On July 22, a foster care caseworker flew from Lubbock to Houston to move a severely mentally disabled 16-year-old girl from a group home she loved to a group home that had lost its secretary of state charter six months earlier.
No explanation was given for moving the girl, an obese diabetic who had recently experienced two emergency trips to Texas Children’s Hospital after the company that manages the foster care system’s Medicaid program reduced coverage for nurses who gave the girl her daily insulin shots.
It was the girl’s third move in six months. In February, the girl – whom we’ll call Vanessa – was one of approximately 80 children moved from residential treatment centers in Lubbock and Levelland run by Children’s Hope, a nonprofit agency that provides 24-hour care for some of the most behaviorally challenged kids in foster care, and shuttled to San Antonio. After the brief stay, she and others were transferred to homes in Houston. Twelve seemed to find a good fit in homes run by a company called Love & Joy.
The state suspended its placements to Children’s Hope in late January, one month after a federal judge issued a scathing finding that state officials had turned a blind eye to widespread abuse of children in the foster care system. After nearly five years of litigation brought by a nonprofit advocacy group, the State of Texas was found liable for violating the constitutional rights of 12,000 kids in foster care. These were children tossed into a tranche known as permanent managing conservatorship – children the state had given up on, and who were expected to be in the system until they aged out.
On the surface, the suspension of Children’s Hope, as well as a series of other facilities that followed, seemed like the state was finally holding caretakers responsible. But records obtained by the Houston Press show that, due to the sudden dearth of spaces for the most emotionally and behaviorally challenged kids, the Department of Family and Protective Services (DFPS) has been placing vulnerable children into facilities overseen by another state agency with a casual approach to quality control, the Department of Aging and Disability Services (DADS).
It’s doubtful that, on July 22, Vanessa had the ability to comprehend the context. All she knew was that a caseworker showed up to take her away from her housemother, Sheila Swirczynski.
In a video from that day, obtained by the Press, Vanessa repeatedly objects to the move. “I want to stay!” she shouts. “I’m not leaving Miss Sheila. I want to stay! They are my family.”
The caseworker patiently and quietly tried to calm Vanessa, saying, “I heard you. I have to do my job, though.”
At Vanessa’s new home in Richmond, the house mother, Jorfui “Dolly” Kandeh-Dabo, is seen telling a nurse that neither DFPS nor DADS told her that Vanessa was diabetic and had recently been hospitalized. This runs counter to DFPS policy, and it clashes with what a DFPS spokesman told the Press – that there’s no way kids would be moved without their new caretaker getting a rundown of their medical needs. As Kandeh-Dabo relates this information, one of Vanessa’s caseworkers sits uninterestedly at a table, filling out paperwork.
Had the Department of Aging and Disabilty Services been up to date, officials would have known that Kandeh-Dabo’s home was operating without a secretary of state charter, which is a violation of DADS contracts. It’s unclear if DADS notified Kandeh-Dabo of the oversight, which is only administrative, and not directly related to patient care.
Twenty-four hours after Vanessa arrived at her new home, she threw a fit, and Kandeh-Dabo apparently saw no other recourse than to call police. Vanessa was transported to a Bellaire psychiatric hospital.
In the days following, three other Children’s Hope refugees were removed from Love & Joy for unclear reasons; two of them were placed with DADS-licensed facilities run by individuals with repeated bankruptcies and civil judgments that forced their operations into receivership and may even have affected their ability to provide food and medication to their clients.
The Children’s Hope case offers a glimpse into how federal orders delivered on high are being carried out in the trenches. Following the West Texas treatment center’s suspension, facilities in Richmond, Conroe and Eddy were shuttered due to continued violations. While suspending problematic facilities looks on the surface like the swift, mindful response to the federal court’s ruling, records obtained by the Press reveal an alarming, continued indifference toward the care of some of the Children’s Hope refugees relocated to Houston.
Just as troubling, officials from DADS and DFPS seemed more intent on finding out how the Press obtained records for this story than looking into actual child welfare concerns. For example, neither agency seemed interested in why Centene, the St. Louis-based health-care juggernaut that manages Medicaid coverage for foster children, initially denied repeated requests to cover nursing visits for Vanessa’s insulin injections. This despite the fact that a Texas Children’s Hospital physician wrote that missed dosages “may be severe and even life-threatening.” (Profoundly intellectually disabled, Vanessa could not be relied on to regularly self-administer.)
After the Press’s initial story on Vanessa on July 16, officials with DADS launched an investigation into the identity of the whistleblower. Instead of looking into the histories of the facilities where vulnerable children were being placed, a DADS official asked the Press for the whistleblower’s name, which we did not provide.
