When a family hires an employee to care for an elderly person in his or her home, is the employee entitled to overtime pay? Under California law, the answer depends on the type of work performed by the caretaker. If the employee performs the work of a "personal attendant[]," defined to mean a "person employed . . . to supervise, feed, or dress" the client, the caretaker is exempt from overtime pay requirements. (Industrial Welfare Commission (IWC) wage order No. 15-2001, §§ 1(B), 2(J), codified at Cal. Code Regs., tit. 8, § 11150.)
The issue here is whether there exists an additional exception to the personal attendant exemption rule applicable if a caretaker, who is not a licensed nurse, performs any form of health care related services for an elderly client. Based on a sentence originally contained in an interpretive bulletin issued by the Division of Labor Standards Enforcement (DLSE) in 1986, the court instructed the jury that the personal attendant exemption to the overtime requirements is inapplicable if a caregiver, who is not a licensed nurse, regularly performs any health care functions, even if those tasks are incidental to the caretaker's primary tasks and regardless of the amount of time spent on these functions. We conclude this instruction reflects an improper interpretation of Wage Order No. 15 and, based on the jury's findings in the special verdict form, constituted prejudicial error.
Plaintiff Joy Cash, who is not a licensed or trained nurse, cared for Iola Winn, who was in her 90's, in Winn's home. After she left the employment, Cash sued Winn for failure to pay her overtime wages. In defense, Winn claimed that no overtime pay was required because Cash was a "personal attendant" within the meaning of Wage Order No. 15. The primary issue at trial was whether Cash met the definition of a "personal attendant" and thus was exempt from overtime pay requirements.
The court instructed the jury that a personal attendant is a person employed to "supervise, feed or dress" an elderly person who needs care, and explained the meaning of "`supervision'" as including assistance with various daily living tasks. The court also instructed the jury that the personal attendant exemption does not apply when (1) the employee performs significant other work duties, meaning "duties which constitute greater than 20% of the weekly work time" or (2) the employee's "duties require the regular administration of health care services such as the taking [of] temperatures or pulse or respiratory rate . . ., regardless of the amount of time such duties take . . . ." (Italics added.)
In a special verdict, the jury found Cash was employed to supervise, feed, or dress Winn and that Cash's other work duties did not constitute greater than 20 percent of her worktime. But the jury also found that Cash's work involved "the regular administration of health care services" under the definition given by the court. Based on these findings and the jury's finding as to the amount of overtime pay owed, the court entered judgment in Cash's favor for $123,205.80, consisting of $33,711.50 in overtime wages, $14,083.40 in prejudgment interest, $72,380.50 in statutory attorney fees, and $3,030.40 in costs. The court denied Winn's posttrial motions.
Winn appeals, contending (1) the court erred in instructing the jury that the personal attendant exemption did not apply if Cash regularly performed any "health care services," defined to include "taking temperatures or pulse or respiratory rate," regardless of the amount of time spent on these tasks and (2) the court erred in denying her motions for new trial and judgment notwithstanding the verdict (JNOV).
We conclude the court prejudicially erred in instructing the jury. We further determine that based on the jury's findings, the court erred in denying Winn's JNOV motion and Winn is entitled to judgment as a matter of law. We thus reverse and remand with instructions to enter judgment in Winn's favor.
In 2005, Cash was working as a caregiver for elderly clients. She had never attended nursing school and was not a licensed nurse or dietitian. Cash, however, had education, training, and experience in massage therapy and nutrition, and had previously operated a childcare facility.
In approximately October 2005, Winn's family members interviewed Cash for a position as Winn's caregiver. At the time, Winn was 94 years old and lived alone in a small cottage about 800 or 900 square feet. Cash knew the Winn family because she had rented property from the Winns in the 1970's. During the interview, the Winn family members told Cash they were looking for someone to be Winn's "companion and check on her and let them know how she was doing, and prepare nutritious meals that would be good for her diabetes." The family members told Cash that Winn was recently hospitalized for a diabetic episode. They also told Cash that the doctors had instructed that Winn have "plenty of protein and fruits and vegetables," but no "sweets" or "sugars." The doctors did not prescribe insulin injections, and instead told the family that Winn's diabetes should be controlled with a proper diet.
