By CCHR International
The Mental Health Industry Watchdog
July 4, 2016

An Illinois man, Jerdie Martin, filed a law suit in June 2016 against Riveredge psychiatric hospital in Forest Park, owned by Universal Health Services—one of the company’s behavioral facilities that are already under U.S. Department of Justice investigation for potential billing fraud. Martin alleges that on May 28, 2014, he was attacked by another patient and was punched several times, causing physical injuries. He holds Riveredge Hospital and UHS responsible because the defendants allegedly failed to provide adequate supervision at all times to prevent their patient from engaging others.[1]

In a separate case, on July 2, Tony Cason, a patient at UHS’s Timberlawn psychiatric hospital in Dallas, Texas, was charged with manslaughter in the death of Dr. Ruth Anne MarDock. Cason tackled her, police said, and during the attack, MarDock struck her head on the floor, lost consciousness and died several days later from her injuries. In March, the Texas Department of State Health Services (DSHS) moved to close Timberlawn, revoke its license and impose a $1 million fine over safety breaches that included a suicide and violent fights among patients.[2]

Citizens Commission on Human Rights International (CCHR) has filed dozens of complaints with Illinois and Texas state legislators, law enforcement agencies and the U.S. Centers for Medicare and Medicaid (CMS) requesting greater monitoring of UHS’s for-profit private psychiatric facilities. It said that CMS and DSHS need to follow through with not only eliminating Medicare funding to Timberlawn and closing it but potentially other facilities too.

Riveredge is not the first UHS Illinois behavioral facility under federal investigation to be sued. On September 9, 2015 a lawsuit was filed on behalf of five plaintiffs against UHS’s now closed Rock River Academy, alleging sexual abuse and rape by staff. Rockford Police Department had fielded more than 700 reports “concerning victimization of girls under DCFS’s care including rape, aggravated battery and sodomy at the Rock River Academy,” during a four-year period.[3]

According to The Chicago Tribune, the Federal Justice Department began investigating UHS psychiatric facilities in Illinois in 2008 after the Tribune documented that juvenile state wards and other youths were sexually assaulted at Riveredge.[4] UHS’s other Illinois facilities under investigation include Hartgrove Hospital in Chicago and Streamwood Hospital in Streamwood.[5] Government inspectors investigating patient complaints have also cited 44 of UHS’s hospitals in 23 states for dangerously poor care or unsafe conditions between 2012 and mid-2015, according to a Dallas Morning News investigation this year.[6]

In June 2016, UHS lost a Supreme Court challenge where the court ruled a family could continue to pursue its lawsuit against UHS and its Massachusetts arm, Arbour Health System over the death of their 19 year old daughter, Yarushka Rivera.

The issue was whether UHS violated the law when it allegedly permitted and billed Medicare for an unsupervised nurse practitioner to prescribe drugs to Rivera. Virtually every therapist who came in contact with Rivera at the company’s clinic was unlicensed and unsupervised. The court said Arbour’s failure to disclose violations of basic staff and licensing requirements constituted misrepresentations.[7]

This seems to be in stark contrast to what UHS states in its “Compliance Manual” which says: “All claims and requests for reimbursement from the Federal healthcare programs including Medicare, Medicaid, and the Veterans Administration—and all documentation supporting such claims or requests—must be complete and accurate and comply with legal requirements. They must reflect reasonable and necessary services ordered by appropriately licensed medical professionals who are participating providers in the healthcare program.”[8] [Emphasis added]

Further, UHS states it is “committed to full compliance with all applicable laws and regulations. Adherence to compliance and ethical standards is part of the job performance evaluation criteria for all UHS personnel. Failure to comply with these requirements is viewed seriously, and will subject individuals to disciplinary action, up to and including termination.”[9]

However, based on information and patients or their families’ concerns, CCHR has called on legislative committees and health and law enforcement agencies to ensure greater monitoring for-profit private psychiatric hospitals.

CCHR documented the prescription costs under Medicare for psychiatrists affiliated with Riveredge, including one psychiatrist who once worked there having prescription costs of $772,000 in 2013[10] and nearly $450,000 in procedures and services billed to Medicare.[11] That same psychiatrist was the second highest prescriber of the antipsychotic clozapine ODT (orally disintegrating tablet) in 2013, according to Medicare prescription retail costs.[12] He was also the tenth highest state prescriber of clozapine. The antipsychotic can cause several dangerous conditions: a serious blood disorder, seizures and myocarditis (swelling of the heart muscle). Doctors and pharmacists must register with a program that monitors the drug’s use. A pharmacist cannot dispense the drug without the results of a blood test.

