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Residential Treatment Facility Abuse

South Carolina Residential Treatment Facility Abuse Attorney

Representing child victims of abuse, sexual assault, and neglect in SC and beyond

Every residential treatment facility (RTF) in South Carolina is bound under the law to protect the children and young adults they purport to serve. If the staff, administrators, contract workers, or volunteers abuse or neglect these children and minors, they can and should be held accountable for their actions.

McGowan, Hood & Felder, LLC fights on behalf of victims of abuse, sexual assault, and neglect in residential treatment facilities in South Carolina, and partners with local counsel in other states. If your child has been hurt, we want to help you seek justice. Contact us today to learn more.

What is a residential treatment facility?

According to the S.C. Department of Health and Environmental Control (DHEC), “Residential Treatment Facilities for Children and Adolescents are operated for the assessment, diagnosis, treatment, and care of two (2) or more children and/or adolescents in need of mental health treatment which provides:

  1. An education program, including a program for students with disabilities, that meets all applicable federal and state requirements, as defined by the South Carolina Department of Education (SCDE). The education program may be provided at the facility, if appropriate space is available to provide a free appropriate public education in the least restrictive environment, or an alternate location;
  2. Recreational facilities with an organized youth development program; and
  3. Residential treatment for a child or adolescent in need of mental health treatment.”

Most facilities accept children up to the age of 21. Obviously, a 21-year-old is considered an adult in the eyes of the law; as such, facilities who accept older adolescents and young adults should provide a special wing or building specifically for these older residents, whose needs will be different from those residents who are children or teenagers.

Some facilities are designed specifically to address behavioral issues, or chemical and drug dependency issues. Some are designed to assist children with special needs, such as those on the autism spectrum. These distinctions matter, because this requires the facility to have the ability to provide health care like a nursing home or assisted living facility.

Important definitions regarding abuse, neglect, and exploitation

Under Regulation 61-103, South Carolina defines the following terms:

  • Physical Abuse. The act of intentionally inflicting or allowing to be inflicted physical injury on a resident by an act or failure to act. Physical abuse includes, but is not limited to, slapping, hitting, kicking, biting, choking, pinching, actual or attempted sexual battery, use of medication outside the standards of reasonable medical practice for the purpose of controlling behavior, and unreasonable confinement. Physical abuse also includes the use of a restrictive or physically intrusive procedure to control behavior for the purpose of punishment, except that of a therapeutic procedure prescribed by a licensed physician or other legally authorized healthcare professional or that is part of a written care plan by a physician or other legally authorized healthcare professional is not considered physical abuse. Physical abuse does not include altercations or acts of assault between residents.
  • Psychological Abuse. Deliberately subjecting a resident to threats or harassment or other forms of intimidating behavior causing fear, humiliation, degradation, agitation, confusion, or other forms of serious emotional distress.
  • Exploitation.
    • Causing or requiring a resident to engage in an activity or labor that is improper, unlawful, or against the reasonable and rational wishes of a resident. Exploitation does not include requiring a resident to participate in an activity or labor that is a part of a written care plan or prescribed or authorized by the resident’s attending physician;
    • An improper, unlawful, or unauthorized use of the funds, assets, property, power of attorney, guardianship, or conservatorship of a resident by an individual for the profit or advantage of that individual or another individual; or
    • Causing a resident to purchase goods or services for the profit or advantage of the seller or another individual through undue influence, harassment, duress, force, coercion, or swindling by overreaching, cheating, or defrauding the resident through cunning arts or devices that delude the resident and cause him or her to lose money or other property.
  • Neglect. The failure or omission of a staff member to provide the care, goods, or services necessary to maintain the health or safety of a resident including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services. Failure to provide adequate supervision resulting in harm to residents, including altercations or acts of assault between residents, may constitute neglect. Neglect may be repeated conduct or a single incident that has produced or could result in physical or psychological harm or substantial risk of death. Noncompliance with regulatory standards alone does not constitute neglect.

How can I tell if my child is being abused or neglected at an RTF?

Because many of the children, teens, and young adults in South Carolina’s residential treatment facilities are unable to advocate for themselves, it is not always possible to ask them if they have been victimized – and all too often, children who do report abuse are ignored or dismissed as lying or exaggerating.

There are signs of abuse and neglect you can look for, such as:

  • Bruises, lacerations, or signs of physical injury
  • Changes in personality, including withdrawal, anger, anxiety, or sexual aggression
  • Repeated medical treatments
  • Overmedication, especially when used as a restraint
  • Refusal to come to the phone or visit during visiting hours
  • Vague responses by staff about how your child is doing
  • New destructive behaviors not in line with their “typical” behaviors
  • Signs of chemical dependency or chemical alteration
  • Being put in seclusion or isolation for long periods of time

You know your child. If your son is in a program for drug treatment and his eyes appear glassy, or he acts as though he is under the influence, this is a likely sign of abuse or neglect. If your daughter is non-verbal but communicates through art, and her drawings feature acts of abuse or aggression, or seem violent in some way, this is a likely sign of abuse. If you see these signs, contact your child’s doctor immediately. Then, call us.

