State acts to close center on the Shore


State officials are taking legal action to shut down a residential treatment center on the Eastern Shore in part because of complaints by staff members who reported that mentally ill youths, including many from Baltimore, were being mistreated and abused.

Health care regulators met this week with the medical director of the Chesapeake Youth Center, a 60-bed facility in Salisbury for youths with serious psychiatric disorders, and told him they intend to revoke the center's license, said Wendy A. Kronmiller, acting director of the Office of Health Care Quality.

The office has been monitoring the youth center since the summer, when it received a formal letter of complaint from the Maryland Disability Law Center, which worked with youth center staff to compile a long list of deficiencies, including residents who were not receiving proper doses of medication or being regularly monitored by a physician. Some youths also were being denied family visits or telephone calls, according to law center officials.

FOR THE RECORD - An article yesterday on the Chesapeake Youth Center gave the wrong location for the Eastern Shore psychiatric facility. It is located in Cambridge. The Sun regrets the error.

More recently, there have been reports of youths being denied food and water, and in some cases, access to mandatory therapeutic and educational programs. The center's policies regarding use of seclusion and physical restraint also have been questioned by state health care officials.

The center's medical director, Dr. Marc Fishman, a Baltimore psychiatrist and part-time faculty member at the Johns Hopkins School of Medicine, said he and his staff intend to remedy the problems to preserve the license as well as the good name of the Chesapeake Youth Center, which has been in operation for about 16 years.

"We are committed to fixing all of these problems," Fishman said. "We are cooperating with the Office of Health Care Quality, and they have said they will work with us so that we can keep treating patients."

Kronmiller said that it is rare for the state to rescind a residential treatment license, but in this case such action is necessary because of "extremely troubling" problems at the youth center. She said center administrators would have 30 days to appeal the decision once it is made final next week.

"Things were horribly wrong," Kronmiller said of conditions at the center, which serves youths ages 14 to 19, a majority of whom are referred by the juvenile justice or foster care system.

None of the youths housed at the center has been removed, because they are not in immediate danger, Kronmiller said, but her office has requested a roster of patients in case action is necessary.

Fishman and his family also manage several other medical facilities in the Baltimore-Washington area, including Mountain Manor drug and alcohol addiction treatment sites in Emmitsburg and Baltimore, a psychiatric center at the Charles H. Hickey Jr. School in Baltimore County, and Riverside Hospital, a psychiatric facility that serves youths from the District of Columbia.

Kronmiller said that when her office first received reports of abuse at the center, she sent investigators to check on the other sites in Maryland. She said that no other deficiencies were reported. District of Columbia officials said they had received no complaints regarding Riverside Hospital, which is managed by Fishman's sister, Rebecca Fishman.

State officials have made more than a dozen visits to the Chesapeake Youth Center in the past several months, Kronmiller said. They have reviewed dozens of patient records and interviewed staff members as well as patients.

On a visit this past summer, investigators reviewed the file of a 15-year-old girl diagnosed with severe psychosis and post-traumatic stress disorder, among other mental illnesses, and found she had not been assessed by a psychiatrist for six weeks.

"Despite the resident's continual out-of-control behavior and frequent need for behavioral consequences, the resident was not regularly evaluated," the state noted in a July 8 report, a copy of which was obtained by The Sun. According to the report, the girl's medication plan also had not been reviewed to make sure she was getting the proper dosages.

Another patient, a 14-year-old boy diagnosed with "major depressive disorder" and attention-deficit hyperactivity disorder, was denied supervised visits with his mother after he refused to behave -- a violation of his patient rights, according to the state. Similarly, a 17-year-old boy diagnosed with schizophrenia was denied telephone privileges after he threw out his medication.

During a visit last month, officials spoke with a 17-year-old girl who told them nurses punished her for assaulting a doctor by making her wear nothing but a paper gown for several days.

The girl told investigators that she felt embarrassed to be in the gown. "There were male staff on the unit and I felt like I was being exposed," she said, according to an Oct. 31 state report, a copy of which was obtained by The Sun. Youth center staff said the girl was ordered to wear the gown because they feared she might be concealing a weapon.

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