One of Ohio’s largest youth residential treatment centers is facing scrutiny after The Marshall Project published an investigation July 30, 2026, into conditions at Fox Run Center for Children and Adolescents in St. Clairsville, Ohio.
The report, based on police records and state inspection reports between 2020 and 2025, and interviews with seven former residents and several former staff at the 100-bed facility, alleges widespread violence, inadequate oversight and failures to report serious incidents to state regulators.
Here are eight things to know:
1. Police responded to the facility frequently. Deputies visited Fox Run, on average, once every 21 days over a five-year period reviewed by The Marshall Project, responding to 52 assaults, 17 sexual assaults and numerous runaway and behavioral incidents. According to the report, some cases involved allegations of physical and sexual violence by staff.
2. Dozens of police incidents were missing from state records. The investigation found at least 40 incidents documented by law enforcement — including assaults, hospitalizations and juvenile arrests — that did not appear in Ohio’s incident reporting database for residential treatment facilities. CEO Randy MacKendrick said a state review found some of the incidents were “not reportable,” while others had already been properly disclosed, though he didn’t specify how many fell into each category. He added that Fox Run hasn’t been cited for violating reporting law on any of the incidents identified by The Marshall Project.
3. Former residents described repeated violence. Interviews with former patients described assaults between youths, suicide attempts, self-harm and physical restraints by staff, with several saying they repeatedly attempted to escape the facility. Fox Run also reported 126 suicide attempts to state inspectors from January 2022 to June 2025.
4. Staff members faced criminal and disciplinary action. The report cites multiple cases in which employees were fired after allegations of abuse, including one staff member who pleaded guilty to assault after kicking a child.
5. State inspectors cited multiple deficiencies. Inspection reports cited Fox Run for issues including unsafe restraints, deteriorating facility conditions, understaffing, medical neglect and failures to properly manage sexual misconduct allegations.
6. Fox Run defended its practices. Mr. MacKendrick said incidents involving aggression, self-harm, suicide and attempts to leave the facility are “not uncommon” among children with complex behavioral health needs. He said the facility cooperates with regulators, investigates concerns and reports incidents when appropriate.
7. The facility’s parent company has faced broader scrutiny. Fox Run is owned by King of Prussia, Pa.-based Universal Health Services, which has previously faced federal investigations and litigation related to behavioral healthcare facilities. The U.S. Senate Finance Committee also examined the company’s residential treatment operations in 2024.
8. The investigation could influence policy. Ohio Rep. Crystal Lett recently introduced legislation that would require stronger regulatory action against youth treatment facilities with serious safety violations, including potential closure, according to the report.
Becker’s has reached out to UHS for comment and will update this story if more information becomes available.
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