Reversed, Rendered, and Opinion Filed March 26, 2024
S In The
Court of Appeals
Fifth District of Texas at Dallas
No. 05-22-01358-CV
DALLAS COUNTY HOSPITAL DISTRICT D/B/A PARKLAND HEALTH
AND HOSPITAL SYSTEM, Appellant
V.
MICHAEL BALLEW, Appellee
On Appeal from the County Court at Law No. 1
Dallas County, Texas
Trial Court Cause No. CC-20-04852-A
MEMORANDUM OPINION
Before Justices Partida-Kipness, Reichek, and Breedlove
Opinion by Justice Partida-Kipness
Appellee Michael Ballew sued appellant Dallas County Hospital District d/b/a
Parkland Health and Hospital System (Parkland) for disability discrimination and
retaliation. Parkland filed a plea to the jurisdiction, which the trial court denied. In
this interlocutory appeal, Parkland argues the trial court’s order is erroneous. See
TEX. CIV. PRAC. & REM. CODE § 51.014(a)(8) (allowing appeal from interlocutory
order denying plea to the jurisdiction by governmental unit). We reverse the trial
court’s November 30, 2022 Order Denying Defendant’s Plea to the Jurisdiction and
render judgment dismissing Ballew’s claims against Parkland for lack of subject-
matter jurisdiction.
BACKGROUND
This proceeding arises from the 2019 termination of Ballew’s employment,
which he contends was the result of disability discrimination. Ballew began working
at Parkland in 2001 as the Accounts Receivable Audit Supervisor. By 2008, he had
been promoted to the position of Director of Patient Financial Services (PFS
Director). At that time, Ballew was one of three directors of patient financial
services, each with different functional responsibilities. The PFS Directors report
directly to the Senior Vice President (SVP) of Revenue Cycle, who in turn reports
to the Chief Financial Officer (CFO). Ballew was the PFS Director over “billing and
collections for third parties and patients, and customer relations related to” those
activities. According to Ballew, from June 2018 forward his responsibilities included
“collections, customer service, cash posting, refunds, cashiers, bank reconciliation,
reporting department, insurance update team, and scanning team.” Between 2015
and 2017, Ballew reported to Rhonda Miller, the SVP of Revenue Cycle.
I. 2016 Integrity Line Complaints
In 2016, employees filed eleven complaints against Miller and Ballew (the
Integrity Line Complaints). Employees accused Miller and Ballew of: (1) displaying
favoritism and poor leadership; (2) retaliating against employees; and (3) engaging
in questionable billing and collection practices. Parkland’s human resources
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department, which is called the Officer of Talent Management (OTM), investigated
the Integrity Line Complaints. Art Ferrell, Parkland’s Director of Employee
Relations at the time, initially recommended Miller and Ballew be terminated. But
after discussions with senior leadership, the decision was made to administer a final
disciplinary action on Ballew rather than terminate him because “the general
consensus” was that Miller’s “domineering style” may have impacted Ballew. In
April 2017, Parkland terminated Miller. However, Ballew petitioned Parkland’s
President and Chief Executive Officer, Dr. Frederick Cerise, and he rescinded the
progressive discipline for Ballew.
II. November 6, 2017 – Miller Replaced by Gerry Baker
Between May 2017 and November 2017, Miller’s position remained vacant
as Parkland searched for a new CFO. In August 2017, Parkland hired Rick
Humphrey as CFO. On November 6, 2017, Humphrey hired Gerry Baker as SVP of
Revenue Cycle to replace Miller. According to Baker, he was hired to improve
Parkland’s revenue cycle management. Baker was also tasked with completing 2017
performance reviews for his direct reports, including Ballew. Those reviews covered
each employee’s performance between October 1, 2016, and September 30, 2017,
which was prior to Baker joining Parkland. Because he did not have firsthand
knowledge of the employees’ performance during that period, he largely adopted
Miller’s evaluation and ratings.
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Ballew received his 2017 performance review on December 19, 2017. He
received an overall rating of “Solid Contribution,” which was consistent with his
2013 and 2015 reviews in which he also received an overall rating of “Solid
Contribution.” Baker included the following comment on the review:
Overall, Michael has done a very good job managing the resources that
he has had available to him. Focus areas for the upcoming year should
be 1) developing staff[,] 2) updating policy and procedure documents
so that they are relevant to how business is done today[,] 3) further
improvement in key performance metrics (e.g., billed claims and
DNB)[, and] 4) development of a formal Denials Management
Program[.]
III. Ballew’s June 2018 Hospitalization
In June 2018, Ballew experienced symptoms of hypopnea, a severe arterial
obstruction. Ballew maintains he told Baker about his condition on June 30, 2018,
before beginning treatment at Parkland. Baker testified he did not know specifically
why Baker was hospitalized in June 2018. Ballew took paid time off (PTO) in June
and July 2018 to undergo treatment. According to Baker, Ballew did not seek
FMLA1 leave for that treatment and did not request an accommodation of any kind
or notify Parkland that he allegedly had a disability. Ballew also did not notify Baker
that his tasks were not complete due to taking leave.
IV. Ballew’s 2018 Performance Review
Ballew’s 2018 performance review covered the period between October 1,
2017, and September 30, 2018. Ballew received the review in December 2018. Baker
1
FAMILY MEDICAL LEAVE ACT OF 1993, 29 U.S.C. § 2601, et seq. (1993).
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gave Ballew an overall rating of “Needs Improvement.” The performance review
addressed Ballew’s completion of performance goals assigned to him for the review
period and his leadership competencies. The three performance goals included in the
2018 review were:
“Implement 2 process improvement initiative that originate from
line staff through a new initiative to be developed to foster
positive exchanging of ideas between leadership and staff.”
“Implement quarterly huddle meetings to share organization
updates and solicit new and innovative ideas to opportunities
from all levels of the departments.”
“Develop job descriptions and retain staff in areas of span of
control--Denials Unit, Collections, Customer Service.”
Baker rated Ballew as “Needs Improvement” on each goal based on Ballew’s
implementation of one or fewer initiatives, implementation of three or less
documented huddle meetings, and developing 75% of job descriptions and
completing 75% of retraining. Baker made the following comments concerning his
review of the performance goals:
Michael has several areas that need improvement as he lacks follow
through and being responsive to internal and external requests for
information or requests. One of his primary goals this year was to create
a Denials Unit. It took many months to recruit and hire staff and
deadlines were not met. He also has not followed through on engaging
employees and being responsive to their development needs.
