‘IT HURTS WHEN THEY RESTRAIN US’
Abuse allegations haunt troubled treatment center
It’s all shrouded in lingo and jargon, complex acronyms that stand for some of the darkest procedures in mental health treatment.
But in the voice of an 11-year-old boy the procedures are clear.
“It hurts when they restrain us,” the child told investigators from the state Department of Health and Human Services. “But that’s the point isn’t it?” According to state and federal rules that regulate psychiatric residential treatment facilities, no, that’s not supposed to be the point.
But state investigators found that all too often it was the point staff at Omega Treatment Facility intended to convey when they used physical or chemical restraints – injections of powerful psychotropic medication – to subdue any of the six children who were housed at the facility on Old Battleground Road in Greensboro from Nov. 2013 until the state shut the facility down in February.
A spokesperson for the Greensboro Police Department confirmed that there is an ongoing investigation of child abuse related to the facility. Spokesperson Susan Danielsen said police are working with the District Attorney’s office and the Department of Social Services to determine if any charges will be brought.
That would at least answer the plea of a 14-year old girl, identified as Client 4 in the state report, who was chemically injected at least seven times in a six-week period by staff at Omega Treatment Facility, in addition to being physically restrained to the point that she begged authorities for help.
“One time, [he] restrained me on my hall and had my head between his knees,” the girl told investigators. “He said ‘we will be here all day if we have to.’ You have to help us. They are torturing us here.”
She was referring to Barsheem Chapman, identified in the report as the CEO and licensee of Omega Treatment. The document is not kind to Chapman. Investigators point out numerous duplicities in his comments to authorities who visited the facility in late January and early February.
The list of egregious violations of state policy,medical practice, and even local fire and commercial building codes is documented in a 176-page investigator’s report released by DHHS as part of a public records request. In a Feb. 12 letter suspending Omega Treatment’s license to operate, state authorities summed it up.
“It is the finding of this agency that the facility has neglected to provide services to assure the health, safety and welfare of the clients,” wrote Stephanie Gilliam, chief of the Mental Health Licensure and Certification Section at DHHS.
Chapman was ordered to shut the facility down by 5 p.m. that day.
“This summary suspension is based on this agency’s findings that conditions at Omega Treatment Center present an imminent danger to the health, safety and welfare of the clients and that emergency action is required to protect the clients,” Gilliam wrote. “This agency has identified the facility failed to be in substantial compliance with rules for which they are licensed.”
“It is the finding of this agency that the facility has neglected to provide services to assure the health, safety and welfare of the clients.”
Gilliam followed up in March by notifying Chapman that the state would also revoke the license for Omega Treatment. The state levied $31,000 in fines against Chapman for five categories of violations, including abuse and restraint. Authorities fined Chapman for operating Omega Treatment without having a medical doctor associated with operations. The state and local health and the fire and building code inspectors found significant problems with the building itself, which is owned by Avery Green of Greensboro.
Green formerly operated the facility as Friendship Care, an assisted living facility for seniors. The state shut the facility down in 2008 and fined Green $20,000 after investigators found evidence of negligence, including failure to properly dispense medication. The building itself was bought by a development company that wanted to build a new elder care facility in the area in 2008. Once that company received rights to build a new facility nearby, Green bought the property at 4501 Old Battleground Rd. back for $1 million in January 2010.
The paper trail picks up in March 2013, when a paramedic notified emergency management authorities that he’d noticed repair work being done at the building.
According to emails received as part of a public information request, EMS authorities were concerned should the place reopen. After EMS and Greensboro Fire Department officials traded emails on March 1, an EMS official rode by to see what was going on.
“I went by there this weekend and most of the work appears cosmetic on the outside,” wrote Jim Albright, deputy director of Guilford County Emergency Services. “If you ever get any plans with any facility that is to be used as an assisted living or skilled nursing facility, can you give us the heads up? It alters EMS demand pretty significantly.”
Chapman was in the process of getting his license from the state DHHS at that time and was making repairs to the building. He called the fire department to begin the inspection process on March 4, 2013. One fire department official raised concerns immediately about introducing children to that facility.
“I’m not so sure that this property, with the condition it is in, and the fact we now are introducing children, wouldn’t need a formal plan review,” wrote Jeff Pritchett of the fire marshal’s office.
Two months later, in May, DHHS inspected the facility and found significant issues with building code violations. According to emails among city officials, Chapman and Green worked with inspectors to address those issues. No supporting documentation was provided in records by either DHHS or the city, however on July 12 the facility’s electrical was approved by Inspector Danny Beal. On July 15, a temporary certificate of occupancy was approved by Inspector Don Sheffield.
Omega Treatment did not admit clients until Nov. 21, and in that time Chapman cobbled together a staff. One of the most troublesome elements of the investigator’s report relates to the role of the Qualified Professional hired at Omega Treatment. In the report, the adolescent patients, who came from local management entities from across North Carolina, identify the QP as combative, short-tempered and abusive.
The report does not identify anyone by name, instead referring to them by job function. One former registered nurse at the facility concurred with the assessment of the QP.
“[She] was constantly throwing around the ‘N’ word,” the nurse said. “She instigates things, comes in the door screaming at [clients], starting trouble with them.”
“You know, overall, it was bad.”
The same nurse said that Chapman himself threatened to spit on a 12-yearold girl, identified as Client 1. The girl had threatened to spit on staff, and in return, Chapman and another staff member “pretended they were going to spit on her.”
“I guarantee you mine will be worse than yours,” she reported Chapman as saying to the child.
The report documents numerous instances of clients being restrained, yet staff at Omega Treatment failed to compile legally required reports, and more importantly, neglected to follow medical procedure in having a doctor examine the patient as part of follow up. Client 1, that 12-year-old girl, for instance, was physically restrained 17 times and chemically injected seven times in six weeks. Contrary to state and federal rules, there was no documentation of follow up or that the child’s legal guardian had been notified.
In fact, one of the most startling revelations in the report is the staff’s lack of knowledge of the rules for running a psychiatric residential treatment facility, even though knowledge of the rules is a requirement for licensure by DHHS.
“I don’t have a full set of state and federal rules, only bits and pieces,” the QP said on Feb. 4. “If you want to give me a full set, I’d love to have it.”
The director of nursing followed suit. “I was given a copy of the state rules for PRTF’s but [Chapman] has the federal rules, and I have not read them.”
Incredibly, Chapman said he didn’t know about the rules either.
“I wasn’t aware of the federal rules, I’ll be honest with you,” Chapman said on Feb. 7. “Can I get a copy of them?” DHHS officials readily provided copies of the investigator’s report and letters documenting the suspension of operating license and admission rights for Omega Treatment. However, the agency refused multiple inquiries about the licensure vetting process or to what level Chapman and Green, who had a previous license suspension, were questioned prior to admitting children for intensive psychiatric care. Calls to DHHS field staff identified in documents were referred back to staff in Raleigh, who in turn claimed to have “no one available for interview at this time.” !