Solution and Salvation? Or Snake Oil.

“Figures often beguile me, particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force:

“There are three kinds of lies: lies, damned lies, and statistics.”

     

     Mark Twain, 1904.

With these wise words echoing from one of the great American scribes, let us look at the manner in which residential treatment centers, and eating disorder treatment professionals in general, judge their long-term effectiveness. We trust our beloved children and loved ones to these centers at a time when, except for hospitalization, they need the most professional, thorough, and expert care available. As parents, spouses, children, we have a right to know.

Unfortunately, with regard to the long-term effectiveness of eating disorder residential treatment programs, there are no third party, objective studies and findings indicating their rate of long-term success or their recidivism rates.  There is not even a consensus on the most effective manner to determine post-treatment patient satisfaction. In a past study, a researcher found the following:

“Sixty-one percent of all programs reported using some type of data to evaluate the effectiveness of their treatment program. Of these 61%, 63.6% of programs used self-report surveys to gauge treatment effectiveness, 36.4% used outcome studies, 18.2% used laboratory tests, and 18.2% used program-initiated telephone calls. Some programs used more than one of the previous listed methods.

Greater than one third (36.4%) of the programs evaluating treatment effectiveness relied only on client-initiated post-treatment telephone calls for effectiveness measures. Thirty-nine percent of all programs did not provide information on the measures used to determine treatment effectiveness.”

As such, with no consensus and no oversight from state or federal agencies, centers are free to market or advertise their “success or satisfaction” rate in any manner they choose.

With regard to this marketing, every state in the United States has laws pertaining to "puffery." The Merriam-Webster Dictionary (which advertises that it has been in existence since 1828) defines "puffery" simply as, (n) - exaggerated commendation especially for promotional purposes.

The Council of Better Business Bureau’s Code of Advertising provides that an advertiser bears primary responsibility to ensure its advertisements are truthful and non-deceptive. The Code of Advertising specifically addresses the subject of “Superlative Claims—Puffery,” distinguishing objective, or factual, claims from subjective, or puffery, claims. It defines objective claims as those relating to “tangible qualities and performance values of a product or service which can be measured against accepted standards or tests.” Because objective claims are statements of fact, “such claims can be proved or disproved and the advertiser should possess substantiation.” Subjective claims, on the other hand, are “expressions of opinion or personal evaluation of the intangible qualities of a product or service.”

Therefore, to attract families and patients, treatment centers can advertise that they “provide the best care available,” or “their counseling methods are tried and true and supported by experts in the field,” or “our patients are very satisfied with the quality of our services.” Each of these statements are matters of opinion. They may be lies. They may even be damned lies. But, they are not actionable as misrepresentations or fraudulent statements because they are opinion based, lack statistical support and do not have an objective or factual basis. Most companies know the difference and steer clear of statistical representations.

But, there are a very few notable exceptions.

CCMP Capital Advisors d/b/a The Eating Recovery Center

CCMP Capital Advisors d/b/a The Eating Recovery Center represents to the general public that with regard to its Child & Adolescent Inpatient/Residential and Partial Hospitalization Programs, “… 99% of parents of child/adolescent patients report that treatment at Eating Recovery Center was helpful, and 97% would recommend Eating Recovery Center to other families in need of treatment.” [emphasis added] These statistical representations are made on their website.

Ninety-nine percent (99%)!  Ninety-nine percent (99%)! 

That number is really quite remarkable since the highest score awarded by the respected American Customer Satisfaction Index to any health care provider was… 76.

But, purportedly Ninety-nine (99%) of its patients report that the provided services helped. This statistical number, since it must be exactingly precise so as not to constitute a gross misrepresentation to the general public, was obviously computed only after CCMP d/b/a ERC developed a fool-proof system whereby 100% of its patients and their families not only stay in communication and remain responsive after they are discharged (or after the applicable insurance company decides to discharge their loved one and only pay for stepped down treatment) but 99% of them state that the treatment was helpful.  Or do they? Note that the representation does not mention “patients surveyed,” or that a reduced or limited class of patients was surveyed.  The very bold claim is that “ … 99% of parents of child/adolescent patients report …”

It is axiomatic that helpful treatment leads to recovery and ipso facto, an end to this insidious disease!  If these statistics are to be believed, this treatment center has in essence, discovered a cure for this insidious disease.  Imagine, no parents left devastated as their child relapses. Imagine, instead of one person being taken by this disease every 62 minutes, that number would be reduced to ... ZERO. That is truly salvation!

But wait.  Let us examine the manner in which CCMP d/b/a ERC compiled these numbers to try to determine their accuracy. It is well known that CCMP d/b/a ERC sends out a general survey to some of its patients or parents four weeks after discharge. Now, there are a number of eating disorder parent support groups on Facebook and other social media. An informal question to one group alone resulted in a significant number stating that they had not been contacted by CCMP d/b/a ERC at all. Other persons reported that they were most assuredly not satisfied with CCMP d/b/a ERC’s treatment program. That in itself is problematic since those dissatisfied persons, or persons who were not contacted at all, would significantly cut into that incredible 99% representation.