Two other Riveredge affiliated psychiatrists had Medicare prescription costs retailing in 2013 at a total of $953,000.

A psychiatrist affiliated with Timberlawn had Medicare drug expenses of $1.09 million in 2013.[13] Texas had the third highest prescriptions for clonazepam, the generic version of the sedative-hypnotic Klonopin. Another Timberlawn affiliated psychiatrist was the eleventh top prescriber of the drug in Texas in 2013.[14] Some people experience mood or behavior changes, agitation, irritability, hostility, and aggression.[15]

CCHR’s ongoing investigations into privately-owned psychiatric facilities—not limited to UHS—has led to calls for governments to ensure greater accountability from the for-profit psychiatric sector, including for its billing practices, the use of restraints, including chemical restraints, the prescription rates of antipsychotics and/or other psychotropic drugs known to cause violence and suicide, the number and amount of psychotropic drug-induced suicides within these facilities, excessive psychotropic drugging of children and adolescents, identifying those psychiatrists responsible for such practices, and the overall quality and standard of care provided.

References:

[1] Louie Torres, “Man says hospital didn’t protect him from psychiatric patient,” Cook County Chronicle, 29 June 2016, http://cookcountyrecord.com/stories/510940839-man-says-hospital-didn-t-protect-him-from-psychiatric-patient.

[2]Marc Ramirez, “Patient charged in death of doctor he tackled at Timberlawn mental hospital,” July 2016, http://www.dallasnews.com/news/local-news/20160702-patient-charged-in-death-of-doctor-he-tackled-at-timberlawn-mental-hospital.ece.

[3] Lorraine Bailey, “Severe Abuse Alleged at Illinois Home for Girls, “Courthouse News.com, 10 Sept. 2015, http://www.courthousenews.com/2015/09/10/severe-abuse-alleged-at-illinois-home-for-girls.htm.

[4] “West Side’s Hartgrove Hospital focus of widening Justice Department probe,” The Chicago Tribune, 1 Apr. 2015, http://www.chicagotribune.com/news/ct-uhs-probe-hartgrove–20150401-story.html.

[5] UHS Inc, SEC Filing, For 8K, 31 Mar. 2015, Item 7:01, Regulation FD Disclosure, http://www.sec.gov/Archives/edgar/data/352915/000119312515113094/d898400d8k.htm; “UHS posts strong quarter even as it faces federal probe,” Phily.com, 30 Apr. 2015, http://articles.philly.com/2015-04-30/business/61657494_1_steve-filton-uhs-strong-quarter.

[6] Miles Moffeit, “Danger in the psych ward: Safety issues plague a chain of mental-health hospitals in Texas and across the United States,” Dallas Morning News, 18 Mar. 2016, http://interactives.dallasnews.com/2016/danger-in-the-psych-ward/.

[7] Liz Kowalczyk, “US Supreme Court rules Mass. family can continue lawsuit,” The Boston Globe, 16 June 2016, https://www.bostonglobe.com/metro/2016/06/16/supreme-court-rules-mass-family-can-continue-lawsuit-against-mental-health-provider/kkNnS3K8kq7FR59T7EoyTP/story.html

[8] UHS’s Compliance Manual, page 22, http://www.uhsinc.com/media/244567/uhs_compliance-manual.pdf

[9] UHS’s Compliance Manual, page 4, http://www.uhsinc.com/media/244567/uhs_compliance-manual.pdf.

[10] http://projects.propublica.org/checkup/providers/1669510954

[11] http://doctors.healthgrove.com/l/239590/J-Antonio-V-Dizon-in-Chicago-Illinois

[12] http://projects.propublica.org/checkup/drugs/8033

[13] http://doctors.healthgrove.com/l/706678/Kochuparampil-Thomas-Varghese-in-Desoto-Texas

[14] http://projects.propublica.org/checkup/drugs/391/states/texas

[15] http://www.rxlist.com/klonopin-side-effects-drug-center.htm