Saturday, June 11, 2011

Michael G. Lindley, Al J. Smith, Brad Gardner, Rodney Cawood and Mike McCulla of Church Street Health Management/Small Smiles Dental Centers have let children die on their watch before it appears

A Pattern of abusing children for profit going back to the 1980's. 
Chad Youth Center deaths in 2007
Former Chad Employee Speaks Out
Quote from Tennessee Hall of Shame
Death ruled a homicide at youth center
Chad administrator McDuffie assured DHS that Chad was a "nurturing and positive environment." He said the facility had hired more staff and made children's safety a priority. The former owners of Chad also said it was a safe and therapeutic place for children when they handed over the keys to Universal Health in October 2005. "Our goal was to effect treatment in as nonphysical a way as possible," former chief executive officer Michael G. Lindley said. Al Smith, another former top executive with Chad's former owner, said: "Did untoward events happen? Absolutely. But was it a culture? I don't believe so."
DHS staffer Haiying Xi reported, a youngster had been cut on the chin in a restraint, requiring stitches. Chad had not reported this to regulators, DHS learned. Finally, DHS official Stephen Rosenberg wrote to Chad. "The investigation could not determine any pattern for the use of illegal physical restraints," Rosenberg wrote.  But children died.
Neil Campbell and Michael Lindley
Above Neil Campbell and Michael Lindley (right) pictured at NAPHS in 2003

I doubt any of the hoodlums are worried about your child dying when they set quota's of 400 children a month for sedation dental treatment at the Small Smiles Dental Centers, what do you think?
Church Street Health Management Patient Advocate

Guess where the Patient Advocate for Church Street Health Management hails from?  You guessed it, Universal Health/Keystone Youth/Chad Youth.  Ms Angela Newberry came from yet another house of death and horrors operated by Church Street Health Management’s Michael G. Lindley, Alfred (Al) J. Smiles, Brad Gardner and Rodney Cawood, Brad Williams and Mike McCulla.

Universal Health Services Securities and Exchange 8-K

More on the Chad Youth Centers, be sure to check the links. 

Files Reveal Other Injuries At Chad Youth Center

Some Had To Be Taken To Hospital

Reported By Nancy Amons
POSTED: 5:02 pm CDT June 29, 2007
UPDATED: 11:26 pm CDT June 29, 2007

NASHVILLE, Tenn. -- Incident reports filed with the state show that twice in 2006, patients were hurt while being restrained at Chad Youth Center.
Some were hurt so badly they had to be taken to a hospital.
In May 2006, Chad reported a resident was injured during a physical hold and suffered a broken left shoulder.
Then in June, another resident was injured in a physical hold and needed four stitches.
State officials were requiring Chad to inform them every time a child got hurt.
The requirement was because in September 2005, a Long Island girl collapsed and died after she'd been restrained.
A 17-year-old from South Philadelphia died earlier this month. The investigation into his death isn't finished yet.
Stacy Wood used to live at Chad. She told the I-Team that restraints are common even for minor infractions of the rules.
“You just look at them, and they put you in restraints,” she said.
Chad isn't taking any new clients until state agencies and the police wrap up the second of two death investigations in two years.
Chad is owned by a private company.
They have not returned phone calls for an interview.
*If you have any information on the Chad Youth Development Center or wish to contact reporter Nancy Amons please call her at 353-2284 or send Nancy an e-mail.
Previous Stories:
Deaths at Chad – Linda Harris of New York –age 14 died September 14 2005 Omega Leach of Pennsylvania – age 17 died June 3, 2007

Al Smith
Administrator at Psychiatric Institutes of Washington (PIW)
4460 Mac Arthur Blvd
Washington DC  20007

Psychiatric Institutes of America (PIA)
Part of NMW Specialty Hospital Group
Part of National Medical Enterprises (NME)
Other names:
Psychiatric Institute of Bedford (fill in city name)
dba ‘s such as Bedford Medadows Hosptial
N.M.E. Psychiatric Properties
N.M.E. Specialty Hospitals, Inc.
  National Medical Enterprises, Inc
Elena SAVAGE, Appellant, v. PSYCHIATRIC INSTITUTE OF BEDFORD, INC., d/b/a Bedford Meadows Hospital;  N.M.E. Psychiatric Properties, Inc.;  Psychiatric Institutes Of America, Inc.;  N.M.E. Specialty Hospitals, Inc.;  National Medical Enterprises, Inc.;  and Elizabeth John, M.D. Appellees
959 F.2d 1062
295 U.S.App.D.C. 58, 1992-1 Trade Cases P 69,765

Taiwo OKUSAMI, M.D., Appellant, v. PSYCHIATRIC INSTITUTE OF WASHINGTON, INC., et al., Appellees.
No. 91-7078.