To put this increased scrutiny into perspective, a recent DADS report showed that, out of 4,287 complaints related to its contracted home- and community-based services program homes in fiscal year 2015, workers only conducted 21 on-site reviews. So it takes a lot to pique the department’s interest.
The following is a look at – eight months after a federal court order demanded better treatment for the state’s most vulnerable children – where some of these kids are being sent.
When Vanessa was removed from Love & Joy, she was sent to a home run by one of Kandeh-Dabo’s companies, Vericon Health Services. At the time, Vericon was operating without a charter through the secretary of state’s office for failure to pay state franchise taxes.
Cecilia Cavuto, a DADS spokeswoman, told the Press that companies like Vericon must have a valid charter. Department policy gives a company 30 days upon notice from DADS to reinstate the charter. It’s unclear if Kandeh-Dabo was ever notified. While an administrative oversight does not speak to a health-care provider’s standard of care, it raises questions about that provider’s ability to comply with other requirements related to patient welfare.
Although Vericon lost its charter on January 26, the company was back in good standing on July 25, days after the Press asked both Cavuto and Kandeh-Dabo why children were still in the Vericon home. Neither party answered our question.
It’s possible the confusion is related to DADS’s compartmentalized approach to the facilities it regulates, which include “licensed home health agencies,” “home- and community-based services,” “Texas home living” and, perhaps the most inconveniently named service of all, “Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Program.” Each has its own state requirements; some are licensed, while others are merely “contracted.”
Approximately two weeks before Vericon lost its charter, a DADS inspection found that staff failed to conduct background checks, administer drugs per doctors’ orders and fully assess clients, among other deficiencies. (Cavuto told the Press, “We approved the corrective action plan and evidence of correction in February of this year. We have no outstanding citations with this provider.”)
Unrelated to Vanessa’s care, the department’s Quality Reporting System shows that another home run by Kandeh-Dabo from 2010 to 2014, Johad Homecare, had not been inspected in at least three years.
Kandeh-Dabo briefly lost control of another company, JD Homecare, in 2007, when her partners in the company sued her in Fort Bend County State District Court, accusing her of embezzling funds and engaging in Medicare fraud with an associate who ran a home health-care service. Both Kandeh-Dabo and her co-defendant in the civil lawsuit, Mbomette Udobong, denied the allegations. (When we previously reported on this suit, Udobong’s lawyer threatened to take legal action.)
Kandeh-Dabo’s partners accused her of cashing Medicare checks the company received and giving the money to Udobong, “who then wrote a check to Kandeh personally,” according to court records, which include copies of checks to Kandeh-Dabo totaling roughly $40,000.
Ultimately, Kandeh-Dabo and her former partners agreed to sell JD Homecare at auction and distribute the proceeds among themselves, after covering outstanding bills. The highest bidder was Georgia Faye Harris, Udobong’s ex-wife, who swore in an affidavit that she was acting as an agent for a man in Nigeria named Israel Udobong.
JD Homecare then went into receivership. But Kandeh-Dabo argued that Harris should have been barred from taking possession of the property if she would not have been the actual owner, and she successfully filed a motion for a new trial. The company reverted back to Kandeh-Dabo. Secretary of state records show that Kandeh-Dabo served as the company’s president until sometime between July and December 2012, when a new set of owners and directors took over.
Kandeh-Dabo also had dealings in federal court. Records show that Kandeh-Dabo was detained by customs agents at Bush Intercontinental Airport in 2010, after a routine inspection revealed she was carrying nearly $20,000 in cash. Federal law requires people to file a report if they’re transporting more than $10,000 in cash out of the country.
According to the federal complaint, Kandeh-Dabo lied to the customs officer and said she was carrying only $5,000. The money was divided among seven envelopes bearing different people’s names.
The money was seized, and Kandeh-Dabo subsequently filed a motion to recover the funds, stating that she was only delivering the money to family members of her associates in Houston. In an agreed final judgment, half of the money was returned.
Kandeh-Dabo did not respond to multiple requests for comment.
Prior to Vericon’s charter renewal, the Department of Aging and Disability Services recently entered into a contract with Vericon worth more than $100,000. Kandeh-Dabo is listed with the secretary of state’s office as the company’s sole governing person. It’s unclear if DADS was aware of the expired charter, or of the histories of Kandeh-Dabo’s other companies.
