Part one of a series
A Native American man thrusts lean arms to the heavens, beseeching Father Sky for blessings, for guidance, for peace.
That’s the cover of Benjamin Barragan’s memorial program. There’s Barragan, grinning widely in snapshots with his five children, posing with his elders, clutching a basketball.
Barragan, 29, was a member of the Spirit Lake tribe in North Dakota. In May, he was recruited to an addiction treatment program in sunny Southern California. In June, he was dead. “Place of Death: Sober Living Facility,” the coroner’s records say.
Hopes for a new life ended in early death for Margaret Dickerson as well. From Illinois, she had struggled with addiction for years, according to her autopsy report. She came to California for treatment just three weeks before a cocaine, fentanyl and methamphetamine cocktail killed her on Jan. 29 in North Hollywood. Fellow patients said she never quite made it into treatment: After she got here, “insurance discrepancies” cropped up and she was “unable to attend be housed (sic) at the facility and subsequently became homeless,” the autopsy says. She was 41.
Emmanuel Mitchell came from Oklahoma, packing a history of cocaine and Percocet abuse. After spending time in detox — the most expensive level of state-licensed addiction treatment in California — he spent two weeks in a sober living home in Los Angeles. He and other residents would routinely come and go with no supervision, his autopsy notes. He was last seen alive going into a bathroom at about 6:15 p.m. on Feb. 7. Minutes later, he was found unresponsive on the floor. He overdosed on fentanyl, the autopsy concluded. He was 28.
What these people had in common — besides visions of a fresh start far from home — was that they landed in the vast rehab empire overseen by Nathan Young, aka “Pablo Lopez,” and associates.
Young’s network weaponizes addiction for profit, insurance giant Aetna has charged in a $40 million lawsuit. One of his sober living homes was denounced as a “haven for drug abuse” and sued by authorities. Many of Young’s operations keep their state licenses and certifications even as state regulators try to revoke others, calling some facilities “harmful to client health and safety.”
The Southern California News Group has been reporting on fraud, abuse and death in California’s private-pay addiction treatment industry for nearly eight years, and the allegations against Young’s businesses are just the latest installment. Despite myriad new laws, more state inspectors and federal crackdowns aiming to rein in the industry, people on the inside say it remains essentially unchanged.
“SCAM ALERT!” a warning from the state of Delaware screamed on June 7. “The claims of residential treatment services and ongoing treatment in California are likely FALSE CLAIMS. Beware of body brokering, cash offers, kickbacks, and insurance fraud.”
Delaware singled out Santa Monica Rehab — one of Young’s many businesses — in the Scam Alert. Just days later — on June 13 — Barragan died.
No one from the sober home alerted his family to his death, his brother said. They heard the devastating news more than a week later from the Los Angeles County Medical Examiner’s office.
“It’s so jumbled,” said a distraught Xavier Barragan shortly after his brother’s death. “It was a bunch of lies.”
Young’s defenders say that, most unfortunately, addiction is a condition that can end in death.
‘Harmful to client health’
On Oct. 10, many months after we began reporting this story and many years after complaints from former workers and patients began rolling in, the California Department of Health Care Services (DHCS) served an accusation, notice of license revocation, and immediate temporary suspension order to Elmo Detox in Los Angeles and Rodeo Recovery in Beverly Hills, two of Young’s many operations.
“DHCS determined that conduct by both programs was harmful to client health and safety due to significant non-compliance with regulatory standards, including failures to fulfill obligations, ensure client well-being and adhere to essential procedures,” DHCS said by email. It’s empowered to take such actions “when violations compromise client health and safety.”
DHCS took similar action against Young’s 33rd Street Detox in May. Young is fighting Elmo’s closure in court, but as the state licenses each treatment facility separately, some 30 residential and outpatient centers in Young’s network remain open, according to DHCS records.
The licensed rehabs include Santa Monica Detox in Santa Monica, Joser Forever in Los Angeles, Revive Premier Treatment Center in Studio City, Healing Path Detox in Huntington Beach, Ocean Valley Behavioral Health in Santa Ana, Sunset Rehab in West Hollywood, Natural Rest House in La Quinta, Antioch Rehab in Los Angeles and the Kiloby Center for Recovery in Rancho Mirage, according to DHCS and court documents.
There’s also a sprawling network of sober living homes that have operated under the 9 Silver and 55 Silver brands, stretching from Ventura to Los Angeles to Orange and Riverside counties. Many clients enrolled in outpatient treatment live in these homes, which are marijuana-friendly. Sober homes don’t need licenses, as no treatment is supposed to happen there, and the government can’t treat them differently than any other family.
Overdoses have occurred in licensed and unlicensed homes alike, according to documents from DHCS and the Los Angeles County Medical Examiner.
DHCS released heavily redacted records on why it closed Elmo and Rodeo Recovery to the Southern California News Group, but its full, unredacted investigative reports on Elmo were filed in court by Young’s lawyers as they challenged the shutdown. Among the serious assertions DHCS made in those documents:
• False record-keeping. Detox is the most fraught stage of treatment, and can be deadly. Elmo staffers failed to check on patients going through withdrawal at required intervals and then falsified records to say they did, the state said.
