Disability Rights Arkansas

Perimeter Behavioral of Forrest City / Woodridge of Forrest City

Location: Forrest City, AR

Population Served: Males ages 12-17 and a specialized sexual rehabilitative unit for males ages 12-17

# of residents per unit: Up to 21 Residents per room: 1-3 (SRU has 1 or 3, never 2) Capacity: 66

Contact with family (Calls and visit schedule): Calls 2x/week.

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

Treatment Components:

Clinical Director - LPC-TA

Therapists: 3 full-time therapists (1 LCSW, 1 LPC, 1 LMSW); 2 part-time/contract therapists (1 LCSW ACSW, 1 LAC)

Treatment modalities offered: DBT, CBT, TF-CBT, Person-Centered, Narrative, Reality, Anger Replacement Therapy

# of individual therapy sessions/week: 1x/week

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

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PRLU or OLTC

Complaint Survey

  • Complaint #AR00028851 was substantiated, all or in part, with no deficiency cited.
  • Regs out of compliance –
    • N 145 – Facility failed to ensure the Face-to-Face Assessments for Emergency Safety Interventions documented the time they took place to ensure they were done within an hour of initiating the ESI for 1 client who was placed in physical restraints.
    • N 189 – Facility failed to ensure a staff debriefing was conducted and documented within 24 hours after 1 client was placed in a physical restraint.

PRLU or OLTC

Children's Records Review, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 11:15am – 12:45pm. Census: 48. Specialist reviewed 2 children’s records.
  • TA –
    • R903.5 – Education documentation will be placed in the children’s chart by 9/16/22.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Specialist viewed the 400 Hall entrance, fence removal, and the doors. Specialist observed the doors closing and not closing; Staff stated the doors will be repaired on 8/31/22. Where the fence was removed, metal was observed sticking out of the maintenance shop; Maintenance was contacted and agreed to repair the metal today, 8/25/22. Specialist observed classrooms 1-4. Hand sanitizer bottles have been removed from all classrooms, and dispensers are on back order and will be arriving on 9/2/22. No licensing concerns noted.

PRLU or OLTC

Complaint Survey

Complaint #AR00028685 was substantiated, all or in part, with no deficiencies cited.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • The following areas were observed: Halls 100, 200, and 400. Specialist observed water on the floor in 100 Hall due to a busted pipe. Staff stated a contractor was coming out today (8/17/22) to repair the pipe. It was reported the pipe busted on 8/15/22 and the residents are using 300 and 400 Hall bathrooms until Hall 100 is repaired. Specialist was informed the Conscious Discipline Training started today and will consist of 10 modules; All staff will be trained.  

PRLU or OLTC

Maltreatment, Notice of Incident

  • Maltreatment
    • It was reported that client was placed in an unjustifiable physical containment after throwing water in a staff member’s face. Staff member was observed on camera footage blocking the entrance and pushing client, posturing at client with a closed fist, and picking up and throwing the client into a chair in the dayroom. Client attempted to run away when staff grabbed client’s arms. Client was assessed by nursing staff while in constraint. Client suffered a broken fingernail. Staff member terminated on 8/16/22.
    • Child Abuse hotline called and accepted, investigation pending. Licensing follow-up on 8/17/22: Camera footage viewed at facility.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client was taken to the ER after complaining of right hip pain from playing kickball outside. No follow-up details.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Accidental Injury)
    • Client was taken to the ER after complaining of hip pain from playing kickball outside. Diagnosis: Contusion to right side of back. Client will follow-up with PCP if symptoms persist. No follow-up details.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Ingested Hand Sanitizer 1)
    • Client admitted to drinking hand sanitizer, a Kool-Aid single pack, and water. Client was taken to the ER. Diagnosis: Encounter for observation for suspected toxic effect from ingested substance ruled out. Facility will remove bottled sanitizer from each classroom and install sanitizer dispensers for all classrooms near the entrance door by 8/19/22.
    • Licensing follow-up: Specialist observed each classroom on 8/25/22.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Ingested Hand Sanitizer 2)
    • Client reported drinking hand sanitizer, a Kool-Aid single pack, and water. Client was taken to the ER. Diagnosis: Encounter for observation for suspected toxic effect from ingested substance ruled out. Facility will remove bottled sanitizer from each classroom and install sanitizer dispensers for all classrooms near the entrance door by 8/19/22.
    • Licensing follow-up: Specialist observed each classroom on 8/25/22.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Allergic Reaction)
    • Client sent to ER for potential allergic reaction to medication. Diagnosis: Allergy status to other drugs, medicaments, and biological substances. Continuance of care to follow-up with prescribing physician.
    • Licensing follow-up on 8/18/22: Medication adjustment.

