But the government compiled an unusual systemwide report on the company last summer at the request of congressmen from Illinois and Massachusetts, where a report by the Boston Globe and another by the Chicago Tribune revealed problems at Universal Health hospitals.

Federal regulators usually focus only on incidents at individual hospitals, not across chains, so government data is fragmented and you can’t easily compare Universal Health to its peers. And the company operates hospitals under a variety of names that can make it difficult for patients and watchdogs to evaluate its overall care.

However federal data suggests that Universal Health has a higher-than-average rate of problems, according to a News analysis of government reports on hospitals that receive funding from Medicaid and Medicare. For example, government inspectors investigating complaints found serious problems at 8.4 percent of Universal’s hospitals in 2014, the most recent full year for which data is available. Nationwide, that figure was 3 percent.

“We are mindful that over the course of treating approximately 2.5 million patients per year, irregular and unpredictable events occasionally occur,” the company said in a statement in response to questions from The News.

The number of government safety citations simply reflects the chain’s size, according to the company, which is based in a suburb of Philadelphia. When problems have been brought to its attention, the company says, it has come up with plans to fix them.

Universal Health, which is valued by Wall Street at over $11 billion, says its overall safety record is excellent. It cites rising patient-satisfaction scores and above-average results on hospital-accreditation evaluations.

“The large number of investigations aimed at misconduct within this hospital system is appalling,’’ said Dr. Peter Breggin, a New York-based psychiatrist who has consulted for the National Institute of Mental Health and the commission that accredits hospitals. “It is especially frightening that these deviations are occurring in the largest network of psychiatric hospitals in the country.’’

Inspectors found safety breaches at 13 of the company’s 26 such facilities in Texas, the hospital company’s largest market. Universal Health is the nation’s biggest for-profit provider of mental-health services, including treatment for depression and addiction, and also owns some full-service hospitals.

Across Texas and around the country, government inspectors investigating patient complaints cited 44 of the company’s hospitals for dangerously poor care or unsafe conditions between 2012 and mid-2015, according to data from the federal Department of Health and Human Services. That’s more than a quarter of the 154 company hospitals that The News identified as receiving taxpayer money to treat the poor and elderly.

Inspection data uncovered by The Dallas Morning News shows that serious safety problems have plagued dozens of mental-health hospitals owned by one giant chain: Universal Health Services Inc.

In San Angelo, hospital employees created infection risks by leaving an observation room covered in vomit and a kitchen black with grease and dead bugs.

IIn Sherman, workers at a psychiatric ward dropped a suicidal patient off at a bus stop; a day later he was found dead after jumping from a Dallas bridge.

The News, which has exposed incidents at Timberlawn, the biggest psychiatric hospital in Dallas, obtained the report and underlying inspection material through the Freedom of Information Act.

The numbers reveal that “patient complaints against the company aren’t just isolated to one region, but extend across the country,’’ said David Wright, deputy regional administrator in Dallas for the Centers for Medicare & Medicaid Services. The federal agency, which monitors hospitals that receive government payments, developed the report.

In all cases, the violations were so egregious that the hospitals faced expulsion from Medicare and Medicaid programs, which cover the poor, disabled and elderly. More than a third of the money Universal Health took in for treating psychiatric patients last year came from those programs, according to the company’s financial filings.

Most of the hospitals came up with acceptable plans to avoid expulsion, but company’s Timberlawn Mental Health System in Dallas was booted last year, and is in the process of reapplying.

Based on the same inspection reports compiled by the federal government, Texas is seeking to shut down Timberlawn and fine it a record $1 million, The News reported earlier this month. The hospital is appealing.

Some of the most serious problems at Timberlawn and other Universal Health hospitals stem from improper care of suicidal patients who harmed themselves.

“One cannot get lax with suicide precautions ever,’’ said Dr. James Knoll, director of forensic psychiatry at SUNY Upstate Medical University in Syracuse, N.Y., who reviewed inspection reports for several Universal Health hospitals. The nagging question, he added, is what causes “the breakdown between an industry leader’s mission and its services in the trenches?’’

The union that represents about 1,800 Universal Health workers, out of more than 68,000, links the problems to inadequate staffing. It has pressed the company to create an independent committee of directors to oversee patient care.

The labor group also asked the company to invest more money in expanding its workforce, Ryan Pfeffer, research coordinator at Service Employees International Union, told The News.

Federal regulations don’t require specific staffing levels. The company declined to comment on the union’s allegations, except to say that “we devote necessary resources to remediating any deficiencies’’ in care.

Experts in psychiatric treatment say that hospital suicides can be prevented. Since 1979, the nonprofit Johns Hopkins Hospital in Baltimore has admitted at least 100,000 patients, said Dr. Geetha Jayaram, a psychiatrist there. Not one has committed suicide at the facility, she said.

The hospital has invested millions of dollars over many years to boost staffing so that it can screen and constantly monitor patients deemed at high risk for suicide, she said. Many hospitals, including Universal Health’s, have a policy of checking on patients only every 15 minutes.

