disposed of Dr. Oommen’s remaining claims on March 28, 2019, when it granted
defendants’ motion for summary judgment. The circuit court dismissed the retaliatory
discharge claim against Brentwood North and Glen Health on the basis that Dr. Oommen had
failed to make a prima facie case that he was an employee of either entity, which was a
necessary component of the claim. The court pointed out that Dr. Oommen had
“acknowledge[d] that he signed a contract characteristic of an independent contractor” and
rejected the doctor’s argument that he was a de facto employee under the multifactor analysis
that looks beyond such labeling by the parties. The court found no evidence that defendants
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had either reserved the right to control or actually controlled the manner in which Dr. Oommen
practiced medicine. In the court’s view, Dr. Oommen’s arguments—that “defendants tried
repeatedly, and generally unsuccessfully, to influence his treatment decisions” and that they
“sometimes ignored his decisions or orders and went around him to accomplish their
objectives”—in fact demonstrated “the opposite of control.”
¶ 12 The circuit court also concluded that Dr. Oommen lacked standing to bring claims under
the Whistleblower Act. For the same reasons that he was not an employee for purposes of a
retaliatory discharge claim, he was not an “employee” under the Act, to the extent the Act
defines an employee as “any individual who is employed on a full-time, part-time, or
contractual basis by an employer.” 740 ILCS 174/5 (West 2014). As the court acknowledged,
the statutory definition was expanded in 2011 to also include licensed physicians who practice
medicine in facilities “funded, in whole or in part, by the State” (Pub. Act 96-1253 (eff. Jan.
1, 2011) (amending 740 ILCS 174/5)). However, the court agreed with defendants that neither
Brentwood North nor Glen Health received state funding within the meaning of the Act. In so
ruling, the court was bound to follow Larsen v. Provena Hospitals, 2015 IL App (4th) 140255,
¶ 60, in which another district of this court concluded that Medicaid payments—which
Brentwood North does receive—are mere payments for services and not “funding” designed
to advance a specific project in the public interest.
¶ 13 As an additional ground for rejecting Dr. Oommen’s retaliatory discharge claim, the court
found that the doctor had not been “discharged” by the termination of his medical staff and
admitting privileges, as neither of those conferred employment.
¶ 14 Dr. Oommen now appeals.
¶ 15 II. JURISDICTION
¶ 16 The circuit court’s order granting defendants’ motion for summary judgment on March 28,
2019, fully and finally resolved all remaining claims in this matter. On April 23, 2019, plaintiff
filed a timely notice of appeal from that order and from the court’s earlier interlocutory ruling
on defendant’s motion for a partial dismissal. We have jurisdiction over this matter pursuant
to Illinois Supreme Court Rule 301 (eff. Feb. 1, 1994) and Rule 303 (eff. July 1, 2017),
governing appeals from final judgments by the circuit court in civil cases.
¶ 17 III. ANALYSIS
¶ 18 On appeal, Dr. Oommen challenges the circuit court’s rulings on defendants’ dispositive
motions—a motion for partial dismissal under section 2-615 of the Code of Civil Procedure
(Code) (735 ILCS 2-615 (West 2018)) and a motion for summary judgment under section 2-
1005(b) (735 ILCS 5/2-1005(b) (West 2018)). Our review of both orders is de novo. Doe v.
Coe, 2019 IL 123521, ¶ 20; Pielet v. Pielet, 2012 IL 112064, ¶ 30.
