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🗞️ When HIPAA Meets the Picket Line: The Roe Case and the Limits of Union Retaliation Claims

A 2-1 NLRB ruling found St. Anthony Community Hospital lawfully fired a union organizer for a HIPAA violation, reversing a judge's finding of illegal retaliation and delivering a significant win for employer defense under the *Wright Line* standard.

onthelaborfront

onthelaborfront

— 5 min read
🗞️ When HIPAA Meets the Picket Line: The Roe Case and the Limits of Union Retaliation Claims

On March 26, 2026, the National Labor Relations Board issued a split decision in St. Anthony Community Hospital, 374 NLRB No. 77, a case that arrived at the collision point of two legally charged arenas: federal patient privacy law and the rights of workers to organize under the National Labor Relations Act.

Andrea Roe had spent 16 years as a radiology technician at the Warwick, New York hospital, earning "exceptional" performance reviews and a reputation, by management's own account, as a candidate for promotion. In early 2021, she became the driving force behind a successful campaign to unionize her department under 1199 SEIU United Healthcare Workers East. Two weeks after the union won its election, she was fired.

The hospital's explanation centered on HIPAA. Management said Roe had improperly accessed the medical records of a patient she had not treated and then disclosed that patient's private health information to her mother-in-law, a receptionist at a local chiropractor's office. The allegation surfaced after Christine Faline, an assistant director of revenue integrity at the hospital's parent health system, visited the chiropractor and was told by the receptionist that her daughter-in-law at St. Anthony's had been "updating" her on the patient's condition. Faline reported the conversation to the health system's vice president of corporate compliance the following day, and an audit of Roe's chart access quickly followed.

The legal question before the Board was whether Roe's firing was a legitimate response to a genuine privacy violation or a pretext for retaliating against the hospital's most visible union organizer. The answer depended on the Wright Line framework, a burden-shifting standard the Board established in 1980 to resolve what lawyers call "mixed motive" cases, situations where an employer may have had both a lawful reason and an unlawful one for taking action against an employee. Under that framework, the General Counsel must first show that union activity was a motivating factor in the discharge. If that threshold is crossed, the burden shifts to the employer to demonstrate it would have reached the same outcome regardless.

Administrative Law Judge Benjamin W. Green, who presided over the case in 2022, concluded the General Counsel had built a strong prima facie case and that the hospital's investigation was too narrow and selective to be trusted as a good-faith inquiry. The hospital had never contacted the doctors or nurses who could have verified that technicians routinely access charts at a physician's request, never interviewed Roe's mother-in-law, and pointedly excluded Roe's supervisor from the managerial meeting where a preliminary decision to fire her was reached, despite that supervisor having corroborated her account of standard hospital practice. Judge Green ordered reinstatement and back pay.

The Board's two majority members, James R. Murphy and Scott A. Mayer, saw the evidence differently. In their view, the investigation was credibly triggered by an independent report from a manager who had no knowledge of Roe's union role and no apparent motive to fabricate. The audit of Roe's chart access partially corroborated the allegation. Roe, for her part, could not remember accessing the records and could not explain why her mother-in-law would have insisted she had been sharing patient information if that were not true. Most importantly, the majority found that the hospital's documented history of discharging other employees for comparable HIPAA violations, none of whom had any union involvement, demonstrated the institution would have acted the same way regardless of Roe's organizing activities.

Member David M. Prouty, the dissenting member of the panel, aligned himself squarely with Judge Green. The investigation, he wrote, amounted to a foregone conclusion. The hospital had been handed a plausible innocent explanation for Roe's chart access and chose not to pursue it. Doctors and nurses who could have shed light on whether Roe accessed the records at a colleague's request were never called. The hospital also stopped Roe from conducting her own inquiry, instructing her not to speak with her mother-in-law about the matter, and then never interviewed the mother-in-law itself. The clearest signal of pretext, in Prouty's telling, came after the firing: when other technicians refused to access patient charts out of fear they would suffer the same fate, hospital management promptly assured them they had nothing to worry about as long as the access was job-related, even if they could not later recall why they had done it. Roe had received no such assurance.

On one point the panel was unanimous. The hospital had crossed a clear legal line when a supervisor asked employee Jeanne Saeli to identify the union's "ringleader." That finding was upheld by all three members and remains undisturbed. The hospital was ordered to post notices affirming employees' rights to organize but was not required to reinstate Roe or make her whole financially.

The decision is a notable early data point for what the reconstituted Board will demand of employers in mixed-motive discharge cases. The majority's reasoning suggests that a credible triggering complaint, an audit that corroborates the allegation, and a track record of consistent prior discipline can be sufficient to satisfy an employer's burden under Wright Line, even when evidence of anti-union animus is substantial and a dissenting judge found the investigation wanting.

Key Points

  • The case: Andrea Roe, a 16-year radiology technician and lead union organizer, was fired in May 2021, two weeks after her union won its election, for an alleged HIPAA violation involving a patient's medical records.
  • The legal test: The Wright Line framework requires the General Counsel to show union activity motivated the discharge, then shifts the burden to the employer to prove it would have made the same decision regardless.
  • The split: A 2-1 NLRB majority, Members Murphy and Mayer, reversed the ALJ's reinstatement order, finding the hospital had a reasonable and consistently applied basis for the termination.
  • The dissent: Member Prouty agreed with the ALJ that the investigation was too one-sided to be credible, pointing to easily available exculpatory evidence the hospital chose not to pursue.
  • Unanimous violation: All three members upheld the finding that the hospital unlawfully interrogated employee Saeli to identify the union "ringleader," a violation of Section 8(a)(1) of the NLRA.
  • HIPAA context: Intentional unauthorized access to or disclosure of protected health information can be grounds for termination under HIPAA; the hospital's prior discipline record showed it had fired other, non-union employees for comparable offenses.
  • Broader significance: The ruling signals a more employer-friendly Board on mixed-motive discharge cases and reinforces that a consistent prior disciplinary record is a critical component of a Wright Line defense.

Primary Source Author: Members James R. Murphy and Scott A. Mayer (majority); Member David M. Prouty (dissent); ALJ Benjamin W. Green

Primary Source: St. Anthony Community Hospital and 1199 SEIU United Healthcare Workers East, 374 NLRB No. 77 (March 26, 2026)

Primary Source Link: https://www.nlrb.gov/case/02-CA-278511

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