Shortly after, the Winn family hired Cash and they agreed on a $10 per hour wage. After about one month, Cash began staying with Winn approximately 18 hours per day, including sleeping in the house. She would usually arrive at Winn's residence about 11:30 a.m. and leave the next morning about 6:00 a.m. A second caretaker worked from 6:00 a.m. until 11:30 a.m. In addition, various Winn family members came to Winn's home in the evenings and on weekend days.
When Cash would first arrive at the house before noon, she would ask the other caregiver about Winn's blood sugar level and would begin planning a noon meal based on that level. She would then cook the meal and eat lunch with Winn. She obtained information from the Internet about diabetes guidelines and attempted to follow them.
According to Cash, her primary tasks during her employment with Winn were helping Winn with grooming, dressing, preparing meals, grocery shopping, picking up medication, helping Winn get ready for bed, and reminding Winn to take her medications. During the afternoons, Cash "was always interacting" with Winn because Winn "was afraid to be left alone." Cash also testified that she would spend substantial time each day performing numerous household maintenance and cleaning tasks, including cleaning the kitchen, doing the laundry, cleaning the bathroom, taking out the trash, arranging and supervising worker appointments, and buying "household supplies."
With respect to Winn's medications, Cash testified that Winn took medications twice a day. Winn's medications were kept in a basket with instructions
When Cash's counsel asked her what she would do on a "daily basis" relating to providing "healthcare" services to Winn, Cash identified several categories of tasks.
First, Cash said she would "massage" Winn's back, feet and legs. She said she performed these tasks "[m]ainly for soothing" purposes to help "settle" down Winn for the night, but she also gave the massages because they were good for "general circulation," and "to make sure there was blood flow in the legs."
Second, Cash said she would check Winn's "vital signs" by feeling Winn's pulse while she was having a "panic attack." Cash said that Winn would have a panic attack about five times a week, and that Cash would check Winn's pulse about four times a week. Cash said she would not write down the pulse rate or communicate the rate to a doctor or the family, but said she would check the rate to "evaluat[e]" Cash's panic attack. Specifically, Cash stated she would take Winn's pulse rate "[j]ust to see if [the panic attack] was a real—you know, if she was really stressed with the panic attack or not."
Third, Cash said she would "measure" Winn's oxygen by observing "blueness in [her] finger." She said she would do this about four or five times per week. Cash would also observe Winn's skin tone and eyes because "you can tell a lot by . . . what we call in Chinese medicine, [the] shin of the eyes."
Fourth, Cash said she would test Winn's blood sugar about once or twice a day. She would perform this test using Winn's over-the-counter blood sugar test kit. When asked how much time she would spend on this task, Cash responded: "15 to 45 minutes, depends on if I did it three times or two times."
Cash also said she would drive Winn to the doctor's office about two to three times per month.
In defense, Winn presented evidence showing that Cash was not hired to, and did not, clean the house, and instead she spent most of her time helping Winn with daily tasks and sitting next to Winn and conversing with her. This
Winn also presented evidence that her daughters, granddaughter, and son-in-law would perform major cleaning tasks and take out the trash during the weekends. Winn's adult granddaughter testified that she would perform a blood sugar test on Winn in the evenings, and that Cash rarely performed this test (if at all).
At trial, both parties agreed that a personal attendant as defined in California law is exempt from overtime wages. (See § 11150, subds. 1(B), 2(J).) However, they disputed the meaning of a personal attendant. Before and after the presentation of evidence, the court and counsel devoted substantial time to crafting a jury instruction to define who is a personal attendant under California law.