The performance review also rated Ballew on three leadership competencies: (1)
driving continuous improvement, (2) developing talent, and (3) driving performance
excellence. Baker rated Ballew as “Solid Contribution” for driving continuous
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improvement and “Needs Improvement” for the other competencies. He commented
that Ballew “has failed to drive performance excellence and motivate his staff to
achieve all that they can. He has not been able to resolve most conflicts when
presented to him.”
V. The 2019 FMLA Leave
In March 2019, Ballew needed surgery. Baker encouraged Ballew to seek
FMLA leave. Ballew applied for FMLA leave and was granted FMLA leave from
March 20, 2019, through May 5, 2019 (the 2019 FMLA Leave). According to Baker,
Ballew did not request any accommodation or notify Baker that he would be unable
to complete certain tasks due to the 2019 FMLA Leave. Baker recalls that, before
Ballew took the 2019 FMLA Leave, he “repeatedly” told Baker in their “weekly
one-on-one meetings that his projects were on track,” and Ballew did not notify
Baker “of any issues or complications that would prevent the completion of his
projects.”
VI. Baker’s Discoveries During the 2019 FMLA Leave
Baker covered Ballew’s responsibilities during the 2019 FMLA Leave. Baker
testified he was “appalled” by what he discovered “and the state of affairs on projects
[he] assigned to Ballew.” Between November 2017 and April 2018, Baker had
assigned Ballew the following projects:
1. Cancel a vendor contract with NThrive because Parkland had
contracted with a replacement vendor;
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2. Develop a Denials Management Group dedicated to appealing
insurance claim denials and hire six full-time employees to staff
the group (the DMG Project);
3. Establish a procedure that would allow Parkland to send out
invoices to self-pay patients (the Self-Pay Accounts Project);
4. Improve the abandonment rate for calls to the PFS call center;
and
5. Improve his responsiveness to his team, customers, and other
departments.
According to Baker, Ballew did not successfully complete any of the assigned tasks.
Baker testified those failures detrimentally impacted his efforts to improve
Parkland’s revenue cycle management and cost Parkland millions of dollars in lost
or delayed revenue.
A. Self-Pay Accounts Project
Ballew’s handling of the Self-Pay Accounts Project was central to Parkland’s
decision to terminate Ballew. When Baker started at Parkland, the billing of and
collection from self-pay patients was outsourced to BCA, a third-party vendor. BCA
was a “soft collection”2 agency, as opposed to a “bad–debt” agency or collector.
BCA earned its fee by delivering a first round of statements to Parkland patients and
then collecting payments from those patients. Baker created the Self-Pay Accounts
2
Soft collections “refer to the process of collecting payment from patients before their medical bills
become delinquent. This collection strategy involves sending reminders and statements to patients who
have not paid their bills on time. Soft collections are less aggressive than hard collections, and they are
often used to prevent the need for legal action or other aggressive collection strategies.”
https://myrcmgroup.com/articles/what-is-the-difference-between-hard-and-soft-collections (last visited
March 26, 2024).
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Project to reduce the amount of fees paid to third-party vendors like BCA to collect
from self-pay patients.
According to Baker, most self-pay patients paid their bills within the first two
months of billing. He concluded the outsourcing fees could be reduced if Parkland,
rather than BCA, generated and sent out the first statement to patients when medical
services were complete and sent the second statement thirty days later if payment
was not received. Parkland would save money under this plan because paying BCA
for collections assistance would be limited to invoices that went unpaid beyond fifty-
five days, when BCA would take over collection efforts. Accounts would be sent to
a “bad-debt agency” if they remained unpaid more than 180 days.
Baker delegated the Self-Pay Accounts Project to Ballew in April 2018
because Parkland’s contract with BCA was set to expire in June 2018. When the
contract with BCA expired, MiraMed3 became the new third-party vendor for self-
pay collections. Under the new process, Parkland would refer past-due accounts to
MiraMed at the fifty-five-day mark. MiraMed would then send statements to and try
to collect payment from those self-pay patients whose account remained unpaid from
day 56 until day 180. If the account remained unpaid for 180 days, MiraMed would
send the account back to Parkland, and then Parkland would send the account to a
“bad-debt agency.”
3
MiraMed, like BCA, is a “soft-collection” agency.
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Baker expected Ballew to have the Self-Pay Account Project completed and
the process in place by July 2018, so there would be no disruption in operations.
Because Parkland did not have the in-house ability to print and mail statements,
Parkland planned to utilize a third-party vendor, Exalt, to print and mail the first two
statements. During the Fall of 2018, Ballew coordinated with Parkland’s IT
department and Exalt to test the new process. During the testing period, Exalt was
allowed to print and mail no more than 500 statements per day. The cap was in place
to test Exalt’s capacity and to make sure the data was flowing correctly from
Parkland to Exalt. But the cap was supposed to be lifted once testing was complete
and Exalt’s capacity confirmed. The plan was for Exalt to print and mail 5,000
statements per day.
But in April 2019, while Ballew was on FMLA leave, Baker discovered the
Self-Pay Accounts Project was never completed. Baker was informed that patients
who had never received a statement from Parkland were complaining about being
turned in to bad-debt collectors. When he began investigating those specific
complaints, he discovered the 500-statement cap had not been removed “for many,
many, many months” and no statements had gone out to thousands of patients. By
May 3, 2019, more than 11,000 self-pay patients had never been sent an initial
statement. Baker determined the cause was Ballew’s unilateral decision to keep the
500-statement cap in place even though Exalt had the capacity to send out 5,000
statements per day. Ballew’s actions and inactions affected between $150 million
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and $180 million of accounts receivable by May 2019, and Baker estimated Parkland
would incur additional, unbudgeted expenses to outsource accounts receivable “to
prevent further delays in efforts to collect some of the cash.” Baker also explained
how Ballew’s actions negatively impacted patient cash collections:
Those patients who would normally pay their balance or a portion after
receiving two statements, have not paid Parkland. On average we
collect approximately 1% of self-pay from patients, which equates to
$1.5-$1.8 million per month in cash Parkland could have received.
Baker estimated Ballew’s actions resulted in the loss of or delay in receiving between
$6 million and $7.2 million during the first four months of 2019.
