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Location: Bono, Arkansas
Population Served: Children and adolescents in need of out of home psychiatric care in a residential setting
| # of residents per unit: 25 | Residents per room: 3-4 | Capacity: 25 |
Contact with family (Calls and visit schedule): Clients have regularly scheduled phone call opportunities. The number of actual calls depends on the clients wish to utilize these opportunities. In person visitation (assuming no quarantine precautions) is available every weekend and can be scheduled at other times as needed by the family or guardian.
| Restraint utilized? Yes | Chemical Restraint utilized? Yes | Seclusion utilized? Yes |
Clinical Director - In process of hiring.
Therapists: 2 full-time therapists (1 LCSW, 1 LPC)
Treatment modalities offered: Facility declined to identify any specific modalities available
# of individual therapy sessions/week: Minimum 1 per week scheduled. May vary upon the treatment plan of the client.
# of group therapy sessions led by a licensed mental health professional/week: minimum of 1 with 2 preferred.
Police Report
Assault
Officer was dispatched in reference to a juvenile making threats of killing staff members. Upon arrival, staff advised that Suspect #1 had put Victim #1 in a headlock and refused to let go. Victim #1 sustained no injuries. The threats towards staff were un-corroborated. Suspect #1 stated that he and Victim #1 were just playing around. Officer spoke with Suspect #1 over his behavior and what the possible consequences to his behavior could be.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Kendra Rice
Census: 15
Licensing Specialist completed an after hours visit. Mr. Brown, Program Consultant escorted Licensing Specialist through the building. There was no staff in the administration offices. Mr. Brown informed Licensing that some residents were in their bedrooms and others were watching a movie in the Big Boy Classroom.
Residents’ Hall ratios in bedrooms: Room 117:2, Room 118:1, Room 119:1, Room 120:1, Room 126:1, Room 128:2, Room 130:1. Licensing observed 3 staff on the residents’ hall, at each end of the hall and one doing laundry.
Mr. Brown escorted Licensing to the Education hall. Education hall ratios: Classroom 1: 2:3. Residents were watching the movie, Surf Ninjas.
Nurse Laura showed Licensing the medication cart. Licensing observed MARs. All initialed and up to date.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client went to use the restroom and closed his middle finger in the bathroom door. Client’s finger was cut and bleeding. Client was taken to St. Bernard’s Emergency Department by ambulance. X-rays showed Tuft fracture of 3rd digit on left hand (also showed client dislocated shoulder again after his shoulder was reset on 11/12/23 due to basketball injury.) ER department reduced left shoulder back in place. Sutures were placed on third digit to be removed in 7-10 days. Continue to wear left shoulder immobilizer in place for dislocation.
Licensing Specialist informed resident is scheduled to have his sutures removed on 11/26/2023 by the facility’s nurse when he returns from pass.
PRLU or OLTC
Accidental Injury, Notice of Incident
While playing basketball in the gym, Client jumped and landed awkwardly on right ankle. Scant amount of edema noted to right ankle without open area or bruising present. X-ray ordered. No acute ankle fracture or dislocation.
PRLU or OLTC
Accidental Injury, Notice of Incident
While playing basketball, Client ran into the wall and injured shoulder. Left shoulder appeared deformed. Mobile X-ray completed. Shoulder seemed to be dislocated. Client was taken to the NEA Baptist Emergency room. Facility informed Licensing Specialist that the emergency room confirmed resident’s shoulder as being dislocated and reset his right shoulder. The emergency room also advised to see an orthopedic as needed if symptoms worsen.
Police Report
Battery
Officer was dispatched to Dacus Treatment Center in reference to a child out of control. Upon arrival, staff advised the child was out of control, hitting one of the staff members and breaking the toilet. Mrs. Banks wanted me to speak with the child about his behavior.
