Acadia Healthcare, one of the country’s largest for-profit chains of psychiatric hospitals, has agreed to pay nearly $20 million to settle a federal investigation accusing the company of defrauding taxpayer-funded health insurance programs like Medicare and Medicaid, the Justice Department said on Thursday.
Prosecutors said that Acadia had held patients for longer than necessary and admitted people who didn’t need to be there. Once patients entered its facilities, the government said, Acadia failed to provide therapy and kept staffing dangerously low, leading to assaults and suicides.
Under the settlement, Acadia has agreed to pay the federal government as well as four states — Florida, Georgia, Michigan and Nevada — to resolve allegations that the company had violated state laws.
Tim Blair, an Acadia spokesman, said that the company had been cooperating with the government and did not admit any wrongdoing. He said that resolving the investigation “allows us to ensure our focus remains on providing quality care to our patients and their families.”
Acadia operates more than 50 psychiatric hospitals nationwide, and more than half of its revenue comes from government insurance programs.
The Justice Department focused on Acadia’s operations between 2014 and 2017. But a New York Times investigation published this month found that many of the practices outlined by the government have continued. The Times investigation, which was based on official complaints, court records and interviews with dozens of current and former Acadia employees, found that in more than half of Acadia’s hospitals, patients were held for financial reasons, rather than medical ones.
Mr. Blair said that the examples cited by The Times overlooked many patients’ positive experiences and that the company’s decisions were driven by the needs of patients.
The government is also investigating Acadia’s more recent practices, according to several former employees in Georgia and Missouri who have been recently interviewed by agents from the F.B.I. and the inspector general’s office of the Health and Human Services Department.
In Georgia, the employees had worked in hospital emergency rooms and assessed whether patients needed to be sent to psychiatric facilities. They said an F.B.I. agent had asked them about pressure to refer patients to Acadia’s hospitals. In Missouri, former Acadia nurses were asked about how the company pressured them to describe patients as uncooperative or combative in order to justify longer stays.
In a statement, Robert DeConti, the chief counsel to the inspector general, noted that the settlement did not prevent investigators “from looking into allegations of more recent conduct.” The F.B.I. and Acadia did not comment on the new investigation.
The settlement with the Justice Department is based on the whistle-blower accounts of three former Acadia employees who worked at two of the company’s hospitals.
In both hospitals, Lakeview Behavioral Health Hospital in Norcross, Ga., and Park Royal Hospital in Fort Myers, Fla., the whistle-blowers described similar patterns: Acadia executives were relentlessly focused on the bottom line.
One whistle-blower, Jamie Clark Thompson, worked as director of nursing at Lakeview. In an interview on Thursday with her lawyers, Renée Brooker and Eva Gunasekera, she said she was shocked at the extent to which executives had skimped on staffing while billing insurance for services like lab tests that the company never provided.
In her lawsuit, Ms. Thompson described dire situations, including a unit that had 19 patients and only one nurse. In other cases, patients never saw a doctor. She also said a hospital executive shredded medical records when state investigators showed up to look into patient complaints.
When Ms. Thompson complained, she was told to “calm down,” according to the lawsuit. “I would come home every night just wanting to bang my head,” she said in the interview.
Another whistle-blower, Brian Snyder, who was an executive at Park Royal, said in an interview that the hospital systematically worked to hold patients with insurance as long as possible.
Mr. Snyder said the problems were widespread at Acadia. “It’s not by accident or a few bad apples,” he said, “it’s by design.”
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