What does neglect in a SC residential treatment facility look like?

Neglect can be as destructive and harmful as abuse. A child whose needs are neglected can suffer long-term physical, social, and emotional injuries. Common signs of neglect include:

  • Symptoms of dehydration or malnutrition
  • Dirty clothing and/or bed sheets
  • Feces or other bodily fluids smeared on walls, floors, or clothing
  • Open, undressed wounds
  • Infestation of vermin, leading to bed bugs or scabies
  • Poor hygiene in the residents
  • Dirty dishes, floors, windows, or other common surfaces

Sometimes, neglect is not what you see, but what you do not see: missing nurses or doctors, or understaffing of security, health aides, kitchen workers, or other staff members. Very young children, such as babies and toddlers, may appear listless or disengaged with their surroundings from lack of stimuli, attention, and care.

Is abuse and neglect common at residential treatment facilities?

Yes – and for years, the government has done nothing to help.

The last formal review of RTFs, issued in 2007 by the U.S. Government Accountability Office (GAO), found “thousands of allegations of abuse, some of which involved death, at residential treatment programs across the country and in American-owned and American-operated facilities abroad,” and investigated 10 cases where teenagers died while living at an RTF. Per the GAO:

GAO found significant evidence of ineffective management in most of the 10 cases, with program leaders neglecting the needs of program participants and staff. This ineffective management compounded the negative consequences of (and sometimes directly resulted in) the hiring of untrained staff; a lack of adequate nourishment; and reckless or negligent operating practices, including a lack of adequate equipment. These factors played a significant role in the deaths GAO examined.

In 2018 – 11 years after the GAO report – Congress passed the Family First Prevention Services Act, “which in part aims to reduce the use of residential treatment centers for foster children by restricting the amount of time most youth can stay in them, and by enacting new, higher standards RTCs [Residential Treatment Centers] must meet in order to receive federal funding.” This may benefit the approximately 47,000 foster children in groups homes or institutions, but does nothing to help children, teens, and young adults who are abused abused, exploited, assaulted, or neglected in private for-profit facilities.

Real examples of abuse and neglect of children in South Carolina’s RTFs

This abuse and neglect is happening here at home. In 2018, the Greenville News reported on multiple incidents of abuse and neglect at Palmetto Pee Dee Behavioral Health, including:

  • January 2017: Nurses failed to document which medication they were dispending for six days. The facility reminded the nurses to do their jobs correctly.
  • March 2017: A child’s arm is broken during a scuffle with another resident. The facility did not report the incident within the mandated five days.
  • March 2017: A resident is bitten multiple times by another resident. The facility formed a committee in response.
  • April 2017: A staff member punches a resident. It is caught on surveillance. The staff member was fired.
  • May 2017: Nine residents ran away because there aren’t enough “qualified staff members.” Seven of the residents had records as runaways. The facility fires two staffers, suspends two staffers, and retrains two others. There is no information whether the staffing shortage has been addressed.

All told, between February 2017 and October 2017, 23 complaints were lodged against Palmetto Pee Dee Behavioral Health.

And this is just one facility; at this time, McGowan, Hood & Felder, LLC is representing multiple clients who have pursued lawsuits against different RTFs in South Carolina:

  • John Doe and Jane Doe v. Chestnut Hills Mental Health, Inc. (formerly known as Springbrook Autism Behavioral Health). Our client’s son, “J.M.” was repeatedly dragged by his wrists, arms, and armpits, forced into seclusion, and pinned to the ground by multiple staff members. He was repeatedly left alone, in seclusion, where he threw himself against walls and banged on the door. He was repeatedly attacked by other residents, leading to bruises, black eyes, and lacerations. He developed urinary tract infections and nausea. He is a six-year-old child on the autism spectrum and diagnosed with Fragile X syndrome, and they dragged him around by the wrists and arms, throwing him into isolation.
  • John Doe and Jane Doe vs. Three Rivers Behavioral Health, LLC et al. Our client’s daughter, “K.J.,” was repeatedly groomed by two male staffers who initiated inappropriate contact. She was reportedly “in a relationship with one of them, a 36-year-old male.” Her confidential records appear to have been accessed by multiple staffers for the express purposes of grooming her for sexual conduct. She is a 15-year-old girl and a survivor of sexual assault.

These are not general cases to us, or unimaginable people: these are our clients’ children who have been abused, neglected, and exploited. And we are taking this personally.

