Report faults care of young psychiatric patients

Reported May 20, 2011

Chicago Lakeshore Hospital
Alleged sex attacks blamed on inadequate staffing, supervision
Written by experts from the University of Illinois at Chicago, the report substantiates a September 2010 Tribune article that revealed four instances in which youth allegedly were sexually assaulted or abused by their peers at Chicago Lakeshore Hospital since 2008. The alleged assaults were among at least 18 reports of rape or sexual abuse of juveniles at a half-dozen Chicago-area psychiatric hospitals during that time, the Tribune found. All the victims were under age 18 and some were as young as 7.

The UIC report also alleged that Lakeshore made medication errors, recycled ineffective corrective action plans and didn't effectively prepare for the treatment and discharge of young patients.

While praising Lakeshore's senior nursing staff, the 44-page UIC report said some units housing youths at the North Side hospital "continue to present unacceptable risks at times because of lax or inconsistent supervision by staff."
The new study underscores how DCFS and the state Department of Public Health are struggling to ensure the safety of young patients at private psychiatric hospitals that combined receive millions of taxpayer dollars annually to treat indigent children with traumatic histories of abuse and neglect.

DCFS and public health officials say they are hamstrung by weak laws and inadequate resources. In response to last year's Tribune article, authorities have beefed up inspections and are seeking other legislative remedies to strengthen oversight at the psychiatric facilities.

Lakeshore administrators sharply contested the UIC report, calling it "undisciplined and highly subjective" in an 11-page "comment letter" to DCFS that was included with the report released Tuesday. Lakeshore said it has provided top-notch treatment to hundreds of DCFS wards suffering from mental health problems.

The UIC report was skewed because it relied on "an isolated or even a small sample of incidents" as "the basis of an indictment of the (hospital's) quality of care," Lakeshore's letter said. A hospital spokesman added that the facility has thoroughly addressed the reports of violence and other alleged deficiencies.

DCFS officials said Tuesday that they stand by the UIC report and are monitoring corrective actions already taken by Lakeshore. The UIC team recommended that DCFS continue conducting unannounced reviews at Lakeshore "over an extended period" to monitor patient safety.

Lakeshore administrators met last week with DCFS officials in an unsuccessful effort to get the agency to change or delete portions of the UIC report before its release, records and interviews show. One concern of the hospital's was a section asserting the alleged problems at Lakeshore were mirrored by shortfalls at other psychiatric facilities controlled by the same corporate owners.

Lakeshore told the UIC team that it is owned by Signature Healthcare Services, a Michigan limited liability company that is privately held by one member, Soon Kim.

At a sister hospital controlled by Kim in California, an employee last year filed a lawsuit alleging that company officials defrauded the government by providing "minimal, substandard care" to patients. That facility, Aurora Las Encinas Hospital, also came under scrutiny after The Los Angeles Times reported the unexpected deaths of three patients and the alleged rape of a teenage patient, all within a five-month period in 2008.

Lakeshore's letter to DCFS said Las Encinas hospital is now in "substantial compliance" with federal regulations and added that the corporate section of the UIC review was "replete with inaccuracies and innuendo ... lack of objectivity, great leaps of logic and bald conclusions."

A Signature Healthcare spokesman declined to discuss Las Encinas but said the company works hard to provide the highest-quality care and to comply with all state and federal regulations.

At Lakeshore, the UIC reviewers sharply criticized administrators and owners for low staffing levels, saying they "routinely observed" instances where one staff member was monitoring as many as 15-22 youths in the unit dayroom areas.

"A supervision failure ... directly contributed to each of the sexual incidents," the UIC report said.

In one of those incidents, state Department of Public Health inspectors cited the hospital for safety violations after an 11-year-old boy alleged that two male patients sodomized him in a bathroom that should have been locked and supervised by hospital staff. The state inspectors found the hospital failed to document whether staff made required 15-minute checks on the two alleged assailants, one of whom had been admitted with "special observations orders for assault precautions."

In another Lakeshore case, three male patients allegedly sneaked into the room of a 15-year-old girl at night. She told police that she tried to push away one of the boys, but he grabbed her by her hair and raped her. A hospital employee told police that "taking into consideration victim's current mental state ... this is not (a) bona fide incident."

Lakeshore said it "was transparent in its handling of the (sexual assault and abuse) cases, conducted internal investigations, and cooperated with all external investigations including those conducted by DCFS. To our knowledge, there were no criminal charges or confirmed assaults made in any of these alleged incidents."

In the UIC report, DCFS also came under fire for failing to quickly locate less-restrictive placements for youth who were ready to leave Lakeshore. One 11-year-old boy was kept at Lakeshore for roughly three months of his 154-day stay "apparently because DCFS could not find an appropriate discharge placement," the report said.

Credits: Los Angeles Times reporter Rong-Gong Lin II
By David Jackson, Tribune reporter and details at: http://www.chicagotribune.com/health/ct-met-lakeshore-hospital-report-20110517,0,788876.story