As of July, two Children’s Hope refugees who were moved from Love & Joy were spending their days at an adult “day habilitation” facility in a southwest business park operated by Meridian Care, Inc. The director and president is Liner Anekwe, who is also listed in secretary of state records as an officer or a director of other health-care companies using a variation of the “Meridian” name – such as Meridian Nursing Services, Inc., and Meridian Transition Services, Inc.
Within the Meridian family of companies, some of which were incorporated in the early 1990s, three names appear regularly as president, officer or director: Liner Anekwe, Godwin Anekwe, and Bernard Ugwu. In some cases, such as Bernard Ugwu’s Meridian Physicians and Associates, Inc., there’s only one name listed as president or director. A fourth common name is Eghosa Aideyan, who is listed with several Meridian companies as the registered agent. (In choosing whether to license or contract with certain providers, DADS takes certain criminal convictions into consideration. Although Liner Anekwe was charged in Harris County District Court with assaulting his wife in 2008 and Godwin Anekwe was charged in Fort Bend County District Court with assaulting his wife in 2009, charges against both men were dismissed, and their relationship with DADS was not affected.)
According to records obtained by the Press, a therapist who visited the boys at the day habilitation facility in southwest Houston in July was concerned about minors and adults in the same setting. Both boys said they wanted to return to Love & Joy, according to the therapist’s notes. (According to a DADS spokeswoman, day habs have historically not been licensed by any state agency, but policy changes effective in late September will require guidelines for some day habs.)
In 2004, Liner Anekwe and Ugwu had a falling out. Anekwe sued Ugwu in Harris County District Court, on behalf of himself and five Meridian companies, alleging that Ugwu failed to pay federal payroll taxes. Anekwe also accused Ugwu of diverting funds from the five Meridian brands into two health-care companies he created with other partners.
In an accompanying affidavit, Anekwe claimed that Ugwu at first stuck to a payment plan with the IRS, but after he missed payments, the “IRS had went drastic in its steps by placing a lien against my family home, my family assets, and that of [Meridian],” and that the IRS threatened to seize the corporate assets and auction them off to satisfy the debt.
Anekwe claimed that one of the companies, Meridian Nursing Services, owed the IRS $700,000, and he also accused Ugwu of diverting $900,000 – as well as Meridian’s clients – into his new health-care services. (Anekwe also claimed that he personally lost $2.5 million.)
The affidavit shows the level of acrimony at the time, with Anekwe alleging that the last time he and Ugwu spoke, Ugwu blamed him “for my troubles, saying that I should not have built such an expensive house in America, and build it in Nigeria, just as he built his in Nigeria, which is beyond the reach of the IRS.”
Records from the suit show that one of Ugwu’s new companies paid him $7,500 a month for consulting services.
Ugwu denied the allegations and filed for bankruptcy in 2005.
But that was not the only time that Ugwe and Anekwe almost lost company assets.
Harris County Court records show that, in 2000, psychologist Jayne Raquepaw sued the branch of the company called “Meridian Rehabilitation Services,” accusing the directors of not paying her $12,480 for her counseling services. A judge found in her favor. (Meridian Rehabilitation Services was incorporated in 1996, with Ugwu and Liner Anekwe listed as two of three directors. At the time of the lawsuit’s filing, the company had lost its charter with the secretary of state, but was reinstated on May 25, 2001. By December 2002, Ugwu was the only listed director.)
In response to Raquepaw’s suit, Meridian Rehabilitation unsuccessfully sought bankruptcy protection. In January 2002, a Harris County judge ordered Meridian Rehabilitation to surrender its assets to a receiver, and Raquepaw’s lawyers showed up at the Meridian offices, with the receiver and a constable, to haul off property. At the last minute, Meridian’s directors had their attorney cut Raquepaw a check, and the case was dismissed.
The same year Raquepaw sued Meridian Rehabilitation, a man named Isaac Asiwe sued “Meridian, Inc.,” Ugwu and a third party, Benson Anekwe, accusing them of stiffing him on a $37,000 loan that was meant to cover Meridian’s payroll. (However, secretary of state records do not appear to show a “Meridian, Inc.” with Ugwu or Benson Anekwe as directors. Asiwe appears to have been confused over what entity he actually meant to sue. In a payment agreement between Ugwu and Asiwe filed in court records, Ugwu is listed as the “borrower” and his address is listed as “Meridian Care.”)
Ugwu accused Asiwe of charging usurious interest, making it impossible to pay off the loan. Ugwu’s bankruptcy filing appears to have delayed activity in the case until 2012, when Asiwe asked the court to force Meridian’s bank to garnish the company’s accounts. His motion was granted.