Baker also discovered Ballew tried to conceal his failure to complete the
project by sending thousands of self-pay account customers to a bad-debt collector
without ever sending the patients a first or second statement. Had he not done so, the
reported amount of Parkland’s receivable on self-pay accounts would have
ballooned and alerted Baker the project had not been completed. Ballew evaded
detection because sending thousands of customers straight to bad-debt collection
made the amount of outstanding accounts receivable appear to not be increasing. But
the number of calls to the PFS call center increased because of calls from “angry
patients who were being hounded by debt collectors.” Ballew’s actions violated
Parkland’s policies and placed added stress on the PFS call center.
B. Denial Management Group Project (DMG Project)
Ballew’s failure to complete the DMG Project also caused Parkland to lose a
valuable revenue stream. Parkland, like many hospital systems, relies on
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reimbursement from insurers to fund patient care. But the insurance claims process
is complicated and often results in insurers denying claims for correctable reasons,
such as typographical errors and incorrect billing codes. Baker charged Ballew with
developing and establishing a group (the Denials Management Group) to amass
denied claims, understand and address the reasons for denial, and then appeal those
claims with insurers as necessary with the goal of obtaining payment. To complete
the DMG Project, Ballew needed to hire the necessary staff to form the group, create
training material and templates for the group to use when challenging the insurance
denials, and create staff workflows and staff training documents. Although Ballew
told Baker the Denials Management Group had been formed, Baker discovered
during the 2019 FMLA Leave that Ballew had not hired or trained the appropriate
staff to form the group.
By the end of March 2019, the amount of denials had grown to $93 million.
At that time, only one full-time employee was handling the denials and could not
keep up with the growing number of denials. Ballew allowed that employee to write-
off old balances instead of trying to resolve the denials and collect the revenue owed
to Parkland. By the end of April 2019, Ballew’s failure to form the Denials
Management Group forced Parkland to write off at least $23 million dollars because
the time to appeal those denials had expired. Baker estimated Parkland could lose an
additional $10 to $15 million dollars as more denials aged out of the appeal window.
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C. The remaining assignments
According to Baker, Ballew also failed to fulfill the remaining assignments.
Ballew’s failure to timely cancel the NThrive contract cost Parkland $120,000. As
for addressing the abandonment rate for calls, Ballew took no steps to improve the
abandonment rate. Call abandonment occurs when a caller hangs up after being
placed on hold. Baker testified Ballew should have addressed this issue by (1)
coaching and training his team to be more efficient, (2) engaging in progressive
discipline, where necessary, and (3) requesting additional full-time employees.
Ballew took none of those steps and, instead, blamed his employees and stated he
could not get them to do a better job. Ballew also continued to be nonresponsive to
his team, customers, and others. He would not return calls, respond to emails, or
answer his team’s questions. This resulted in patient questions remaining
unanswered and required Baker to intervene on multiple occasions.
VII. Parkland’s Investigation
On May 3, 2019, Baker wrote a memorandum outlining Ballew’s performance
issues (the May 3, 2019 Memo). In it, Baker described the discoveries he made
regarding the Self-Pay Accounts Project, the DMG Project, and the NThrive
cancellation. Baker stated Ballew’s “behavior has likely cost Parkland
approximately $40-50 million in recoverable revenue” and demonstrated Ballew’s
integrity and transparency were “lacking and extremely troubling.” Baker
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recommended an immediate investigation and indicated the results of that
investigation would determine if he would recommend Ballew be terminated.
Ballew’s 2019 FMLA Leave ended on May 5, 2019. On May 9, 2019,
Parkland placed Ballew on administrative suspension with pay while it investigated
the state of PFS and Baker’s allegations. Baker testified the investigation complied
with Parkland’s standard operating procedures.
In his interrogatory responses, Ballew stated he first told Parkland he was
“being treated unfairly because of his health condition” on May 9, 2019, when they
suspended him:
The complaint was made to Gary Baker and the human resource
representative who was present. He also complained of discrimination
and retaliation on his appeal to the persons involved in the appeal.
Parkland retaliated against him by making false statements about him,
by not conducting a fair investigation or appeal, and by terminating his
employment.
Ballew presented three written statements to explain his actions between May 9,
2019, and June 10, 2019. In them, Ballew denied wrongdoing and challenged the
accuracy of the May 3, 2019 memo.
For example, he insisted the cap on self-pay statements was necessary because
the system was not ready for increased output. He also insisted it was Baker’s “call”
when to lift the cap. He also asserted that patient complaints about being sent to
collections without receiving statements had been “known and ongoing since around
August 2018.” Ballew maintained Baker “reviewed and approved” the cap on
statements and “was keenly aware” the cap would cause Parkland to “encounter
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months of little to no placements.” He blamed Baker’s decision to change the self-
pay methodology for “the lapse in bad debt placements.” He also stated the Self-Pay
Accounts Project could not be completed without hiring new full-time employees,
and he blamed Baker and Miller for understaffing the PFS. According to Ballew,
Parkland approved new hires in November 2018, but did not hire anyone until March
2019. He contended he was unable to participate in hiring and training because he
was on FMLA leave when those events occurred. Ballew also denied being tasked
with creating a denials work group and stated Baker told him not to create such a
group. In his May 21, 2019 statement, Ballew described the suspension as “another
step in a pattern of retaliation directly linked to [Ballew’s] health issues.”
Pamela Brooks, a member of Parkland’s employee relations team, conducted
the investigation. In June 2019, Baker sent a follow-up email to Brooks and Arthur
Ferrell, the head of Parkland’s employee relations team. In that email, Baker
provided additional information concerning the situation and a recap of a meeting
he had with Ballew at which he posed a series of questions for Ballew to answer.
Baker noted he had “no confidence in Mr. Ballew’s integrity” because Ballew “was
not honest in his answers to questions today nor in his written statements from May
9th and May 21st.” Baker also suggested Ballew lacked compassion and did not have
the ability to uphold Parkland’s values because he turned patient accounts over to
debt collectors as bad debts without first sending them a statement or following
Parkland policy guidelines. Baker recommended Parkland terminate Ballew.
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After completing the investigation, Brooks provided an investigation report to
Farrell in which she recommended Ballew be terminated. Farrell reviewed the
investigation report and approved Brooks’ recommendation to terminate Ballew.
Farrell testified the issues with Ballew were “of gross misconduct,” so the lack of
prior progressive discipline was not a factor. Because the misconduct was considered
so egregious, “the first time it occurred could indeed lead to termination of
employment, which was the case here.”
