Less than a month after the state ended its Medicaid contract with Shadow Mountain Behavioral Health System, the facility had fewer patients in its care.
Shadow Mountain’s contract to provide services paid for by the state’s Medicaid program, also known as SoonerCare, was terminated effective Aug. 1. On Aug. 23, the facility had only 13 of 48 beds surveyed filled, a newly released report from the Oklahoma State Health Department found.
“The (Shadow Mountain’s) CEO stated, due to the loss of their Healthcare Authority contract on on 08/07/17, multiple patients had been transferred to other facilities,” the report states.
Shadow Mountain, 6262 S. Sheridan Road, came under investigation by state and federal authorities in April following a Buzzfeed News story that reported fraudulent Medicaid billing practices, patient abuse and neglect, and violations of state and federal regulations.
Following the investigation, the Oklahoma Health Care Authority canceled its SoonerCare contract with the facility, the Oklahoma Department of Human Services opened several dozen investigations into the treatment of patients at the facility and the U.S. Department of Justice opened a criminal investigation of the facility.
At least five lawsuits have been filed in district and federal courts.
In August, the Oklahoma State Department of Health conducted an unannounced survey of the facility. The inspection was a follow up to a May inspection that found several deficiencies, some of which were serious.
The new report found facility deficiencies only at a “standard” level, which are typically considered to be minor. This means the Health Department now recognizes the facility to be in compliance with agency standards.
Whether the report’s findings will affect the facility’s prospects of getting its Medicaid contract back is unclear.
A message left with Shadow Mountain seeking comment was not returned on Monday. An Oklahoma Health Care Authority (OHCA) spokeswoman declined to tell The Frontier the status of the facility’s contract, citing pending litigation.
However, court records show the facility and OHCA have been in negotiations since August.
Department of Health report
The Oklahoma State Department of Health’s inspection in August found Shadow Mountain had fewer patients in its care at the time and had closed one of its children’s units.
On Aug. 23 during a tour of the facility, Health Department staff found there were no patients admitted to one of the children units, which cared for youths ages four to 12, according to the report. The unit had 12 empty beds.
A staff member told Health Department employees the unit was not closed, just empty.
In a 16-bed unit that admitted youths ages 12 to 17, there was only one patient. Another eight-bed unit that cared for youths of that same age was closed.
An adult unit that had 24 beds was only half full.
The facility’s CEO told Health Department workers the low number of patients was due to the loss of the facility’s Medicaid contract, the reports states. Several patients were transferred to other facilities.
More serious deficiencies cited during the Health Department’s inspection in May were found to be corrected, said agency spokesman Cody McDonell. Shadow Mountain is encouraged to submit an acceptable plan of correction to the deficiencies but is not required to, he said.
In court records, OHCA states the decision to terminate Shadow Mountain’s contract was not spur-of-the-moment or a result of Buzzfeed’s investigation, but instead was “preceded by a rocky relationship that spanned years and involved repeated instances” of not complying with regulations.
The decision also came in the wake of reports from the state’s Department of Human Services and Health Department, according to court records.
In court records, Shadow Mountain calls the Buzzfeed investigation “sensational and highly misleading.”
In July, there were 62 SoonerCare patients at Shadow Mountain, according to court records. The facility contended OHCA terminated the Medicaid contract without cause and that children in its care were safe.
“Each of the children will be negatively impacted due to a change in their attending psychiatrist, therapists and social workers,” court records filed by Shadow Mountain state. “There will not be any continuity of care for children with complex and significant psychiatric and behavioral health issues.”
Motions filed in the District Court of Oklahoma County indicate Shadow Mountain and OHCA have been in negotiations to resolve the case since at least August.
Mark Spencer, an attorney representing Shadow Mountain, told The Frontier on Monday that the facility and OHCA are nearing the end of negotiations, but a deal has not yet been made. He declined to say what that deal could be.
Past reports from state agencies
In May, the Health Department conducted a survey of Shadow Mountain, and found multiple deficiencies at the facility.
The department’s 27-page report is critical of the hospital’s patient grievance process and highlights incidents in which the hospital failed to protect patients and staff from harm, as well as several incidents of employees improperly restraining patients.
On April 27, a 12-year old patient accessed a medication cart and swallowed non-prescribed anti-psychotic medicine, the report states.
Shadow Mountain’s report on the incident said the child was acting aggressively and knocked the glasses off of an employee as the patient swung their arms, the health department found.
The facility’s report addressed that the child was restrained and/or secluded as a result of the incident, but did not investigate how the patient gained access to the medication.
The health department’s survey of the facility also found several incidents of employees improperly restraining patients.
In once instance, an employee grabbed a patient and pushed her onto a stool on her back, the survey states.
“Video shows no effort to avoid physical confrontation by moving to put space between the patient and staff member or waiting for assistance and utilizing a team approach,” the survey says.
The employee was later seen on video in a second altercation with the patient, when the employee placed her in a headlock and wrestled her to the floor, the survey states.
When Buzzfeed’s investigation was published, the Department of Human Services Office of Child Advocacy was investigating nine reports of possible neglect or abuse at Shadow Mountain facilities.
As of Sept. 11, of those nine reports, six were closed as unsubstantiated, and one was confirmed. Two others had not yet been finalized, DHS spokeswoman Sheree Powell said at the time.
Since Buzzfeed’s investigation, OCA had received 33 additional reports of possible abuse or neglect, Powell said. Of those reports, 17 are still under investigation and 12 have been closed as unsubstantiated. Four of the investigations are complete but the findings are under appeal, she said at the time.
Paula Christiansen, an Oklahoma Office of Juvenile Affairs spokeswoman, said the agency, which sent youth to Shadow Mountain in the past, does not currently have a contract with the facility.