Officer spoke with the child. He stated he couldn’t do his school work because he didn’t have glasses to see it. He then got upset at the staff and went off on them. The child agreed to stay calm and let the staff know when he was struggling with a problem. The staff advised they didn’t want to pursue anything, that if he would keep his behavior down they didn’t mind helping him with any problem.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client jumped and tried to climb on a basketball hoop and fell. Client reported pain of 10/10, moderate amount of edema noted, capillary refill < 3 seconds, color pink. Client could move fingers freely, but it caused pain. Arm was stabilized with a pillow and an ice pack applied. Mobile x-ray ordered. Client was sent to the ER. Fracture of the distal radius with dorsal angulation; Fracture of the ulnar styloid acute. Due to the nature of the injury and the required follow-up care from orthopedic surgeon, Client was discharged from facility on 11/5/23.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Kendra Rice.
Licensing completed buildings and grounds from 12:30pm – 1:45pm. The following areas were observed: Grounds, dining room area, activity room, bathrooms, bedrooms, seclusion room, gym, administration hall, nurse’s station, and courtyard. MARs reviewed for 5 residents. No licensing concerns noted during visit.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
Client disclosed to nurse that staff brought in a phone, THC and nicotine vape into the facility and gave this to a peer to use. Client further states the staff member has been instructing him to lie on other staff instead of telling on her. Client does state he used staff’s phone to text brother. Staff was suspended pending further investigation. Child Abuse Hotline was called and accepted (combined with other allegations).
Licensing Specialist requested documentation regarding this complaint. Licensing Specialist informed that resident was the first to inform staff of the vapes. Resident denied using the vape and tested negative for THC. Resident was not placed on precautions or Focus.
CACD investigation was unsubstantiated. Licensing unfounded complaint.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
Client disclosed to nurse that staff brought in a nicotine vape and a THC vape for him to use. Client tested positive for THC on 10/16/23. Client further states that the staff member was instructing him to lie on other staff regarding who brought in the vapes. Staff was suspended pending further investigation. Child Abuse Hotline was called and accepted (combined with other allegations). Client was placed on 60k focus and restricted from going on pass home until he is able to test negative for THC.
Licensing Specialist requested documentation regarding this complaint. Licensing Specialist informed that resident was drug screened and tested positive for THC. Resident will continue to be monitored with weekly UDS screens.
CACD investigation was unsubstantiated. Licensing unfounded complaint.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
Client disclosed to nurse that staff brought a THC vape and nicotine vape into the facility for him to use. A THC vape and nicotine vape were confiscated on 10/16/23. Client did test positive for THC. Staff was suspended pending further investigation. Child Abuse Hotline was called and accepted (combined with other allegations). Client was placed on 60k focus and restricted from going on pass home until he is able to test negative for THC.
Licensing Specialist requested documentation regarding this complaint. Licensing Specialist informed resident was drug screened and tested positive for THC. Resident will be monitored with weekly UDS screens.
CACD investigation was unsubstantiated. Licensing unfounded complaint.
Police Report
Battery
Officer was dispatched to facility for uncontrollable juvenile. Upon arrival, juvenile was sitting in a large room and eventually spoke with officer. The officer, program nurse, and another staff member were able to get the suspect settled down.
Later that evening, dispatch received another call in reference to the same juvenile. Upon arrival, officer spoke with staff who advised the juvenile was again acting out. Staff advised the juvenile became angry when he was told he could not be in his room and hid under his bed. Once the nurse entered his room, juvenile began hitting his head against the wall. The juvenile then threw food at staff and began punching staff and bit him. Staff stated when he grabbed the juvenile to restrain him, juvenile began to kick him. The juvenile was placed on Group 2 side where he he urinated on the other patients doors and in their rooms.
Staff advised officer he wanted to press charges on juvenile for hitting and biting him. Craighead County JDC would not take juvenile unless Boone County would pay for the jail bill. Officer spoke with juvenile’s caseworker who advised the preferred action would be for Methodist Family Health to take juvenile to an emergency department and have him assessed. Staff advised they would start working on juvenile’s transfer.
Medicaid Inspection of Care
Inspection of Care Report
No deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted on 09/19/23.
