U.S. Senate Finance Committee Chairman Ron Wyden, D-Ore., calls for “bold action” after his committee released a report detailing systemic problems at residential treatment facilities. (Yuri Gripas/Abaca Press/TNS)
In a scathing new report, U.S. Senate investigators say residential treatment facilities that serve children with developmental disabilities and other behavioral needs are a hotbed of abuse and neglect.
A two-year investigation by the Senate Finance Committee found that children regularly suffer physical, sexual and verbal abuse in such facilities. According to researchers, inappropriate use of restraint and seclusion is widespread, unsafe and unhealthy conditions exist, staff are unqualified and inadequate, and the behavioral health care that is supposed to be provided is often lacking.
The findings detailed in the 136-page report report published this month focuses on four of the nation’s largest residential treatment facility providers: Universal Health Services, Acadia Healthcare, Devereux Advanced Behavioral Health and Vivant Behavioral Healthcare. The companies’ offerings include specialized programs aimed at children with intellectual and developmental disabilities and those with other mental and behavioral health needs.
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Investigators reviewed more than 25,000 pages of company documents, media reports, conversations with dozens of experts and conducted site visits. Their report describes a business model that is based on maximizing profits at the expense of children in need of care.
“It is clear that the operating model of these facilities is to store as many children as possible while keeping costs low to maximize profits. Too often, abuse and neglect are the norm in these facilities, and they are prepared to allow this to happen,” said Sen. Ron Wyden, D-Ore., who chairs the Senate Finance Committee.
Researchers found that residential treatment facilities often do not administer the behavioral treatment outlined in the plans, and instead, children spend most of their time with unqualified general staff. Additionally, they said the facilities limit communication between children and their families, hold children for long periods of time, do not involve guardians in developing treatment plans, and do not provide quality discharge plans.
The report cites examples of one facility where 110 restraints and seclusions occurred in just 30 days and another where an employee who routinely sexually assaulted a child was found to have been moved to a different wing rather than fired. The staff then approached the boy’s window every night and planned to continue the abuse after the boy left the facility, investigators said.
In other cases, children have died due to staff actions or suicide, according to the report.
Meanwhile, much of the care provided in residential treatment centers is paid for with federal dollars, primarily from Medicaid or the child welfare system, Wyden noted. In some cases, she said, Medicaid pays more than $1,200 per child each day.
The report urges state and local governments, federal agencies, accrediting bodies, and residential treatment facilities to take steps to improve standards and oversight and prioritize community-based services. Wyden said he plans to introduce federal legislation to promote the recommendations.
Marc Miller, president and CEO of Universal Health Systems, was invited to testify before the Senate Finance Committee, but declined. In a statement, the company rejected the results of the investigation.
“The report attempts to extrapolate certain incidents and survey reports into a false narrative about the treatment provided, the environment of care, and regulatory compliance at our facilities. “We vehemently discussed this characterization of our facilities,” the company stated. “While even a single incident of damage is one too many, we have provided information demonstrating that rates of such occurrences are extremely rare across the UHS spectrum and refutes this inaccurate description.”
Acadia Healthcare officials responded to the report by saying they are “committed to doing everything in our power to ensure that all patients in Acadia’s care receive the support and compassionate treatment they deserve” and noted that the incidents mentioned in the report occurred almost five years ago or more.
Devereux Advanced Behavioral Health said “personal well-being, safety and individualized treatment success” are its top priorities and that, as a nonprofit, the organization invests revenue and donations in care.
Representatives for Vivant Behavioral Healthcare could not be reached.
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