Alsana did not arrive in Birmingham as an innocent treatment provider suddenly confronted by an unpredictable act. It arrived carrying a corporate history of lax oversight, inadequate supervision, disputed treatment practices, warnings from former executives and unresolved patient safety failures at its facilities in Missouri. By the time a patient was sexually assaulted at its Birmingham residential program on July 26, 2025, Alsana had already been told, repeatedly and from multiple directions, what happens when growth, census and operational convenience overtake clinical judgment.

The assault was not the beginning of the story. It was the consequence.

Alsana may attempt to deflect and allege the attack was the unforeseen misconduct of one patient. However, evidence indicates that Alsana employees knew the offending patient had engaged in prior acts of public masturbation, sexually intrusive conduct, physical boundary violations and an escalating fixation on other vulnerable patients. Another former patient reported that the same individual sexually assaulted her and that management failed to act despite numerous prior reports. The eventual victim then warned staff directly, asked to be separated from the patient and explained that something was seriously wrong. Alsana left them together. After the sexual assault, the offending patient reportedly still remained in the program for a short period of time. Despite repeated warnings.

Reports indicate the offending patient was a private pay patient. Whether financial considerations influenced that decision is a question regulators and discovery will answer.

That sequence is the center of ongoing issues involving Alsana. Alsana sold safety, received warnings, yet failed to comply with its own safeguards and retained a patient whose conduct it was either unable or unwilling to manage. Once those facts are placed inside the company’s history, the July 2025 assault stops looking like an aberration.

Instead, it is the predictable result of the corporate system Alsana created.

The False Assurance of Safety

Residential eating disorder treatment is not housing with therapy added. Patients enter because they require an environment more structured and protective than the one they are leaving. The provider controls admissions, staffing, supervision, medical oversight, patient separation, behavioral intervention and discharge. Families entrust vulnerable loved ones because the company represents that it possesses the judgment and resources necessary to keep their loved ones safe.

Alsana continues to make precisely that representation. Its website promises a “safe, supportive space” and describes its residential program as providing structured care and support twenty-four hours a day, seven days a week. It created a marketing campaign emphasizing “Everyone deserves flowers.” The contrast is striking. While the company promoted “Everyone deserves flowers,” the allegations concerning staffing shortages, inadequate supervision, delayed intervention, and failures to protect vulnerable patients are especially troubling.

The Birmingham evidence indicates that when protection was actually required, another patient had to leave the victim during the assault and search for the only direct care employee available.

Alsana’s own staffing ratio was allegedly one direct care employee for every six patients. Seven patients were present that evening, including a patient whose known conduct demanded greater observation rather than the bare minimum. The same staffing deficiency allegedly appeared during a later physical altercation, when the sole direct care employee again had to leave the scene to obtain assistance. That repetition suggests an operating practice, not a solitary scheduling mistake.

This is where the marketing representation becomes deceptive.

Alsana advertised a controlled residential environment while staffing below its own ratio and retaining a patient whose behavior exceeded the facility’s ability to supervise. The company did not merely fail to prevent every conceivable act of misconduct. It failed to provide the protection it had promised after the specific danger was already known.

And yet, warning signs were present.

The Birmingham facility did not operate outside Alsana’s institutional history. Alsana was intertwined with Castlewood Treatment Center, whose Missouri operations generated years of controversy involving treatment practices, patient safety, supervision and institutional response. In 2022, admissions were halted at the St. Louis programs after allegations of inappropriate conduct involving direct care employees and a patient became public. This was only a few months after Alsana’s Birmingham operations opened.

In June 2022, Alsana’s former leaders also identified the corporate force driving these failures. Former CEO Jennifer Steiner testified under oath that she became concerned about Alsana’s decision to maximize growth and revenue and was then terminated and sued after refusing to support board decisions she believed would jeopardize patient care. Her exact words were: “Specifically, I became concerned with the direction of the company and what I considered to be Alsana’s decision to maximize growth and revenue above all else. When I refused to go along with certain decisions of Alsana’s Board, including decisions that I believed would jeopardize patient care, I was terminated.” 

Former Chief Clinical Officer Nicole Siegfried described growth and revenue being prioritized to the detriment of patient care, training, staff retention and culture. Other senior clinical leaders gave similar accounts.

Alsana’s former highest-ranking officers supplied more than reputational discomfort. They gave notice that weak supervision, boundary violations and an opaque response to patient complaints could cause serious harm. The Birmingham allegations involve those same categories: known inappropriate conduct, inadequate staffing, delayed intervention, fragmented authority and institutional secrecy after the event.

