Lifeways' addiction treatment center in Ontario is undergoing remodeling to comply with state mandates. The center, which treats substance abusers, closed in April in a way that drew state scrutiny. (The Enterprise/Kezia Setyawan)

ONTARIO – Lifeways Inc. is facing tight state oversight as it moves to reopen its substance abuse program after regulators found its residential program in Ontario put clients at risk of harm and didn’t comply with state requirements.

The state Health Systems Division on Friday, June 5, imposed new requirements on Lifeways that mean regulators will monitor the nonprofit’s treatment of clients on a weekly basis. The requirements will last, the division said in a letter to Lifeways, until conditions “have been corrected” and “systems are in place to ensure that similar circumstances do not recur.”

Tim Hoekstra, Lifeways CEO, initially agreed to an interview but instead a subordinate responded to questions submitted by the Enterprise.

“We learn from these reviews and modify practice to ensure that our clients, patients and communities receive the best in mental health and wellness care/services/programming,” said the statement from Dena Sites, Lifeways compliance and privacy officer.

Lifeways delivered another statement to state regulators to share with the Enterprise.

“Lifeways is working closely with the state to ensure all licensing and regulatory requirements are adhered to. We will continue to update the community and our partners on our team’s progress,” the statement said. Lifeways provided the statement after it learned the state agency was preparing to release public records to the Enterprise.

When pressed for details about the issues, Hoekstra said in an email Saturday that he considered the requests “hostile and demanding…Hostility will be viewed as harassment and we will take protective action accordingly.”

DOCUMENT: State letter to Lifeways

State regulators moved to review Lifeways’ treatment program after the agency in March suddenly closed its Ontario treatment center, where clients live in a residential setting. Lifeways gave the clients a few days’ notice they had to leave, but state regulators said later they were required to get 30 days’ notice. The state also said that some clients hadn’t been given appropriate help to move to another program.

Last month, Hoekstra declined to address what he termed “journalistic curiosities” about the state’s concerns at that time.

In its recent letter imposing the license conditions, the state said Lifeways “substantially failed” to obey state rules on notices. The letter said that “circumstances at the facility threaten the health, welfare or safety of individuals” because plans to move them to another program “may or may not have been adequate.”

Cissie Bollinger, behavorial health policy manager at the state Health Systems Division, said in an interview that Lifeways acted in April as the pandemic took hold.

“Nobody has experienced that before,” Bollinger said. “We had programs needing to close.”

She said because Lifeways acted “in an emergency,” its closure “wasn’t done in a way envisioned by the rules.”

The license conditions are unusual.

“We don’t have a lot of condition letters like this,” Bollinger said. “The number one goal is that the individuals being served are being served well.”

Lifeways officials didn’t address questions about when it plans to open the Ontario treatment center. Bollinger said the state has been advised Lifeways is aiming to restart that service in August.

Lifeways, a nonprofit founded in 1997 to take over Malheur County mental health services, provides mental health and addiction treatment services and also now serves Umatilla County and has expanded into Idaho. Its tax return showed that in 2018, the nonprofit had $25 million in revenues. The agency wouldn’t provide its most recent tax return though federal law requires such documents be provided to the public.

State officials say they intend to closely monitor Lifeways as it starts up its addiction treatment program.

“We’re going to be intensely involved in a meaningful way,” Bollinger said.

The notice means state regulators will be looking over the shoulder of Lifeways as it again provides services to those being treated for drug and alcohol abuse. The recovery center is licensed for 60 people.

Lifeways is being required to screen employees and clients for COVID-19 and plan for what the center will do if someone tests positive for the virus.

Once the center opens, Lifeways will have to submit to the state weekly reports on its clients, staffing, daily schedules and daily menus. In addition, Lifeways will have to turn in “clinical documentation” every week showing its treatment of clients.

Bollinger said state regulators want the weekly reports to ensure Lifeways is properly treating its clients.

“We’re always working toward that discharge” from treatment, Bollinger said.

She said the weekly reviews impose additional work on state regulators.

“It’s a big job, but it is important,” Bollinger said.

In its statement, Lifeways said it had a “collegial conversation” with state regulators in late May. The agency said it agreed to the state’s conditions and is updating “operational procedures and clinical programming after multiple conversations with our referral and community partners.”

“We are grateful for the state’s and community’s partnerships as we move through an unprecedented and unforeseen set of circumstances,” the statement said.

Bollinger said a factor in the emergency closure of the recovery center was that its kitchen wasn’t in order and food had to be brought in for clients.

Problems with the kitchen were flagged in a state inspection report more than a year ago, according to documents released to the Enterprise under the state public records law.

A state report said an April 2019 review of Lifeways’ recovery center flagged 22 violations the state ordered corrected.

DOCUMENT: Lifeways review report

Among the findings by the Health Services Division:

-Lifeways “did not allow visitation for residents in this facility. This was restricted and was only allowed after 2 weeks and only off campus.” State regulations say every resident has a right to visitations.

-“7 out of 7 service records did not contain documented evidence to show that staff were providing individuals with a description of their rights at the time of entry.” State regulations require residents be given a written statement of their rights.

-State regulations require “a written, individualized plan” that includes treatment objectives that are measurable. Reviewers found that two plans “contained the exact same objective for two different residents,” that five of seven plans examined “did not contain treatment objectives that were measurable” and that all seven plans reviewed “did not contain a baseline evaluation for the purpose of evaluating progress.”

The reviewers reported problems with the Recovery Center building, among them:

-The men’s kitchen wasn’t functional because the stove had been removed and “plaster was peeling off wall.”

-The women’s kitchen wasn’t functional because the stove had been disconnected and “the kitchen cupboards were badly worn and dirty.”

-“The walls and ceiling in the dining room of the men’s program had food stains.”

-A thermostat was pulled away from the wall “exposing wires.”

-“The couch fabric was torn and dirty.”

Lifeways didn’t answer specific questions about the facility, but said that it was “in compliance with any Corrective Action Plans.” The agency didn’t provide those plans. It said in its statement that remodeling of the recovery center was intended to provide “up-to-date health and safety measures.”

On Monday, June 15, Lifeways posted an update on its website, noting that “the remodel of our kitchen is coming along nicely! Check back here for photos next week.”

The state is requiring Lifeways to regularly report on the remodeling.

“We want to make sure it’s in tip-top shape,” said Bollinger.

DO YOU HAVE INFORMATION? The Enterprise is continuing its reporting on Lifeways. Share your experiences or information with editor Les Zaitz by email at [email protected]

PREVIOUS COVERAGE:

'Retaliated against': Patients, staff reel as Lifeways closes one facility in Ontario

State reviewing Lifeways residential facility's abrupt shutdown

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