Unfortunately for Asiwe, he and his lawyer were confused by the plethora of companies under Ugwu’s and Anekwe’s control that bore the “Meridian” brand. Anekwe interjected himself into the suit, saying that Asiwe had forced the bank to garnish the wrong Meridian account. (Anekwe claimed that accounts at Meridian Care, Inc., were garnished and shouldn’t have been because Meridian Care, Inc., wasn’t even part of the lawsuit.)
Anekwe claimed that the litigation had affected patient welfare. He filed a motion claiming that “disabled and disadvantaged patients experienced a serious and substantial disruption of their medical and custodial services” and that Meridian Care “was unable to pay for food [and] medication.”
It’s unclear the extent to which and for how long patients went without food and medication.
Aideyan told the Press that Meridian’s financial problems stemmed from the federal Balanced Budget Act of 1997, which changed how Medicare paid for home health services. He said this affected all health-care providers, not just Meridian.
“Every business has its ups and downs,” Aideyan said.
He chalked up Liner Anekwe and Meridian’s 2004 lawsuit against Ugwu as a “misunderstanding,” saying that the partners resolved their differences.
Although Ugwu, Liner Anekwe and Godwin Anekwe initially told the Press they would respond to written questions, they never did. Instead, the Press received an email from an attorney, Franklin Bynum, who said he would speak on Meridian’s behalf. We re-sent our questions, but did not hear back.
Currently, Meridian’s future appears to be in the hands of a Houston insurance agent named William Sartain, who won a $112,000 judgment against Ugwu in 2006 for his failure to make loan payments on a home in Fort Bend County. (Although the property was in Richmond, Sartain filed suit in Harris County District Court. He declined to comment for this story.)
In May 2016, a judge appointed a receiver, who ordered Ugwu to turn over financial records for all companies in which he has an interest, including Meridian. (It’s unknown what affect this may have on Meridian’s financial operation or any of the Meridian companies’ relationships with DADS. It’s also unclear if DADS is aware of the lawsuit.)
DADS inspections of two facilities called “Meridian Living Center I” and “Meridian Living Center II” from January and February 2016 found failures to provide health services, provide annual physical exams and maintain medical records, among other things. All these deficiencies were shown to have been corrected within two months, leaving the facilities in good standing.
The living centers were recently awarded contracts with DADS totaling more than $200,000.
Despite the fact that at least one of the Meridian companies was having trouble feeding and medicating its patients in 2012, Anekwe and Aideyan thought it would be a good idea to open a mental health facility in Ruston, Louisiana, which they did, calling it Meridian Psychiatric Hospital. (Louisiana secretary of state records list Liner Anekwe as the hospital’s president and Aideyan as executive vice president.)
The company rented a huge facility in the small north Louisiana town and proceeded to run their venture into the ground. According to bankruptcy records filed in Louisiana in 2013, the facility operated from February 2012 until September 13, 2013, when key staff notified the Louisiana Department of Health and Hospitals that they had resigned.
A memorandum from the department’s lawyer, filed in bankruptcy court, states that department personnel drove to the facility for an on-site inspection on September 17, only to find it closed and locked.
Department staff “knocked loudly on the doors several times; no one answered,” according to a letter from the department’s health standards section. Phone calls made the following day went unanswered, and there was no voicemail system.
Inspection reports from the Louisiana Department of Health and Hospitals describe an underqualified, bare-bones staff toiling in a poorly managed facility with a mostly absent medical director and psychiatrist. The nurses routinely failed to asses patients, who were often discharged without ever receiving treatment. One patient, who was leaving after eight days, told the inspector, “Everything has been good, except I have not seen a psychiatrist or a medical doctor.” (In a March 2013 visit, inspectors found that none of the 11 patients had been evaluated.)
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The staff barely had a handle on their patients, many of whom suffered from severe psychiatric illnesses; one patient was able to destroy an air-conditioning unit, spilling coolant into the hallway and forcing an evacuation, after which he escaped, but was swiftly apprehended by police. The lack of monitoring also allowed him, on other occasions, to drink bleach and cut himself with shards of a mirror.
After the hospital closed, disgruntled employees complained to a local Fox affiliate about bounced paychecks. One former staff member told a reporter that hospital administrators threatened to sue the staff if they asked the Fox crew to film on the hospital grounds
The hospital’s bankruptcy filings show that, at the time of closure, Meridian Psychiatric owed $184,000 to the IRS for unpaid taxes and also owed $17,000 in unpaid state taxes. The facility also owed $170,000 to contractors and $362,000 to its landlord.
As executive vice president Eghosa Aideyan might say, every business has its ups and downs.