Client complained of hand pain after playing in the gym. An x-ray was ordered. Results revealed no abnormalities or dislocation.
PRLU or OLTC
Accidental Injury, Notice of Incident
PRLU or OLTC
Accidental Injury, Notice of Incident
Client was playing in the gym. X-ray was ordered on left knee due to client complaining of knee pain and having palpable knot on the lower part of his knee with increased warmth and some possible swelling. Results came back and are: No acute fracture or effusion, but did show fragmentation along the tibial tuberosity with mild overlying soft tissue swelling suggestive of Osgood-Schlatter disease (more so from overuse).
PRLU or OLTC
Accidental Injury, Notice of Incident
Client was in the gym playing when he rolled his left ankle and complained of pain. An x-ray was ordered and results are: There is no acute fracture or dislocation. He was given an ice pack, elevation, and PRN Tylenol.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Clayton DeBoer
Buildings & Grounds conducted. Census: 28. Classroom 1 staff/client ratio: 2:8, Classroom 2 staff/client ratio: 2:8, Hallway staff/client ratio: 2:7, Milieu staff/client ratio: 1:2.
All buildings and sleeping areas clean, safe and in good repair. Bathrooms observed clean and sanitary with functioning sinks, showers, and toilets. Grounds clean and free of safety hazards. Fire and severe weather drill logs checked today. MARs checked. All initialed and up to date.
PRLU or OLTC
Notice of Incident, Peer Sexual Contact, Visit Compliance Report
A former resident at the facility reported the following allegations: Other kids would pick on him and touch him inappropriately while they would shower. The client stated they would touch his penis, and also that they would touch his butt and put a finger inside his rectum. He stated he would tell them to stop, and they wouldn’t. The client never did say how many people would do this to him but he said there were a lot of them. He was discharged from the facility on 11/17/23. This was reported to the AR Child Abuse Hotline and accepted.
Licensing Specialist: Clayton DeBoer.
Licensing spoke with staff regarding the complaint. No timeframe is given to review video. No video is available for the shower area where some of the alleged incidents occurred. Staff stated the clients shower alone with no other clients present.
The CACD case was unsubstantiated. The Licensing complaint was unfounded.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client reported he injured his hand outside of the facility, but during Recreational Therapy, he was trying to dodge a ball and fell on his right wrist. An x-ray was completed finding no acute fractures or dislocations.
PRLU or OLTC
Accidental Injury, Notice of Incident, Visit Compliance Report
Client needed an x-ray of his right wrist. Client was playing a game in the gym with his peers, when he slid into base and fell on his right arm. An x-ray was completed, finding no acute fractures or dislocation.
Licensing Specialist: Clayton DeBoer
Facility cited 110.17 for late reporting (client received the x-ray on 1/4/24 and it was reported to licensing on 1/8/24). In-service training will be provided to nursing staff and a verbal warning will be provided to the responsible nursing staff on serious incident reporting procedures.
PRLU or OLTC
Corrective Action Plan, Recertification Survey, Revisit Survey
A validation survey was conducted from 12/18/2023 through 12/21/2023. The facility was not in compliance with §483, Subpart G – Conditions of Participation for Psychiatric Residential Treatment Center:
- N 127 – Facility failed to ensure a physician’s order for a physical restraint was received for 1 (Client #5) of 1 client.
- N 142 – Facility failed to ensure an order for physical and chemical restraints were not received at the same time for 3 (Clients #1, #2 and #5) clients.
Plan of Correction:
- The policy and procedure in place already requires orders to be obtained for any restraint. Upon being notified of the deficiency, additional monitoring steps were put in place. The Nurse Manager is responsible for checking that orders are obtained for all restraints and seclusions and now checks these twice weekly for compliance. The RTC program has enlisted the assistance of the HIM department to monitor the completion of seclusion and restraint documentation and physician orders. The results of these audits are reported to administration. The Nurse Manager reports on accuracy of S&Rs at the bi-monthly Department Head meetings.
- Nurses were educated to ensure that no simultaneous orders for physical and chemical restraints are obtained. Nursing staff are required to indicate that less restrictive measures have been attempted and failed within supporting documentation on the Seclusion and Restraint form. The Nurse Manager is now responsible for monitoring that orders for physical and chemical restraints have not been received simultaneously.
During a revisit conducted on 2/21/24, the facility was found to be in compliance with program requirements.
PRLU or OLTC
Medical, Notice of Incident
Client complained to the Physical Therapist Specialist of pain and discomfort in her right shoulder. An x-ray was ordered and findings are: No acute findings, no foreign bodies to be found, all skeletal structures are intact.
Police Report
Non Police Incident
Officers were unable to locate the building the hang up call was coming from. No answer on call back. Officers circulated the area with negative results.
Police Report
Battery
Officers responded to a disturbance at 2002 S Fillmore. Upon arrival officers made contact with Methodist Children’s Home staff. While attempting to intake Juvenile1 (Jv1), he became irate and punched a staff member, Mr. Justin Smith, in the head. Mr. Smith advised Jv1 stated he was about to start beating everybody up and Jv1 decided to hit him first. Officers did not observe any injuries. The Methodist nursing staff issued medication while Jv1 was restrained prior to officers arrival to calm him down. Officers stood by while MEMS transported Jv1 to the Methodist Maumelle facility. Officers provided Mr. Smith with an incident number and left the location without further to report.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Clayton DeBoer
Buildings & Grounds conducted from 11:00 AM – 12:00 PM. Census: 28
Dayroom staff/client ratio: 4:9, Classroom staff/client ratio: 3:8, Milieu staff/client ratio: 1:1, Therapist office staff/client ratio: 1:1
Hall C and D observed to be clean, safe and in good repair. Bathrooms clean and sanitary with functioning sinks, showers, and toilets. Cafeteria observed to be clean and sanitary. Gym observed to be clean and free of safety hazards.
