News 13 Special Report: WBI Investigation

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CASPER - In March 2017, News 13 received multiple tips about the Wyoming Behavioral Institute (WBI) here in Casper. Of the many complaints, they all center on malpractice. News 13 has followed this story from the beginning.

Early this March, Donovan Edwards found himself in crisis. After checking into the ER for suicidal thoughts, he was taken to WBI.

“I wasn't really even told I was being put on a 72 hour hold until they were ready to ship me out. I was totally unaware until they were like, we're taking you to WBI, and I was like, uh no. No no no.”

He had heard the horror stories from his two friends: Aaron and Mari.
Aaron was taken years prior for sleep deprivation. He suffers from epilepsy and in years past was put under a chemical sleep while doctor's monitored him. This time was different.

“They diagnosed me with bipolar disorder and that's not why I went there at all. It was because of sleep deprivation,” says Aaron.

His wife Mari was afraid. “It was days and days and days before a patient advocate even spoke with my husband or myself to help us out.”

Aaron says for the first day in a half, he didn't get his epilepsy medicine. When he did, it was at a much lower dose. Edwards has a similar story.

“I was never given any of my diabetic medications for the whole four days I was there. I wasn't even able to check my blood sugar. I didn't have my stuff with me. But when I got out I think it was 350 and I hadn't had a blood sugar over 150 in months.”

For four days Edwards says he tried to speak with a therapist, each time, his request denied. He says he only saw his therapist before discharge.

And that’s where Melissa King comes in. She was in WBI for depression after her second miscarriage. She says her experience there scarred her. She still has nightmares.

“I didn't actually get any medication whatsoever until the third day I was in there. I didn't talk to any therapist whatsoever until discharge. I pray to God that my daughter never goes there,” she said through tears.

So News 13 took these complaints and concerns directly to WBI’s Chief Operating Officer. As for medication, Shea Ward says verifying medication taken for other medical purposes can take a while. He also says patients should see their psychiatrist in the first 24 hours.

“We're trying to focus on the psychiatric stabilization. Certainly want to be concerned about any of their underlying medical concerns but we're really focused on that psychiatric crisis. There's a lot of people working around that person when they first come in so it may be confusing at times on what part of the treatment team is who.”

It was after Edwards was discharged he wrote to Governor Mead and started a blog about his experience.

“What I went through in that whole process and not getting the help I need, I said, that's enough for me to speak out.”

“They have important concerns that we want to hear. It would've, I think, better to hear them while they were in than rather out on social media but you know, we've reached out to several of them which is something, you know, we haven't done really previously,” says Ward.

Upon further investigation, News 13 discovered a recent Department of Health and Human Services survey of WBI taken after a complaint was received.

According to the survey, patients were not given the option to inform their family, friends, or physician they were admitted to WBI; although it's required in regulations.

The survey also shows one patient was not given their diabetes medication. When asked, a Physician's Assistant said she had no rationale for discontinuing that patient's medication.

And finally, WBI failed to provide an organized nursing staff with 24 hour nursing available according to the survey.

The report shows a patient had a rapid change of condition. The patient was admitted on March 23, 2017 with prior medical conditions. On March 31st at 5:52 A.M., a Mental Health Worker noted the change of condition. At 6:10 A.M., the patient was found unresponsive, not breathing, and foaming at the mouth. The report says the Mental Health Worker didn't obtain the patients vitals when the change of condition was noted. Likewise, the nurses didn't assess the patient until 18 minutes later, when they were found unresponsive. The patient died at 6:30 A.M.

That survey notes, while WBI submitted a Plan of Correction after the survey, it doesn't mean staff admit these incidents occurred or an admission of guilt.

When these five people sat down with News 13 earlier this year, they all mentioned one thing: they felt WBI’s staff kept them as patients longer to get more money.

“I have a suspicion they were milking the insurance for as much as they could get,” says Aaron.

“We follow rules and regs as a Medicare provider. We take that role very important. Very seriously,” says Ward.

While investigating News 13 learned United Health Services, the owner of WBI, is under federal investigation. According to a BuzzFeed article, the FBI, Department of Defense and Department of Health and Human Services are investigating the health care giant for Medicare/Medicaid fraud. We received this statement from United Health Services.

“UHS has consistently and appropriately disclosed in our public filings the existence of an investigation by various government agencies, and complied with requests for documentation. UHS unequivocally disputes any and all allegations that it has engaged in any fraudulent conduct and will vigorously defend itself and its facilities.
UHS facilities will continue to do what we have done for nearly 40 years – provide high quality patient care, delivered by dedicated, compassionate clinicians and staff.”

According to WBI’s Chief Operating Officer in Casper, WBI is not specifically under investigation.

While these patients say they refused to pay WBI for the care, because they felt they didn't receive any, they say they came forward to effect change.

“Our politicians, our county commissioners, our governor, we all need to take, everybody, we all need to take a really long, hard look at Wyoming and mental health care and addiction abuse,” says Cerri Watkins, who’s family and friends have been patients at WBI.

Edwards agrees. “If you're going to treat the bean, treat the whole person. And that's where we're lacking. We're not taking care of people's mental health issues.”

So we spoke to Department of Health representatives here in Wyoming on how they regulate local places like WBI.

The Health Department is tasked with licensing and checking up on facilities. If a complaint is received, an agent follows up.

“There's a care standard and there's a facility standard and there's where they are combined as well. Surveyors, they're called, go and visit a facility to follow up on those complaints to ensure compliance and see if there are issues to be followed up on,” says Kim Deti, the Public Information Officer for Wyoming’s Department of Health.

But what about the claim: Wyoming lacks in mental health care?

“There's certainly gaps especially in a rural and frontier state where we don't always have the right resources in the right place at the right time. But again in this time of budget environment, I think the task for all state agencies including ours is to do more with less and so we're trying to target the dollars to be most effective for the people most in need,” says Stefan Johansson, a Policy Administrator for Wyoming’s Department of Health.

Ward acknowledges WBI has had issues, but hopes they are able to move forward. Edwards says it's imperative these problems are fixed.
“We want to provide excellent clinical care, believe we do and we want to do it in an environment that's supportive to a patient’s recovery, and part of that I think is being transparent,” says Ward.

“If they're not going to get the help, what if they kill themselves next time? Or, because I'm sure they'd rather do that than go back to WBI. And I know it sounds bad to say that, but like I put in my letter, I would kill myself before I go back in that facility,” says Edwards.

In response to our story Tuesday, WBI officials sent us this statement saying:
"Deficiency statements as a result of surveys cite not only a finding, but also the actual regulation referenced.
- Wyoming Behavioral Institute does have nursing staff on site around the clock, providing care to our patients.
- We encourage all patients to include their family members in their treatment."

Johansson with the Department of Health says he hopes the new Comprehensive Crisis and Stabilization Service at the Central Wyoming Counseling Center will provide another option for patients needing outpatient care in Casper.