Parkland terminated Ballew’s employment. In a June 21, 2019 termination
letter, Brooks informed Ballew of the outcome of the investigation:
The investigation findings indicate that you have exhibited behavior
that does not align with Parkland values and failed to meet the
performance standards expected of a leader. As such, your employment
is terminated effective June 20, 2019 for not adhering to the Standards
of Service Excellence (OTM Procedure 6000-210) required of Parkland
employees, and also failing to demonstrate the values of Compassion,
Integrity, Respect, and Stewardship. The Progressive Discipline Report
documenting the reasons for your termination is attached.
The reasons for progressive discipline described in the report mirrored Baker’s
allegations. Parkland’s internal termination statement listed the following reasons
for the termination:
Lack of integrity and not carrying out job responsibilities: Mr.
Ballew was responsible for establishing a process to hold self-pay AR
in-house for 55 days and to send (2) statements to patients and then
outsource the AR to an Early Out vendor.
Honesty, Personal Accountability: Mr. Ballew was tasked with
for[m]ing a denials unit within the department in early 2018.
Throughout the entire performance year Mr. Ballew and Mr. Baker
repeatedly discussed his progress. By the time annual reviews were
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conducted, Mr. Ballew still had not accomplished this task and this was
highlighted as a deficiency in this FY 2018 annual review. Mr. Ballew
repeatedly told his leader that he had established the work.
Farrell and Brooks testified the reasons for Ballew’s termination were the poor
performance issues and concerns with Ballew’s integrity and honesty as set out in
Baker’s May 3, 2019 memo and follow-up email and as summarized in Brooks’
investigative findings.
Ballew appealed the termination internally, and Parkland upheld the
termination. On December 9, 2019, Ballew filed a charge of discrimination with the
EEOC alleging disability discrimination and retaliation. In the charge, Ballew
asserted Parkland discriminated against him because he had a serious blood vessel
circulation condition. He also claimed Parkland’s reason for terminating him—
performance—was not true because his “performance was not an issue.” After
exhausting his administrative remedies and obtaining a right to sue letter from the
EEOC, Ballew filed the underlying lawsuit.
VIII. Parkland’s Plea to the Jurisdiction
Parkland filed a plea to the jurisdiction in the trial court. In support, Parkland
submitted nearly 600 pages of evidence, including Baker’s affidavit, documents
related to Baker’s concerns and the investigation, Ballew’s 2013, 2015, 2017, and
2018 performance reviews, Ballew’s request for FMLA leave and the approval of
that request, Ballew’s investigation responses, the termination notice and
accompanying documentation, Ballew’s EEOC charge, and the deposition
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transcripts of Baker, Brooks, Ferrell, Humphrey, Ballew, and three other witnesses
employed at Parkland at the time of the investigation. Ballew filed a written response
to Parkland’s Plea to the Jurisdiction. In support of his response, Ballew submitted
excerpts from his deposition, two personal declarations, his medical record excerpts
and 2017 performance review, the deposition of Humphrey, and a declaration from
former Parkland employee Sheri Kowalski. The trial court held a hearing on the plea
to the jurisdiction on November 21, 2022, and denied the plea on November 30,
2022. This interlocutory appeal followed.
STANDARD OF REVIEW
Governmental entities, including hospital districts, are immune from suit
unless the state consents. Tex. Dep’t of Parks & Wildlife v. Miranda, 133 S.W.3d
217, 224 (Tex. 2004); Harris Cnty. Hosp. Dist. v. Tomball Reg’l Hosp., 283 S.W.3d
838, 842 (Tex. 2009) (hospital districts have governmental immunity). “The
TCHRA4 waives immunity, but only when the plaintiff states a claim for conduct
that actually violates the statute.” Alamo Heights Indep. Sch. Dist. v. Clark, 544
S.W.3d 755, 770–71 (Tex. 2018) (citing Mission Consol. Indep. Sch. Dist. v. Garcia,
372 S.W.3d 629, 636 (Tex. 2012)).
Immunity from suit may be asserted through a plea to the jurisdiction and may
challenge the pleadings, the existence of jurisdictional facts, or both. Alamo Heights
I.S.D., 544 S.W.3d at 770–71. When a jurisdictional plea challenges the pleadings,
4
Texas Commission on Human Rights Act (TCHRA).
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we determine if the plaintiff has alleged facts affirmatively demonstrating subject-
matter jurisdiction. Id. (citing Miranda, 133 S.W.3d at 225–26). If, however, the plea
challenges the existence of jurisdictional facts, we must move beyond the pleadings
and consider evidence when necessary to resolve the jurisdictional issues, even if
the evidence implicates both subject-matter jurisdiction and the merits of a claim.
Id.
Here, Parkland’s jurisdictional plea challenged the existence of jurisdictional
facts with supporting evidence. The standard of review, therefore, mirrors that of a
traditional summary judgment:
[I]f the plaintiffs’ factual allegations are challenged with supporting
evidence necessary to consideration of the plea to the jurisdiction, to
avoid dismissal plaintiffs must raise at least a genuine issue of material
fact to overcome the challenge to the trial court’s subject matter
jurisdiction.
Id. (citing Miranda, 133 S.W.3d at 221). In determining whether a material fact issue
exists, we must take as true all evidence favorable to the plaintiff, indulging every
reasonable inference and resolving any doubts in the plaintiff’s favor. Id. (citing City
of Keller v. Wilson, 168 S.W.3d 802, 811–12, 822–23, 827 (Tex. 2005)). We cannot,
however, disregard evidence necessary to show context, and we cannot disregard
evidence and inferences unfavorable to the plaintiff if reasonable jurors could not.
Id. at 771 (citing 42 U.S.C. § 2000e–2(a)(1)).
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APPLICABLE LAW
The Texas Commission on Human Rights Act (TCHRA) prohibits an
employer from committing an “unlawful employment practice” against an employee
“because of” the employee’s “race, color, disability, religion, sex, national origin, or
age.” TEX. LAB. CODE § 21.051. Under the TCHRA, an employer commits an
unlawful employment practice if the employer discharges an individual “because of”
a disability. Id. § 21.051(1). Generally, an employer commits an unlawful practice
“because of” an employee’s disability if the employee’s disability “was a motivating
factor for an employment practice, even if other factors also motivated the
practice, . . .” Id. § 21.125(a).