MAR checked. All initialed and up to date.
Annual Review/Policies PRTF Checklist completed. All items accounted for except a log or file of all calls to the child abuse hotline. Facility cited 110.11. UMCH PRTF Director Kaylynn Bennett created an electronic child abuse hotline log prior to conclusion of today’s visit.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client was playing in the gym with peers. Client complained of some ankle pain. An x-ray was ordered and the results are: normal x-ray examination of ankle. No findings of any irregularities.
PRLU or OLTC
Notice of Incident, Self-Harm
Client was upset and punched a door. Nurse assessed client and client refused ice packs stating he was fine. APRN came and visited on 11/14/23 and ordered an x-ray. X-ray results of his left hand were normal (no fractures or abnormalities).
PRLU or OLTC
Accidental Injury, Notice of Incident
Client was in the gym playing catch with a peer. She began running to catch the ball and fell on her left knee. She was assessed by the nurse and an x-ray was ordered due to a birth defect that the client has. Client x-ray was completed on 11/13/2023, X-ray results indicates no findings of an acute fracture.
Police Report
Battery
Officers responded on a battery. Upon arrival officers made contact with Vic#1(Pearson). Pearson advised officers he is an employee at the facility. Pearson advised officers he told Susp#1(Juvenile 1) it was time to take a shower. Pearson advised the juvenile pushed him into the wall and began poking himself with a pen. Pearson advised he attempted to take the pen from the juvenile and the juvenile scraped his arm and stomach with the pen. Pearson advised officers this has happened multiple times in the past with various staff members. Officers observed very minor scrapes to the stomach and arm of the victim. Pearson advised officers he wanted a report made so he can seek warrants on the juvenile, officer gave Pearson an incident number. Officer asked Pearson if he needed medical attention, he refused.
On 11/10/2023, at approximately 2234 hours, officers responded back to the location and made contact with Pearson. Pearson advised Juvenile 1 pushed him and hit him again. He said he did not sustain any injuries this time. Pearson said he was leaving work after he was done speaking with officers and his supervisor did not want officers speaking with Juvenile 1.
PRLU or OLTC
Notice of Incident, Self-Harm
Client got upset with another peer, walked out of designated area and kicked through some doors, complained of knee and hand pain. An X-ray was ordered and results are: No fractures and normal anatomy of his right hand and right knee. Likely he just has soft tissue injury/inflammation causing his current discomfort.
PRLU or OLTC
Medical, Notice of Incident
Client reported abdominal pain to right lower quadrant with nausea and episodes of diarrhea earlier today. An x-ray was ordered and the results were normal; no issues noted. He did have a moderate amount of stool in his bowels and may just need to have a bowel movement.
PRLU or OLTC
Notice of Incident, Self-Harm, Suicide Attempt
Client was sent to Arkansas Children’s Hospital after reporting she broke a pair of sunglasses, used the screw for self-harm, then swallowed the screw. X-ray findings: No acute findings. Waiting for foreign body to pass in client’s stool.
PRLU or OLTC
Medical, Notice of Incident
Client complained of abdominal pain. An x-ray was ordered. Findings: Normal examination of the abdomen and pelvis. No acute issues noted.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client complained of ankle pain from falling the gym. An x-ray was ordered. Findings: No acute fracture, normal findings.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client complained of pinky toe pain on 10/30/23 due to kicking a soccer ball on 10/29/23. An x-ray was ordered and he has an acute nondisplaced proximal phalanx fracture.
PRLU or OLTC
Complaint, Medical, Notice of Incident
Licensing received a complaint on 11/1/2023 regarding a child who was picked up from the facility on 10/28/2023 by her guardian for a visit. The child was complaining of ongoing pain in her stomach, so the guardian took her to the emergency room and was then transported to ACH for further treatment of pancreatitis, a blood clot in her spleen, and sepsis. The child reported she was complaining to the nurses about the pain since Wednesday 10/25/2023 and they gave her ibuprofen on Thursday 10/26/2023. The child reported that when she continued to complain of pain, the staff told her to quit faking it. Child Abuse Hotline was called and accepted.
Nursing notes gathered from the facility do show the resident received 800mg of Ibuprofen on 10/26/2023, but there were no other nursing notes for the resident after that time.
11/9/2023 – Licensing spoke with guardian who stated the resident was discharged from the hospital on 11/7/23 and is now home and recovering. There was no identified cause for the medical issues the resident experienced. Guardian provided email attachments showing the resident’s diagnosis from her 10 day stay at Arkansas Children’s Hospital along with a timeline of events.
Email sent to UMCH 11/14/23 to ascertain what the plan of action is for UMCH’s nursing department to correct any issues (if they have identified any) to prevent incidents like what happened with resident.
Facility reported that client did begin complaining of stomach pain on 10/25/23 with no other significant symptoms, and continued to participate in facility activities. Facility stated the medical staff would not have reasonably suspected pancreatitis in the timeframe prior to her leaving on pass due to her symptoms and the short period of time between the onset of symptoms and when she experienced severe abdominal pain on 10/28/23 when she was taken to the ER. Therefore, there does not seem to be a need for change or improvement in the performance of nursing staff.
CACD investigation was unsubstantiated. This complaint was unfounded by Licensing. No visit conducted for this case and no licensing citations issued.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client fell while in the gym playing and twisted her ankle. An x-ray was completed Saturday 10/28/23. Findings: No acute fractures or dislocations that could be identified.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client fell while in the gym playing and stated she twisted her ankle. An X-ray was ordered. Findings: Normal x-ray examination of the ankle.