¶ 19 A. Retaliatory Discharge
¶ 20 1. The Individual Defendants Were Not Proper Parties
¶ 21 We first address Dr. Oommen’s argument that the circuit court erred when it dismissed his
retaliatory discharge claims against the individual defendants. That ruling was, as the doctor
acknowledges, based on controlling authority holding that a plaintiff’s former employer—and
not the employer’s agents—is the only proper party to such a claim. Buckner v. Atlantic Plant
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Maintenance, Inc., 182 Ill. 2d 12, 22 (1998). Dr. Oommen characterizes the reasoning
underlying this rule as “naïve” because it “allows a tortfeasor to use the corporate fiction as a
shield for personal liability.” Requiring a discharged employee to pierce the corporate veil
before asserting such claims is, in Dr. Oommen’s view, “an entirely unnecessary additional
hurdle.” In support of this argument, he draws our attention to the laws of New Jersey, Arizona,
and West Virginia, which all recognize some form of individual liability for retaliatory
discharge. See Ballinger v. Delaware River Port Authority, 800 A.2d 97, 110 (N.J. 2002);
Higgins v. Assmann Electronics, Inc., 173 P.3d 453, 458 (Ariz. 2007); Harless v. First National
Bank in Fairmont, 289 S.E.2d 692, 699 (W. Va. 1982). Defendants argue in response that the
reasoning in Buckner is as compelling today as it was 20 years ago and that the holding in that
case, arrived at after careful consideration of a split in authority, should be viewed as settled
law under the doctrine of stare decisis.
¶ 22 Defendants also argue that Dr. Oommen effectively abandoned this claim by failing either
to seek an interlocutory appeal from the circuit court’s dismissal order or to incorporate the
claim by reference in his amended complaint. See Vilardo v. Barrington Community School
District 220, 406 Ill. App. 3d 713, 719 (2010) (discussing a party’s options when faced with
such a ruling). Dr. Oommen acknowledges this oversight but notes that the judge in this case
treated the claim as if it had been preserved, concluding his summary judgment order by
stating, “[f]inally, the individual defendants cannot be held liable for retaliatory discharge.”
¶ 23 We need not decide whether the claim was abandoned because, even if it was not, all of
the arguments the parties raise are ones properly addressed only to our supreme court. As an
intermediate appellate court, we are bound by controlling precedent. See Illinois Labor
Relations Board v. Chicago Transit Authority, 341 Ill. App. 3d 751, 758 (2003) (“only the
supreme court has the authority to overrule or modify its decisions”). Accordingly, we affirm
the circuit court’s dismissal of Dr. Oommen’s retaliatory discharge claims against Mr. Glenner,
Mr. Ray, and Mr. Thompson.
¶ 24 2. Dr. Oommen Made No Prima Facie Case That He Was an Employee
¶ 25 Dr. Oommen also argues that the circuit court should not have granted summary judgment
in favor of the corporate defendants, Brentwood North and Glen Health, on his claim for
retaliatory discharge. Summary judgment is proper where the pleadings, depositions,
admissions, and affidavits on file reveal that there is no genuine issue of material fact and the
moving party is entitled to judgment as a matter of law. See 735 ILCS 5/2-1005 (West 2018).
¶ 26 A defendant may move for summary judgment in one of two ways: (1) by affirmatively
demonstrating that some element of the case must be resolved in the defendant’s favor or (2) by
filing a motion—of the type recognized by the United States Supreme Court in Celotex Corp.
v. Catrett, 477 U.S. 317, 322 (1986)—that points out an absence of evidence supporting one
or more elements of the plaintiff’s claim. Willett v. Cessna Aircraft Co., 366 Ill. App. 3d 360,
368-69 (2006). In the case of a Celotex motion, if the defendant carries its initial burden of
production, the burden then shifts to the plaintiff to establish facts supporting each element of
the claim. Id. at 369. “While parties opposing a summary judgment motion are not required to
prove their case, they are under a duty to present a factual basis which would arguably entitle
them to judgment in their favor, based on the applicable law.” (Internal quotation marks
omitted.) Id.
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¶ 27 Although the general rule in Illinois is that “an employer may discharge an employee-at-
will for any reason or for no reason” (internal quotation marks omitted), our supreme court has
recognized “a limited and narrow cause of action for the tort of retaliatory discharge.”
Fellhauer v. City of Geneva, 142 Ill. 2d 495, 505 (1991). To succeed on such a claim, a plaintiff
must establish that (1) he was an employee, (2) he “was dismissed in retaliation for his
activities,” and (3) the dismissal was “in contravention of a clearly mandated public policy.”