PRLU or OLTC
Notice of Incident, Self-Harm, Suicide Attempt, Visit Compliance Report
Client broke the soap dispenser in the bathroom and refused to exit the bathroom, then proceeded to hit and kick walls and doors. While transitioning downstairs, client attempted to go down the stairs head first. Once staff instructed him to stop, client complied. Once the client reached the bottom of the stairs, he broke the handicap chair lift. While in the transitional hallway, client screamed, threatened to kill staff and a peer, and kicked doors and walls. Client took his hoodie and placed it around his neck in the cafeteria. Upon nurse assessment, slight redness was present to right hand with no other injuries noted. Client transferred to acute care via ambulance.
Licensing Specialist: Kendra Rice.
Licensing Specialist reviewed camera footage on 9/13/23. No issues were noted by licensing. Per maintenance, the chair lift has been repaired. Resident returned from acute care on 9/12/2023.
PRLU or OLTC
Notice of Incident, Self-Harm, Visit Compliance Report
Client became argumentative and defiant after receiving consequences (60k focus and assault precautions) for behavior and struck the wall with a closed hand. Mild amount of edema to 5th knuckle noted. Mobile x-ray results: Acute angulated distal 5th metacarpal fracture. Client was taken to the ER and given a splint for the injury.
Licensing Specialist: Kendra Rice.
Licensing reviewed camera footage on 9/13/23. Client was observed striking the water fountain with ratio 1:1. No issues were noted by licensing.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
Staff placed client in a restraint due to client screaming in the dayroom. After client was released from the hold, client immediately tried to attack staff. Staff placed client back in a restraint, and after 3 mins of being in the hold, the nurse instructed staff to release the hold. Staff pushed client back and client fell to the floor. Nurse instructed staff to leave the room. No injuries noted. Child Abuse Hotline referral not accepted. Staff member was suspended.
Licensing Specialist: Kendra Rice.
Facility visited and camera footage was reviewed. Staff was seen placing client in a restraint for an unknown reason and pushing client resulting in client falling to the floor. Upon video review, Licensing Specialist called the hotline and reported the incident (not accepted).
Facility cited for R109.1.g and R905.4.g due to staff member pushing the resident. Staff member was observed displaying unprofessional conduct and demonstrating improper restraint techniques. Program Director informed Licensing Specialist that staff was retrained in CPI with focus on using a physical restraint being used as a last resort. Staff member received written warning stating any other policies or procedures which are not followed would result in immediate termination.
Police Report
Battery
Officer responded to facility in reference to a juvenile out of control. Staff reported the juvenile got upset and kicked a trash can across the room, then punched a staff member. Staff reported the juvenile has hit staff in the past, and causes problems with the other juveniles when he gets out of control. Juvenile was transported to Juvenile Detention Center (JDC) and will be charged with Battery 3rd.
PRLU or OLTC
Notice of Incident, Peer Altercation, Visit Compliance Report
Client stepped on a peer’s foot and later hit the peer in the head with a notebook. Staff intervened, separating the client from peer. Client then tried to break the leg off of a chair and attempted to get a pencil, threatening to stab someone. Client’s aggression increased when a male staff entered the room, and client punched staff and swung at staff with a closed fist while also threatening to harm him. The client was placed in a child protective position for 1 minute. The client got out of the position and continued to hit staff. Bono Police Department was called to the facility and the client was transported to Juvenile Detention Center (JDC).
Licensing Specialist: Kendra Rice.
Facility visited on 9/5/23 and video reviewed of incident. No issues noted by Licensing. Licensing was informed the resident will not be able to return to the facility.
Police Report
Disorderly Conduct
Officer responded to facility in reference to a juvenile being disruptive. Officers spoke with the juvenile and got him calmed down. Juvenile advised he took a piece of wood off the bed and was hitting the walls to make noise, but never tried to attack anyone. Juvenile advised the people there were unfair and he wanted to leave, but stated he would not cause anymore trouble.
