FARGO – An investigation by North Dakota officials has revealed systemic problems at a drug treatment center found to have broken state laws by abruptly discharging a group of patients from a state-funded residential program in February.

North Dakota's Behavioral Health Division, which licenses treatment centers, opened an investigation into the Sharehouse facility in south Fargo on March 9 as a result of The Forum bringing the sudden discharges to the attention of state officials.

Among the discharged patients was 42-year-old Shawn Hansen, who left Sharehouse on Feb. 25, said his sister, Barbara Olheiser. The next day, he was found dead from a possible overdose at a Moorhead motel, police said.

Pam Sagness, director of the Behavioral Health Division, said Wednesday, April 13, that the state's investigation did not explore whether Sharehouse was at all responsible for Hansen's death. But investigators did find that Sharehouse hastily and inappropriately discharged the group of patients in a way that broke state laws and threatened the patients' health and safety, according to the investigation report.

The investigators, who visited Sharehouse and interviewed staff and patients, expressed concern that Sharehouse is putting financial considerations ahead of medical needs when making admission and discharge decisions, the report said.

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Hansen and the other patients learned of their discharges Feb. 25 and had to leave by Feb. 29, the same day that 25 Sharehouse employees, including several who worked with the discharged patients, were laid off.

"There is concern these abrupt discharges may have been due to the impending staff dismissals or funding issues," the report stated.

Sharehouse CEO Nate Medhus has said the discharges were not related to the layoffs. Although, he's acknowledged that Sharehouse faced a funding crunch that recently prompted the organization to significantly reduce the average length of stay for residential patients.

Corrective action required

The investigation report goes beyond the one cluster of discharges in late February to say that Sharehouse has often violated its own policies, state laws and the American Society of Addiction Medicine's best practices when it comes to discharging patients.

Investigators reviewed the discharges of 30 patients and found that over 25 percent fell short of requirements, Sagness said.

The investigation's findings included:

• Patients were discharged without the right planning. The appropriate referrals to housing agencies, outpatient treatment programs and other services were not made.

• Patients were discharged without meeting certain criteria, such as being ready for a less intensive level of treatment.

• Patients were receiving addiction counseling from staff not licensed to practice as addiction counselors in North Dakota.

On March 14, state officials ordered Sharehouse to not discharge any residential patients and asked the organization to make a temporary corrective-action plan for how future discharges would be supervised. Four days later, after state officials learned Sharehouse had created the plan and was following it, the facility was once again allowed to discharge patients, the investigation report said.

Sharehouse must submit a more permanent plan of corrective action on May 24. After that, state officials will conduct follow-up reviews to see if Sharehouse is complying with the plan, the report said. If Sharehouse does not comply, its treatment center license could be suspended for 99 days, and further noncompliance could lead to revocation of the center's license, Sagness said.

'I am hopeful'

The Forum first reported on the late February discharges March 13 after speaking with four laid-off Sharehouse employees. Two of those employees said they pleaded with their supervisor to delay the discharges, especially for patients deemed a high risk to dangerously relapse.

The former Sharehouse employees said the discharged group consisted of six patients in the state-funded Robinson Recovery program, which serves North Dakotans who can't pay for residential treatment out of pocket and don't have insurance to cover the cost.

Sharehouse, a private nonprofit group, holds the state contract to run the program, which mostly treats those with severe addictions to meth or opiates, including heroin.

Asked if the investigation found that Sharehouse had in any way broken its contract with the state, Sagness said the contract will be reviewed. "At this time, there have been no changes to the Robinson Recovery contract," she wrote in an email.

Medhus, the Sharehouse CEO, said he would not comment on the investigation report because of the possibility of Olheiser, Hansen's sister, suing Sharehouse.

Olheiser, who lives in a Phoenix suburb, has said she's been in contact with a law firm that's looking into whether Sharehouse bears any legal responsibility for her brother's death. Detectives are investigating Hansen's death as a possible overdose as they await the results of an autopsy, Moorhead police said.

Olheiser said in an email that the investigation report validated her concerns that Sharehouse improperly discharged her brother. "I am hopeful that steps are being made to ensure that future residents/patients do not face the same potential situation and outcome as my brother," she wrote.