To establish unlawful discrimination, a plaintiff may rely on either direct or
circumstantial evidence. Id. at 782. When, as here, there is no direct evidence of
discrimination or retaliation, we follow the burden-shifting framework the United
States Supreme Court established in McDonnell Douglas Corporation v. Green, 411
U.S. 792 (1973). Alamo Heights, 544 S.W.3d at 764, 782. Under this framework, (1)
the plaintiff must first create a presumption of illegal discrimination by establishing
a prima facie case, (2) the defendant must then rebut that presumption by
establishing a legitimate, nondiscriminatory reason for the employment action, and
(3) the plaintiff must then overcome the rebuttal evidence by establishing the
defendant’s stated reason is a mere pretext. Id. at 782. The burden of persuasion
showing the existence of subject matter jurisdiction always lies with the employee.
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Id.; Flores v. Tex. Dep’t of Crim. Just., 634 S.W.3d 440, 451 (Tex. App.—El Paso
2021, no pet.) (Flores II).
ANALYSIS
In two issues, Parkland contends the plea to the jurisdiction should have been
granted because (1) Parkland’s reasons for terminating Ballew were undisputed and
legitimate and nondiscriminatory, and (2) Ballew failed to make a prima facie case
of discrimination, retaliation, or hostile work environment. Parkland maintains it is
unnecessary to determine if Ballew presented a prima facie case for each alleged
TCHRA violation because Ballew presented no evidence Parkland’s legitimate,
nondiscriminatory reasons for terminating Ballew’s employment were false and
pretextual.
We agree Parkland’s arguments regarding Ballew’s disability discrimination
and retaliation claims may be decided without determining if Ballew established a
prima facie case on each of those claims. However, it is unclear whether the
McDonnell Douglas framework applies to a hostile work environment claim in this
context. We will, therefore, analyze that claim outside of the McDonnell Douglas
framework.
I. Disability Discrimination and Retaliation Claims
There is no direct evidence of disability discrimination or retaliatory conduct
in this case. The burden-shifting framework set out in McDonnell Douglas,
therefore, applies to Ballew’s claims for discrimination and retaliation. See Alamo
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Heights, 544 S.W.3d at 782 (noting the McDonnel Douglas burden-shifting steps
applied in discrimination claims also apply to retaliation claims). We assume without
deciding that Ballew established a prima facie case of discrimination and retaliation
and, as a result, a rebuttable presumption of discrimination and retaliation arose.
Under McDonnell Douglas, the burden then shifts to Parkland to rebut the
presumption by producing evidence of a legitimate, nondiscriminatory reason for
the termination of Ballew’s employment. Id.
A. Legitimate, nondiscriminatory reasons for terminating
Ballew
Parkland contends it “proffered ample legitimate and nondiscriminatory
reasons for firing Ballew.” Specifically, Parkland maintains its evidence showed
Ballew engaged in conduct requiring him to be terminated. That conduct included
failing to execute Parkland’s objectives, acting callously toward Parkland’s patients,
and lacking integrity, honesty, and personal accountability in his job performance.
We agree.
Parkland presented declarations, deposition transcripts, and supporting
evidence showing the conduct for which it decided to terminate Ballew. That
evidence is discussed at length above and will not be repeated here. However,
included in that evidence was testimony from Farrell and Brooks confirming that the
reasons for Ballew’s termination were the poor performance issues and concerns
with Ballew’s integrity and honesty as set out in Baker’s May 3, 2019 memo and
follow-up email and summarized in Brooks’ investigative findings. Brooks also
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testified the performance issues that lead to Ballew’s termination occurred prior to
the 2019 FMLA leave. Those issues were not discovered until he was on leave,
however, because Ballew did not communicate any problems with implementing the
projects to Baker or escalate any issues to Baker for resolution.
Under this record, we conclude Parkland’s evidence established that its stated
reasons for terminating Ballew’s employment were legitimate and non-
discriminatory. By doing so, Parkland rebutted any presumptions of discrimination
and retaliation. See Crawford v. Formosa Plastics Corp., La., 234 F.3d 899, 902 (5th
Cir. 2000) (finding “unsatisfactory performance as a manager” sufficient to meet
burden of production); See also Perez v. Region 20 Educ. Serv. Ctr., 307 F.3d 318,
326 (5th Cir. 2002) (“Poor work performance is a legitimate, non-discriminatory
reason for discharge”); Gold v. Exxon Corp., 960 S.W.2d 378, 383 (Tex. App.—
Houston [14th Dist.] 1998, no pet.) (loss of confidence caused by an employee’s job
performance is a legitimate nondiscriminatory reason). The burden then shifted back
to Ballew to show Parkland’s stated reasons were false and a pretext for
discrimination.
B. No evidence of pretext
To raise a fact issue on the pretext element of a discrimination claim, the
employee must present evidence proving the reasons stated by the employer were
not its true reasons, but were a pretext for discrimination, or the reasons were not
credible. Reeves v. Sanderson Plumbing Prods., Inc., 530 U.S. 133, 143 (2000);
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Chandler v. CSC Applied Techs., LLC, 376 S.W.3d 802, 814 (Tex. App.—Houston
[1st Dist.] 2012, pet. denied) (quoting Elgaghil v. Tarrant Cnty. Junior Coll., 45
S.W.3d 133, 139 (Tex. App.—Fort Worth 2000, pet. denied)); Jespersen v.
Sweetwater Ranch Apartments, 390 S.W.3d 644, 655 (Tex. App.—Dallas 2012, no
pet.). However, “an employer would be entitled to judgment as a matter of law if the
record conclusively revealed some other, nondiscriminatory reason for the
employer’s decision, or if the plaintiff created only a weak issue of fact as to whether
the employer’s reason was untrue and there was abundant and uncontroverted
independent evidence that no discrimination had occurred.” Reeves, 530 U.S. at 148.
“The issue at the pretext stage is not whether the employer made an erroneous
decision; it is whether the decision, even if incorrect, was the real reason for the
termination.” Jespersen, 390 S.W.3d at 655 (first citing Sandstad v. CB Richard
Ellis, Inc., 309 F.3d 893, 899 (5th Cir. 2002), and then citing Mayberry v. Vought
Aircraft Co., 55 F.3d 1086, 1091 (5th Cir. 1995)). The employer “is entitled to be
unreasonable so long as it does not act with discriminatory animus.” Sandstad, 309
F.3d at 899.
“If the employee intends to show the explanation is so unreasonable it must
be pretextual, it is the employee’s burden to proffer evidence creating a fact issue
regarding reasonableness.” Jespersen, 390 S.W.3d at 655 (citing Sandstad, 309 F.3d
at 899). “An employee’s subjective belief of discrimination or retaliation, no matter
how genuine, cannot serve as the basis for judicial relief.” McCoy v. Tex.