Chain of Mental Hospitals Faces Inquiry in 4 States
Ex-psychiatric hospital exec admits bribing physicians
A former Dallas hospital executive confessed Monday that he bought patients with at least $20 million in bribes to referring physicians and other health care professionals.

The federal government reimbursed the executive's company, which billed Medicare for between $20 million and $40 million in bribes that were disguised as salaries, the executive admitted.

Peter Alexis, former "administrator of the year" for Psychiatric Institutes of America, pleaded guilty to conspiracy and false-statement charges before U.S. District Judge Joe Kendall in Dallas. He said he helped bribe more than 50 physicians across the nation.

Mr. Alexis agreed to become a prosecution witness in a nationwide investigation, and prosecutors agreed not to seek additional charges against him.

Judge Kendall asked Mr. Alexis several times whether he was aware of the rights he waived with his guilty plea.

After Mr. Alexis repeatedly stated that he is voluntarily exposing himself to as many as 10 years' imprisonment, Judge Kendall replied: "I'm just wondering how many doctors out there in the Dallas-Fort Worth area aren't sleeping too well these days."

At Judge Kendall's request, Mr. Alexis explained his role in what he said was a companywide conspiracy. "I paid physicians to refer patients to our hospitals," Mr. Alexis said.

"So, it was just a mass kickback scheme? You were buying patients?" the judge asked.

"Yes, your honor," Mr. Alexis replied.

Mr. Alexis served for several years as administrator at Psychiatric Institute of Fort Worth. He became PIA's vice president for the Texas region in 1989 but resigned in 1990 after some patients complained that they had been hospitalized unnecessarily so that PIA officials could collect huge sums from insurance companies and Medicare programs.

He declined to comment after the hearing Monday.

"Mr. Alexis is the highest-ranking PIA executive to plead guilty, so far," U.S. Attorney Paul Coggins said. The continuing FBI investigation is nationwide in scope, Mr. Coggins said.

"There will be many other states affected by this investigation, " Mr. Coggins said. "We think this case may take months or even years to resolve."

Doctors weren't the only ones bribed, Assistant U.S. Attorney Christopher A. Curtis said. He said that illegal payments also went to therapists and social workers.
Psychiatric Institutes of America was absorbed last year by its corporate parent, National Medical Enterprises Inc.

Diana Takvam, a spokeswoman at NME's headquarters in Santa Monica, Calif., declined to comment on Mr. Alexis' courtroom statements.

Ms. Takvam, however, said NME is attempting to negotiate a settlement with officials at the Department of Justice and has "established a reserve of $375 million."

NME has not yet agreed to pay that money to the government, Ms. Takvam said.

Another NME official previously reported that the firm is selling or shutting down all of its psychiatric hospitals in Texas.

According to a written statement, NME officials hope that the proposed agreement with the Department of Justice "will close all open investigations of NME."

Judge Kendall told Mr. Alexis that he could not predict how many of the possible 10 years federal officials will recommend under sentencing guidelines. But he advised Mr. Alexis that federal law no longer permits parole, and he said the defendant should not expect a minimum sentence.

"Without even looking, I would guess that your guidelines . . . will be off the charts," the judge said. Judge Kendall did not immediately schedule a sentencing hearing for Mr. Alexis. He said he will wait to review the depth of Mr. Alexis' cooperation with prosecutors.

