Disability Rights Arkansas

Millcreek Behavioral Health / Habilitation Center, Inc.

*Photos taken by DRA staff during onsite monitoring visits. Photos reflect the most recent conditions observed by DRA staff but may not reflect the current conditions at the facility. If you are associated with a facility and have updated information or photos you would like to share, please contact DRA at [email protected]

Location: Fordyce, AR                   Population Served: Youth ages 6-17

# of residents per unit: Up to 20 Residents per room: 2-3

Capacity: 162 (111 Arkansas Medicaid PRTF beds, 51 Residential beds used for out-of-state resident PRTF placement or AR contract beds).

Contact with family (Calls and visit schedule): Family visits vary on a case-by-case basis. Phone Calls are allowed on 4 days of each week and are limited to 10 minutes unless otherwise specified.

Restraint utilized? Yes Chemical Restraint utilized? Yes Seclusion utilized? Yes

Treatment Components:

Clinical Director: LPC                    Therapists:8 full-time therapists (LPC-S, 5 LPC, 1 LCSW, 1 LMSW)

Treatment modalities offered: 1 EMDR, TF-CBT

# of individual therapy sessions/week: 1

# of group therapy sessions led by a licensed mental health professional/week: 3

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Police Report

Runaway

On Sunday March 20, 2023 at approximately 1300 hours. Officer was dispatched to Darryl’s for a runway juvenile from Millcreek. Dispatch advise it was a [REDACTED]. He was wearing a white t-shirt and black jacket. On arrival I saw the indivual who fit the description of the information I had. Officer spoke with him. He stated that he was trying to go to McDonalds. I called Millcreek to speak with someone about the runaway juvenile and I sated that I will be in route with the juvenile for return.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 10:30am – 12pm. Census: 166. Pebble Creek, Rock Hill, Deerfield, and Store observed. Store is for faculty use only at this time. Maintenance will address citations on or before 04/03/23 and Rock Hill flooring repairs will be contracted out. MARs reviewed for 5 residents.
  • Regs out of compliance –
    • 901.3 – No posted client rights in Deerfield.
    • 911.6 – Shower nozzle was broken in bathroom and scattered spots on ceiling in bathroom (Pebble Creek). Chipped paint on bedroom 1 wall, flooring not laid adjacent to the door hinge in bedroom 2 leaving an open area that had collected dirt, missing baseboard in bedroom 4, graffiti on shelf in closet of bedroom 5, missing shower rings in bathroom 2, and flooring in common area had holes throughout (Rock Hill). Baseboards in bedroom 1 tattered and not connecting (Deerfield).

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

  • Maltreatment
    • During a therapy session, client reported that a staff member had threatened to “cut his vocal cords” because he wouldn’t stop humming, made him get under a table and pushed a chair against him, made him “stand up in a corner when it was time to go to bed”, and “poked him with a pen” behind his ear and the side of his head. Nurse noted a healed abrasion with scab behind ear. Child Abuse Hotline was called and accepted. Staff member was placed on administrative leave pending the investigation.
    • Licensing follow-up: Video reviewed on 03/13/23 showed client being directed to stand in the corner from 7:15pm until 9:40pm with brief breaks (on 03/09/23). The office door was open during the entire time reviewed, and a staff member was on her cellphone during most of the video. During further review, a staff member was seen bumping client with her stomach area to direct client back to the corner (Child Abuse Hotline was called separately for this incident) and a client is seen transporting a cleaning agent unsupervised (later determined to be soap).
    • Unfounded: At no time is alleged staff member seen pushing a chair against client or poking him with a pen.  
    • Founded: Client was observed being directed by 2 staff members to stay in corner area until 9:40pm. On 03/17/23, facility indicated staff 1 remains on administrative leave pending certain termination and staff 2 will be retrained on TCI which encompasses appropriate staff/client interaction.
    • CACD investigation was unsubstantiated as of 05/03/23. Staff 1 was terminated on 03/23/23. Staff 2 was retrained and has since been terminated as of 05/22/23.
  • Regs out of compliance –
    • 905.3 – Child stood in the corner from 7:15pm – 9:40pm.
    • 905.4.f – Child stood in the corner from 7:15pm – 9:40pm.
    • 907.2 – Door to the office in video reviewed was open with no staff inside the office for duration of the video. A client is seen transporting what appears to be a cleaning agent unsupervised.
    • 905.4.g – Staff member bumped client with her stomach to direct him back to a corner he had been standing in for an extended period of time.

