An Indiana administrative law judge has ruled against Nashville, Tennessee-based Landmark Recovery’s initial appeal to reopen three shuttered addiction treatment facilities.
The development is a serious setback for a once-promising business that faces several critical struggles.
The regulatory actions by the Indiana Department of Mental Health and Addiction (DMHA) were prompted by three sudden patient deaths at Praxis of South Bend by Landmark Recovery in Mishawaka, Indiana.
Since then, Behavioral Health Business verified with law enforcement and fire officials that another Landmark Recovery patient died following an undetermined medical incident at its Willard, Ohio, facility on Aug. 28.
Local officials declined to provide additional details pending further investigation.
DMHA revoked on July 27 the licensure for three of the four facilities Landmark Recovery operated in Indiana following the deaths from July 3 to July 9. Landmark Recovery also do not report other critical events at Praxis of South Bend by Landmark Recovery, further leading to the license revocation, according to the administrative judge’s ruling.
However, the matter is not settled.
Landmark Recovery CEO Matt Boyle told BHB in an email that the organization will have a “full evidentiary hearing” before the administrative court in the coming months.
“Most regulatory issues do not play out in court, because that often takes years,” Boyle said. “It is also certainly possible that we resolve the issue in some manner before the court schedule. In the meantime, we are focused on our other 11 facilities.”
He also said the patient at the Willard location, Praxis of the Firelands by Landmark Recovery, was pronounced dead after being taken to the hospital. The patient was checked every 30 minutes and was found by staff during one of those checks.
Landmark Recovery has also instituted another round of layoffs as it restructures under the weight of losing 300 beds due to a loss of its licenses. The company laid off about 300 staffers who supported the three closed Indiana facilities at the end of August.
It’s unclear how many roles were eliminated by what impacted staffers describe as a “restructuring” in social media posts. The roles impacted included senior vice president roles related to human resources and director roles for communications. Boyle and other Landmark Recovery officials have not yet responded to questions about the restructuring.
Court rules against license revocation appeal
On Sept. 1, Administrative Law Judge Wendy Messer ruled against Landmark Recovery’s petition to stop DMHA’s revocation of the licenses for Praxis of Carmel by Landmark Recovery, Praxis of Fort Wayne by Landmark Recovery and Praxis of South Bend by Landmark Recovery.
To secure a stay, a petitioner must show “a reasonable probability the agency action is invalid or illegal” and “a petitioner must show a reasonable probability of success on the merits of the underlying claim.”
However, Messer ruled that Landmark Recovery’s petition and information presented at a hearing held on Aug. 17 provided “insufficient evidence” that Landmark could succeed on the merits of its claim. Further, she ruled that “at this stage, these facts are sufficient to show that the DMHA issuance of the emergency revocation order was reasonable.”
Landmark Recovery argued that the DMHA’s ruling would cause irreparable damage to Indiana residents in the form of lost wages for employees and lost access to care at the three Praxis facilities. Messer disagreed with this conclusion, noting that the Praxis facilities closed and transferred or discharged all patients well before their Aug. 17 deadline to do so with the help of other providers.
“While it is of course important that that Indiana residents have access to substance abuse and mental health treatment options, it is also critical for there to be access to quality treatment and services consistent with prescribed operational and training requirements in furtherance of the overriding public interest in consumer safety and wellbeing in any treatment setting certified by the DMHA,” the ruling states.
By the time the three patients in the Mishawaka facilities died, the three Landmark Recovery Praxis facilities were already on corrective action plans and operating under conditional licenses for dozens of noncompliant issues cumulatively.
On February 15, DMHA prioritized its annual certification review for Praxis of Fort Wayne by Landmark Recovery based on complaints the department had received. That facility and the other two Praxis facilities were placed on conditional certification after DMHA’s review raised concerns about noncompliance on issues such as “resident safety, medication, documentation, environmental safety, and consumer rights.”
One vital issue in the judge’s decision was the timing of Landmark Recovery officials reporting the deaths to DMHA. Indiana state law requires such incidents to be reported within one working day. In this case, the deaths were reported two to three days after the incidents.
The three deaths at the Mishawaka facility are not the only ones.
On Jan. 1, 2023, a patient at the Praxis of Fort Wayne by Landmark Recovery walked out of the facility, disappeared and was found dead a month later. 21 Alive reports that Landmark Recovery officials admit the facility made mistakes in handling the patient’s discharge in a report submitted to and a public hearing before the Bluffton city council.
Other legal challenges, allegations mount
Landmark Recovery faces a growing list of lawsuits over its actions at the Indiana facilities.
The family of one of the deceased patients at the Mishawaka facility filed a wrongful death suit against Landmark Recovery in August, according to WBST 22.
Attorney Trevor Crossen from Crossen Law Firm sued Landmark Recovery on Aug. 8, representing former patients who allege Landmark Recovery was negligent in its care and endangered its patients. The number of former patients joining the Crossen suit totaled 97 as of Aug. 15, according to a blog post from the firm.
Dynamic Mechanical Services, a plumbing and heating company based in Indiana, sued Landmark Recovery, alleging a breach of contract and that it is owed more than $13,000 in building and plumbing maintenance, according to WSBT 22.