"The prudent thing to do would be to sentence you sometime off in the future," the judge said.
Maximize Profits, Lock Up Teens
By Judith Moore
Christy Scheck, on March 6, 1992, a Friday evening, walked into a bathroom in Southwood Psychiatric Center's Residential Treatment Center in Chula Vista (now called Bayview and under new management). Thirteen-year-old Scheck had been a patient at Southwood, a for-profit psychiatric facility, since early November 1991. Christy slipped off the sash from her bathrobe and hanged herself. She died, without regaining consciousness, two days later in Children's Hospital's intensive care unit.
Christy's parents, Robert and Merry Scheck, in March 1994 brought suit against Southwood Psychiatric Institute and its corporate owner, National Medical Enterprises. Also named were a series of defendants, including Christy's psychiatrist at Southwood and a number of workers employed at Southwood. The Schecks' suit alleged that the defendants engaged in insurance fraud, "crafted diagnoses to meet patients' insurance coverage," failed to properly train staff, used unlicensed staff in positions for which regulations required licensed workers, decreased patient-staff ratios to unsafe levels, and awarded bounties to employees as incentives to acquire and keep patients longer than their condition warranted. There were more charges - fraud, breach of contract, medical malpractice, and finally, wrongful death. In July 1994, days before going to trial in San Diego County Superior Court, Scheck vs. Southwood was settled in mediation in favor of the Schecks.
David R. Olmos, writing in the Los Angeles Times, described Southwood's out-of-court settlement with the Schecks as "an extraordinary admission of corporate responsibility." Olmos added, "It is the first admission of responsibility in any of the nearly 150 lawsuits alleging physical mistreatment and abuse of patients that NME [National Medical Enterprises] has faced since the late 1980s. The Santa MonicaPbased hospital firm has settled about 75 percent of those cases but had never admitted responsibility." Olmos also noted that in June 1994, just previous to their settlement with the Schecks, "NME settled a federal fraud investigation of its psychiatric and substance abuse hospitals by paying $379 million in fines and restitution."
Now, Leon Bing, the Pasadena-based author of two previous books that focus on teenagers, Do or Die and Smoke, has written about what happened to Christy Scheck and why. Billed as "a tragic story of what happens when a medical care system cares more about profit than medicine," A Wrongful Death: One Child's Fatal Encounter with Public Health and Private Greed (Villard Books) mixes the Schecks' story with investigation of for-profit psychiatric institutions whose patients are primarily adolescent. If you are a parent, grandparent, aunt or uncle, if you are a teenager, A Wrongful Death is a book you should read and study.
The gist of Ms. Bing's book is this: when the Schecks, at the recommendation of their family therapist, entered Christy in Southwood, "They had no idea that the hospital's CEO had instituted an unlawful system to extract extraordinary levels of profits. Insurance policies were processed to maximize reimbursements; the staff held 'chart parties' to ensure that patients' records would reflect a need for continued treatment; psychiatrists' hours were drastically reduced; and families were shut out of decision-making processes. Tragically, this non-care led Christy to an overdose of medication that resulted in hallucinations. She wrongly accused her father of sexual abuse, and ultimately Christy committed suicide."
Further, writes Ms. Bing, the Schecks, when they brought Christy to Southwood, had no idea that the hospital "was one of a chain of 76 hospitals spread over 24 states. The chain was known as Psychiatric Institutes of America (PIA), and its corporate parent was National Medical Enterprises (NME), a $4 billion company. [The Schecks were] unaware that another pia facility, Colonial Hills Hospital in San Antonio, Texas, was at the eye of a controversy that had culminated, two months earlier, with the Texas attorney general filing suit against PIA, alleging fraudulent conduct."
On the afternoon that Ms. Bing and I talked, I said that 20 years ago placing a troubled teenager in a psychiatric hospital or residential treatment center was something about which one never heard.
She agreed. "Twenty and 30 years ago, if kids acted out and it was really extreme behavior, a boy might be sent to forestry camp or military school and a girl to boarding school. It had to be a pretty extreme case for a teenager to be sent even to therapy, let alone to a private psychiatric hospital. If the family couldn't afford any of this, then they just dealt with the kid as best they could.
"But now because most health insurance covers this hospitalization, kids are more likely to be sent away to a treatment center. I can't think of any other reason than this availability of insurance money. The world is certainly more violent, kids are facing more problems - gangs, sexual experimentation can kill them. There are a million more reasons why this is not as gentle a time as it was two and three decades ago.
"However, if we were interviewing a journalist in 1945, we would probably hear similar statements. 'The times are so violent.' In the 1920s, you might have been told, 'Kids don't have manners anymore, and they're running around in roadsters.' I think each generation has had similar complaints about young people. So that all I can figure is that the reason so many kids are sent into residential hospitals is because the insurance pays the freight."
