Report Looks at Rehab Deaths
DANVERS — The company that operates an addiction treatment center where two patients died last year said one death may have been caused by “contraband” brought into the facility, while the cause of the other death is unknown.
The information on the two deaths at Recovery Centers of America at Danvers is included in state records released by the Department of Public Health after a public records request by The Salem News.
The state suspended inpatient admissions at the Danvers facility last August after the second patient died, and ordered the company to submit a “root cause analysis” of the deaths. The facility has since reopened under stricter state supervision.
Copies of the analyses were heavily redacted by the state and give only glimpses about what actually happened at RCA, a luxury treatment center that opened in January 2017 at the site of the former Hunt Hospital. The facility is located off Route 62, in the Lindall Hill neighborhood of town.
Regarding the first death on Feb. 22, the company’s analysis said the patient left the facility twice that day and might have returned with illegal drugs. The patient did not sign out as required, and might have been able to leave because nurses turned off a door alarm due to “alarm fatigue.” The company said nurses who were busy with patient care would disarm the alarm because it was set off so often by employees failing to swipe their badges as required.
The patient, whose identity was redacted by the state, also received “special privileges” that day, although the section of the analysis describing those privileges was redacted.
The company’s analysis also cited other factors in the incident, including a lack of communication among staff, lack of supervision on outside trips to Alcoholics Anonymous and Narcotics Anonymous meetings, unsupervised internet communication between patients and outside contacts, and lack of staff training on how to perform patient body searches.
The analysis concluded that, “Contraband brought into facility potentially led to patient fatality.”
The analysis of the second death, which occurred six months later, on Aug. 18, said the patient died of “unknown causes” within 24 hours of being admitted to RCA. The company said the patient was admitted for ethanol, crack and cocaine dependence, and had used heroin and cocaine the day before admission.
The patient, whose identity was also redacted by the state, was given several doses of methadone to treat withdrawal symptoms and other medicines for nausea, anxiety, stomach cramps and diarrhea. That afternoon or night, a nurse found the patient unresponsive and without a pulse in the patient’s room.
After the second death, the state shut down in-patient admissions at the facility on Aug. 25. On Sept. 6, the Department of Public Health issued a “deficiency corrective order” ordering RCA to improve patient safety checks, treatment planning, documentation of patient records, and other procedures.
On Jan. 30, the state granted RCA a six-month provisional license to reopen its clinical stabilization unit, according to DPH spokeswoman Ann Scales. The provisional license allowed RCA to begin accepting residential patients under certain conditions, including limiting the number of patients to 30. The facility has capacity for 207 beds.
The state also imposed a variety of other conditions, including the establishment of “safety monitoring stations” to control patient movement. It ordered the company to submit a monthly staffing report to the state’s Bureau of Substance Addiction Services. The agency will also conduct unannounced visits during the six-month licensing period, Scales said.
The facility could lose its license if it fails to comply with any of the conditions, she said.
The two deaths were not the first time RCA came under state scrutiny. Last May, in response to a complaint about an alleged sexual incident, inspectors observed patients on video walking through the building without staff oversight, and cited “several incidents” when patients took elevators to the roof to smoke or have sex, according to inspection reports.
‘We can help’
Laura Ames, who took over in January as CEO of the Danvers facility, said RCA has treated 52 in-patients since getting the go-ahead from the state. The average stay is 21 to 28 days.
Ames said she could not comment on the investigations into the two deaths. But she said the facility has made several changes to improve patient safety, including more security cameras and additional training for staff.
“We went through some challenges,” Ames said. “But we’re in a very good place. We’re all eager to get fully licensed and really help patients. Twenty-six patients in Essex County died due to a drug overdose in January and February, and we’ve not been open. We can help people.”
Recovery Centers for America is based in King of Prussia, Pennsylvania, and operates six treatment centers in Massachusetts, Maryland, New Jersey and Pennsylvania. The company spent $25 million to renovate the former Hunt Hospital and opened the facility in January.