Psychiatric Hospital Chain’s Practices Called Into Question By Damning BuzzFeed Investigation

By Keri Blakinger 12/14/16

“People don’t understand. They think we’re going to diagnose them for anxiety or depression. Our goal is to admit them to the hospital.”

Doctor in the dark.

America’s largest psychiatric hospital chain may be unnecessarily committing patients to boost profits, according to a recent BuzzFeed investigation published last week. “Your job is to get patients,” said one former clinician. “And you get them however you get them.”

Universal Health Services—better known as UHS—runs more than 200 psych facilities nationwide, serving over 460,000 patients annually and netting nearly $7.5 billion in revenue in 2015. But as a reporter’s yearlong deep dive found, some former patients and staff have serious questions about the company’s practices. 

Currently the company is under federal investigation into whether UHS committed Medicare fraud; three UHS hospitals are under criminal investigation for allegedly abusing Florida’s involuntary commitment law to lock up patients who didn’t need forced inpatient treatment.

One former UHS administrator said the company tracked each center’s “conversion rate,” or the percentage of those who came for free psychiatric assessments and became psych ward patients. “They keep track of our numbers as if we were car salesmen,” said Karen Ellis, a former counselor at Salt Lake Behavioral Health in Utah.

Other ex-staffers concurred. “The goal when you’re on the phone with someone is to always get them into the facility within 24 hours,” said a former UHS employee in Texas. “People don’t understand. They think we’re going to diagnose them for anxiety or depression,” said another former Salt Lake Behavioral employee. “Our goal is to admit them to the hospital.”

One of the go-to justifications for hospitalization was “suicidal ideation,” ex-staffers told BuzzFeed. Starting from at least 2009, the code for suicidal ideation consistently increased, according to the news site’s analysis of UHS Medicare claims. By 2013, UHS hospitals were submitting claims citing suicidal ideation at 4.5 times the frequency of non-UHS psych hospitals.

And when UHS bought around 100 hospitals from one of its competitors, the use of the suicidal ideation billing code increased six-fold in the course of a year. 

Former administrators and staff lobbed claims of inadequate staffing, insufficient training and overfilled hospitals. “That was the worst clinical experience that I had — and I worked at a prison at one point,” said one former doctor at a Philadelphia UHS hospital.

A state-funded report from 2011 found one Chicago hospital’s staffing “woefully inadequate” and cited a pattern of admitting too many patients “to maximize financial profit.” But the healthcare provider vehemently defended its record against the claims by former patients and staff. 

“Our record speaks for itself,” UHS said in a nine-page rebuttal calling BuzzFeed’s findings “contrary to factual record and UHS policies and practices.” Point by point, the hospital denied the news site’s claims, citing federal oversight, accreditation requirements, and clinical standards. 

The company said it "rejects any accusation" that any of its affiliate hospitals improperly manipulated length of stay to increase financial performance, adding that its typical length of stay did not exceed the national average. 

Even so, UHS recently entered into an undisclosed settlement agreement with a former patient in Texas who sued the company for false imprisonment and negligence. “It was a shame and humiliation that I’ve never experienced in my life,” she said of her experience with UHS. 

In the aftermath of the in-depth investigation, UHS stock fell nearly 12% in one day, according to CNBC.

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Keri Blakinger is a former drug user and current reporter living in Texas. She covers breaking news for the Houston Chronicle and previously worked for the New York Daily News and the Ithaca Times. She has written about drugs and criminal justice for the Washington Post, Salon, Quartz and more. She loves dogs and is not impressed by rodeo food. Find Keri on LinkedIn and Twitter.

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