Inspectors pass different judgments on Duluth methadone clinicDuluth’s methadone clinic received a highly positive report in June from its accrediting agency. But investigators with the Minnesota Department of Human Services said they found 56 violations of standards.
Duluth’s methadone clinic received a highly positive report in June from its accrediting agency — three months before the state of Minnesota conducted its own inspection and recommended the clinic be shut down.
The nonprofit Commission on Accreditation of Rehabilitation Facilities, or CARF, gave the Lake Superior Treatment Center high marks, finding the clinic met or exceeded standards for other methadone clinics in numerous measures.
“On balance, Lake Superior Treatment Center has made a dedicated effort to maintain international accreditation and is providing much needed services to persons in the local community in need of treatment for opiate dependence,” the agency said in a report, a summary of which was provided last week to the News Tribune.
But investigators with the Minnesota Department of Human Services, who inspected the clinic on Aug. 2 and 3, said they found 56 violations of standards for methadone clinics, many of them repeats from inspections done earlier in 2012 as well as from 2009.
Violations the state said it found included failing to check that patients were properly using take-home doses of methadone — high-level doses of the drug that are popular on the street; providing false information to investigators; and overworking counselors by giving them case loads of 80 clients — 30 more than federal law allows.
The Department of Human Services announced in September that the clinic’s license would be revoked. The clinic appealed the revocation, allowing the treatment center to remain open as the case is heard before the Minnesota Office of Administrative Hearings. A preconference hearing in that case is scheduled for Dec. 6.
After reviewing the accrediting agency’s report last week, Jerry Kerber, Department of Human Services inspector general, noted the gap between the state’s assessment of the clinic and CARF’s.
“The evaluation of the program services by the CARF organization appears to reach some different conclusions about the acceptability of care provided by this organization.” Kerber said in a written statement. “While there are many recommendations for improvements in the report, there are some ‘strengths’ listed that are completely inconsistent with the findings of the Department of Human Services.”
A spokesman for CARF declined to comment on the discrepancy between findings from the nonprofit’s report and the state’s condemnation of the treatment program’s operation. The treatment center is responsible for the costs of the inspection.
Florida-based Colonial Management Group, which owns the Lake Superior Treatment Center, declined a request for comment for this article.
Federal law mandates that clinics such as the Lake Superior Treatment Center be inspected and accredited in order to provide methadone, a responsibility often passed on to private accreditation groups.
The Commission on Accreditation of Rehabilitation Facilities has accredited 789 methadone clinics and more than 6,500 health-care facilities, said Al Whitehurst, a CARF spokesman.
Accredited facilities pay several thousand dollars for a CARF inspection and accreditation, said Whitehurst. He declined to say how much the Lake Superior Treatment Center paid.
Following an inspection at the treatment center on May 17, which was being conducted because its accreditation was due to expire, CARF reaccredited the clinic for three years, the lengthiest time possible, according to the agency.
CARF’s report said the clinic “has developed and implemented a comprehensive performance analysis and improvement process to address the concerns of the Minnesota (DHS) licensing division.”
The CARF report said the Treatment Center experienced “almost a complete turnover in personnel, including its leadership.”
“Compliance experts were brought in to determine the extent of the problems, and a new program director was hired. She has assembled an exceptionally qualified staff for the organization. Clinical concerns for documentation of services, personnel trainings and service access have been formally addressed by management.”
The DHS report, however, was highly critical of the treatment center’s hiring and staff, saying mandatory background checks weren’t conducted on 14 of its staff members at the time of its August inspections, and that the director of the program didn’t work full-time at the center and didn’t “know and understand” Minnesota Rules pertaining to methadone clinics.
DHS cited the clinic for numerous violations for staff members failing to provide adequate care to patients as well as failing to adequately update patient files and monitor their treatment.
CARF’s Whitehurst said that stipulations were placed on the Lake Superior Treatment Center’s accreditation in September. He declined to say what those stipulations were, or why they were put on.
Whitehurst said more than 95 percent of service providers seeking CARF accreditation receive it, with just over 80 percent receiving the full three-year accreditation.
Whitehurst said that among service providers that have already achieved CARF accreditation and are resurveyed to continue their accreditation, less than 1 percent receive non-accreditation. More than 90 percent receive three-year accreditation.
The Lake Superior Treatment Center has been accredited by CARF since 2006.