Further, any company with in essence a 100% customer satisfaction rating should be an incredible place to work. And yet, a well known website gauging employees’ satisfaction with their employer tells an alarmingly different story.

The following statements are representative of the work environment at CCMP d/b/a/ ERC as conveyed by former employees:

They say safety is a priority, yet the patient’s [sic.] go on pass and HARM themselves. ..

A very toxic and racist environment. The company as a whole steers clear of diversity in the workplace.

Non caring management, unrealistic expectations, lack of experience for some in management positions. Growth has made the management team not care about the people only money.

High turnover, lack of communication, company is all about making money, understaffed, underappreciated by management

Underpaid, understaffed, money hungry, has grown so big that patient care is compromised, not consistent, poor communication, as the founders/thought leaders retire the vision is being lost, I could go on

Reading all the other reviews is validating and a relief- working there and felt horrible about it almost daily. Lack of heartfelt, meaningful, engaged , or even pleasant lead management.

Management are removed from milieu and daily experiences of clients and staff, unsupportive and unprofessional management and supervisors,

Frequently told to bring in patients first with the highest reimbursement, regardless of health status of patient.

For-profit hospital- evident in every way that everything is about money

No care for mental health of staff, minimal supervision support, profit-obsessed to the point of being unethical

A large company that recently cut a ton of jobs "rightsizing" equals for profit care to the extreme. Horrible communication, terrible management, the worst work/life balance I have ever experienced.

I witnessed the quality of the services go down by changes made by management in Denver that never made it a point to see how operations run in the Sacramento location. Many of the changes appeared to focus more towards retaining revenue rather than investing in quality services

This company only looks at their financials and nothing else.

They're going around acquiring tons of treatment centers and slapping their name on them while laying people off, cutting pay and hours where existing sites are struggling

Not enough staff to provide any real treatment whatsoever. This is basically a fake treatment center that bills insurance companies for services NOT rendered. 

You are ruining everything that you stand for, or STOOD for, by being so money hungry.

They continue to expand without the infrastructure to support the growth leading to burnout because staff is just expected to cover extra shifts every week. It is all a numbers driven approach to admissions and you are expected not to question

The attitude from the top down is negative and untrustworthy. The emphasis is strictly on numbers in an effort to sell the company. 

Working for a private hospital comes with a focus on business, profit, and insurance, which may not appeal to some. 

Note that these complaints, yes albeit, anonymous, do not involve the usual employees' complaints about their employer being "mean" or evidence disgruntled employees with a personal axe to grind. These complaints focus on the overall toxic corporate environment, on the manner in which the Corporate Practice of Medicine is changing the environment at CCMP d/b/a ERC and that their mission has changed to become a revenue producing entity. And yet, we are naively supposed to believe the Ninety-nine Percent (99%) number is remotely accurate when it has been established that:

1. The manner in which CCMP d/b/a ERC computed this number is undisclosed and on the surface, cannot be verified;

2. The number itself is refuted by real life complaints and information provided by parents of patients;

3. The work atmosphere at CCMP d/b/a ERC is focused on the bottom line and making a profit, and not on the safety and welfare of the patients or employees.

And what started with great potential, a presumably honest representation of an incredibly important and material fact that could be relied upon by the millions of people suffering from this cruel, insidious disease, a possible salvation is simply another form of ... snake oil.

Ninety-nine Percent (99%)!

That appears to be more than just a lie.  That appears to be more than just a damned lie. That number is a hard and obviously false statistic... a misrepresentation of fact, and a statistic that could result in possible liability.

In the eyes of the court system, actionable representations must involve material facts, not mere opinion or puffery. See Prudential Ins. Co. of Am. v. Jefferson Assocs., 896 S.W.2d 156, 163 (Tex.1995). "A representation is `material' if it is important to the party to whom it is made in making a decision regarding the particular transaction." Burleson State Bank v. Plunkett, 27 S.W.3d 605, 613 (Tex.App.-Waco 2000, pet. denied). "`Material means a reasonable person would attach importance to and would be induced to act on the information in determining his choice of actions in the transaction in question.'" Id. (quoting Beneficial Pers. Servs. v. Porras, 927 S.W.2d 177, 186 (Tex.App.-El Paso 1996, writ granted, judgm't vacated w.r.m.)).

"When a speaker purports to have special knowledge of the facts, or does have superior knowledge of the facts—for example, when the facts underlying the opinion are not equally available to both parties—a party may maintain a fraud action." Paull v. Capital Res. Mgmt, Inc., 987 S.W.2d 214, 219 (Tex.App.-Austin 1999, pet. denied).

This snake oil statistic is designed to do one thing and one thing alone... drive fearful and desperate people to CCMP d/b/a ERC. And the overwhelming circumstances surrounding the operation of CCMP d/b/a ERC leads one to the only logical conclusion ... that that representation is not accurate and is designed to merely increase the company's bottom line.

When your medical practice is owned by a non-medical corporation driven to make the highest possible profit within a limited time window before selling to the highest bidder, the company's bottom line is the only importance and its patients become commodities to be churned into grist by the Private Equity Mill.

The Demon may still still laughing, but the winds of litigation war blow stronger.