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Instruments, Inc., 183 S.W.3d 548, 555 (Tex. App.—Dallas 2006, no pet.);
Jespersen, 390 S.W.3d at 655–56 (“An employee’s subjective belief that he suffered
an adverse employment action as a result of discrimination, without more, is
insufficient to survive a summary judgment motion.”).
In the trial court, Ballew argued his performance was “not an issue,” and he
was a “good worker” with “high” performance. He argued Parkland’s performance-
based reasons for terminating his employment “were false and a pretext to cover up
discrimination and retaliation.” Ballew denied all the allegations against him, and
maintained any problems were due to lack of personnel or were caused by other
managers or other departments. For example, Ballew stated the NThrive cancellation
issue was caused by the legal department’s failure to timely cancel the contract.
Similarly, he insisted Baker’s allegations that Ballew did not form the Denial
Management Group and did not complete the Self-Pay Accounts Project were false.
Ballew maintained Baker was the problem, not him.
The evidence submitted by Ballew to support his arguments, however,
consisted only of his own, conclusory statements in two personal declarations and
similar deposition testimony. Ballew presented no documentary support for those
allegations. Moreover, Ballew does not dispute Parkland’s findings that the Self-Pay
Accounts Project was not completed, the Denials Management Group was not
formed, or the NThrive contract was not timely cancelled. Similarly, he does not
dispute that he left the 500-statement cap in place past the testing period or that he
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sent thousands of patient accounts to bad-debt collection without first sending
statements to those patients and seeking payment. Instead, he blames other Parkland
employees, including Baker, for those actions and their consequences, and insists he
acted in accordance with Baker’s directives.
Ballew’s evidence, at most, shows his subjective disagreement with
Parkland’s investigative findings and his subjective beliefs that he was a high
performing employee who acted appropriately and per the direction of management.
His beliefs, standing alone, are insufficient to show pretext. See Tex. Dep’t of Aging
& Disability Servs. v. Lagunas, 618 S.W.3d 845, 853 (Tex. App.—El Paso 2020, no
pet.) (a plaintiff must do more than make a “bare assertion” or merely express his
“subjective belief” that the defendant’s reasons for its employment decision were
both false and pretextual) (internal citation omitted). Other than stating Parkland’s
accusations are false, Ballew did not attempt to refute Parkland’s evidence that he
performed poorly and violated Parkland protocols. He provided no evidence to show
he performed the assignments in a timely and appropriate matter, to prove his actions
were all at the direction of Baker or other employees, or to disprove Baker’s findings
and the timing of those findings. He, therefore, failed to rebut Parkland’s reasons for
terminating him and failed to create a genuine issue of material fact on whether the
poor-performance reason given by Parkland was mere pretext for discrimination.
See, e.g., Ajao v. Bed Bath & Beyond, Inc., 265 Fed. Appx. 258, 263 (5th Cir. 2008)
(in failing to provide evidence of his own good job performance, plaintiff failed to
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create genuine issue of material fact on whether poor performance reason given by
employer was mere pretext for discrimination).
Moreover, an employee does not raise a fact issue on the question of pretext
merely because he disagrees with the employer’s assessment of his performance;
rather, the issue is whether the employer’s perception of his performance, accurate
or not, was the real reason for his termination. See Donaldson v. Tex. Dep’t of Aging
& Disability Servs., 495 S.W.3d 421, 438–39 (Tex. App.—Houston [1st Dist.] 2016,
pet. denied) (employee’s affidavit testimony denying employer’s allegation of poor
job performance and offering an explanation for the cited performance issues and
work rule violations did not raise a fact issue as to pretext); see also McCoy, 183
S.W.3d at 555–56 (noting that absent discriminatory motive, disagreement about job
performance is not actionable and that even incorrect belief that employee’s
performance is inadequate constitutes legitimate, non-discriminatory reason for
termination). Similarly, an employee’s denials of bad performance and his subjective
belief that his employer has given a false reason for its employment decision does
not raise a fact issue as to pretext. Waggoner v. City of Garland, 987 F.2d 1160,
1166 (5th Cir. 1993) (“[plaintiff] must, instead, produce evidence demonstrating that
[the City’s decisionmakers] did not in good faith believe the allegations, but relied
on them in a bad faith pretext to discriminate against him on the basis of his age.”
(emphasis in original)); Little v. Tex. Dep’t of Crim. Just., 177 S.W.3d 624, 632 (Tex.
App.—Houston [1st Dist.] 2014) (“[T]he United States Supreme Court has made it
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clear that it is not sufficient merely to show that the employer’s reasons are false or
not credible; the plaintiff must prove that the employer discriminated intentionally.”)
(citing Reeves, 530 U.S. at 146–47).
Parkland cited many job-related reasons for losing confidence in Ballew and
for terminating him. Those reasons were based on conduct that occurred before
Ballew took the 2019 FMLA Leave and before Baker was aware Ballew had a
disability due to his medical condition. Further, although Parkland did not suspend
or terminate Ballew until he returned from the 2019 FMLA Leave, temporal
proximity alone cannot rebut an employer’s legitimate, nondiscriminatory reason for
the employment action. Stingley v. Den–Mar Inc., 347 F. App’x 14, 20 (5th Cir.
2009) (per curiam); Roberson v. Alltel Info. Servs., 373 F.3d 647, 656 (5th Cir. 2004)
(affirming grant of summary judgment in favor of employer where plaintiff
attempted to rebut the employer’s legitimate, nondiscriminatory reason for a
termination with only timing allegations) Reed v. Cook Children’s Med. Ctr., Inc.,
No. 02-13-00405-CV, 2014 WL 2462778, at *8 (Tex. App.—Fort Worth May 29,
2014, no pet.) (mem. op.) (temporal proximity argument alone is insufficient to
create a genuine issue as to pretext where employer provided a nondiscriminatory
reason for employment action). Here, the evidence shows the timing was the result
of Baker discovering the performance issues while covering Ballew’s job when he
was on leave.
