Individual Treatment - Luxury Rehab

Written by Ben Camp, CEO of RehabPath

Over the past few years, I’ve had the chance to visit a number (the current count is 19, I believe) of the luxury rehabs listed on our site.

I’ve enjoyed meeting the teams behind each one, but have come to particularly appreciate and recognize the unique benefit of family-owned and operated centers. Here are a few of the reasons that dynamic can be so special.

Financial Independence

There’s certainly nothing inherently wrong with institutional investors, but a key benefit communicated to me when visiting these centers is that without an institutional investor to answer to, family-owned rehabs find they are freer to make decisions that put client needs over profit when necessary.

Don Lavender (Programme Director) and his wife Meena (Family Therapist & EMDR Practitioner) run Camino Recovery in Malaga, Spain. Don and Meena spent many years working for institutional treatment centers in the US and UK, and Don was happy to share the benefits of operating a family-owned center.

team camino — Don (right) and Meena (front, 2nd from left) and their team at Camino Recovery.

“Meena and I wanted to do this on our own. Even though we’ve been approached a number of times, we haven’t gone with or worked with investors. Because when you have to pay more attention to the bottom line than paying attention to the welfare of the client, sometimes a good business decision can turn out to be a poor clinical decision.”

Jan Gerber, Managing Director of Paracelsus Recovery in Switzerland, who runs the company with his mom, the Clinical Coordinator, and dad, the Medical Director puts it this way, “I have a very strong belief that institutional money, institutional investments, and mental health don’t work together. Because when it comes to mental health treatment, be it addiction treatment, eating disorders, depression, or anything else, there is no objective decision. Does a person need more psychotherapy or less psychotherapy? More of that treatment or less of that treatment? It needs to be a clinical decision where the budget and financial side is completely cut off.”

Screenshot 2018 03 01 10.15.29 — Jan (center) and his mother Dr. Christine Merzeder (center right) meeting with their team.

Intimate Atmosphere

For the most part, family-run treatment centers tend to be smaller, more intimate environments. Of the four I mention in this post, Camino is the largest with a maximum of 8 clients, which is well below the norm for residential treatment centers.

Dr. David Nesenoff, of Tikvah Lake Recovery in Florida, provides an extremely personalized treatment experience with treatment taking place entirely in his home.

“Even though Tikvah Lake Recovery is a 15,000 square foot mansion on a 200-acre private lake, this is our home. My wife Nancy and I live here. There are no signs outside and if one were to poke their head in they would see a peaceful home with a few guests visiting. Our clients are considered guests in our home and they are treated as such. Discussions around our table can be anything from talking about the unbelievable food in front of us or about our day or just some fun stuff hosts and guests usually talk about around the family table. Our clinical director becomes part of the family as well as he often joins us around the lunch table and he and his staff are on-site working with our guests one-on-one every day.”

Dr. Nesenoff welcomes potential clients into his home in the short clip above.

David and his son Adam, who operate the center together, believe that the size of the facility (the program is limited to a maximum of 6 people) and the home-like atmosphere are key factors to their guests’ success.

Ameet Braich, Clinical Director of Camino Recovery (and the son of Meena Lavender) also sees great benefit in a more intimate setting. “We’ve all come from years in the field, working in larger institutions and have found that working in a clinical environment is detrimental to the therapeutic process. Having a small, intimate space where people can really get honest and open up about their issues, really works well in this setting.”

Addiction Is a Family Problem

My first exposure to a family-owned and operated treatment center was Duffy’s Napa Valley. From its founding in 1967 until it was acquired in 2015, Duffy’s operated as a family-run business, and frequently described themselves as “A family business for a family problem.” That slogan resonated with me, and I think its a key component to why family-owned centers are so special.

Addiction is a problem that affects the entire family and can also be a byproduct of problems within the family. So “it is natural for the solutions to these struggles and barriers to be learned within a family environment,” says Nesenoff.