Id.
¶ 28 Here, the circuit court concluded that Dr. Oommen failed to make a prima facie case that
he was an employee of either Brentwood North or Glen Health. As this court has noted, “there
is no rigid rule of law governing the determination of whether an employer-employee
relationship exists.” Netzel v. Industrial Comm’n, 286 Ill. App. 3d 550, 553-54 (1997). A
number of factors typically bear on such a determination, including “the method of payment;
the work schedule; the right to discharge; who provides tools, materials or equipment; the skill
required in the work to be done; whether the worker’s occupation is related to that of the
employer; and who deducts or pays for insurance, social security and taxes.” Id.
¶ 29 The “single most important factor in determining the parties’ relationship,” however, is
“the right to control the work.” Id. As our supreme court has explained:
“ ‘An independent contractor is one who renders service in the course of an occupation
representing the will of the person for whom the work is done only as to the result of
the work and not as to the means by which it is accomplished, [citation] and is one who
undertakes to produce a given result without being in any way controlled as to the
method by which he attains that result. *** The test of the relationship is the right to
control. It is not the fact of actual interference with the control, but the right to interfere,
that makes the difference between an independent contractor and a servant or agent.’ ”
(Emphases added.) Carney v. Union Pacific R.R. Co., 2016 IL 118984, ¶ 31 (quoting
Hartley v. Red Ball Transit Co., 344 Ill. 534, 538-39 (1931)).
¶ 30 As defendants point out, “[t]he granting of medical staff privileges merely demonstrates [a
medical facility’s] determination that a physician’s credentials are such that he or she is
qualified to practice medicine at the hospital” and does not, in and of itself, confer employment.
Bryant v. Glen Oaks Medical Center, 272 Ill. App. 3d 640, 651 (1995). Dr. Oommen also does
not dispute that his credentialing packet and the contracts he entered into with both Brentwood
North and Glen Health all indicated that he was to be an independent contractor. The Corporate
Medical Advisor Agreement with Glen Health expressly states that “[t]he facility and the
Medical Advisor agree that their relationship is that of independent contractors and not of
employer and employee or principal and agent.” Dr. Oommen’s contract with Brentwood
North, though referenced a number of times, does not appear in the record. But in his affidavit,
Dr. Oommen agreed with statements made in an earlier affidavit submitted by Mr. Thompson
in support of defendants’ motion to dismiss that “[a]t Brentwood, all physicians work[ed] as
independent contractors,” that “[i]n October of 2008, [Dr. Oommen] signed a Medical Director
Agreement with Brentwood as an independent contractor physician with the facility,” and that
“[i]n February of 2012, [he] signed a Corporate Medical Advisor Agreement with Glen Health
*** as an independent contractor with the facility.”
¶ 31 Dr. Oommen’s argument is not that defendants formally reserved the right to control him,
but that they actually controlled him, treating him as a de facto employee. In this regard, he
urges us to find the facts of his case analogous to those in Netzel, where we held a finding that
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a workers’ compensation claimant was an independent contractor, and not an employee, was
against the manifest weight of the evidence. Netzel, 286 Ill. App. 3d at 554-55. Although we
noted that the claimant’s job as an unlicensed private duty nurse at the respondent’s nursing
home “contained elements of both an independent contractor and an employee relationship,”
we concluded that the weight of the evidence supported the conclusion that she was an
employee. Id. at 554. The claimant in Netzel was not just subject to regulations governing the
work she did. Rather, “the entire scope of her work and day were controlled by [the nursing
home],” which “regulated [her] movement from the time she entered its doors.” Id. The nursing
home provided the claimant with all of the equipment she was to use to perform her duties, a
head nurse gave her regular instructions regarding the care of her patients and directly
supervised her for more complex tasks, and the claimant was required to provide a verbal report
to the nurse in charge when she left for the day. Id. We concluded that these requirements—
set out in the nursing home’s “private duty nurse instruction sheet” and the violation of which
could result in termination—demonstrated that the facility “not only had the theoretical right
to control,” but “did in fact control [the] claimant’s activities and the method and manner in
which she performed her duties.” Id. at 554-55.