At the conclusion of these discussions, the parties agreed that a personal attendant is someone who is employed to "supervise, feed, or dress a . . . person who by reason of advanced age, physical disability, or mental deficiency needs supervision." (§ 11150, subd. 2(J).) The parties further agreed that this status applies only "when no significant amount of work other than the foregoing is required" (ibid.), and that the phrase "significant amount of work" means duties that constitute greater than 20 percent of the weekly worktime. The parties also agreed that the term "supervision" includes various caregiving functions in which the employee assists an elderly client with daily living activities (as detailed in the instruction below). Thus, the court prepared a special instruction (Special Instruction No. 1) reflecting these concepts. The first three paragraphs of this instruction read:
"1. `Personal Attendant' . . . means any person employed by a private householder or by any third party employer recognized in the health care industry to work in a private household, to supervise, feed or dress a child or person who by reason of advanced age, physical disability or mental deficiency needs supervision. The status of `Personal Attendant' shall apply when no significant amount of work other than the foregoing is required.
"2. The term `supervision' as used in these instructions is limited and may include certain work duties essential for the independent living of the
"3. The exemption for `personal attendant' shall not apply when the employee performs significant work duties other than the supervision, care and feeding of the supervised person. Significant work is defined as duties which constitute greater than 20% of the weekly work time."
Neither party challenged these paragraphs of the instruction. However, the parties strongly disagreed about whether the jury should also be instructed on an additional exception to the definition of a "personal attendant" to exclude all individuals who regularly perform any type of health care function. Relying on several opinion letters prepared by the DLSE that discussed or referred to a sentence in a 1986 DLSE interpretive bulletin, Cash's attorney requested the court to instruct the jury that Cash "would not be a personal attendant if you find that she regularly provided the defendant with medication, or took her vital[] signs, or observed the defendant's general physical, emotional and medical condition, and reported those conditions. It does not matter how much time was spent performing these tasks as long as they were done on a regular basis."
Over Winn's objections, the court agreed to instruct the jury on these concepts, but modified the language. The court included this additional instruction as a fourth paragraph to Special Instruction No. 1. This fourth paragraph read: "Any worker whose employment duties require the regular administration of health care services such as the taking [of] temperatures or pulse or respiratory rate, or similar health care functions, or the administration of prescription medication other than medication ordinarily self administered by an individual, regardless of the amount of time such duties take does not qualify for the `personal attendant' exemption." The court also instructed the jury that Winn had the burden to show Cash was an "exempt personal attendant."
During closing arguments, Cash's attorney focused primarily on the fourth paragraph of Special Instruction No. 1, arguing: "[P]aragraph four is really what this case is about. What this says is the defendant has to prove to you
In response, Winn's counsel highlighted the evidence showing that Cash's caretaking activities consisted primarily of "supervising, feeding and dressing" Winn. Winn's counsel urged the jury to reject Cash's testimony that she devoted a substantial amount of her worktime to cleaning and maintaining the household, emphasizing the contrary testimony of the defense witnesses, the small size of Winn's cottage, and Cash's conflicting statements on this issue. Counsel also urged the jury to reject Cash's testimony that she regularly checked Winn's pulse rate and Winn's blood sugar levels, and argued that even if Cash did engage in these activities, they were a small part of her overall employment.
On a special verdict form, the jury responded to three questions pertaining to the "personal attendant" issue. First, the jury answered "Yes" to the question: "Did plaintiff Joy Cash perform any of the duties of a personal attendant as defined in paragraphs one and two of Special Jury Instruction No. 1?" Second, the jury answered "No" to the question: "Did plaintiff Joy Cash spend more than 20% of her weekly work time performing other duties for defendant Iola Winn as described in paragraph three of Special Jury Instruction No. 1?" (Italics added.) Third, the jury answered "Yes" to the question: "Did plaintiff Joy Cash's employment duties require the regular administration of health care services as described in paragraph four of Special Jury Instruction No. 1, regardless of the amount of time it took to perform such duties?"
Winn moved for a JNOV and a new trial. She argued primarily that the fourth paragraph of Special Instruction No. 1 was an incorrect statement of the law. She also argued she was entitled to judgment as a matter of law based on the jury's express findings that she proved Cash performed the duties of a "personal attendant" and that Cash did not spend more than 20 percent of her time on other tasks. The court denied the motions.
