Signature Health Has Questionable Record of Care for Behavioral Health Patients - But Far Northern California Counties are Facing Bed Shortages and High Suicide Rates

Signature Health is applying for a $150 million grant from the State of California’s BHCIP* round 2 funds program, offering to put in $50 million of their own funds to construct a $200 million campus somewhere in Shasta County, possibly in the City of Shasta Lake.  The facility, called True North Behavioral Health Campus (Campus), would have 72 beds and 32 chairs and include crisis stabilization units, a social rehabilitation facility, inpatient psychiatric units, a high-acuity youth residential unit, and a partial hospitalization/intensive outpatient program.  A facility that large will be bringing in patients from other counties, which is one of the reasons, Shasta County Board of Supervisors Chair Kevin Crye has stated he is against the proposal.  A review of reports of incident reports at Signature Health Behavioral Health Facilities in California indicates a less-than-stellar level of care that is being provided due to chronic staffing shortages.  Signature Healthcare Services (SHS) is one of California's largest for-profit operators of psychiatric hospitals, operating 19 free-standing behavioral health hospitals in California, Nevada, Arizona and Texas, focused on acute inpatient care for mental health and substance use disorders. These serve children, adolescents, adults, and seniors with services like crisis stabilization, therapy, medication management, and some outpatient programs. 

Arch Collaborative CEO Kimberly Johnson, has been assisting Signature Health with the application process and has been meeting with various community officials for input on what is needed at the campus and for letters of support.  The application was due for submission to the State on October 28^th.  A letter of support from the county where the proposed facility would be located is requested from the State as part of the application criteria; however, not having a letter may not necessarily disqualify the proposal.

The Shasta County Board of Supervisors called for a special meeting which was held on Friday, October 24, wherein Shasta County’s Behavioral Healthcare Director, Christy Coleman, presented her list of reasons why she cannot support this proposed facility.  Shasta Unfiltered reported on her presentation in a prior article.  The supporters of the mental health campus spoke at the meeting to explain how a shortage of beds here in Shasta County has been very detrimental to mental health care access, with many patients needing to seek inpatient treatment in facilities two to five hours away from home.  Crye, came out against the proposal and advocated for a letter of opposition to the project, which Supervisors Chris Kelstrom and Corkey Harmon also agreed to oppose.  The project is supported by Board Supervisor Matt Plummer.  Supervisor Allen Long wanted to remain neutral until more information could be gathered.

Kimberly Johnson said a letter of support from the County was not vital for the application to move forward, since there have been many other County officials who are supporters, including Sheriff Michael Johnson, District Attorney Stephanie Bridgett, Redding Police Chief Brian Barner, Modoc County Sheriff Tex Gowdy, Redding City Councilman and North Valley Medical Association President Dr. Paul Dhanuka. 

For Fiscal Year 2024-2025, over 300 Shasta County residents were sent out-of-county for inpatient behavioral health services. This figure was cited by Kimberly Johnson, CEO of Arch Collaborative, which points to a very real need.  Also, the County Health and Human Services Agency reported in March that Shasta County’s suicide rate of 25.2 suicides per 100,000 residents is more than double the state average of 10.3 per 100,000.  According to the California Department of Public Health (CDPH), Colusa, Tehama, Lassen, Modoc, Del Norte, Siskiyou and Trinity Counties have very high rates as well. 

A large protest of the Board’s decision was held on Tuesday in front of the County Administration Building prior to the Board’s Tuesday morning meeting.  Johnson spoke to supporters at the protest and indicated that Signature Health would go forward with the application even though the County is opposed to the Campus.  A decision will be made in the Spring of 2026 about the grant award.

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To provide a more complete context of what is being considered here, comparison charts are provided that point to spending per patient per types of facilities and to outcomes.  Staffing levels at private for-profit behavioral health facilities tend to be less than at nonprofit facilities and psychiatric units in hospitals.

Metric	Signature/SHS For-Profits	General Hospital Psych Units	Nonprofit Psych Hospitals	Kaiser Permanente (CA leader)
Daily Direct-Care Spend (2022)	$390/patient	$930/patient	$1,000/patient	N/A (integrated model)
Staff per Patient	35-41% fewer nurses/aides	Full licensed ratios (1:6)	Highest licensed staff	Top-rated integrated care
Serious Safety Violations (2022)	3x higher per patient	Baseline	0 reported	5/5 stars (2019)
Patient Activities	Often limited (e.g., word searches due to shortages)	Full therapy/outdoor	Comprehensive	Outpatient excellence

Incidents Comparison: SHS has disproportionately high adverse events, with under-reporting rampant (e.g., police logged 160+ assaults in 5 facilities 2021-2023 vs. only 10 CDPH citations). CDPH oversight is lax: Hundreds of violations since 2019, but no license revocations, minimal fines ($94K total statewide)—just "plans of correction" often ignored.

Category (2019-2024)	Signature/SHS	All CA For-Profits (21 facilities)	State Hospitals (e.g., Napa/Patton)	Other Privates (e.g., Del Amo)
Preventable Deaths	11 (66% of total)	17	4-6 each (2009-2021)	3 each
Assaults Cited	Dozens (e.g., riots, stabbings)	128 physical/sexual	Lower per bed	Varies
Sexual Abuse	Multiple (staff/patient; e.g., nurse molestation)	High	Rare	Isolated
Suicide/Neglect Deaths	5+ (e.g., unmonitored nooses, unsafe discharges)	Majority	Some	Fewer
Restraints/Seclusion Violations	20+ improper	77 total	Regulated	Lower

SHS Examples:

• Santa Rosa: Riots**, 5+ sexual assaults, 3 deaths (e.g., suicide after lost track); falsified checks.

• Aurora San Diego: 22-year old suicide (ignored monitoring).

• Vista Del Mar: 5 deaths in 2 years (overdoses, asphyxiation).

• Bakersfield: 200+ unreported abuses; violence.

  
  

To summarize the above findings, Signature Health Services excels in capacity but lags critically in safety and quality vs. nonprofits (superior staffing) and Kaiser (outpatient gold standard). They have a worse record than state hospitals on recent per-bed incidents. California’s for-profit reliance amplifies risks with patients facing a higher risk of harm.

*BHCIP funds refer to grants awarded through California's Behavioral Health Continuum Infrastructure Program (BHCIP), a state initiative administered by the Department of Health Care Services (DHCS). Launched in 2021 via budget legislation (AB 128, SB 144), the program provides competitive grants to address critical shortages in behavioral health facilities, including mental health and substance use disorder (SUD) treatment infrastructure. These funds support the construction, acquisition, rehabilitation, and expansion of properties to create a full continuum of care—from crisis stabilization and residential treatment to supportive housing and mobile crisis services—prioritizing underserved populations like those experiencing homelessness, Medi-Cal beneficiaries, youth, veterans, and Tribal communities. 

**Riots at Santa Rosa Signature Healthcare Hospital were reported on by the San Francisco Chronicle in their article entitled "Violence and neglect plague a Bay Area psychiatric hospital. California has left its patients in danger", by Joaquin Palomino and Cynthia Dizikes, updated March 19, 2025