Years of troubles spur hospital’s closure
Failure of safety inspection hastens end of psychiatric facility for the poor
For most of a decade, until its closure two weeks ago, HopeBridge Hospital in southwest Houston had served as a destination of last resort for poor and homeless patients in need of psychiatric care.
It treated mentally ill people picked up by police and warehoused disturbed children under the care of child protective services. And although its patients often were of little means, the majority were insured through Medicare or Medicaid, ensuring a steady flow of public dollars.
Then last month, after years of problems at the 137-bed facility once known as Westbury Community Hospital, federal and state officials delivered the death blow: The government notified the hospital it would be cut off from future Medicare payments.
“That was the end of it,” said Anthony Brown, who had served as HopeBridge’s chief financial officer since 2012, when he was hired to manage the facility through bankruptcy, and who later purchased a stake in the hospital. “There was no way we could continue operating at that point.”
The closure forced a handful of remaining patients to be transferred to
other facilities and left more than 160 hospital employees without payment for their final weeks of work. And it raises questions about the quality of psychiatric care available to vulnerable patients in Houston.
An April citation report from the Texas Department of State Health Services painted a picture of a run-down hospital filled with unmitigated safety hazards. Several patients interviewed by investigators over the course of multiple visits reported being abused at the hospital, but staff had not investigated or reported the incidents to the state. A dozen others on suicide watch were being kept in rooms furnished with doorknobs, faucets and other fixtures they could have used to hang themselves, according to the report obtained by the Houston Chronicle.
Final word came April 20, in a letter from the federal Centers for Medicare and Medicaid Services: The agency, which agreed with the state’s findings, would not grant the hospital additional time to bring the facility up to code. Separately, the state announced its intention to fine the hospital $455,000 and strip it of its operating license.
Previous owner’s schemes
On Monday, as workers filled blue trash bins with papers and stacked twin mattresses in empty halls, Brown sat behind his desk and tried to make sense of “how we even got here.” He told a story of a psychiatric hospital whose previous owners had taken advantage of mentally ill patients in order to bilk the federal government. They had hospitalized people who did not require psychiatric treatment while pocketing hundreds of thousands of dollars in a kickback scheme that ended earlier this year with two of the former operators pleading guilty in federal court.
Brown said he and his business partners inherited an operation in much worse shape than they first realized. For five years, he said, they worked to right the ship. They purchased the hospital in 2015 and began working with state and federal regulators to bring it up to code. But a new name and brightly colored logo failed to change the hospital’s reputation.
Several former employees interviewed by the Chronicle described a difficult work environment and ghastly living conditions for patients, even after the change of management.
“For months at a time, the place had no hot water,” said Charlene Freeman, a mental health technician who worked at HopeBridge for a year until its closure. “Every day it was a war zone. It was like these people didn’t have money, so they don’t deserve better than this.”
After several inspections between August and March, state regulators cited the hospital for failing to monitor suicidal patients and for improperly allowing several to leave the facility. One who walked out later reported being sexually assaulted while away from the hospital, but staff did not report the incident to the state as required.
Despite those concerns, it was the poor condition of the 40-yearold building and lack of modern safety features that factored most prominently in the decision to cut off government insurance payments, according to the federal citation. The facility likely needed millions of dollars worth of additional renovations, Brown said.
His team had been rushing to make upgrades but not fast enough to appease regulators, he said while walking a reporter through the hospital’s dank and darkened halls last week. Brown pulled out a pillow case and tied it around one of the doorknobs recently installed in patient rooms, demonstrating that a patient would be unable to hang himself from it.
“We’ve made these upgrades throughout all the rooms on the first and second floors,” Brown said.
Tried to upgrade building
On the third floor, which had not yet undergone repairs, disturbing messages had been carved on windows. Floor tiles were chipped and cracking. In one room in the section of the hospital that once housed children, a toilet had been ripped from the floor and holes punched through walls.
The building, Brown conceded, needed more work, but he emphasized that he and his business partners do not own the physical structure, just the business that had been operating inside it.
Feroze “Fred” Bhandara, the landlord, had leased the building to the owners of Westbury Community Hospital before Brown’s team took control. Bhandara did not return a call requesting an interview.
Tim Simmons, the hospital’s chief executive officer, agreed the facility needed work, but he argued that federal regulators did not allow enough time to make upgrades after initially citing the hospital in early March. He pointed out that some of the fixtures flagged as unsafe by federal regulators had been approved a year earlier by the state. And he defended the hospital’s safety record: Over the past five years, he said, thanks to staff efforts to mitigate environmental hazards, no patients had killed or seriously hurt themselves.
“We totally understand they want to have a safe environment for patients,” Simmons said. “We totally agree with that and have been striving for that.”
Asked to respond to criticisms of the government’s handling of the situation, Bob Moos, a Centers for Medicare and Medicaid Services spokesman in Dallas responded in an email: “We’d prefer to let the most recent inspection report and enforcement letter speak for themselves.”
In a last-ditch effort to appease regulators and keep the operation afloat, Brown said the hospital owners poured $250,000 over the past month into safety upgrades. The renovations halted abruptly three weeks ago when federal regulators declined to grant the hospital more time.
Hospital workers, aware of the looming sanctions as early as April, continued showing up for work in the intervening weeks, holding out hope that management would fix the problems and save their jobs. Word reached them in early May that the effort had failed, though some continued reporting to work to help wind down the operation.
After the final patient had been discharged last week, several employees showed up at the hospital to ask when they would get their final paychecks. They received an additional shock when Brown came outside and said there was no money left to pay them.
Exploring legal options
Andrea Roberson, a mental health technician, spent six years at the hospital, working first under the cloud of the FBI investigation and then through the 2012 bankruptcy and change of ownership. She lived in constant fear, she said, that the hospital would go under and she would be left without a job. She never imagined she would be denied payment for her final month of work.
“We were all counting on that money to pay rent, to pay bills,” Roberson said. “They just pulled our lifeline from us.”
Brown said he regrets that employees have not been paid on time, but he said he is confident they will be eventually. He put the blame on Cenpatico, an Austin company that processes Medicaid payments, which he says owes HopeBridge at least $1.6 million — money he says was owed to the hospital long before the facility got into trouble with regulators, but that had been tied up in a processing glitch.
The hospital is exploring legal options to force the company to pay up, Brown said. A spokeswoman for Cenpatico did not return phone calls or emails seeking comment.
“As soon as we receive that money,” Brown said, “the employees will receive the money that’s owed to them.”
“For months at a time, the place had no hot water. Every day it was a war zone. It was like these people didn’t have money, so they don’t deserve better than this.” Charlene Freeman, mental health technician