¶ 32 Dr. Oommen’s efforts to cast his experience at Brentwood North in a similar light fall flat.
In the affidavit he submitted in opposition to summary judgment, for example, Dr. Oommen
detailed a number of instances in which defendants ignored his medical decisions. When he
ordered an expensive medication or manner of administering a medication, for example,
defendants required “corporate” approval first and would often carry out a less expensive
alternative intervention or simply fail to follow his instructions at all. Dr. Oommen claimed
that, contrary to his orders, defendants would also delay the transfer of patients into or out of
the nursing home in order to maximize payments. All that these examples show, however, is
that Dr. Oommen had little control over defendants’ actions once he had rendered his medical
opinions and issued his orders concerning a patient’s treatment. They do not demonstrate that
defendants controlled or reserved the right to control the manner or methods in which Dr.
Oommen performed his duties as a doctor.
¶ 33 Dr. Oommen also maintained in his affidavit that defendants created a paper trail to make
it look like he had signed off on things he had not, in some cases causing his patients to receive
different medications than the ones he prescribed and to be seen by hospice doctors he had not
referred them to. But again, such conduct—though certainly troubling—is not evidence of the
nursing home’s day-to-day control over the method and manner in which Dr. Oommen did his
job.
¶ 34 Instances Dr. Oommen recounted in which Mr. Thompson attempted to instruct the doctor
on how to answer questions from government investigators or how to refer to things in his
medical records were, as the circuit court noted, at most failed attempts at actual control. Dr.
Oommen stated in his affidavit that he “refused [the] attempt at coaching” and made clear to
Mr. Thompson that he “wasn’t going to change the language in [his] charting.”
¶ 35 Dr. Oommen also recounted ways in which he claimed defendants treated him like a
“company doctor” and required him to do tasks that were not only outside the scope of his
agreements with them but sometimes outside the traditional practice of medicine. According
to Dr. Oommen, defendants required him to serve as a “back up doctor” to other physicians
credentialed at the nursing home; asked him to write prescriptions for Mr. Ray, Mr. Glenner,
and Mr. Glenner’s wife without examining them first; required him to perform employee health
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checks on defendants’ staff; and, on various occasions, required him to perform unskilled labor
like moving oxygen tanks and cleaning exam rooms. Dr. Oommen insists, with no explanation,
that defendants “would not have instructed an independent contractor to perform these tasks.”
This argument is misplaced. It is not the assignment of tasks that is the hallmark of an
employment relationship, but the right to control the manner in which those tasks are carried
out. If defendants were not abiding by the terms of their contracts, Dr. Oommen’s recourse
was a claim for breach of contract. Their assignment of new or different responsibilities is not
evidence that they controlled or reserved the right to control the manner and methods by which
Dr. Oommen practiced his profession.
¶ 36 Although Dr. Oommen also averred that, when seeing patients at Brentwood North, he
wore a lab coat bearing Glen Health’s logo rather than the name of his own practice, kept
patient medical records at Brentwood North, and used Brentwood North’s address as his own
mailing address, we find that these facts, largely matters of convenience, are insufficient on
their own to constitute prima facie evidence of an employment relationship. Dr. Oommen was
not prohibited, like the physician in Thede v. Kapsas, 386 Ill. App. 3d 396, 401 (2008), from
practicing medicine elsewhere. Indeed, the record reflects that he enjoyed privileges to see
patients at seven other facilities, was not on Brentwood North’s payroll, and received no
employee benefits.
