Soon after the Union County psychiatric center opened its doors, the trouble started, state documents show.
Patients at Anderson Health Services — teenagers as young as 13 with histories of physical and sexual abuse, suicide attempts, sex trafficking and assault — stole drugs and obtained a knife, a hammer and a wooden chair leg that was wielded as a weapon, according to a June 1 report. One girl ran away three times in 11 days, requiring police to use bloodhounds to help track her down.
The N.C. Department of Health and Human Services, which licenses and oversees psychiatric centers, announced Monday that it has suspended most operations at Anderson Health and plans to move patients to other facilities for treatment.
Anderson Health is one of 37 psychiatric residential treatment facilities in North Carolina where patients get care for severe mental and behavioral problems.
Newly released state records and investigative reports obtained by the Observer detail allegations of physical abuse, faulty treatment and failures by Anderson Health Services since it opened in Marshville in September.
In a blistering report released Monday, the state said Anderson Health's actions put patients in "imminent danger."
"Systemic failures of the facility endangered the health, safety and welfare of the clients resulting in serious abuse, harm and neglect," the report said.
Staffers made a patient sick by giving him the wrong anti-psychotic drug and other medicine, used improper restraint holds, and failed to adequately treat a girl who needed stitches after she was injured trying to scale an 8-foot fence during an escape attempt, according to the recently released reports. In one instance, nursing staff left 29 pills used to treat attention deficit hyperactivity disorder on top of a refrigerator. The pills disappeared and were never found.
Some workers were not adequately trained, and managers once promoted a cook to counselor without requiring additional training, documents show. The person second-in-charge of the center was responsible for supervision, corporate compliance and documentation intake and coordination for new clients despite having no documented training for the job.
The state said staffers at Anderson Health in April used zip ties to restrain a 14-year-old girl who was attempting to run away. She was zip tied for more than an hour and no staffers intervened to help free her, the report said. State investigators called the incident "serious abuse and neglect," and suggested a $3,000 fine.
In another case, the state says Anderson Health did not investigate or properly report allegations of abuse against a 16-year-old who said a staffer put him in a choke hold. The two staff members present both denied the choking incident.
Anderson Health operator Alfred Owens referred questions to Charlotte attorney Richard Tomberlin. In an email, Tomberlin said Anderson Health had filed an appeal, disputing the state's allegations. He refused to answer questions or provide a copy of the appeal.
Documents portray the 72-bed facility, about 35 miles southeast of Charlotte, as struggling to supervise and care for patients since it opened.
Patients received educational instruction only three hours a day due to lack of staffing. Some workers couldn't demonstrate competency required to help patients, records show.
A worker told state investigators in April that staffing was so thin there were not enough workers on shifts to properly restrain patients who might harm themselves or others.
"There was usually only one staff working with the clients, but 'maybe two if you are lucky,' " a staffer told the state, according to the documents.
At Anderson Health, nine girls and eight boys lived in separate units, where problems were documented and operations have been suspended, said Cobey Culton, a spokesman for DHHS. On Tuesday, officials were still seeking new placements for them, Culton said.
A third unit, licensed separately from the others, is still open, but the state has halted new admissions, Culton said. He said he did not know how many children were in that unit, which is allowed to treat up to 12 people.
Even the most well-run psychiatric centers can encounter problems. Patients with serious psychiatric conditions sometimes behave violently.
But the state found that Anderson Health did not develop strategies to address dangerous behaviors from patients and did not provide therapy spelled out in treatment plans.
In one example, state investigators said, four girls were able to obtain "contraband" on nine separate occasions in a roughly two-week span between April and May. They locked themselves in a bathroom and used the contraband to cause self-harm, investigators reported.
Yet Anderson Health implemented no treatment plan to address the self-harm and made no environmental changes to ensure increased safety.
Other times, the state says, staffers did not take proper and immediate action to help patients who were injured.
In one instance, a girl injured her wrist attempting to scale an 8-foot fence to run away from the facility, requiring 15 stitches. Her wound "turned black and sutures were not removed within 7 to 10 days as ordered," the report said.
Another time, nursing staff did not get a patient proper medical treatment recommended by paramedics and police after that patient was injured by an unapproved physical hold by a staffer, according to a June 1 report.