Clients at a family-operated program get the chance to see family dynamics in action, which in itself can be helpful. Don says, “We’re imperfect just like every family. But when we mess up or make mistakes, we acknowledge it. And, in a way, it gives the clients the permission to learn.”

As a key part of their program, Camino invites the families of their clients to join them on site for a 5-day workshop, where according to Don, they teach them about the “disease concept and codependency” as well as a focus on enablement.

He doesn’t doubt that there is a connection between Camino’s family ownership and the effectiveness of their family program. “Camino is a family-owned and family-run business. … We pay attention to families seriously, not only our own family but the family systems of others. … Family is important. It is of value. And when people leave us, they return to family.”

A Dream Come True

“It’s a dream come true.” This is how Debby Berry, co-founder of Kembali Recovery described starting and running a treatment center with her son Clayton.

Clayton and Debby show us a nearby waterfall for our Bali Destinations episode.

As anyone who runs a family business knows, it has its challenges. But more often than not, the benefits are worth the effort, and felt not only throughout the organization but by the clients and their families in desperate need of help.

When considering treatment options, you should always investigate the quality of the program. Search our collection of rehabs and find key information such as licensing, accreditations, and pricing at a glance. Whenever possible, consult a trusted medical or mental health professional before a final decision is made.

Frequently Asked Questions About Family-Run Rehabs

What are the benefits of a family-run rehab?

Family-run rehabs may have more flexibility and tend to prioritize clinical care over profits. Most treat a few patients at a time in an intimate, home-like setting. This comfortable atmosphere helps patients open up in therapy.

What is the difference between a family-owned rehab and state-funded rehab?

The cost of treatment without insurance is a key difference between family-owned and state-funded rehabs. State-funded rehabs offer low- to no-cost treatment for uninsured people. However, it often takes longer to enter state programs compared to family-owned rehabs.

Do family-run rehabs have better family programs?

Family-run rehabs tend to pay special attention to their family program. Patients also get to see healthy family dynamics in action and can apply these to their own lives.

Deciding to look for help is a massive step in the right direction when you’re struggling with an addiction or mental health disorder. However, finding a residential treatment center that meets your or your loved one’s needs can sometimes be an even harder step to take.

With an overwhelming number of options and approaches, you’re trying to find high-quality treatment within your budget, in hopes that it will save your life. That’s where a recommendation from a trusted professional can be so helpful.

But what if that recommendation from your doctor or therapist wasn’t completely unbiased? What if you were to find out that the treatment facility your doctor recommended gave your doctor a cut from the costs you paid for residential treatment?

Unfortunately, referral fees and “kickbacks” have been a reality—most recently highlighted in the UK—for some time now in the mental health field. Some facilities who are desperate for clients, especially those offering private, residential treatment, will gladly pay referrers 10, 20, sometimes 30% of the costs they collect from the referred client.¹ In recent months, this practice has been brought to light by The Sunday Times in a few comprehensive articles based on undercover reporting. Most recently, a June 3rd report exposed a number of high-profile kickback arrangements,² causing at least one psychiatrist to promise to return all the referral fees he received.

Are Referral Fees Legal?

It depends on a variety of details—on the location, the definition of a “referral fee,” who is doing the referring, which healthcare program is involved, etc.

For example, in the United States, Stark Law prohibits physicians from receiving payments for referrals when specific federal healthcare programs are involved. The Anti-Kickback Statute broadens the restriction to any federal healthcare program and any referral source. Additionally, laws vary by state. For instance, the states of California and Florida have several laws clearly prohibiting centers from patient brokering. M. David Meagher, a lawyer and addiction treatment professional in California, warns that continuing in illegal practices will have significant adverse consequences for the industry:

“The practice of paying for referrals³calls into question our integrity. If examined closely by the media or the justice system, it is inevitable that families will lose faith in our ability to help their loved ones. The result will be another collapse of treatment centers across the country. Once our integrity is compromised, it will be a long and difficult road back to respectability.”