¶ 37 Finally, although we question defendants’ characterization of the statement as a “judicial
admission” (see National Union Fire Insurance Co. of Pittsburgh v. DiMucci, 2015 IL App
(1st) 122725, ¶ 2 (noting that “[s]tipulations are judicial admissions in the case in which they
are made” and “are admissible in other cases as evidentiary admissions”)), it is worth noting
that Dr. Oommen described himself as “an independent practitioner with clinical privileges”
at Brentwood North in a report he provided in support of the lawsuit filed against the facility
by Mr. Cavicchioni’s estate. This statement—as well as the parties’ agreement under their
contracts that Dr. Oommen would serve as an “independent practitioner”—further militates
against any possible finding that he was, in fact, an employee for purposes of a claim of
retaliatory discharge.
¶ 38 We agree with the circuit court that Dr. Oommen failed to submit evidence reflecting a
degree of control over the method or manner in which he practiced his profession that created
an issue of fact as to his employee status. Because employee status is a threshold requirement
for a claim of retaliatory discharge, judgment in defendants’ favor on this claim was proper.
¶ 39 In light of this holding, it is unnecessary for us to consider, as the circuit court in this case
went on to do, whether the termination of Dr. Oommen’s privileges to practice medicine at
Brentwood North qualified as a “discharge.”
¶ 40 B. Dr. Oommen Has Standing Under the Whistleblower Act
¶ 41 Dr. Oommen argues that the circuit court erred when it concluded that he lacked standing
to bring various claims against defendants under the Whistleblower Act (740 ILCS 174/1
et seq. (West 2014)), legislation that, among other things, protects employees from retaliation
for “disclosing information to a government agency that the employee reasonably believes
violate[s] a state or federal law, rule, or regulation” (Roberts v. Board of Trustees of Community
College District No. 508, 2019 IL 123594, ¶ 40).
¶ 42 Although only employees may avail themselves of the Act’s protections, in 2011 the Act’s
definition of “employee” was expanded beyond the common law definition to also include “a
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licensed physician who practices his or her profession, in whole or in part, at a hospital, nursing
home, clinic, or any medical facility that is a health care facility funded, in whole or in part, by
the State.” Pub. Act 96-1253 (eff. Jan. 1, 2011) (amending 740 ILCS 174/5). The circuit court
concluded that Dr. Oommen did not come within this expanded definition because Brentwood
North was not “funded, in whole or in part, by the State.” However, both Dr. Oommen and the
Illinois Trial Lawyers Association (ITLA), which was permitted to file an amicus curiae brief
in this matter, make several arguments in favor of an understanding of this expanded definition
that would include the doctor in this case. For the reasons that follow, we agree that this
expanded definition does include Dr. Oommen.
¶ 43 We must first address—and reject—Dr. Oommen’s cursory and unsupported argument that
the circuit court was wrong to even consider whether Brentwood North was “a health care
facility funded, in whole or in part, by the State.” Dr. Oommen suggests that, properly read,
the clause only modifies the last item in the list, “any medical facility,” and not any of the
preceding items, including “nursing home.” Although Dr. Oommen does not refer to it by
name, the rule he attempts to invoke is the “last antecedent rule.” This is a rule of statutory
construction that our supreme court has frequently applied (Kozak v. Retirement Board of the
Firemen’s Annuity & Benefit Fund of Chicago, 95 Ill. 2d 211, 216-17 (1983)), and particularly
where the modifying clause is not separated from the listed items by a comma (In re E.B., 231
Ill. 2d 459, 468 (2008)). The rule is not without its limitations, however. As Justice Kagan
noted in Lockhart v. United States, 577 U.S. 347, 363, (2016) (Kagan, J., dissenting, joined by
Breyer, J.), the rule “can assuredly be overcome by other indicia of meaning.” (Internal
quotation marks omitted.) She went on to explain that where the listed items are simple,
parallel, and of the type a reader would expect to see together—the example she gave was “the
laws, the treaties, and the constitution of the United States”—the reader will intuitively apply
the final modifier to each item in the list. (Emphasis and internal quotation marks omitted.) Id.
at 367 n.2. Such is the case here, where the listed items are hospital, nursing home, clinic, or
any medical facility. We also view the last item, “any medical facility” as a catch-all
incorporating each of the items listed before it. The circuit court was entirely correct to consider
whether Brentwood North was “a health care facility funded, in whole or in part, by the State.”
