Less than a week after the 9-year-old boy arrived at the Hoke County psychiatric center, the bruises and abrasions started to spread across his body, state documents show.
Before he left Canyon Hills Treatment Facility roughly two weeks later, the boy says, a staff member grabbed him by the shoulder, rubbed spit across his face and kicked him in the groin.
“He looked like he had been through a war zone,” his mother told investigators.
State records obtained by the Observer detail allegations of physical and verbal abuse and other failures by Canyon Hills to care for patients as young as age 6.
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In accounts, nurses at the facility told state investigators they witnessed an employee choke a patient and grew concerned the children got so little food they could not properly grow and develop.
Records show that at least eight clients in the 24-bed facility had lost weight after they were admitted for treatment. But the employee charged with purchasing food for clients had said the food budget had to be reduced, nurses said, according to the documents.
Canyon Hills, located about 100 miles east of Charlotte in Raeford, is one of 37 licensed psychiatric residential treatment facilities in North Carolina, where patients get round-the-clock care for severe mental and behavioral problems. Patients can come from around the state for services.
The N.C. Department of Health and Human Services is threatening to revoke Canyon Hills’ operating license, according to an Oct. 26 letter the agency sent to Canyon Hills Chief Executive Officer Micheaux Hollingsworth.
“The failure of the facility to provide a structured living environment and staff trained to provide adequate supervision ... subjected all clients to serious harm, abuse and neglect,” the state concluded, according to records.
Hollingsworth referred a reporter to attorney Jonathan Charleston, who refused to answer questions.
In a written statement, Charleston denied the allegations contained in the state report.
“The findings cited by the state, which are factually and legally unfounded, relate to allegations by a former disgruntled employee of the company and matters that we have appropriately addressed through our own internal review,” he said. “We will vigorously challenge these findings and are confident that our company and its employees will ultimately be found to have acted within the rules.”
But state records make clear the allegations were identified through interviews with multiple Canyon Hills’ employees, patients, local law enforcement and child protective services.
Documents also show the facility promised in August to evaluate the competency of staffers. Canyon Hills said it had reached out to a local pediatrician, who would monitor the patients’ body weight.
‘Slap them up’
The state investigative findings against Canyon Hills represent at least the third time this year residential facilities treating children have faced discipline. Patients at Strategic Behavioral Center in south Charlotte and Anderson Health Services in Union County also alleged abuse.
In Canyon Hills’ case, the state conducted an investigation earlier this year. Authorities suspended admissions in late October.
Charleston would not say how many patients remain at the facility when asked by a reporter.
Cardinal Innovations Healthcare coordinates care for Medicaid recipients in Mecklenburg and 19 other counties.
Spokeswoman Ashley Conger said Cardinal had one client in Canyon Hills when it received a report about the allegations. That person was transferred to another center on Oct. 31, Conger said.
Reports and interviews compiled by investigators paint a grim picture.
Patients and nurses said staffers physically harmed clients, harassed them and called them names, according to an investigative report.
They “beat on the boys,” an 8-year-old told investigators, the documents say.
“’‘Staff go toe to toe with the kids’ - argue and use vulgarities,” Canyon Hills nurses said, according to the report. “Staff ‘slap them up and slap them around - on the butt and bottom.’”
When confronted and told their actions are wrong, documents say, employees denied hurting the children, saying they were only horsing around.
In one case, documents say, a patient said employees mocked and harassed him by asking about his sexual orientation.
“Staff asked him, ‘Do you prefer men or women?’” the report says. “Staff call people names. They called me a f--got.’”
Nurses reported that some clients did not get a sufficient amount of food, documents say.
One patient circulated a petition signed by all the clients in his unit asking the facility for bigger portions and better food, the report said.
Clients were temporarily “punished” and were given even less food after they gave the petition to staff, the client said, according to the report.
A patient said a nurse told him the facility intentionally gives clients “a little bit of food” because they do not need to eat a lot, documents say.
“Your stomach will shrink and then you will not be hungry,” he said the nurse told him.
Charleston, Canyon Hills’ attorney, said the facility places a high priority on compliance with state rules.
In August, Canyon Hills vowed to make changes to correct problems, records show.
The agency said it had contacted a pediatrician to provide medical treatment to the clients. Children who have difficulty maintaining or gaining weight would get a treatment plan developed based on guidance from the pediatrician.
State records detail alleged transgressions by staffers, including a worker suspected of smoking marijuana in a car. The worker apologized to another employee, but was allowed to remain on the job, according to the documents.
In some cases, the report says, employees placed children in rooms with other kids who had bullied them. One client was forced to remain in a room with patient who “gave him a black eye,” the report said.
Canyon Hills said it would evaluate employees through job shadowing and observation. A monthly training schedule will be developed to assist staff based on findings from the evaluation, the center said, according to documents.
In May, state records say, a parent accused Canyon Hills of refusing to provide information about injuries her son suffered while in the facility.
The 9-year-old with a history of oppositional defiant disorder, sensory processing disorder and head injury, had bruises and abrasions across his body.
His mother asked Canyon Hills to investigate a large bruise on his arm because the explanations the facility offered “did not make sense.”
A Canyon Hills employee reported that an internal investigation looked into whether the patient was pushed into a bed, but Canyon Hills was unable to provide documentation of the investigation, state records show.
Local police and child protective services looked into accusations of physical and verbal a client made against staff at Canyon Hills. The report does not make clear whether the allegations came from the 9-year-old boy or involve another patient.
Two Canyon Hills employees were “resistant and uncooperative” with police and child protective services’ attempts to speak with clients and other staff, they said, according to documents. The employees refused to let them meet with a patient who alleged he was sexually molested by another client, the report says state investigators were told.