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 rstanford@disabilityrightsar.org

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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PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

Received complaint 4/13/23 as follows: Member’s guardian [REDACTED] said she’s dissatisfied with Millcreek of Arkansas’ services. Guardian reported that he has had on campus visit withjt he member and each time she has witnessed poor hygiene. Dirty clothes, dirty fingernails, toenails, and brusies. Guardian also reported the member always says he’s hungry during phone calls and appears to be starving whenever she sees him. Guardian also mentioned that when she calls Millcreek of Arkansas she hardly ever gets soemone to answer the phone and that they have only been giving the meber antibiotiucs and medication to help with bowel movements. Guardian said she spoke with the CEO once and he was nice but did mention that they normally don’t take in indcivuals that wear pull ups, who aren’t potty trained, and that the meber is old enough to go to the restroom on his own. Guardian said the CEO was really nice aside from that statement. Guardian said there are no changes in member’s medications and that she was under the impression that Millcreek would be helping the member, but instead his behaviors have worsened.

Licensing Specialist: Clayton DeBoer. Regulations out of compliance: 908.8 – The administering of all medications, including over-the-counter, shall be logged at the time the medication is given, by the person administering the medication.

PRLU or OLTC

Accidental Injury, Notice of Incident

Client engaged in a game of recreational kickball. She slipped and fell while kicking the ball. She reported pain in her right wrist and lower arm. Slight swelling noted. Sent to Dallas County Medical Center for outpatient x-ray. X-ray report indicated no fracture. She was released to return to the facility.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Client was sent to Dallas County Mecial Center for assessment following a physical altercation. They reported dizziness during his on-site nursing assessment. ER report indicates no loss of consciouness, no vision changes, no neurologic deficits.

Licensing Specialist: Clayton DeBoer. Regulations out of compliance: 907.2 – Child caring staff shall be responsible for providing the level of supervision, care, and treatment necessary to ensure the safety and well-being of each child at the facility, taking into account the child’s age, individual differences and abilities, surrounding circumstances, hazards and risks.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Client was sent to Dallas County Medical Center following a physical confrontation. He reported pain in his nose during the on-site nursing assessment. He was sent for outpatient x-ray. X-ray report indicates ” CT imaging would best define if needed clinically.” Tylenol was provided for pain. He was released to return to the facility. Licensing Specialist: Clayton DeBoer. Regulations out of compliance: 907.2 – Child caring staff shall be responsible for providing the level of supervision, care, and treatment necessary to ensure the safety and well-being of each child at the facility, taking into account the child’s age, individual differences and abilities, surrounding circumstances, hazards and risks.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Review of the agency’s current mandated reporter policy revealed it does not comply with A.C.A 12-18-402 nor Minimum Licensing Standards. Please ensure facility policy is updated to reflect the need of all staff to report directly to the child abuse hotline without delay. The updated policy shall be submitted to the Licensing Unit by 04/14/23 and all applicable staff shall be retrained on the updated policy within 2 weeks of the enactment of the updated policy.
  • TA –
    • 110.9 – Any owner/operator, employee, foster parent, or volunteer in a child welfare agency shall immediately notify the Child Abuse Hotline if he or she has reasonable cause to suspect that a child has been subjected to child maltreatment, died as a result of child maltreatment or if they observe a child being subjected to conditions or circumstances that would reasonably result in child maltreatment.
    • 102.3.h -Child Maltreatment/Mandated Reporter policy; according to Arkansas law, including, procedures to ensure that alleged, suspected, or witnessed incidents of maltreatment are reported to the Child Maltreatment Hotline, and documented as required by these or other applicable rule or laws.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Licensing documented employment status of persons not eligible to be employed by a child welfare facility. Offer was rescinded for 3 individuals, 3 individuals were never hired, 1 individual was terminated on 01/23/23, and 1 individual who was on leave since 03/23/23 is scheduled to be terminated on 03/28/23.

PRLU or OLTC

Self-Harm

Client was sent to Dallas Co. Medical Center for outpatient x-rays. Following his punching a closed-door multiple times, he reported pain in his right hand during a nursing assessment. ER Discharge report indicated . The finger was reset, and he was released to return to the facility.

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.