¶ 44 In our own consideration of this question, Dr. Oommen urges us to begin with the
amendment’s legislative history. In particular, he directs us to the following exchange, just
preceding a unanimous vote in favor of the amendment by the Illinois House of
Representatives, between state Representative Ken Dunkin and the amendment’s sponsor,
Representative Elaine Nekritz:
“NEKRITZ: *** Under existing law, the Whistleblower Act protects those who
report misdeeds only if you’re an employee. And the purpose of [House Bill 6231] is
to extend that to those that might also serve on a medical staff even though there isn’t
an employer-employee relationship. In a lot of ways, doctors and other health care
professionals are in a very good position to see if there’s Medicaid or Medicare fraud
going on. But *** if they report they’re not protected under the Whistleblower Act.
There is actually a case out there ongoing right now where a doctor did report and did
suffer some retribution as a result. And so, this would protect the people in that position.
***
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DUNKIN: *** [H]ow would something like this apply to a private hospitals [sic]
who are in similar situations or find themselves in a similar situation to a public
hospital?
NEKRITZ: I don’t think the Bill distinguishes between public and private hospitals.
It’s anyone *** practicing at a hospital, nursing home, clinic or medical facility.
DUNKIN: Well, according to my analysis …
NEKRITZ: Oh.
DUNKIN: … they would allow doctors on staff at a state-funded hospital or
medical facility …
NEKRITZ: Well, it’s … it’s if they’re funded in whole or in part by the state. So,
you know, I don’t know that there… if they’re … if they’re not accepting any public
money any … they’re not accepting a single Medicaid or single Medicare participant
then I could imagine that they would be excluded, but I don’t know how many facilities
out there that are like that.
DUNKIN: So, you’re saying, this does apply to private, not-for-profit or for-profit
hospitals?
NEKRITZ: As long as they’re taking some public funding.
DUNKIN: Thank you.” 96th Ill. Gen. Assem., House Proceedings, Mar. 17, 2010,
at 98-99 (statements of Representatives Nekritz and Dunkin).
¶ 45 We agree that this exchange evidences an intent to consider a private healthcare facility to
be “funded, *** in part, by the State” if that facility accepts even one payment from a State-
funded program like Medicaid. We reject defendants’ argument that Dr. Oommen forfeited his
ability to cite this transcript because he did not expressly rely on it in the circuit court or focus
there on the legislative history of the amendment. “We require parties to preserve issues or
claims for appeal; we do not require them to limit their arguments here to the same arguments
that were made below.” Brunton v. Kruger, 2015 IL 117663, ¶ 76. In the circuit court, Dr.
Oommen incorporated into his summary judgment response brief the argument, first made in
his opposition to defendants’ motion to dismiss, that under the Act’s expanded definition of
“employee,” Brentwood North was a medical facility “funded, in whole or in part, by the State”
because it accepted Medicaid payments. And at the hearing on defendants’ motion, Dr.
Oommen’s counsel plainly argued “[i]f you read the legislative history, it’s clear that the only
state funding necessary in order to invoke the protection of the Whistleblower Act is Medicaid
and Medicare; and it’s undisputed in this instance that the defendants received both Medicare
and Medicaid payments.” This sufficiently preserved the issue for appeal. Dr. Oommen is free
on appeal to reassess the strengths of his arguments in support of a ruling in his favor on that
issue, and we will not strictly limit him to the sources he cited in his briefs below or preclude
him from reassessing his best arguments. Indeed, it would have been surprising for Dr.
Oommen to focus on this argument in the circuit court, where the judge was bound by Larsen’s
contrary reading of the amendment, a reading we are free to disagree with. We find no grounds
for forfeiture here.
