Universal Health Services (UHS) is the largest chain of psychiatric facilities in the USA, with 2.5x more beds than its closest competitor, and dozens of whistleblowers from inside the company told a Buzzfeed reporter that they were pressured to find pretenses to lock up people who voluntarily presented for assessments, holding them against their will until their insurance ran out, with massive bonuses for executives who increased profits (and much smaller bonuses for execs who improved health outcomes for patients).
UHS hospitals are incredibly profitable, running at 30-50% margins, and whistleblowers say these margins are attained by dropping staffing to unsafe levels and preferentially hiring underqualified and inexperienced people; while simultaneously packing in patients by bedding them in closets, in isolation cells, and on mattresses on the floors of day-rooms.
Meanwhile, the whistleblowers say that patients in desperate need of care are refused admission, or are kicked out early, if they don't have insurance. A large plurality of UHS's patents are covered by tax-funded Medicare, and 10% of the company's hospitals are currently under investigation for Medicare fraud. Patients say that their confinement has eaten into the days of mental health care they are entitled to under Medicare, meaning that if they end up in distress later that they will not be able to get care.
The core tactic the whistleblowers describe is to manufacture "suicidal ideation" in prospective patients, turning any statement about self-harm into an imminent danger warranting involuntary confinement and sedation.
UHS denies everything.
Meanwhile, pressure to admit more patients was so great, staff members said, they did so even if the hospital was already at capacity, thinning resources even further.
"If we didn't have beds, it doesn't matter — just go ahead admit them anyway," Rebecca Palmer recalled being told by her supervisors when she worked at The Ridge in Kentucky.
There would be "every bed filled on the kid unit, teenagers boarding on the child's unit, and kids sleeping in the dayroom on rubber mats," Palmer told BuzzFeed News. "And also in the seclusion rooms — they would be sleeping in there as well."
Seclusion rooms are meant to contain patients who have become dangerous. According to federal regulations, the rooms are necessary to protect staff and other patients. Yet staff at four other UHS facilities told BuzzFeed News that there, too, the rooms were repurposed when the hospitals ran out of regular beds.
Federal inspectors noted in 2014 that River Point hospital in Jacksonville, Florida, had more patients than beds. They discovered vinyl mattresses tucked in a closet and on the floors of some patient rooms. A hospital official told regulators the arrangement was "better than throwing a blanket on the floor."
Intake [Rosalind Adams/Buzzfeed]