Because Robert Scheck was a retired career Navy man, CHAMPUS was the Schecks' health insurer. "CHAMPUS," Bing writes, "stands for Civilian Health and Medical Program of the Uniformed Services, a federal health insurance program that covers both active and retired military personnel and their families. CHAMPUS mental-health benefits include 30 days annually of inpatient care for adults, 45 days for children, and 150 days for adolescents in residential treatment centers. Additional days are authorized when deemed necessary.... Bob Scheck was not on active duty, so his champus benefits would cover 80 percent of Christy's hospital fees. If Scheck had been on active duty, CHAMPUS would have paid the full amount."
As Ms. Bing interviewed persons knowledgeable about medical insurance providers and their relationship to psychiatric hospitals, she learned that teenagers whose parents are covered by CHAMPUS are considered particularly desirable by hospital marketers assigned to "gets heads in the beds." She quotes from an interview with a past employee of Southwood.
"Every morning we'd start the day off with an intake meeting in which we'd review marketing contacts, incoming calls, evaluations, and admissions from the previous day. And we'd look at the discharge calendar, to see who was getting out, and we'd look to see what patients would be left and what their coverage was. The reimbursement rate was different for each company (the payor), and the payor mix was determined by which patients were covered by what policy. CHAMPUS, which paid approximately $1000-per-day for every CHAMPUS patient, was at the top of the list. MediCal, at about $350 per day, was at the bottom. All other coverage - Medicare, Aetna, and so on - was in between."
Ms. Bing's informant explained that on at least one occasion while he was at Southwood, a MediCal patient was dismissed before she was ready in order to make room for a patient whose parents could afford the $1000-per day fee. "That," he told Ms. Bing, "is human damage perpetrated for a $600-a-day difference in bed rate. That's a real story, and that's only one of them. Over a payor mix." I noted that Ms. Bing's book makes clear that many of these teen psychiatric care facilities send the patient home when his or her insurance runs out. Ms. Bing said that she had heard of only a few cases "where a kid is kept on a pro bono basis."
Ms. Bing first became interested in for-profit psychiatric hospitals in 1985 when she worked in the adult and adolescent unit in a for-profit hospital in the San Fernando Valley. Her title there was "Mental Health Technician." The title, she said, makes the work sound more glamorous than it is. "In actual fact what you do is make sure patients get their meals, get to school, get to group sessions, 12-step meetings. You also are available to search rooms, and you're kind of like a guard."
After Ms. Bing finished Smoke, she decided to write about the for-profit psychiatric hospitals. For 18 months, she interviewed teenagers who had been placed in psychiatric facilities.
I asked if she found that many teenagers she interviewed really did not belong in psychiatric institutions.
"I pretty much knew that when I worked at the facility in 1985. Some did and some didn't. And the ones who didn't said, 'I don't belong here.' My only advice to them could be and was, 'It doesn't matter. This is their ride and you're on it.' So what I told kids at that hospital was, 'Listen, whether or not you belong here is beside the point; what you have to learn to do is tell them what they want to hear. That's the only way out of here. You have to learn, in other words, to kiss a little butt.' I did not say, 'When your insurance runs out, you'll be out.' "
Ms. Bing came to the Christy Scheck story through David Olmos's Los Angeles Times story about the Scheck vs. Southwood settlement. Bing subsequently spent many months interviewing the Schecks, their friends and neighbors, Christy's teachers and therapist, the Schecks' lawyers and various ex-employees of the now-defunct Southwood. National Medical Enterprises executives consistently refused to speak with Ms. Bing. I asked Ms. Bing what she suggests parents do when considering placing their child in a psychiatric facility.
"I would certainly make sure that I investigated the facility thoroughly and sat down for a face-to-face with anyone who would be coming in contact with my child. I would find out who owns that facility, who is the parent company, what is their history, have there been any federal fines or awards for malpractice. All of that is in the public domain. All this, of course, is a lot of work. At a crisis point, it's often difficult to stop and do this work. But, it's your kid."
The Schecks, she added, "were too frightened by Christy's behavior and too concerned. And, remember, their therapist had recommended Southwood."
I asked if a therapist's recommendation would be sufficient for Ms. Bing.
"Would that be enough for me? Not now it wouldn't. And frankly, it wouldn't have been enough for me in 1985 when I was working in such a facility. But then I was there, I was seeing what was going on. If I had not worked in that facility, I don't know. It would probably have been enough for me. Parents get scared. They feel they're at a crisis point, and they could well be. When you're in a crisis point, if blood is pouring out of a gash, and someone says, 'Let's tie up that wound and you won't bleed to death,' you're perhaps not going to investigate. You're likely to turn that kid over to almost anyone with credentials. I don't say this in a pejorative sense. Someone says, 'I can help you.' Parents hope that's what will happen. If they're lucky, they get the right kind of help. If they're not, as in the case of Christy Scheck, they don't. I hope this book will make parents think two and three times and do that arduous legwork."