¶ 46 We likewise reject defendants’ suggestion, raised for the first time at oral argument in this
appeal, that if we agree to consider the legislative purpose behind the expanded definition of
an “employee” under the Act, we should conclude that it provides employees falling within
this expanded definition only with the right to assert claims premised on Medicaid or Medicare
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fraud. Although such claims may have been the primary concern of the bill’s sponsor, there is
absolutely nothing in the amendment’s text reflecting such a limitation. Indeed, the types of
prohibited conduct for which those deemed “employees” under the Act may bring claims are
set out elsewhere in the Act. See 740 ILCS 174/15, 20, 30 (West 2014). Legislative history
may, where appropriate, aid us in construing a statutory provision, but our interpretation must
still be firmly grounded in the text.
¶ 47 We do agree with defendants, however, that some ambiguity is required before we should
consider this legislative history. Dr. Oommen assures us that “[e]ven where a statute is
unambiguous, a [c]ourt can examine legislative history” like this “to better understand a
legislative amendment.” This is, in our view, contrary to well established principles of statutory
construction. Our goal in construing a statute is always to ascertain and give effect to the
legislature’s intent, but the best indication of that intent will generally be the plain and ordinary
meaning of the statute’s language. Krohe v. City of Bloomington, 204 Ill. 2d 392, 394-95
(2003). “Where the language is clear and unambiguous, we must apply the statute without
resort to further aids of statutory construction” (id. at 395), including materials evidencing its
legislative history (see Nevitt v. Langfelder, 157 Ill. 2d 116, 134 (1993) (“a basic rule of
statutory construction forbids a court to canvass legislative history for evidence of legislative
intent if the meaning of a provision can be determined from its text”)).
¶ 48 As the only opinion of this court specifically addressing the issue, the circuit court in this
case was bound to follow Larsen, 2015 IL App (4th) 140255. The Larsen court did not mention
or apparently consider the legislative history behind the 2011 amendment to the Whistleblower
Act’s definition of “employee.” Instead, with the aid of a legal dictionary, the court concluded
that the plain meaning of the amendment was clear and Medicaid payments do not qualify as
State “funding.” Id. ¶ 62. The Larson court relied on the fact that “[t]he definition of ‘fund’ is
‘[t]o furnish money to (an individual, entity, or venture), [especially] to finance a particular
project’ ” id. ¶ 59 (quoting Black’s Law Dictionary 697 (8th ed. 2004)), while “ ‘[p]ayment’
is defined as the ‘money or other valuable thing so delivered in satisfaction of an obligation.’ ”
Id. (quoting Black’s Law Dictionary 1165 (8th ed. 2004)). Armed with these definitions, the
Larsen court reasoned that “the purpose of the Medicaid program is to defray the cost of
providing medical care to the poor and needy by providing payment in satisfaction or partial
satisfaction for the medical services provided.” (Emphasis in original.) Id. ¶ 60. In the Larsen
court’s view, such payments are no different than the ones medical providers receive directly
from patients or from health insurance companies on behalf of their beneficiaries. Id. The court
then concluded that “[p]ayments such as these cannot reasonably be considered funding as
contemplated by the Whistleblower Act.” Id. What the Act instead contemplated, the court
opined, was funding of the sort allocated “to financially support a particular program,
experimental medical trial, or project offered by a health care facility,” where “the funds
allocated do not represent a direct exchange but, rather, finances provided to advance a project,
program, or other laudable endeavor that the [S]tate has determined is in the public’s best
interest.” Id. ¶ 61.
¶ 49 The Larsen court’s premise, that transactional payments in exchange for services and State
“funding” of programs in the public interest are mutually exclusive, ignores, in our view, the
reality of the State’s role. The State, in contrast to an ordinary consumer, such as a patient or a
health insurance company, makes payments on such a vast and systemic scale that the line
between funding and payments will often blur. It is appropriate, then, to consider the specifics
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of the Illinois Medicaid program to see if payments from that program in fact operate to fund,
in whole or in part, the hospitals, nursing homes, clinics, and other medical facilities that
participate in that program. As our supreme court has made clear:
“When discerning legislative intent, it is *** proper to compare statutes relating to
the same subject matter as well as statutes upon related subjects though not strictly
in pari materia because statutes are to be read in the light of attendant conditions and
the state of the law existent at the time of their enactment.” (Internal quotation marks
omitted.) JPMorgan Chase Bank, N.A. v. Earth Foods, Inc., 238 Ill. 2d 455, 470 (2010).