Alsana’s lack of transparency on its operation’s many failings extend to its very ownership.

Who owns this place?

In late 2016, The Riverside Company acquired Alsana. Press releases and social media announcements were plentiful.

These facts make it all the more perplexing when in August 2025, The Riverside Company divested itself of Alsana. There was no announcement. There were no press releases. None could be found. No buyer is identified. Alsana, whatever it is at this point, likewise failed to publicly disclose whether the transfer was an ordinary sale, a recapitalization, a lender-controlled transaction or a management acquisition.

New entities subsequently appeared. Alsana Parent Holdings, LLC, Alsana Holdings, LLC, Alsana Management, LLC, Alsana East LLC, Alsana West NorCal LLC and Alsana West – SoCal LLC. Most if not all of these entities were organized in Delaware and registered in the State of California.

However, what is curious is that none of these entities are listed with the Alabama Secretary of State and as such, are not authorized to conduct business in that state. What is also curious is that none of these entities are registered with the Alabama Department of Mental Health as a certified provider or are listed by the Alabama Department of Public Health Bureau of Health Provider Standards as a licensed facility operator.

The National Plan and Provider Enumeration System (“NPPES”) is a database managed by the Centers for Medicare & Medicaid Services (CMS) that assigns unique 10-digit National Provider Identifiers (NPIs) to healthcare providers and organizations in the United States. NPI records list Alsana Parent Holdings LLC as the parent organization for newly enumerated Alsana provider entities, including Alsana East LLC at the Birmingham address.

So, Alsana and whoever its owner and overlord is, publicly represented itself in a federal provider registry as connected to an Alabama psychiatric residential treatment facility and mental health clinic at 5101 Cyrus Circle in Birmingham. But, the Alabama Secretary of State, ADMH, and ADPH do not list them as authorized entities. Which to families seeking care and treatment should be very concerning.

Patients and regulators are entitled to know who oversee operations, appoints the board, controls staffing budgets, selects medical leadership and assumes responsibility for the liabilities inherited from Missouri and Birmingham.

Rather than provide any answers, Alsana expanded its virtual treatment program to include up to 40 states in early 2026. This should not be surprising since at least some of Alsana’s independent contractor medical doctors appeared only virtually in Birmingham. You entrust your loved one to a brick-and-mortar residential treatment center. And the medical doctor overseeing your child’s care is a mere face on a laptop monitor.  

On the other hand, Alsana did launch its “Soul Hearted” rebranding campaign, promising that patients and the eating disorder field “deserve flowers.” The campaign presented a “new beginning” without acknowledging the company’s history, former executive warnings, unresolved ownership questions or allegations of patient harm.

The flowers are not harmless silliness. They are reputation laundering through emotional imagery. Alsana is asking the public to experience the company as compassionate while withholding information necessary to judge whether it is safe.

Alsana Was Offered an Honorable Way Out

Before administrative complaints or litigation, Alsana and the responsible parties received an extensive pre-suit brochure. It explained the prior warnings, the assault, the alleged cover-up, the staffing failures, Missouri history, former executive testimony, ownership questions and physician licensure concerns.

The proposal gave Alsana a professional way to resolve the victim’s private claims. It did not demand the concealment of patient safety information, withdrawal of regulatory reports or silence concerning matters within the jurisdiction of government agencies. The victim expressly preserved her right to communicate truthfully with licensing and patient safety authorities.

Alsana could have compensated the victim, confronted the evidence and begun demonstrating that accountability would finally replace concealment. Attorneys appointed through its directors and officers insurance coverage initially engaged in discussions. They then stopped responding substantively.

Silence was their choice. But silence does not erase the evidence or prevent the next stage.

First the Regulators. Then the Courthouse.

Administrative complaints will now be filed with the Alabama Department of Mental Health, the Alabama Board of Medical Examiners and any other licensing authorities possessing jurisdiction. Those complaints will address staffing, incident reporting, patient retention, ownership disclosures, physician credentialing, telemedicine practices and whether present patients remain exposed to the same institutional failures.

Civil litigation will follow the administrative complaints. Discovery will obtain the prior reports, staffing records, private pay revenue, internal communications, Missouri investigations, Riverside’s exit, the new holding companies and every decision that left a known sexual safety risk in the residential population.

Alsana was warned in Missouri. Its former executives warned the board. Patients warned the Birmingham staff. The victim asked for protection. After the assault, Alsana was offered an honorable opportunity to resolve her private claims without buying silence from the public or the regulators.

Instead, Alsana chose concealment, flowers and silence.