• Overdose. A patient left against medical advice shortly before New Year’s, returned the next day with fentanyl hidden in a hair scrunchie, then overdosed on site. The patient had to be revived with five sprays of Narcan. Though policy requires immediate discharge and referral to other programs for on-site overdoses, the client was allowed to remain on site. “I left because I’ve been asking these (expletives) … to take me to the hospital,” the DHCS quotes the patient as saying. “None of the staff would take me to a doctor. I could not breathe, I kept coughing, and I have bronchitis. I asked every single staff member … to take me to the doctor, but they were all too busy….” The patient’s insurance was authorized for addiction treatment through Jan. 11, and they were discharged that day.
• Unreported mental health breakdown requiring emergency care. After relapsing and using drugs several times last December, a client became hysterical during a group therapy session, punching themselves and banging their head on the floor. Fire and police departments were called and the client was taken to the hospital, but DHCS was not notified as required.
• Questionable record-keeping, which could result in questionable insurance billings. DHCS was recording an interview with two patients at the very same time they were marked as present and fully engaged in therapy sessions. Their files contained detailed notes such as “(Client 4) was early for group” and said, “I am excited to be sober!” and “(Client 5) was present and punctual … highly engaged and willing to share,” and said, “I need to worry about my sobriety over everything else.” DHCS said the notes were “inaccurate.”
•
More questionable record-keeping. A doctor, Bryan Yang, provided medical services without proper clearance from DHCS, was unfamiliar with detox protocols and insisted he saw patients who said they had never met him. When DHCS asked Yang for documentary proof of his medical evaluations for these patients — such as a log of video calls from Zoom — Yang responded by email: “I don’t believe the way I conduct Zoom is set up the way you are looking for … sorry I couldn’t be of more assistance!” Said DHCS: “As of the date of this writing, Dr. Yang has not submitted proof (i.e. Zoom history information, emails or text message communications from Program staff) that he met with” those two clients when he said he did.
Yang did not return calls for comment. Young declined to answer detailed questions but said this through a spokesman: “I’m out here helping homeless people stay sober, find jobs and reintegrate into society without any help from charities or taxpayer subsidies. Can city and state officials say the same?”
Abused its discretion
In court, Young’s attorneys aggressively tried to counter the state’s assertions in an effort to keep Elmo open until a hearing on the closure is held next year.
The DHCS ultimately did approve Yang to provide medical services, they said in court filings. Workers who allegedly falsified records were let go. A compliance consultant was brought in to improve operations. But DHCS didn’t weigh any of that, they argue.
State regulators also erred by citing Elmo for failing to comply not with state law or regulations, but with the company’s own internal policies. “Simply put, there is no statute or regulation that elevates a program’s policies and procedures to the level of a licensing requirement,” Young’s attorneys argue.
And if DHCS actually believed patients faced serious risk, why did it wait nearly a year to act? The state exceeded its authority and abused its discretion, resulting in a “senseless shutdown” that left some residents “back on the street” and some staffers without jobs, they argue.
After DHCS’s first visit last December, it issued three “Notices of Deficiencies.” The program director promptly provided a “Corrective Action plan,” which was approved by DHCS about a week later. Young brought on the compliance consultant in August. But DHCS made no effort to determine if the deficiencies still existed, and didn’t return to the site until it shut things down, attorneys argued.
“While I am informed that a few residents ended up in other detoxification/residential treatment facilities, others were not so fortunate and, I fear, will relapse into their addiction or worse,” Young said in the filing.
Young’s attorneys have said insurer Aetna’s “outrageous allegations” are causing immense damage to business and should be thrown out, and dismissed Delaware’s Scam Alert as “fiction” and “inflammatory speculation” so Aetna can avoid paying millions in outstanding claims. In his newly filed declaration, Young defended the nobility of his calling.
“My dedication to serving others began in early adulthood, when I enlisted in the U.S. military, from which I am now an honorably discharged veteran,” Young said in the declaration.
“I began my professional journey in hotel management, where I made it a priority to provide employment opportunities to formerly incarcerated individuals and the homeless. The tragic loss of my long-term girlfriend to an accidental overdose fueled my resolve to make an even greater impact and led me to transition to the substance abuse addiction industry.”
A hearing challenging Elmo’s license revocation is slated for Jan. 24. The request to lift DHCS’s order in the meantime was rejected by a judge.
“Elmo is unable to operate and yet must continue to pay rent and other overhead relating to the facility,” Young said. “As a result, Elmo is on the verge of having to be permanently closed. This is causing permanent damage to Elmo’s (and my) reputation in the substance use disorder treatment community, including with health care providers and referral sources.”
There’s no shortage of bad blood against Young, however. He and his companies have been repeatedly dragged into court for allegedly stiffing workers out of pay, stiffing landlords out of rent, and firing whistleblowers who balked at the unethical and/or illegal things they were expected to do, according to court documents.
Many people who’ve worked inside his operations have harrowing tales to tell. Others, still enrolled in treatment and employed by the network, sing its praises. Can they all be right?
Next in this series: Inside the operations.
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