Winn contends the court erred by including the fourth paragraph in Special Instruction No. 1 regarding the "regular administration of health care services" exception to the personal attendant exemption rule set forth in Wage Order No. 15. Winn argues this exception does not exist under California law as applied to a household employee who is not licensed or trained to perform nursing or other medical services.
The IWC thereafter promulgated Wage Order No. 15, which governs minimum wage and overtime protections for individuals who work in "household occupations." "`Household Occupations'" is defined to mean "all services related to the care of persons or maintenance of a private household or its premises by an employee of a private householder. Said occupations
Further, under the express terms of Wage Order No. 15, the personal attendant definition applies only "when no significant amount of work other than the foregoing [(supervising, feeding, or dressing)] is required." (§ 11150, subd. 2(J).) The court instructed the jury that a "significant" amount of work means tasks that take more than 20 percent of the employee's time. This definition was based on a Court of Appeal decision (see Cardenas v. Mission Industries (1991) 226 Cal.App.3d 952, 958 [277 Cal.Rptr. 247], disapproved on another ground in Smith v. Rae-Venter Law Group (2002) 29 Cal.4th 345, 370 [127 Cal.Rptr.2d 516, 58 P.3d 367]), the DLSE's prior interpretations
The issue here, however, is whether a person, who is not a licensed nurse of any type (professional, registered, graduate, or trained) and whose work is primarily (more than 80 percent of the time) that of a personal attendant as defined above, loses his or her status as a personal attendant because the employee regularly performs any health care related services, such as taking a "temperature[] or pulse" or assisting with over-the-counter blood sugar tests. In other words, does a caretaker for an elderly person fall outside the "personal attendant" definition merely by spending a few minutes each day on these routine health-related tasks, even if the employee spends more than 80 percent of his or her time supervising, feeding, or dressing the elderly individual?
Moreover, such an interpretation would be inconsistent with the policy underlying the narrow personal attendant exemption rule, which seeks to control home care costs for elderly individuals who need help with daily
Our conclusion is also supported by the provisions of Wage Order No. 15 relating to in-home nursing employees. The wage order specifically provides that certain categories of licensed registered nurses who work in the home providing nursing services are not exempt from overtime regulations (§ 11150, subd. 1(A)(3)(f), (g)), leading to a reasonable inference that the IWC did not intend to extend this exception to other categories of individuals (such as caregivers who are not nurses) merely because a small portion of their work can be characterized as health care services. Under federal law, there is an analogous overtime pay exemption for in-home caregiving work referred to as "companionship services" (29 U.S.C. § 213(a)(15)), and the implementing federal regulation expressly states that "`companionship services' does not include services relating to the care and protection of the aged or infirm which require and are performed by trained personnel, such as a registered or practical nurse. . . ." (29 C.F.R. § 552.6 (2011), italics added.) This trained-personnel exception to the personal attendant exemption is not specifically contained in the personal attendant provisions of Wage Order No. 15. But even assuming the IWC intended to include such an exception, the exception would not be applicable here because the undisputed evidence showed that Cash was not a trained nurse and there was no evidence or argument that Cash engaged in activities that could only be performed by a trained or licensed nurse.
In two of the letters, the DLSE chief counsel referred to a health care services exception to the wage order's "personal attendant" definition by referencing a rule promulgated in Interpretive Bulletin 86-1. (DLSE Opn. Letters Nos. 1994-10-03-2 & 1994-02-03-2.) Interpretive Bulletin 86-1 was issued by the Labor Commissioner on March 12, 1986, and is contained in the DLSE's former 1989 Operations and Procedures Manual.
