By CCHR International
August 10, 2015

The psychiatric hospital chain, Universal Health Services (UHS), reported in its Security Exchange Commission (SEC) second quarter filings that it’s in more government trouble over its psychiatric-behavioral facilities.[i]  With already 21 of its facilities in nine states and its corporate office under multi-federal government-agency investigation, [ii] UHS added two Texas behavioral facilities in its 30 June 2015 SEC filing: Timberlawn mental health hospital in Dallas and Texoma Medical Center in Denison. UHS could lose more than $20 million in annual government funds.[iii]

Under “Regulatory Matters” in the filing, UHS said, “On July 23, 2015, Timberlawn Mental Health System (‘Timberlawn’) received notification from CMS [Center for Medicare and Medicaid] of its intent to terminate Timberlawn’s Medicare provider agreement effective August 7, 2015” because of the facility’s failure to comply with conditions for the federal program participation.  Timberlawn was cited for deficiencies, some which were considered by CMS to be an “immediate jeopardy” situation for patients.

UHS is appealing the termination which has been extended to August 13, 2015 pending further review and rulings by the U.S. District Court for the Northern District of Texas.

UHS points out, “We can provide no assurance that we will be successful in the administrative appeal or litigation or that Timberlawn will not ultimately lose its Medicare/Medicaid certification.  Any such termination of Timberlawn’s Medicare/Medicaid certification, should it ultimately occur, would have a material adverse effect on the facility’s future results of operations and financial condition and could result in closure of the facility.”   

During the second quarter of 2015, Texoma Medical Center which includes TMC Behavioral Health Center in Sherman, Texas was also faced with Medicare/Medicaid termination, stemming from failures to comply with conditions of participation primarily involving Texoma’s behavioral health operations.  UHS says it entered into a “Systems Improvement Agreement” (“SIA”) with CMS until October 2, 2016, thereby abating termination. The agreement requires them to engage “independent consultants/experts approved by CMS to analyze and develop implementation plans at Texoma to meet Medicare conditions of participation.”

• At least one psychiatrist at TMC Behavioral billed Medicare $662,000 for procedures and services in 2013 and his prescription costs (including refills) retailed at $491,000. [iv]

• A psychiatrist at Timberlawn’s Medicare Drug Expenses were $1,085,957 (522% above Texas average) in 2013 and his total number of prescriptions was 10,694 (608% the Texas average).[v]

• Texas had the third highest prescriptions in the U.S. for the benzodiazepine clonazepam (generic of Klonopin). The Timberlawn psychiatrist was the 11^th top state prescriber of the drug, along with two other psychiatrists affiliated with UHS facilities in Texas.[vi]

Timberlawn was cited for deficiencies, some which were considered by CMS (Center for Medicaid and Medicare Services) to be an “immediate jeopardy” situation for patients.

Timberlawn’s CMS-cited deficiencies included:

• Electrical cords and other unsafe objects remained in rooms within reach of suicidal patients. [vii]

• Nurses frequently unavailable to assist patients in distress and routinely did not check on suicidal patients.[viii]

Additionally, state officials also are determining whether any referrals need to be made to law enforcement or licensing boards. [ix]

Attorney Skip Simpson represents a family of former Timberlawn patient, Brittney Bennetts, who hanged herself from a closet doorknob at with a torn bedsheet. Five months before Bennetts’ suicide on Dec. 3 2014, Timberlawn officials had been warned by an internal survey that such doorknobs posed a potential “ligature risk,” meaning they could be used by patients to hang themselves. Simpson called the circumstances surrounding Bennetts’ suicide “absolutely appalling” and the hospital’s failure to change the doorknobs beforehand “completely reckless.”[x]

References:

[i] http://www.philly.com/philly/business/20150808_Business_news_in_brief.html

[ii] 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

[iii] https://www.cchrint.org/2015/07/28/timberlawn-mental-hospital-cut-off-from-federal-funding-over-safety-issues/; http://thescoopblog.dallasnews.com/2015/08/dallas-imperiled-timberlawn-psych-hospital-tells-judge-it-will-close-if-feds-pull-funding-friday.html/; http://www.healthcarefinancenews.com/news/timberlawn-mental-health-system-faces-closure-after-cms-finds-major-safety-problems

[iv] http://doctors.healthgrove.com/l/738440/Oluyemi-Aina-in-Durant-Oklahoma; http://projects.propublica.org/checkup/providers/1083700041

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

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

[vii] https://www.cchrint.org/2015/07/28/timberlawn-mental-hospital-cut-off-from-federal-funding-over-safety-issues/

[viii] https://www.cchrint.org/2015/07/28/timberlawn-mental-hospital-cut-off-from-federal-funding-over-safety-issues/

[ix] https://www.cchrint.org/2015/07/28/timberlawn-mental-hospital-cut-off-from-federal-funding-over-safety-issues/

[x] Jessica Huseman, “Timberlawn Psych Hospital’s Funding at Risk After Patient Hangs Herself,” Dallas Morning News, 5 June 2015, http://www.skipsimpson.com/timberlawn-psych-hospital-funding-at-risk-after-patient-hangs-herself