Family Sues Kentucky's Addiction Recovery Care Over Rehab Patient's Death

The brother of a 56-year-old man who died at a Pikeville treatment center has filed a wrongful death lawsuit against Addiction Recovery Care, once Kentucky's largest addiction treatment company, alleging the facility was so short-staffed that no one checked on him in the hours before he was found dead. Earl Rison filed the suit in Pike Circuit Court on Sept. 14, according to the Lexington Herald-Leader, which reported the filing on Oct. 12 after obtaining his brother's 368-page client file.

Mike Rison was found dead in his bed around 4 a.m. on July 17, 2025, less than six weeks after he voluntarily admitted himself to Riverplace, a 120-bed men's facility. A coroner's report listed cardiac arrest as the cause and estimated he had been dead eight to 10 hours before staff discovered him.

The lawsuit claims medical and corporate negligence, fraud, and violation of the consumer protection act, alleging that ARC accepted patients at Riverplace even though the company was "systemically understaffed with unqualified personnel."

In a statement, ARC spokesperson Vanessa Keeton extended the company's condolences to the family of Michael Anthony Rison and said the company takes the allegations seriously but does not comment on pending litigation.

What the lawsuit alleges

The suit contends that Rison, who had chronic obstructive pulmonary disease and inflammation of a heart valve, required heightened observation after staff increased the dose of a long-acting injectable medication used to treat opioid use disorder. According to the complaint, his Brixadi dose began at 16 milligrams weekly on June 18, 2025, rose to 24 milligrams on July 9, and reached the maximum labeled weekly dose of 32 milligrams a week later.

On June 23, Rison was taken by ambulance to Pikeville Medical Center with crushing chest pain and labored breathing, then released back to Riverplace with a prescription for oral antibiotics. The complaint states that he was also taking central nervous system depressants, a combination the medication's label warns can raise the risk of respiratory problems, coma and death.

Staff recorded the 32-milligram injection at 2:20 p.m. on July 16, roughly 14 hours before he was found. The lawsuit alleges that no staff member checked on him afterward and that "no vital signs, respiratory assessment, sedation assessment, pulse oximetry or clinical evaluation of any kind was performed."

It also claims the last vital signs in his medical file were recorded three days before his death by a peer support specialist. Peer specialists are certified to lead recovery discussions but are not medically licensed, and the suit calls relying on them to take vital signs a violation of state and clinical rules. No hourly check-in logs were recorded for him in the seven days before he died, and the file notes that he fell at noon on July 13.

The complaint points to a discrepancy in the record: ARC staff charted Rison as attending sessions through 2 p.m. on July 16 and receiving medication, but the coroner's report, based on information from the facility, listed 9:30 a.m. that day as the last time he was seen alive.

"These were not one-off mistakes," the family's attorney, Kevin Hackworth, said. He said the company knowingly staffed the facility with too few qualified, licensed people and did so for financial gain. "Mr. Rison did what we ask people struggling with addiction to do: he asked for help," Hackworth said. "His family believes he should have been safe while he was getting it."

A state investigation found the same gaps

The lawsuit lands on top of a state review that reached similar conclusions. In 2025, the Kentucky Cabinet for Health and Family Services investigated Riverplace in Pikeville, Yellow Banks in Owensboro and Crown Recovery Center in Springfield, finding an "absence of qualified, licensed clinical personnel" that investigators described as a "sustained and systemic pattern."

The state's report concluded that Riverplace operated at least 16 hours a day without certified medical personnel on site — 112 hours a week with no medical staff on the property — a condition it called a substantial regulatory violation that created a foreseeable risk of serious harm to patients in withdrawal. ARC subsequently entered an agreed order relinquishing its license at the three facilities, which halted its ability to operate as a residential program managing withdrawal.

A separate whistleblower complaint filed by three former ARC employees in 2023 alleged widespread Medicaid billing fraud and the same staffing practices that appear in the Rison suit, including unlicensed staff distributing medication and recording patients' vitals. The Herald-Leader and ProPublica reported in April that former employees said they were encouraged to submit false billing reports. ARC has denied fraudulent billing and agreed in July to pay $16.2 million to resolve a federal False Claims Act case, a settlement covered in detail here.

More than 80% of ARC's clients were covered by Kentucky Medicaid, according to company leaders. The river of public money that financed the company's expansion — and the collapse that followed — is now central to how Kentucky regulates the treatment industry.

Recorded concerns from inside the company

The filing follows reporting that drawn on internal emails in which ARC staff warned leadership that chronic understaffing was putting patients at risk. In August 2025, a month after Rison died, an employee who supervised staff across several ARC centers wrote to three company leaders that "the term 'sufficient staffing' has been reduced to a technicality, rather than a standard tied to real client needs."

"For us, 'sufficient staff' must mean more than meeting a minimum headcount," the employee wrote, according to the Herald-Leader. "At our current ratios, we cannot realistically or safely meet that standard."

Rison told clinicians during his June 10, 2025 intake interview that he had been using drugs since he was 8 years old and had never had the chance to go to residential treatment before. "I've never had an opportunity to go to rehab before, and I'm too old to keep doing this life," he said, according to his client file. "I want to try to have something better." He had 30 days of sobriety when he died.

What the case tests

The lawsuit turns on whether a treatment provider can be held liable for the clinical gaps that state regulators already documented. Kentucky tightened oversight of residential addiction care after the FBI opened an investigation into ARC in 2024 and after the state reined in Medicaid spending on treatment, and several ARC facilities — including Riverplace — have since closed.

For families weighing medication-assisted treatment options, the case also puts a spotlight on monitoring standards for long-acting injectable buprenorphine products such as Brixadi, which are marketed for their convenience but still require clinical assessment after each dose. The lawsuit is pending in Pike Circuit Court.