The last section of Interpretive Bulletin 86-1 additionally discusses the "`no significant amount of other work'" requirement of the "personal attendants" definition, and concludes as follows: "Usually, such `other' work involves housekeeping duties. It should be noted that practical nurses are explicitly covered by Order 15 and may not be exempted as personal attendants even though many of their duties are the same. Any worker who regularly gives medication or takes temperatures or pulse or respiratory rate, regardless of the amount of time such duties take, falls within some classification of nurse, licensed or unlicensed." (Italics added.) The February 1994 and October 1994 DLSE opinion letters cited by Cash quote from the last sentence of this paragraph, leading Cash to argue, and the trial court to agree, that it should instruct the jury in the language of this sentence. (DLSE Opn. Letters Nos. 1994-10-03-2, 1994-02-03-2.)
In Tidewater Marine Western, Inc. v. Bradshaw (1996) 14 Cal.4th 557 [59 Cal.Rptr.2d 186, 927 P.2d 296] (Tidewater), the California Supreme Court "held that all of the DLSE's interpretive policies contained in its 1989 operations and procedures manual [are] regulations that [are] void because
Cash contends this rule prohibiting reliance on a former DLSE interpretive bulletin does not extend to matters contained in DLSE opinion letters, which are "advisory" opinions issued by the agency.
Without providing any analysis, the two 1994 DLSE opinion letters relied upon by Cash merely quote from the rule set forth in Interpretive Bulletin 86-1 pertaining to the definition of a personal attendant. (See DLSE Opn. Letters Nos. 1994-10-03-2 & 1994-02-03-2.) In the February 3, 1994 letter, the DLSE's chief counsel states he "find[s] that the Interpretive Bulletin
With respect to the third DLSE opinion letter relied upon by Cash, the DLSE was responding to an inquiry about the distinction between a "personal attendant" and a licensed "practical nurse." (DLSE Opn. Letter No. 1997-10-21-1.) The DLSE's chief counsel concluded that "the distinction between the services or procedures performed by a practical (or vocational) nurse and those performed by a personal attendant is easily drawn: the personal attendant is employed only to supervise, feed and dress the individual and may not engage in those procedures which are exclusively limited to the nursing profession. The nurse is primarily employed to supervise the individual in regard to their health needs and is allowed to perform the services and procedures provided in their license." (Ibid., italics added.) This distinction is consistent with our conclusion here. The fact that Cash engaged in some incidental nursing tasks that did not require a nursing license (see Bus. & Prof. Code, § 2727, subd. (b)), and thus were not exclusively limited to the nursing profession, did not necessarily take her outside the wage order's personal attendant definition. (§ 11150, subd. 2(J).) The court instructed the jury that a caretaker's regular performance of any health care related services automatically takes the employee outside the personal attendant definition. The October 21, 1997 DLSE opinion letter does not support the existence of this broad exception.
Aside from the DLSE opinion letters, Cash argues that the fourth paragraph of Special Instruction No. 1 was appropriate because the word "`"supervise"'" cannot be logically "stretched to encompass an employee performing. . . medical or health care functions for an elderly person" and that "the term supervise cannot include one performing medical or health care services for another."
We agree that when a person performs nursing-type functions, these functions may fall outside the scope of a personal attendant as that phrase is defined in Wage Order No. 15. However, the jury here was expressly instructed as to the limited definition of the term "`supervision,'" which did
Winn also contends the court erred in denying her JNOV motion.
In this case, the jury expressly found (1) Cash performed the duties of a personal attendant as defined in the first and second paragraphs of Special Instruction No. 1 and (2) Cash did not spend more than 20 percent of her weekly worktime performing other duties, as described in the third paragraph of Special Instruction No 1. Based on these findings, Cash met the definition of a personal attendant within the meaning of Wage Order No. 15. (§ 11150, subd. 2(J).) Cash does not dispute the propriety of the first, second, or third paragraphs of the instruction, and does not suggest any basis upon which she could prevail if we were to remand for a retrial without the erroneous instruction.
Cash argues only that substantial evidence at trial showed her employment tasks consisted primarily of providing health care to Winn, emphasizing the
Judgment is reversed. The matter is remanded for the court to vacate the judgment and enter a judgment in favor of Winn. Respondent to bear appellant's costs on appeal.
O'Rourke, J., and Irion, J., concurred.