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation
    • Client engaged in a physical confrontation with a peer and was punched in the nose. Nurse noted slight swelling to the bridge of the nose. Client was sent to the ER, and x-rays indicated no fracture was present. Client returned to facility.

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation
    • Client punched a peer on 03/07/23, and no injury was verbalized or observed during initial nurse assessment. On 03/08/23, client reported pain and bruising to his hand/wrist area. Client was sent to the ER, and x-rays indicated no fractures. Client returned to the facility.
    • Licensing follow-up: Will continue to monitor.

Police Report

Third Degree Escape

Officer was dispatched at approximately 1210 hours for a juvenile who ran away. The juvenile was located by Millcreek staff at approximately 1800 hours.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • After being prompted to get up and take his medication during med pass, client became upset and punched a cinderblock wall. Nurse noted edema and mild deformity to the right metatarsal. Client was sent to the ER, and x-rays revealed an angulated fifth metacarpal shaft fracture. A splint was applied, and client returned to the facility. A follow-up appointment will be scheduled with an orthopedic clinic.
    • Licensing follow-up: On 03/06/23, Licensing requested results of follow-up appointment from facility.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client slipped in the mud while returning to his unit from an outdoor activity. Client complained of pain to his shoulder and nurse noted redness with slight bulging to the shoulder. Client was sent to the ER, and x-rays indicated no fractures or dislocations.
    • Licensing follow-up: Client remains at facility. Will continue to monitor.

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation
    • Client was punched in the nose by a peer. Client was sent to the ER; X-ray indicated no fractures.
    • Licensing follow-up: Client remains at facility.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

  • Peer Altercation
    • Client was punched in the face by a peer. Residents were separated, and nurse noted bruising to both lower eye areas with swelling and bruising to nose. Client sent to the ER; X-rays indicated no fractures.
    • Licensing follow-up: No video footage available due to it occurring in client’s bedroom. Facility visited on 02/09/23 and residents interviewed. Residents stated they fought for less than 5 minutes before a peer went to get staff who separated the fight.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client reported continued pain from injury he sustained on 02/02/23. Client stated he fell during an outdoor basketball game, hurting his right forearm and wrist. Nurse noted swelling to forearm, and client was sent to the ER. X-ray indicated no fractures.
    • Licensing follow-up: Client remains at facility.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client reported to his therapist that several days earlier, he became upset with a peer and punched a tree, injuring his hand. Nurse assessment: Swelling and laceration to client’s hand. Client was sent to ER for x-ray.
    • Licensing follow-up: Client scheduled for x-ray on 02/03/23.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

  • Complaint
    • Complainant reported the following concerns: 1) daughter was treated poorly by staff and wasn’t being given her medication properly during her stay at the facility, 2) staff would yell/cuss at children and when a resident reported this, the resident was retaliated against by staff, 3) residents are not allowed to do things such as recreation, phone calls with family, or go to school if any of the residents are having “acting out” behaviors.
    • Licensing follow-up: Facility visited on 03/13/23. Staff reported the facility was aware of the allegations and has performed in-service training for several staff listed in the complaint regarding cleanliness, recreational activities, supervision, and not canceling activities due to other residents’ behaviors. Regarding resident’s medication complaint, the DON and unit nurse reported it should be given at 6am from the night nurse and all other medications should be given at 8am after breakfast; The MARs documentation for the resident showed her medication was all being given at 8am by the morning nurse. Licensing discussed this with staff, who stated the pharmacy consultant reported there are no contraindications between her medications. Upon interviewing residents, it was noted staff do occasionally yell and use profanity on the unit. Facility reported they will complete their “Nurture Heart” training with staff listed in the complaint, supervisory training for the unit coordinator, and will conduct ongoing monitoring of the unit. On 03/21/23, Licensing requested client’s MARs and was informed client is no longer at facility. MARs were requested for other clients on similar medication, and all were being distributed at 6am.
  • Regs out of compliance –
    • 908.8 – Medication for resident was being given at 8am; DON stated it should be given at 6am.
    • 905.4.c – Staff were using cuss words in communicating with residents.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury 1
    • While exiting the cafeteria, client slipped on a wet floor tile and fell to the floor. Client reported ankle pain and was referred to the ER. X-ray indicated no fractures.
    • Licensing follow-up: Client remains at facility.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury 2
    • While exiting the gym, client began running and tripped and fell to the ground. Client reported ankle pain and was assessed by nurse. Client reported continued pain on 02/01/23 and was sent to the ER. X-ray indicated no fractures.
    • Licensing follow-up: Client remains at facility.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client slipped while playing basketball, bending his left leg back and hitting his knee on the floor. Client presented to nurse with knee pain and was transported to the ER. X-ray indicated no fracture; Client will receive follow-up assessment with PCP on 01/31/23.
    • Licensing follow-up: Client remains at facility.