PRLU or OLTC

Children's Records Review, Self Report Visit, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility cited (907.2) regarding 8/5/22 incident; The corrective action plan took place on 8/10/22. Staff involved will receive progressive disciplinary actions up to termination, additional training on supervision, and head counting before and after transitions by the Clinical Director. Specialist viewed camera footage from 8/5/22 and observed resident coming from behind bedroom after staff had checked the bedroom.
  • Specialist viewed 6 residents files. One resident did not have a master treatment plan completed in 30 days.
  • Regs out of compliance –
    • 9.907.2 – 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.
    • 9.903.4 – The treatment plan shall be developed within thirty days after placement.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Passed Out, Hit Head)
    • Client passed out during medication pass and fell, hitting head on floor. Client was transported to ER. Continuance of care through nurses and APRN.
    • Licensing follow-up on 8/8/22: Ibuprofen and Acetaminophen for medication. Further diagnostic work up recommended if condition worsens.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Neck Pain, Involuntary Movements)
    • Client complained of involuntary neck movement and pain. It was reported that client was not doing anything before the incident. Client was taken to the ER and diagnosed. No follow-up details.

PRLU or OLTC

Maltreatment, Notice of Incident

  • Maltreatment
    • Client was left unsupervised from 8:33am – 9:56am. During transition to outside activity, the client stepped out of line and hid behind bedroom door. Camera footage was reviewed, and nursing assessed client. Staff involved will receive progressive disciplinary actions, additional training on supervision, and head counting before and after transitions. Staff will not work in direct contact with any residents and work business hours when facility administrators are present pending investigation.
    • Child Abuse Hotline was called, accepted on 8/8/22 (initially not accepted); Investigation pending. Licensing follow-up: 8/10/22, staff involved will be trained by the Clinical Director before their work shift.

PRLU or OLTC

Notice of Incident

  • Client jammed middle finger while playing basketball; Swelling noted. X-ray was scheduled.
  • Licensing follow-up: Copy of x-ray received.

PRLU or OLTC

Notice of Incident

  • X-ray (Finger Pain)
    • Client complained of pain in right index finger; No swelling or edema noted. X-ray: No findings were noted. No follow-up details.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Not listed.
  • The following areas were observed: Hall 100 bedrooms, dayrooms, classrooms 1-4 in the school, dining room. MARs checked for multiple residents.
  • TA –
    • 9.911.6 – All buildings and furnishings shall be safe, clean, and in good repair.

PRLU or OLTC

Children's Records Review, Personnel Record Review, Visit Compliance Report

  • Licensing Specialist: Not listed.
  • Facility visited from 10:00am – 12:30pm. Two client records reviewed: One client missing a social security card copy. No correspondence could be found in file documenting attempts to retrieve SS card. Five personnel records reviewed: One staff member did not have 3 letters of reference.

PRLU or OLTC

Elopement, Notice of Incident

  • Elopement
    • Client eloped from administration building after kicking through exit doors. Staff pursued client and maintained visual throughout the incident. No follow-up details.

PRLU or OLTC

Consensual Sexual Contact, Notice of Incident

  • Sexual Contact (Consensual)
    • Client reported consensual sexual contact with roommate that occurred a few weeks ago inside their room. Client was reassigned to a new room, separating each youth on opposite ends of the milieu and placed on peer restriction from one another. A sexual safety plan has been implemented.
    • Licensing follow-up on 07/11/22: Licensing inquired if the hotline was called. The agency reported they did not due to the sexual contact being consensual. Licensing explained this should be reported due to the residents being underage and placed in a facility that requires a high level of supervision. Licensing confirmed there was no date of the incident, so camera footage would not be reviewed. Child Abuse Hotline was called, not accepted.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Peer Altercation)
    • Client was stabbed in the left shoulder and right hand during an altercation with peer. Client received immediate first aid and sent for consultation with APRN.
    • Licensing follow-up on 07/06/22: In response to request for further information, the facility reported the peer used a pen to stab client.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Not listed.
  • Buildings & Grounds conducted from 9am – 10am. Census: 44. Covid positive client quarantined in 300 Hall, and 1 staff on leave with Covid. Hall 400, cafeteria, and gymnasium checked. MARs checked for multiple residents. No licensing concerns noted.

PRLU or OLTC

Notice of Incident, Sexual Misconduct

  • Sexual Misconduct
    • Upon camera review, client was seen masturbating on the outside of their pants while looking at roommates who appeared to be sleeping. Client then exposed themselves and continued to masturbate while looking at roommates until staff approached the room for 15-minute observation checks. The client was reassigned to a single room and a sexual safety plan implemented. No follow-up details.

PRLU or OLTC

ER Visit, Notice of Incident

  • ER Visit (Peer Altercation)
    • Client was bitten by a peer during an altercation. Client was taken to the ER.
    • Licensing follow-up on 6/22/22: Emailed the facility requested further information on safety precautions put in place to separate the residents. Facility reports the peers were placed on peer restriction.