Universal Health is profitable, reporting earnings of more than $680 million last year on revenues of about $9 billion. Company executives told investors last month that their psychiatric facilities have a 27 percent operating margin, making them far more profitable than the company’s regular hospitals.

The company is also at the center of a U.S. Supreme Court case where allegations of fraud, staffing problems and safety violations intersect.

"We're living with this giant hole in our lives every day. I don't really understand why industry changes have been so slow in coming.''​ - Anne Millar Williams, whose husband committed suicide a few days after he was released from a Universal Health hospital in Arkansas.

A Massachusetts couple alleged in a lawsuit that one of the company’s clinics fraudulently billed Medicaid for services that unlicensed and unsupervised therapists provided to their teenage daughter. Inspectors identified 23 unlicensed therapists at the clinic, in violation of health regulations. The family said such breaches made the clinic’s billing claims bogus.

Universal Health contends regulations didn’t specifically make compliance a condition of getting paid by Medicaid. Its position has been backed in court by the American Hospital Association and other industry lobbying groups. The high court will hear arguments April 19.

In addition, the company faces separate and expanding investigations by the U.S. Justice Department and the inspector general for the Health and Human Services Department into potential billing fraud and other matters. The inquiries involve the corporate headquarters, according to the company’s financial filings, as well as about two dozen of its hospitals.

At least four of the hospitals cited for serious safety failures are also targets of billing inquiries, according to a review of company filings with the Securities and Exchange Commission.

News about safety failures saddens Anne Millar Williams of Little Rock. Her late husband, John, was discharged from a Universal Health hospital there in 2006, less than 24 hours after he had told doctors he had planned to shoot himself. A few days later, he committed suicide.

After members of the Millar family sued, Universal reached a confidential settlement with them. But a decade later, “We’re living with this giant hole in our lives every day,’’ she said. “I don’t really understand why industry changes have been so slow in coming.’’

Freelance reporter Daniel Lathrop contributed to this report.

SUICIDE HOTLINE:

Call 24/7: 1 800 273-8255

www.suicidepreventionlifeline.org/

Unsettling cases

Government regulators have cited at least three Universal Health Services psychiatric facilities in Texas since 2012 for failing to safeguard suicidal patients who went on to harm or kill themselves. The company did not comment on the individual cases but said “patient safety is our highest priority,’’ adding that 11 company facilities are now serving as pilot sites for a new suicide-prevention program. Here are descriptions of the incidents from government reports:

Texoma Medical Center in Sherman

In July 2014, the hospital’s behavioral-health facility admitted a patient with “suicidal ideation’’ after he had jumped through a glass window. He was later found unconscious on the floor of his patient room with a “long elastic bandage around his neck’’ and blood in his mouth. He was resuscitated but suffered brain damage. Here's the report.

Two months later, another patient who had threatened to hang himself followed through, “slinging a knotted sheet over the door to his room and tying it around his neck.’’ Nurses pushed their way inside the room, where his body was blocking the door, just in time to save him. Here's the report.

In January 2015, another patient’s attempt proved fatal. The 33-year-old man checked into the hospital, confiding that he had suicidal thoughts and had come up with a plan to jump off a bridge. After 10 days at the facility, he was still under “suicide precautions” but the hospital discharged him. Less than 24 hours later, he was found dead underneath a bridge near the Trinity River. The Dallas County medical examiner ruled it suicide. Here's the report.

Austin Oaks Hospital in Austin

Inspectors found that nurses violated the rights of a suicidal 15-year-old who had been raped by a relative. On Oct. 14, 2014, a male nurse, struggling to medicate her, “grabbed the patient’s gown with his right hand and ripped the gown off, leaving the patient completely nude.’’ She was shut in isolation, naked, for about 23 minutes. Regulators and experts say solitary confinement can re-traumatize patient and should be used only as a last resort. Here's the report.

Timberlawn Mental Health System in Dallas

A patient who was left unobserved hanged herself from a closet doorknob with a torn sheet on Dec. 3, 2014, after repeated threats to kill herself that way. Timberlawn’s policy was to check on patients only every 15 minutes, regulators said, but there was no evidence that occurred in this case. Hospital officials knew from an internal survey that such doorknobs posed a risk for hanging. Here's the report.

Texas violations

Federal health regulators flagged serious care violations at 13 Universal Health Services facilities in Texas

Northwest Texas Hospital, Amarillo

Texoma Medical Center, Denison, and its affiliated TMC Behavioral Health Center, Sherman

Hickory Trails Hospital in DeSoto

Austin Lakes Hospital, Austin

Austin Oaks Hospital, Austin

Timberlawn Mental Health System, Dallas

Kingwood Pines Hospital, Kingwood

Cypress Creek Hospital, Houston

El Paso Behavioral Health System, El Paso

Millwood Hospital, Arlington

West Oaks Hospital, Houston

Glen Oaks Hospital, Greenville

River Crest Hospital, San Angelo