State regulators are investigating 14 allegations of abuse and neglect against a Fayetteville mental-health treatment center for children, including poor supervision that led to sexual contact — both “forced” and “consensual” — among the young residents.
Disability Rights Arkansas’ allegations against Piney Ridge Treatment Center, based on visits Sept. 19-20, also include excessive use of physical and chemical restraints, dirty conditions and housing of up to six children to a room without consideration of their mental illness and developmental disorders.
Piney Ridge is Arkansas’ only facility that exclusively treats children “who have sexually problematic behaviors in addition to a major mental illness,” according to the for-profit facility’s website.
A separate group, a Little Rock nonprofit that performs investigations for the state, confirmed many of Disability Rights’ findings.
[DOCUMENT: AFMC inspection report in response to Disability Rights Arkansas email » arkansasonline.com/1110report/]
In a letter to a Piney Ridge official, the Arkansas Foundation for Medical Care also found allegations of sexual contact among children and a facility “in extreme disrepair and very dirty.”
The investigators toured the Fayetteville center Oct. 14, interviewed 20 children and 10 staff members and reviewed the files of the children and the employees and other records.
Two kids reported having sexual contact with other children while at the treatment center, according to the organization’s report. Sixteen said they had heard of others having such contact.
[DOCUMENT: Piney Ridge Treatment Center's letter to Democrat-Gazette responding to Disability Rights Arkansas allegations » arkansasonline.com/1110piney/]
One staff member also reported that sexual behavior between patients takes place with “no consequences.”
The Arkansas Democrat-Gazette obtained the Arkansas Foundation for Medical Care’s Oct. 28 report and Disability Rights’ Oct. 2 allegations through Freedom of Information Act requests.
The 17-page Arkansas Foundation for Medical Care report is on letterhead that also contains the logo of the Department of Human Services’ Provider Services and Quality Assurance Division. The department licenses psychiatric facilities like Piney Ridge Treatment Center.
The center at 2805 E. Zion Road is licensed to serve 102 patients ages 7 to 17.
[DOCUMENT: Email from Disability Rights Arkansas to state regulators detailing results of inspection of Piney Ridge Treatment Center » arkansasonline.com/1110disability/]
Piney Ridge CEO Adrienne Catalina wrote in a letter to the newspaper that staff members supervise children constantly, including from outside bedroom doors at all times during sleep hours.
Catalina’s letter in response to Disability Rights’ allegations did not directly address the watchdog group’s claims of “frequent consensual” sexual contacts between patients nor the group’s claim of “forced” sexual contacts.
She wrote that any allegation of abuse among residents “is promptly reported to law enforcement, state agencies and guardians. Any allegation is thoroughly investigated and, when indicated, corrective action is taken,” she added.
Her letter said that physical restraints and chemical injections are used according to state and federal regulations. She denied several other Disability Rights allegations and didn’t respond to others.
Disability Rights’ Reagan Stanford told the newspaper that “general living conditions” at Piney Ridge and the “number of children who are housed together, coupled with lack of supervision” are the issues of greatest concern because they have led to sexual contact among children.
Disability Rights Arkansas is a nonprofit that is federally authorized to monitor treatment of people with disabilities.
Amy Webb, a spokeswoman for the Human Services Department, wrote in response to the newspaper’s questions that the agency is monitoring the Piney Ridge center.
The department sent staff members Oct. 7 after the state received the Disability Rights letter and again on Oct. 31. It also handed the complaint investigation to the Arkansas Foundation for Medical Care on Oct. 10.
“Piney Ridge does have work it needs to do to improve its facility, and we are actively monitoring their efforts,” she said.
The state has several options, which range from a corrective action plan to license revocation.
When the department conducts investigations of this kind, officials who identify problems can either ask for a plan of correction or ask the facility to fix the problem on the spot if it’s more serious, Webb said.
Depending on risk factors, the facility has between one and 30 days to provide the action plan. The state then monitors to ensure it’s followed.
If a serious licensing violation exists, the state can revoke a facility’s license or put it on probation, Webb said.
‘NO WAY THERAPEUTIC’
Disability Rights learned of purported abuses at Piney Ridge from people “with firsthand knowledge of the facility,” Stanford said.
After the Sept. 19 and 20 visits, the Disability Rights group summarized its findings in an email to the state’s Office of Long-Term Care, a branch of the Human Services Department.
“The facility is in disrepair and very dirty,” the watchdog group said in its Oct. 2 email to state regulators. “The general environment is loud and chaotic, and in no way therapeutic. … The state of the physical facilities is representative of the care and attention put into all aspects of the program.”
The nonprofit’s email also alleged the facility “indiscriminately” houses “a large population of youth who are lower functioning and youth with autism” with all other patients, “subjecting them to the same chaotic environment and ‘programming.’”
Stanford and others visited the treatment center again in October and found some cleanup and repairs, but few other changes, she told the newspaper.
Piney Ridge residents and staff members also told the Disability Rights group that the treatment center gets warning up to 48 hours before visits by state inspectors, Stanford said.
Webb said all visits connected to licensing and complaint response are unannounced; the only time state regulators give warning is when a facility requests a visit for technical support.
“Staff are absolutely not alerted,” Webb wrote in an email to the newspaper.
The Human Services Department dispatched Arkansas Foundation for Medical Care investigators after receiving Disability Rights Arkansas’ allegations.