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Ballew presented no competent evidence to dispute Parkland’s evidence or its
legitimate, nondiscriminatory reasons for his termination. Rather, he relied solely on
his own, conclusory testimony to insist Baker knew the Self-Pay Accounts Project
was not completed, chose to keep the 500-statement cap in place despite the
consequences, and did not task Ballew with implementing a Denial Management
Group. That testimony is insufficient to raise a fact question as to pretext. See
Coastal Transp. Co., Inc. v. Crown Cent. Petroleum Corp., 136 S.W.3d 227, 231–
32 (Tex. 2004) (“Opinion testimony that is conclusory or speculative is not relevant
evidence, because it does not tend to make the existence of a material fact ‘more
probable or less probable.’”) (quoting TEX. R. EVID. 401); see also Cas.
Underwriters v. Rhone, 132 S.W.2d 97, 99 (Tex. 1939) (holding that a witness’s
statements were “but bare conclusions and therefore incompetent”).
Ballew states in his brief that he is using evidence of “pattern and practice, or
systemic discrimination, . . . as part of showing pretext. . . .” In support, he cites only
conclusory statements from his declarations. Those statements include his allegation
that he has personal knowledge of “Parkland’s pattern and practice of discriminating
against persons with disabilities,” his assertion that disability discrimination “is
widespread and well known at Parkland,” and his claim that he witnessed disability
discrimination against other Parkland employees. To the extent Ballew relies on this
purported evidence of pattern or practice to show pretext, we conclude it does not
raise a fact issue as to pretext. Ballew submitted no evidence to support his
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allegations. Rather, they are simply his unsubstantiated opinions. Such testimony is
insufficient to raise a fact question as to pretext. See TEX. R. EVID. 401; see also
Coastal Transp. Co., 136 S.W.3d at 231–32; Rhone, 132 S.W.2d at 99. Further, the
pattern-or-practice evidence cited by Ballew refers to alleged conduct related to
other Parkland employees and far in time from Ballew’s termination. Those
allegations do not raise a fact issue on the question of pretext.
Under this record, we conclude Ballew produced no competent evidence that
Parkland’s reasons for terminating him were false or a pretext for discrimination.
Accordingly, the trial court erred by denying Parkland’s plea to the jurisdiction as to
Ballew’s disability discrimination and retaliation claims. We sustain Parkland’s
issues as to those claims.
II. Hostile Work Environment Claim5
Ballew’s pleadings below reference his contention that Parkland’s actions
against Ballew created a hostile work environment. It is unclear whether the
McDonnell Douglas framework applies to a hostile work environment claim in a
case alleging disability discrimination. Compare Carpenter v. Haaland, No. 19-CV-
13208, 2021 WL 1198261, at *10 n.122 (E.D. La. Mar. 30, 2021) (concluding the
5
Ballew’s pleadings also reference his contention that Parkland engaged in a pattern or practice of
discrimination. On appeal, Ballew confirmed he is not asserting a separate claim or alternative theory of
pattern and practice discrimination. Rather, he contends evidence of pattern and practice is “part of showing
pretext or the totality of circumstances to show discrimination.” Ballew cannot rely on evidence of “pattern
or practice,” however, because that theory of recovery is available only to plaintiffs in a class action. E.g.,
Rogers v. Pearland ISD, 827 F.3d 403, 408 (5th Cir. 2016) (confirming pattern-or-practice method of
proving discrimination is unavailable in a private, non-class action).
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McDonnell Douglas burden-shifting analysis does not apply to hostile work
environment claims because an employer “may not offer a legitimate reason for
creating such an environment.”), EEOC v. Bass Pro Outdoor World, LLC, 35
F.Supp.3d 836 (S.D. Tex. July 30, 2014) (hostile work environment claims are not
proven using McDonnell Douglas scheme), and Razavi v. Franklin Apartment
Mgmt., Ltd., No. SA-21-CV-01093-JKP, 2022 WL 4545755, at *9–11 (W.D. Tex.
Sept. 28, 2022) (applying traditional summary judgment burdens to hostile work
environment claim), with Hayatdavoudi v. Univ. of La. Sys. Bd. of Trs., 240 F.3d
1073 (5th Cir. 2000) (applying McDonnell Douglas framework to each alleged
adverse employment action within plaintiff’s hostile work environment claim).
Under the McDonnell Douglas framework, Parkland’s plea to the jurisdiction
should have been granted as to a hostile work environment claim for the same
reasons Ballew’s discrimination and retaliation claims should be dismissed; Ballew
failed to raise a fact issue as to pretext. The result is the same if we apply general
summary judgment standards because Ballew failed to present evidence of a prima
facie case of a hostile work environment claim.
A hostile work environment claim entails ongoing harassment, based on the
plaintiff’s protected characteristic, so severe or pervasive it alters the conditions of
employment and creates an abusive working environment. Filardo v. Baylor Scott
& White Health, No. 05-21-01066-CV, 2023 WL 5317870, at *11 (Tex. App.—
Dallas Aug. 18, 2023, no pet.) (mem. op.) (first citing In re Parkland Health & Hosp.
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Sys. Litig., No. 05-17-00670-CV, 2018 WL 2473852, at *8 (Tex. App.—Dallas June
4, 2018, no pet.) (mem. op.), and then citing Anderson v. Houston Cmty. Coll. Sys.,
458 S.W.3d 633, 646 (Tex. App.—Houston [1st Dist.] 2015, no pet.)). The elements
of a prima facie case of hostile work environment are (1) the employee belongs to a
protected group; (2) the employee was subjected to unwelcome harassment; (3) the
harassment complained of was based on the protected characteristic; (4) the
harassment complained of affected a term, condition, or privilege of employment;
and (5) the employer knew or should have known of the harassment and failed to
take prompt remedial action. Parkland, 2018 WL 2473852, at *8; Anderson, 458
S.W.3d at 646. An employee complaining of harassment by a supervisor need only
show the first four elements. Parkland, 2018 WL 2473852, at *8; Anderson, 458
S.W.3d at 646. We consider the totality of the circumstances when reviewing a
hostile work environment claim, including: “the frequency of the discriminatory
conduct; its severity; whether the conduct was physically threatening or humiliating,
or a mere offensive utterance; and whether it unreasonably interfered with the
employee’s work performance.” Donaldson, 495 S.W.3d at 445.
In his pleadings below, Ballew included the following paragraph addressing
the hostile work environment claim:
Parkland discharged Mr. Ballew and discriminated in its treatment of
him in connection with the terms, conditions, or privileges of
employment because of a disability. Parkland’s treatment of Mr.
Ballew was severe and pervasive harassment that altered the terms and
conditions of his employment by making his employment multiple
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times harder than before he was diagnosed with his medical condition.
