WASHINGTON – Sen. Chuck Grassley sent a letter to Health & Human Services (HHS) Inspector General Daniel R. Levinson seeking answers to continued reports of wrongdoing at Universal Health Services (UHS) facilities, the country’s largest psychiatric hospital chain. This is the latest in a series of letters from Grassley to HHS, HHSIG and the Centers for Medicare and Medicaid Services (CMS) regarding disturbing news reports of patient abuse, as well as hospital accrediting organizations’ ability to access patient mistreatment complaint databases.
Grassley’s oversight work has found that accrediting organizations (AOs) do not have access to the “Immediate Jeopardy and High Priority” cases in CMS’ Automated Survey Processing Environment (ASPEN) database and ASPEN Complaints/Incidents Tracking System (ACTS). These systems may help AOs determine whether hospitals and facilities meet accreditation standards.
Grassley has sent several letters to CMS asking for additional information about the problem and potential solutions. In response to Grassley’s October inquiry, CMS Administrator Seema Verma sent a letter noting that “AOs currently do not have access to ASPEN or ACTS, nor do we support providing access to these systems” and that CMS does “not believe access to ASPEN or ACTS would provide substantive benefit to the AOs or assist them to be more effective in their investigative or enforcement actions.” The response also noted that CMS is “in the early stages of designing a replacement system for ASPEN and ACTS and will consider the data needs of AOs as we progress through the design phase.” That response can be found here.
“The response given by CMS regarding these serious issues indicates that they need to take a deeper dive into whether information sharing between ASPEN or ACTS will assist accrediting organizations in their investigatory duties. The continuing reports of patient abuse show an alarming pattern of misconduct,” Grassley said. “Access to information is critical to solving problems. This is especially true in cases related to health care and patient safety.”
Last year, news reports surfaced detailing disturbing behavior from several medical facilities within the UHS system. These reports described patients being physically abused, over-prescribed medications, placed in unwarranted physical restraints and completely neglected. Despite these conditions, at least one facility was designated by The Joint Commission as a “Top Performer in Key Quality Measures” from 2011-2015.
The news reports raised questions about how facilities like these receive accreditation, maintain high rankings and continue to operate without repercussions or reforms. Earlier this year, Grassley sent letters to the HHS Office of Inspector General and The Joint Commission on these cases seeking answers. He also sent a letter on this issue last December to the HHS Office of Inspector General.
“Oversight, accountability, and communication are critical to ensure quality patient care and maintain high standards of conduct and service from medical providers,” Grassley continued. “The Department of Health and Human Services and its Inspector General must address these concerns and take immediate steps to fix the problems of patient abuse highlighted by the news reports.”
The letter can be found here or below.
December 13, 2017
The Honorable Daniel R. Levinson
Inspector General
U.S. Department of Health and Human Services
330 Independence Avenue SW
Washington, DC 20201
Dear Inspector General Levinson:
            I have previously written to you in regards to news reports that raised significant examples of wrongdoing at Universal Health Services (UHS) facilities, the country’s largest psychiatric hospital chain.  The continued reporting on UHS facilities shows a disturbing trend of behavior.  The most recent allegations cause significant concern about whether UHS has the ability to adequately manage the facilities under its control.
            On November 11, 2017, another report was released focusing on the Hill Crest Behavioral Health facility in Alabama. [1]  The investigative report cites specific incidents of abuse at the hands of Hillcrest staff that were caught on video. [2]  The investigative report notes that improper restraints, sometimes even chemical restraints, were used by Hill Crest staff putting some patients at serious risk of injury.  Allegedly, even more egregious acts occurred off camera, sometimes physical beating resulting in significant injury. [3]  The investigation also noted that some patients were given chemical sedatives five or six times a week and that some children were so sedated that they had to miss school. [4]  One patient in particular missed so many days that he had to attend summer school in order to make up for time lost. [5] 
The investigation also raises concerns over the death of a patient after being physically and chemically restrained. [6]  And finally, the investigative report alleges UHS employees falsified patient records, defrauded insurers, and withheld information from government regulators. [7]
These are serious allegations and the continuing reports further show an alarming pattern of conduct surrounding UHS facilities and its apparent inability to adequately manage its staff.   Please explain what steps your office is taking to investigate UHS for the aforementioned abuses at Hill Crest Behavioral Health.   If you have any questions, please contact Josh Flynn-Brown of my Judiciary Committee staff at (202) 224-5225.