Who is liable for abuse, sexual assault, or exploitation at an RTF?

Depending on the facility, the following parties may be held liable if they have harmed or put your child in danger:

  • The owner and operator of the facility
  • Any staff or personnel who engaged in abusive or neglectful acts
  • Volunteers and people doing community service hours
  • Doctors, nurses, and health aides
  • Drivers and other people providing transportation services
  • Other residents

It is important to note that under Regulation 61-103, resident-on-resident harm is explicitly excluded from the definition of “physical abuse.” However, there may be different rules governing the contracts for private facilities, and for criminal acts of sexual assault or abuse. Furthermore, even if we cannot hold another resident liable for attacking your child, we can hold the facility liable for failing to supervise the residents and/or for negligent hiring practices, depending on the situation.

Frequently asked questions about making claims against RTFs, and our services

  1. I live out of state, but my child resides in South Carolina; can you help me?
  2. I live in South Carolina, but my child resides elsewhere; can you help me?
  3. Can you explain what “negligent hiring” practices are, and how they apply to RTFs?
  4. My child fell down the stairs and sustained a serious injury; can I file a lawsuit?
  5. My child died while in residence at a treatment facility; what do I do?
  6. I think my child is being abused; what should I do?

I live out-of-state but my child resides in South Carolina; can you help me?

Yes, we can. McGowan, Hood & Felder, LLC represents victims of abuse, neglect, and exploitations throughout South Carolina. The laws in our state may be different from the laws where you live, so retaining local counsel in South Carolina is critical to ensure your best chances at success.

I live in South Carolina, but my child resides elsewhere; can you help me?

We can and have worked with out-of-state attorneys before on various types of cases, and can do so to help you as well. We can also provide referrals for attorneys we trust to help you through this terrible situation.

Can you explain what “negligent hiring” practices are, and how they apply to RTFs?

Employers owe their clients (or in the case of RTFs, the children in their care and their parents) a duty of care, whether those employers work in a retail store, a restaurant, or a professional service. Often, residential treatment facilities offer positions for “health aides” – minimum-wage positions that require no formal training in physical or mental health treatment or services. This means that despite the titles they use, their employees do not have a background in medicine. These employees are often under-trained, under-supervised, and underqualified for these positions.

Further, all employers should initiate background checks for any potential employees. Failure to do so can result in the negligent hiring of child predators or other unsuitable candidates. If an untrained, unqualified employee causes your child harm, we can file a claim for negligent hiring practices.

My child fell down the stairs and sustained a serious injury; can I file a lawsuit?

Yes, you can. Under the doctrine of premises liability, RTFs are required to ensure that their premises are safe for visitors, employees, and residents. If the premises are unsafe – there are broken stairs or handrails, there are broken lights or security cameras, they don’t lock up the medications at night, etc. – you can file a personal injury claim alleging neglect.

My child died while in residence at a treatment facility; what do I do?

If the unthinkable has happened and your child died while under the supervision and custody of a residential treatment facility, you have legal options for holding the facility accountable. Please contact us so we can discuss those options with you.

I think my child is being abused; what should I do?

Report the suspected abuse to the authorities immediately, to local law enforcement and/or the South Carolina Department of Social Services. RTF employees are mandatory reporters, which means they are required by law to report abuse. If they failed to do so, ignored signs of abuse or neglect, or engaged in abuse or neglect, you want to have a police record of the incident, and get an investigation into the facility. If you are unsure how to do this, we can help.

Next, document everything you can. Take photos or videos; write down your thoughts about the facility, or ask your child what he or she thinks (if possible). Speak with your child’s pediatrician about changes you have observed.

Third, immediately remove your child from the facility, and seek medical treatment. His or her medical records will be an important part of your case against the facility. You should also consider having your child work with a therapist, especially if he or she is non-verbal or otherwise unable to communicate with police or the pediatrician.

Fourth, take a deep breath and repeat this statement: “This is not my fault.” You did what you thought was best for your child. If someone harmed or neglected your son, daughter, or legal dependent, remember that you are not the one who committed the crime or the heinous act. Do not admit fault to something you did not do.

Finally, pick up the phone and call McGowan, Hood & Felder, LLC, so we can get started on your case. We have experience filing these types of lawsuits against residential treatment facilities. We are here to protect you and your child, no matter what.

Fighting for child victims of abuse, neglect, and exploitation in South Carolina

Residential treatment facilities are supposed to help your children, not harm them. The South Carolina injury lawyers at McGowan, Hood & Felder, LLC fight for families whose children have been abused, neglected, sexually assaulted, and exploited in these facilities. To schedule a free consultation, please call 855-296-0828 or complete our contact form. We serve clients across the state, and have a team of caring people who will guide you through the litigation process.