Police Report
Battery
Officer responded to facility in reference to a juvenile out of control and hitting a staff member. Upon arrival, officer spoke with the staff member who stated the juvenile began hitting him with a tee shirt and cursing at him, then punched him. The staff member did not want to pursue charges but requested officer speak with him about his behavior. Juvenile advised officer this wouldn’t happen again.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Kendra Rice.
Licensing completed buildings and grounds from 1:30pm to 3:00pm and observed the following areas: Activity room, dining room, nurse’s station, big boys hall, little boys hall, laundry room, focus room, seclusion rooms, and classrooms.
MARs were reviewed for 5 residents. No licensing concerns noted during visit.
PRLU or OLTC
Notice of Incident, Peer Altercation, Suicide Attempt, Visit Compliance Report
Client got into a verbal altercation with peer. The peer proceeded to jump over the table to get to the client. The client and the peer exchanged hits with closed and open hands. After the two were separated by staff, the client became defiant throwing items and getting on top of tables. Client threatened to elope and tried to break in the cafeteria window. Client took his shoes, socks, and shirt off. Client later took clothing and wrapped it around his neck. Staff removed clothing. Client did not have any injuries. No pain noted. Client was placed on 60K focus, assault precautions, elopement precautions, and suicide precautions. Licensing Specialist reviewed camera footage for ELS case [REDACTED] for licensing concerns. The provider reported incident took place in the dining room area, ratio 2:4. Two residents observed sitting down at the table and two walking around. Licensing Specialist observed resident come across the table, jump on the table, jump off the table toward a peer, and the altercation began. Licensing Specialist observed staff separate the residents by taking them to different areas of the dining room. The resident broke free from staff and ran around the room toward his peer.
PRLU or OLTC
Notice of Incident, Suicide Attempt
Client kicked wood panel out from the bed. Client used the panel to knock holes in the wall. Client stated, “he wanted to die.” While in his bedroom, client took a piece of blue jean material from his jeans and wrapped it around his neck. Staff retrieved the fabric. Client did not have any injuries. No pain noted. Client was placed on assault precautions, suicide precautions, and line of sight to be directly supervised by staff at all times. Licensing narrative: Licensing Specialist reviewed provider reported incident for licensing concerns. Licensing Specialist will inquire about the damages. Licensing Specialist informed that the maintenance supervisor is scheduled to have repairs completed by 1:00 pm. There is no camera footage due to incident taking place in the resident’s bedroom.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist conducted an annual review of policies and procedures for Dacus RTC at Methodist Family Health. [REDACTED], compliance specialist, assisted Licensing Specialist with the review. Policies and procedures for Dacus RTC complied with minimum licensing standards. Licensing Specialist: Kendra Rice.
PRLU or OLTC
Notice of Incident, Self-Harm, Suicide Attempt, Visit Compliance Report
7/2/2023 staff [REDACTED] informed the client [REDACTED] it was time for bed. Client refused to go to bed. Client ran behind the desk detached the HDMI cord and wrapped it around his neck. Client crawled under the desk. Staff unwrapped the cord from around the client’s neck. Client grabbed a staff’s clipboard, ran down the hallway and tried to use the metal part to cut his arm. The nurse noted client made a small 1-2 cm abrasion to left forearm. A small amount of blood was noted. Client denied having pain. The wound was cleaned and bandaged. Client was placed on assault precautions, elopement precautions, suicide precautions, and line of sight to be directly supervised by staff at all times. Licensing Specialist reviewed camera footage for ELS case [REDACTED] for licensing concerns. Licensing Specialist observed ratio (1:2) they were siting in a classroom. The resident was sitting at a desk and the other resident was sitting by the staff’s desk. Licensing Specialist observed the resident get up from the desk and walk over to staff’s desk. He was dropping things on the ground and moving objects on the desk. Another staff entered the classroom ratio (2:1). Resident walked over to desk again, unplugged something on the desk, and proceeded to go under the desk area. Staff can be seen looking and bending down under the desk, using a phone flashlight to see what the resident was doing under the desk. The resident can be seen escorted from under the desk and staff members took what appears to be a cord from the resident. Licensing Specialist: Kendra Rice.