¶ 50 In its amicus brief in this matter, ITLA persuasively argues that the Illinois Medicaid
program exhibits the classic characteristics of State funding identified by the Larsen court.
ITLA points out that Medicaid payments are not simple and direct exchanges of money for
services, but are in fact influenced by a host of broader considerations, including the desire to
compensate providers for their general administrative costs (89 Ill. Adm. Code 140.533
(1988)), to reimburse them for the cost of their compliance with regulations instituting nursing
home reforms (89 Ill. Adm. Code 140.540(a)(2) (1988)), and to ensure each facility’s
profitability and ability to make a return on its investment (305 ILCS 5/5-5.5(b)(2) (West
2014)). The State indeed makes payments for services through the Medicaid program. It does
so, however, not as a simple market actor, but for the broader purpose of support[ing] the
medical safety net.
¶ 51 On this point, ITLA also directs our attention to the “Declaration of Purpose” found in the
Illinois Public Aid Code, which states that the “[p]reservation of health, alleviation of sickness,
and correction of disabling conditions for persons requiring maintenance support are essential
if they are to have an opportunity to become self-supporting or to attain a greater capacity for
self-care.” 305 ILCS 5/5-1 (West 2014). This is especially important “[f]or persons who are
medically indigent but otherwise able to provide themselves with a livelihood” because, for
those individuals, the State has an interest in “maintain[ing] incentives for continued
independence and preserv[ing] their limited resources for ordinary maintenance needs to
prevent their total or substantial dependency.” Based on these statements, ITLA argues that
Medicaid payments are not mere transactional exchanges but, in the Larsen court’s words, are
indeed “finances provided to advance a project, program, or other laudable endeavor that the
[S]tate has determined is in the public’s best interest.” Larsen, 2015 IL App (4th) 140255, ¶ 61.
¶ 52 We agree. In the context of nursing homes and other medical facilities that are paid for
their services in part by State-funded programs broadly established in the public interest, we
find that the phrase “funded, in whole or in part, by the State” is, at the very least, subject to
more than one reasonable interpretation. See Krohe, 204 Ill. 2d at 395-96 (“A statute is
ambiguous if it is capable of being understood by reasonably well-informed persons in two or
more different ways.”). Given this ambiguity, it is proper for us to consider the legislative
history of the amendment, which, as we noted above, makes clear that, for purposes of the Act,
Medicaid payments do indeed constitute State funding and doctors practicing at medical
facilities receiving such payments are “employees” with standing to sue under the Act.
¶ 53 IV. CONCLUSION
¶ 54 For the above reasons, the circuit court’s judgment in defendants’ favor on Dr. Oommen’s
retaliatory discharge claims is affirmed, its judgment in their favor on his Whistleblower Act
claims is reversed, and the case is remanded for further proceedings consistent with this
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opinion.
¶ 55 Affirmed in part and reversed in part.
¶ 56 Cause remanded.
¶ 57 JUSTICE GRIFFIN, specially concurring:
¶ 58 I concur with the well-reasoned and well-written opinion. I respectfully disagree with
paragraph 43, however. The clause in question states as follows: “a licensed physician who
practices his or her profession, in whole or in part, at a hospital, nursing home, clinic, or any
medical facility that is a health care facility funded, in whole or in part, by the State.” Pub. Act
96-1253 (eff. Jan. 1, 2011) (amending 740 ILCS 174/5). The use of the Oxford comma after
“clinic” and applying the well-accepted last antecedent rule further broadens and supports our
holding that the legislative intent was to consider physicians in Dr. Oommen’s position
“employees” for the purposes of the Whistleblower Act.
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