“I didn’t feel safe.” anonymous employee. “If it weren’t for five men staying up all night, my staff and I may have been victims. I started carrying a pocket knife.” Why did this former employee not feel safe? It wasn’t just here, “I know that other female staff carried around mace.” It was the need for more security, being outnumbered, and walking alone in dark hallways. It could also be the types of patients that were admitted to the facilities.
Before Mishawaka’s opening, new hires had to conduct training with toilets that wouldn’t flush. The septic tank was full and overflowing. Mishawaka went from zero patients to a full 160-bed facility in weeks. The staff was completely outnumbered, and there needed to be enough security guards. Nicole Carter oversaw this facility and was well aware of the issues at this facility.
How did LR allow this to Happen?
When LR LR posted ads for admissions consultants ACs, they mentioned earning a commission. It is illegal for companies to pay commissions in the healthcare field. Instead, LR called this a bonus. LR paid the admissions people a commission if a patient walked into a facility and got admitted. The ACs were paid on a tiered system, 27 to 36 admits, $25 per admit, $45 for 37 to 42, and $75 for over 43 admits per month. If you didn’t get more than 26 admits, you didn’t get a bonus that month. If the ACs got somebody to agree to enter treatment, they would fail to complete the prescreening process. A prescreen summarizes what they have been using, any diagnosed medical or psychiatric conditions, medications, legal issues, if they’re homicidal or suicidal, and if they have a history of suicidal/homicidal ideations. LR offers HLOC a Higher Level of Care. The ACs didn’t pass this information to the facilities. LR would admit sex offenders and people with violent pasts and not tell staff.
Let’s circle back to the female employee that didn’t feel safe. Her fears were entirely justified. LR didn’t have her safety in mind. It was all about Fill The Fucking Beds. Admissions had a Do Not Readmit list. These people had left too many times, were violent, or brought in contraband. Instead of barring these patients, they would be moved to a different facility. A few patients got banned from all facilities.
Admissions would follow up with discharged patients to see if they relapsed. This was a required question. If they admitted to relapsing, they were encouraged to reenter rehab. The AC would again receive another $250 bonus. I question LR’s how many lives have been impacted when it was a revolving door of patients to be readmitted. When the census count is low, management will present the ACs with a target list of people to call. They were offered an additional bonus of $50 to $200 if they got somebody on the list into rehab that day. ACs and upper management tried admitting people should have been turned away.
I’m fairly certain that Landmark Recovery violated numerous Stark Law violations by paying for patient flights, transportations, and doing whatever needed, including braking the law, to get beds filled.