The department’s Provider Services and Quality Assurance Division contracts with the nonprofit foundation to conduct certain inspections for psychiatric care facilities like Piney Ridge that have patients under age 21 and receive Medicaid dollars, according to Webb.
The state’s Placement and Licensing Unit also inspects each facility four times a year, she said.
The investigators’ report quotes interviews with unnamed child residents and staff members, as well as cites records.
Two children, who told investigators that touching and other sexual behavior had happened to them, were quoted as saying: “Roommate touched my private part.”
The Arkansas Democrat-Gazette would like to talk with current and former patients, their family members, and staff at Piney Ridge Treatment Center and other Acadia-owned facilities in Arkansas. The newspaper understands many of the issues are sensitive and may include personal information about minors. If you would like to talk with a reporter, contact:
“Staff didn’t see it because they were trying to keep someone out of a room.”
“Staff is there but they wait for them to look away,” was another comment.
Eleven children said they had received at least one physical or chemical restraint; several said they received more than one chemical injection.
“2 shots,” said one comment.
“Yes…multiple…black needle and the red needle.”
“Four shots the first time, second time just two shots.”
Seven children also told inspectors that “they did not feel safe” at Piney Ridge because of other children’s bullying and fighting or staff members’ yelling and “slamming” residents into walls and doors, according to the report.
Up to 32 kids stay on the same unit at a time, and in interviews with the inspectors, some Piney Ridge employees said they needed more workers at the facility. One added that employees “can’t handle these kids.”
All 20 children interviewed reported that they showered daily, although two said clean clothes weren’t always available.
Ten interviews with Piney Ridge staff members included three who were “highly satisfied” with no complaints. Others cited issues such as sexual behavior taking place, inadequate schooling, too little food for the children and poor building maintenance.
Arkansas Foundation for Medical Care inspectors also found most children in “very quiet” classrooms during their visit and “busy with classwork.” Certain paperwork such as psychosexual exams were in place for all children checked.
The report contained a copy of a 2006 waiver from the Human Services Department allowing Piney Ridge to house as many as six children per bedroom. The state normally allows no more than four.
Also in the Arkansas Foundation for Medical Care report were seven pages of photographs of the facility, some showing dirt or disrepair.
“Based on the findings from this focused investigation,” the report concludes, “AFMC recommends a follow up full Inspections of Care at Piney Ridge Treatment Center within the next month.”
‘PRONE TO OUTBURSTS’
Piney Ridge Treatment Center is “a specialized program that works with at-risk youth,” its chief executive wrote to the Democrat-Gazette. “They are very vulnerable children and often act out because of their psychological and health histories.”
All children there are “individually evaluated prior to admission” and given individual treatment as needed, Catalina, the CEO, wrote. They are grouped based on age, function and clinical needs.
The facility does allow children with different levels of function to interact, she wrote, to improve “the outcomes of natural teaching methods and positive peer interactions.”
Catalina didn’t respond to questions about cleanliness of the facility, but acknowledged that property damage does occur.
“The population of youth we care for here are prone to outbursts and property destruction and damage. … There is a consistent workforce in place to make repairs.”
Her letter also notes that the facility is “surveyed regularly by independent regulatory agencies and views such surveys as essential to its goal of continuously improving patient care.”
Catalina didn’t answer follow-up questions.
Piney Ridge, which opened in 1996 as a smaller facility, has been the subject of news articles in recent years about a fight among children and efforts by Springdale residents to prevent the Fayetteville treatment center from putting up a new building in their neighborhood.
Two Piney Ridge employees were placed on leave in 2016 after the allegations surfaced that they allowed the fight at the center, according to newspaper archives.
Springdale residents that same year fought the proposed new building. The zoning request was approved. It’s not clear where that project stands.
Piney Ridge parent company Acadia Healthcare Inc. is a publicly held, multinational behavioral health care operator with 595 facilities in 40 states, the United Kingdom and Puerto Rico, according to the company’s website. Its headquarters are in Franklin, Tenn.
Acadia operates six facilities in Arkansas.
In Fayetteville, in addition to Piney Ridge, is Vantage Point of Northwest Arkansas. Others are Millcreek Behavioral Health, Fordyce; Conway Behavioral Health Hospital, Conway; Riverview Behavioral Health, Texarkana; and Valley Behavioral Health System, Barling.
Founded in 2005, Acadia Healthcare has facilities that have been the target of lawsuits and allegations of patient abuse in recent months, according to public records and news reports.
The publicly held company also has experienced top-executive turnover and sliding stock prices. Shares traded at more than $80 in 2015. Its stock price closed Friday at $30.74.
A 2018 class-action shareholder lawsuit in federal court alleged that top Acadia officials took part in an insider-trading scheme to inflate the performance and outlook for the company, artificially raising the value of stock shares.
According to the U.S. Department of Justice, Acadia will pay $17 million in the largest health care fraud settlement in the history of West Virginia. The settlement in May was from a lawsuit accusing Acadia of defrauding Medicaid of $8.5 million through a lab-testing scheme in seven drug-addiction treatment centers, according to the Nashville Post, an online news service in Tennessee.
New Mexico officials shut down an Acadia youth treatment center in Albuquerque earlier this year after abuse allegations, several lawsuits and loss of state certification.
Desert Hills of New Mexico was accused of failing to protect clients from physical and sexual abuse by workers and other patients. The lawsuits also cited internal “fight clubs” instigated by staff members, sex between staff members and young patients, unchecked spread of HIV among patients and excessive use of restraints on children, the Nashville Post reported.