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation
    • Client engaged in a verbal altercation with peers; Peer became upset and approached him aggressively. Staff stood between the residents, but peer punched client in the face. Two other peers joined in, and staff were able to separate them. Nurse noted bruising and swelling to client’s eye, and he was referred to ER. Diagnosis: Fracture to occipital lobe. Client was referred to ACH for follow-up treatment.
    • Licensing follow-up on 02/03/23: Facility visited, and video reviewed. No inappropriate holds observed. Safety plan: Client was moved to a different cottage on 01/31/23. Client will remain on close observation until 02/26/23. 
    • Licensing follow-up on 03/03/23: Licensing reviewed video of the incident again and observed staff responding slowly to the altercation, with 1 staff member seen with his hands in his pockets and pushing multiple clients during fight. At no time did staff attempt to call for help. Training for staff involved will include Protective Interventions, Proximity, and the use of codes when in a crisis situation. Licensing advised staff should be engaging with the residents and mixed around the common area, and if staff realize clients are overstimulated, they should be actively engaging using skills learned in training. Licensing requested all staff involved be retrained on appropriate interventions and de-escalation techniques.
  • Regs out of compliance –
    • 109.1.g – Staff aggressively pushed residents several times during the incident.
    • 907.2 – Staff (3) failed to ensure the safety and well-being of the resident who was attacked.

PRLU or OLTC

Children's Records Review, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Records reviewed for 6 residents. No licensing concerns noted.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 10:30 am – 11:30 am. Census: 162. Magnolia and Eagle Halls observed, and MAR checked for 5 residents. No licensing concerns noted.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client reported he slipped while getting out of the shower and fell on his arm. Nurse assessment noted pain while rotating arm, palms bluish in color, and light swelling. Client reported to have broken his arm 3 or 4 times before. Client was sent to the ER and diagnosed with a probable nondisplaced fracture of the radial styloid; He was provided with a wrist brace and sling.
    • Licensing follow-up: Facility reported they observed the shower area and did not see anything that would increase the potential for slipping. Facility visited on 01/24/23, and the shower area was observed to have slip resistant tile with no water build up.

PRLU or OLTC

Notice of Incident, Peer Altercation, Self-Injury

  • Self-inflicted Injury, Peer Altercation
    • Client became upset after a peer punched him in the back as they returned to the living unit from lunch (staff separated them). Client punched the bedroom door with his fist. Upon assessment, nurse noted slight bruising to 5th digit on left hand. Client was sent to the ER on 01/17/23 due to continued complaints of pain, and the x-ray results indicated a fracture.
    • Licensing follow-up: Facility sent x-ray results on 01/18/23. Client will be seen by medical director for decision on treatment.

PRLU or OLTC

Children's Records Review, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Multiple children’s records reviewed.
  • Regs out of compliance –
    • 9.902.3 – Clients (3) did not have immunizations or proof of requesting immunizations

PRLU or OLTC

Notice of Incident, Suicide Attempt, Visit Compliance Report

  • Suicide Attempt
    • Client swallowed approximately 2 oz. of Pine Sol cleaner. A peer in the living unit had just completed their nightly chores, and the cleaner was accessed on a table in the day area. Poison Control was contacted and encouraged client be assessed at a medical facility. Client was sent to the ER and monitored for 6 hours; No treatment was deemed necessary. Client was placed on 1:1 supervision until 01/16/23.
    • Licensing follow-up: Licensing inquired of client status. Facility reported client has been incident free since Friday and is remorseful of his actions.
    • Facility cited for 910.1 (safety hazard was accessible to client) and 907.2 (client was not supervised for a length of time long enough to ingest safety hazard).

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation (1)
    • After an altercation with peer, client was assessed by nurse and was given Tylenol and told to elevate his leg. On 01/12/22, he reported continued pain in his right knee. Client was sent to the ER and an x-ray indicated there was no fracture.

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation (2)
    • Client was involved in an altercation with peer, and no complaints or injuries were noted upon nurse assessment. On 01/12/22, client reported he woke up with swelling and pain in his right hand. Client was sent to the ER and an x-ray indicated there was no fracture.