Court rules Inova not joint employer of nurses fired over vaccine refusal

Hoffman and Austin were Certified Registered Nurse Anesthetists employed by American Anesthesiology of Virginia, a NAPA subsidiary. Under a service contract, American Anesthesiology provided anesthesia staff exclusively to Inova facilities. Hoffman had worked there for five years; Austin for twenty. When Inova denied their exemption requests in 2022 and suspended their clinical privileges at its facilities, both nurses argued that the company’s role in their professional lives was substantial enough to make it their employer too – a legal concept known as joint employment.

The court was not persuaded.

To determine whether an organization qualifies as a joint employer, courts in the Fourth Circuit examine nine factors, with the three most important being whether the entity had the power to hire and fire, whether it supervised day-to-day work, and whether it controlled the physical workspace and equipment. On the first two, Inova fell short. On the third – use of its equipment and facilities – the court found that factor carried little weight in a hospital setting, where all clinical staff use the same tools and spaces regardless of who employs them.

The court found that NAPA – not Inova – held the authority to terminate the nurses. While Hoffman’s contract allowed Inova’s removal demand to serve as grounds for dismissal, the final call still belonged to NAPA. The nurses also alleged that Inova “exercised oversight” over their work, but offered little to support that claim beyond a single incident where Inova staff told them they could leave early and other Inova staff later disciplined them for it. One apparently erroneous instruction, the court said, does not amount to daily supervision.

The nurses also pointed to Inova’s control over medication approvals. The court acknowledged it but found it carried no real weight as evidence of employment. Hospitals, it noted, must exercise a baseline level of clinical oversight over everyone working in their facilities – employees and outside contractors alike. That kind of control comes with running a healthcare facility, not with employing the staff.