Columbia, SC (WLTX) - One child was punched by a staff member and grabbed in a headlock while other children were repeatedly bitten at a state-licensed residential treatment center, prompting the state's regulatory agency to accuse the facility of failing to provide basic protection, records collected by The Greenville News reveal.
Those health investigation reports of Palmetto Pee Dee Behavioral Health were filed by the state Department of Health and Environmental Control, which regulates such facilities, since February 2017, after an investigation by The Greenville News documented abuse and a litany of violations, problems and complaints at the 59-bed facility in Florence.
Palmetto Pee Dee Behavioral Health is one of 11 residential treatment centers licensed by the state for troubled children ages 7 to 21. It treats children from across South Carolina and from other states, and it accepts private insurance and Medicaid.
It is owned by Universal Health Services, the largest facility-based behavioral health provider in the nation, with more than 230 facilities in 37 states, according to its website. United Health Services reported nearly $10½ billion in net revenues in 2017, according to its annual report.
Daniel Eichelberger, the CEO of Palmetto Pee Dee Behavioral Health, said his facility has addressed all regulatory and licensing concerns and has remained clear of DHEC citations since May. He said Palmetto Pee Dee Behavioral Health is now fully compliant with state and federal regulations.
"At Palmetto Pee Dee Behavioral Health, we are committed to providing quality treatment and care in a compassionate, safe environment," Eichelberger said in an emailed statement. "We value our relationships with our regulators, view surveys as an opportunity for continued improvement, and take all feedback seriously."
Facility representatives have noted that it serves children and adolescents with "special and often complex mental health needs."
In July The Greenville News requested records of complaints, inspections and investigations as well as any penalties assessed against Palmetto Pee Dee Behavioral Health since February 2017.
Those records, recently released by DHEC, show:
► In a March 2017 report, the agency alleged that a staff member was attempting to separate two fighting residents when the employee heard a “popping sound” coming from a child's arm that was being pulled. The resident was later sent to the hospital. His condition was blacked-out on the report. The complaint that triggered the investigation alleged the resident’s arm was broken.
The facility was cited for not reporting the incident to DHEC within five days. The facility responded that it tried to report the incident in required time but, because of a weekend, it did not get delivered within five days.
► One resident was injured by other residents at least six times, four by biting. The facility was cited in March 2017 for not affording the resident the right to be free from harm.
The facility reported it had formed a committee to monitor biting incidents, which it said had been cut in half.
► On six days in January, there was a lack of proper documentation of medication being administered by nurses. The facility was cited for failing to keep the proper documentation.
The facility’s director of nursing reported later that she had reminded nurses of the need to complete documentation.
► In April 2017, a staff member entered a bedroom, according to a surveillance camera, and "was observed punching" a resident, then placing him in a headlock, a report alleged. The report stated the altercation lasted more than two minutes before it was broken up by another staff member.
Palmetto Pee Dee Behavioral Health said in its response in the report that the staff member who punched the resident was immediately fired.
► In May, nine residents ran away from the facility at the same time through two different doors at the facility. One was caught by staff while the other eight were returned to the facility by Florence police 30-40 minutes later. DHEC cited the facility for insufficient staff, saying, “There was not sufficient qualified staff members to provide supervision as determined by the condition of residents,” finding seven of the residents had eloped before.
The facility said it fired two of the staff, suspended two others and put others involved through training and coaching.
Altogether, according to DHEC, there have been 23 complaints about Palmetto Pee Dee Behavioral Health that DHEC has investigated since February 2017.
DHEC fined the operators of the facility $19,700 for previous violations earlier this year, according to the agency. Eight of the 23 complaints came after the fine was paid in January, according to DHEC.
DHEC conducted two inspections at the facility from March 2017 to August 2018, according to the agency.
Though DHEC says the number of complaints against Palmetto Pee Dee Behavioral Health has decreased this year, the agency has been working on what to do next about the facility, including more enforcement action, said Tommy Crosby, a DHEC spokesman.
Residential treatment facilities for children in South Carolina by law are those which are operated for the assessment, diagnosis, treatment and care of two or more children and adolescents in need of mental health treatment.
Palmetto Pee Dee Behavioral Health’s website states that it treats children for “severely psychiatrically disturbed males and females with varying degrees of intellectual and developmental functioning,” including those with schizophrenia, bipolar disorder, conduct disorder, Asperger’s and autism.
Palmetto Pee Dee Behavioral Health entered into a consent order with DHEC earlier this year, according to DHEC. In a consent order, the licensed organization agrees to certain terms and conditions, including the payment of any penalty.
According to records of the complaints since February 2017 and to inspections and reports by DHEC, there have been three Class 1 violations at the facility, the most serious citations issued by the agency, as well as nine Class 2 violations and four Class 3. Some of the complaints were not verified by DHEC.
Multiple complaints alleged that residents were having sex with each other, but DHEC did not substantiate those claims, though it did find one couple kissing and embracing each other in a laundry room that was supposed to be locked.
Palmetto Pee Dee Behavioral Health was fined $19,700 in January 2018 after the agency cited the facility for numerous prior violations. The Greenville News reported last year that DHEC had issued 19 violations in December 2016 and January 2017, including allegations of abuse, understaffing and not controlling children who bit and attacked each other more than a dozen times in 2016. The facility objected to three of those violations dealing with staffing and asked DHEC to reconsider.
DHEC said its January 2018 enforcement action was "based on a history of violations and related considerations."
According to DHEC regulations, violations can result in monetary penalties ranging from several hundred to several thousand dollars, depending on the classification of the violation and whether it is a repeat offense. Facilities are generally given a chance to submit plans for correction of any cited violations.
Current and former workers at the facility alleged in January 2017 that children at Palmetto Pee Dee Behavioral Health have been hurt in altercations with staff and given inadequate food and programming while the facility often was short-staffed. Workers also alleged the aging facility suffered a host of maintenance problems, including broken laundry equipment, malfunctioning showers and mold.
Halle Mechling, a former spokeswoman for the facility, previously described the allegations as "dubious" and said that patients' care at the facility was the organization's highest priority.
The workers' allegations came after DHEC confirmed it was looking into complaints by a Columbia mother that her autistic child had lost excessive weight at the facility and had been bitten repeatedly while there, with one of the wounds becoming infected, The Greenville News reported in December 2016.
Mechling last year said in response that it strives to "maximize the safety of our patients" and learned from the findings by DHEC.