The harassment included preventing Mr. Ballew’s ability to make
decisions within his job responsibility, ostracizing him, displaying a
hostile attitude demeaning him in leadership meetings, creating
unnecessary obstacles for Mr. Ballew’s job, subverting his work by
diverting needed information to other departments, and creating
unnecessary problems with inconsistent direction and leadership, all in
an intentional effort to place undue pressure and anxiety upon Mr.
Ballew.
In response to Parkland’s plea to the jurisdiction, Ballew stated the following
regarding his hostile work environment claim:
Mr. Baker’s [sic] boss, who had the power to make hiring, firing, and
promotional decisions, made continuous false statements and
instructions, making impossible demands that were contrary to
Parkland’s instructions and then holding him accountable for the false
narrative rather than the true instructions. (Ex. 1, P1. Appx. 1-18). It is
hard to conceive of a more severe and pervasive environment short of
physical assault. (Ex. 1, Pl. Appx. 1-18).
As evidence to establish a prima facie case, Ballew cited to the entirety of his
eighteen-page declaration.
On appeal, Ballew asserts he belonged to a protected group because of his
disability and again references Baker’s allegedly “impossible demands” and
“outrageous accusations” as the alleged harassing conduct:
He was subjected to unwelcome harassment that included outrageous
accusations of costing Parkland “tens of millions of dollars in lost
revenue” and exposing a “lack of integrity, candor, and compassion.”
Appellant Brief p. 2, 8, 23. 4CR1069.6 In addition to the outrageous
accusations, Ballew suffered a false and unmerited reprimand, poor
6
These citations are to allegations made in Parkland’s brief at pages 2, 8, and 23, and statements by
Baker in his declaration in support of the plea to the jurisdiction.
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performance review, and write up, as well as an underserved
suspension.
Baker’s [sic] boss, who had the power to make hiring, firing, and
promotional decisions, made continuous false statements and
instructions, making impossible demands that were contrary to
Parkland’s instructions and then holding him accountable for the false
narrative rather than the true instructions. CRSUPPL717. It is hard to
conceive of a more severe and pervasive environment short of physical
assault. The harassment was all tied to the disability for which no
remedy was given to stop or prevent the harassment. Ballew has
established sufficient facts for a hostile work environment for damages
suffered before the termination of his employment.
Ballew cites no authority to support his contention these allegations establish a prima
facie case of hostile work environment claim. Parkland contends these arguments
and evidence fail to establish a prima facie case because they do not mention
harassment based on a disability and do not show an objectively or subjectively
hostile environment. We agree.
The third and fourth elements of a hostile work environment claim require
Ballew to show the harassment complained of was based on the protected
characteristic and affected a term, condition, or privilege of employment. Anderson,
458 S.W.3d at 646. Ballew’s pleadings of hostile work environment and his
allegations and cited evidence in response to Parkland’s plea and appeal do not
reference his disability. Nor does Ballew assert or imply that Baker’s alleged actions
were because of Ballew’s disability. Ballew, therefore, failed to present a prima facie
case of the third element of a hostile work environment claim.
7
This citation is to paragraph 148 of Ballew’s declaration.
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His proof also falls short on the fourth element. To satisfy the fourth element
of a hostile environment claim, a plaintiff must show the workplace was permeated
with discriminatory intimidation, ridicule, and insult sufficiently severe or pervasive
to create a hostile or abusive working environment. See Lauderdale v. Tex. Dep’t of
Crim. Just., 512 F.3d 157, 163 (5th Cir. 2007) (citations omitted); Waffle House, Inc.
v. Williams, 313 S.W.3d 796, 806 (Tex. 2010) (noting abusive environment is
created “[w]hen the workplace is permeated with ‘discriminatory intimidation,
ridicule, and insult.’”) (citation omitted). The work environment must be both
objectively and subjectively offensive—one that a reasonable person would find
hostile or abusive and one that the victim perceived to be so. City of Hous. v.
Fletcher, 166 S.W.3d 479, 489 (Tex. App.—Eastland 2005, pet. denied);
Donaldson, 495 S.W.3d at 445.
The conduct alleged by Ballew, even if true, does not rise to a level to support
a hostile work environment claim because it either occurred when Ballew was on
suspension and not present in the work environment (i.e, Baker’s allegations against
him during the investigation), or describes work assignments as “impossible
demands” without discussion or proof as to how those assignments were offensive.
Moreover, none of the alleged conduct involved comments or actions targeted at
Ballew’s disability, and the conduct alleged to have occurred before his suspension
was not physically threatening or humiliating.
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Under this record, we conclude Ballew failed to raise a genuine issue of
material fact on the third and fourth elements of a hostile work environment claim.
Accordingly, the trial court erred by denying Parkland’s plea to the jurisdiction as to
the hostile work environment claim.
CONCLUSION
Ballew presented no competent evidence to show or even suggest Parkland’s
legitimate, nondiscriminatory reasons for terminating his employment were
pretextual. Further, he presented no evidence supporting his hostile work
environment claim. Ballew, thus, failed to meet his burden of proof to waive
Parkland’s immunity from suit. Accordingly, we reverse the trial court’s order
denying Parkland’s plea to the jurisdiction and render judgment dismissing Ballew’s
claims against Parkland for lack of subject matter jurisdiction.
/Robbie Partida-Kipness/
ROBBIE PARTIDA-KIPNESS
221358F.P05 JUSTICE
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S
Court of Appeals
Fifth District of Texas at Dallas
JUDGMENT
DALLAS COUNTY HOSPITAL On Appeal from the County Court at
DISTRICT D/B/A PARKLAND Law No. 1, Dallas County, Texas
HEALTH AND HOSPITAL Trial Court Cause No. CC-20-04852-
SYSTEM, Appellant A.
Opinion delivered by Justice Partida-
No. 05-22-01358-CV V. Kipness. Justices Reichek and
Breedlove participating.
MICHAEL BALLEW, Appellee
In accordance with this Court’s opinion of this date, we REVERSE the trial
court’s order denying Appellant’s plea to the jurisdiction and RENDER judgment
dismissing Appellee Michael Ballew’s claims against Appellant for lack of subject
matter jurisdiction.
It is ORDERED that appellant DALLAS COUNTY HOSPITAL
DISTRICT D/B/A PARKLAND HEALTH AND HOSPITAL SYSTEM recover
its costs of this appeal from appellee MICHAEL BALLEW.
Judgment entered this 26th day of March 2024.
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