In the UK, the General Medical Council (GMC) prohibits doctors from receiving referral payments. It violates the 7 Principles of Public Life.⁴ Kickbacks could also be in violation of the Bribery Act of 2010.⁵

Legality Aside, Referral Fees Are an Ethical Issue

While kickback arrangements are a common practice for some treatment providers and referring professionals, many have realized that—legal or not—referral fees are an ethical issue.

In December, we visited Paracelsus Recovery in Zurich, Switzerland, and discussed this very issue with the center’s Managing Director, Jan Gerber. He was eager to share with us that he and his family-owned business passionately stands against this practice—even when they’ve lost business over it.

From his perspective, “it’s an ethical question.” And in the worst case, it can “cost somebody’s life.”

Jan Gerber summarizing Paracelsus Recovery’s stance on referral fees.

Castle Craig, a residential center in Scotland, clearly states their stance on referral agencies and fees: “We feel that using these agencies turns patients into commodities who are effectively brokered from agencies to treatment centres.” They do not pay referral fees and “refuse to work with any referral agencies currently operating in the United Kingdom.”

If you are a treatment provider or referring professional who would also like to go on record against this practice, we’re happy to add your quote to this post.

How to Protect Yourself

Be Careful of Free Helplines: A Source of Referral Fees

If you’re looking for treatment for yourself or your loved one, be cautious of websites that appear to provide independent information about treatment options but require you to call a hotline to learn about them. These hotlines often work with treatment centers on a referral fee basis, meaning they’re more likely to refer you to centers that are willing to pay them a fee. Sometimes they have centers of their own that they will try to recommend without disclosing the affiliation.

Ask Specific Questions

When your doctor, psychiatrist, therapist, etc. makes a recommendation, politely ask if they receive compensation or favors for recommending you those centers.

For example, you could say something like, “I’ve read in the news about referral fees and kickbacks, and I’m concerned. With the utmost respect, do you receive compensation for recommending me to that center?”

Ask the treatment provider you’re considering what their opinions are about referral fees. You could also ask if they can provide an itemized quote of the costs. Upon seeing line items, ask for clarification if the description seems vague or suspicious.

Look for Credible Accreditations and Memberships

This is not 100% fail-proof as complaints go unfiled and enforcement takes time, but it’s a very good sign if a treatment provider is licensed, accredited (by the Joint Commission or CARF), and belongs to an organizing body with relevant guidelines. For example, in the U.S., members of the National Association of Addiction Treatment Providers (NAATP) must adhere to its code of ethics⁶ which prohibits referral payments.

Finding Treatment You Can Trust

For more information on what to look for in a rehab, see our article on avoiding addiction treatment scams and identifying quality programs.

Visit our searchable collection of rehabs to compare programs, pricing, reviews, and more, and to reach out to centers directly.

Frequently Asked Questions

What are referral fees, and how do they work at luxury rehab centers?

Referral fees are a payment that a rehab center makes to a third-party service or individual in exchange for referring a new patient. At luxury rehab centers, these fees can be substantial, ranging from a few thousand to 10s of thousands of dollars per referral.

Q: Are rehab referral fees legal in the United States?

Referral fees are legal in the U.S., but they’re subject to certain regulations under federal and state law. For example, the Anti-Kickback Statute prohibits healthcare providers from paying or receiving kickbacks in exchange for patient referrals. Violations of these laws can result in civil and criminal penalties, including fines and imprisonment.

Q: What risks do referral fees pose for patients seeking treatment at private rehabs?

Referral fees create conflicts of interest. A healthcare provider may be more likely to recommend a particular rehab center based on the size of the referral fee rather than the patient’s needs. This can lead to inappropriate or ineffective treatment, as well as higher costs for patients.

Tag: Individual Treatment

More Than a Business: The Unique Benefits of a Family-Owned Rehab