Disability Rights Arkansas

Perimeter Behavioral of Forrest City / Woodridge of Forrest City

*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: 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

Medical, Notice of Incident

Resident complained to nurse of feeling lightheaded. When the resident stood up from his chair, he fainted and hit his head on the wall at the Nurse’s Station. Resident did not disclose any activities or reason for feeling lightheaded prior to going to the Nurse’s Station. Nurse assessed resident and APRN recommended he be sent to FCMC. Diagnosis: Syncope and collapse – recurrent after assessment by physician at FCMC. Resident has been referred to see a cardiologist specialist on 10/17/23.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident presented to nurses’ station complaining of swallowing a lego and complaining of pain on the left side of his chest. Upon assessment B/P 110/74, Oxygen level 97%, Heart Rate 74, Respiration 20. APRN notified and an order was obtained to send client to FCMC for further evaluation and treatment. Results: Foreign Body (lego) of alimentary tract, part unspecified, follow-up as needed.

Licensing Specialist inquired if resident was placed on any precautions. Licensing Specialist informed that resident reported he was trying to break the pieces apart and accidentally swallowed one.

PRLU or OLTC

Notice of Incident, Self-Harm

Nurse was notified to come and check on resident who had punched the chair with his hand after feeling overwhelmed. Upon assessment, the right knuckle was slightly swollen and reddened. Action taken: APRN notified and an order was obtained to send resident to FCMC for further evaluation and treatment. Results: Right hand contusion, PRN Ibuprofen ordered for pain.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Resident was in a physical altercation with a peer. Per staff, resident was hit multiple times on the left side of his face. APRN notified and an order was obtained to send client to FCMC for X-ray of Face. No acute facial fracture or dislocation. The visualized paranasal sinuses are clear. No air fluid levels are present. The mandible and temporomandibular joints are intact.

Licensing Specialist: Kendra Rice.

Facility visited on 8/23/23 and camera footage reviewed. Licensing Specialist observed the peer jump on resident and staff were observed separating the residents and keeping other residents from participating. Both residents were placed on assaultive precautions and peer restriction.

Police Report

Elopement

Caller advised that a juvenile left the building, unknown direction of travel. Approximately 10 minutes later, officer located the juvenile and brought him back to the facility.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident continued to complain of elbow pain previously reported on 8/18/23 (resident was not able to be sent out due to verbalization of planning to elope when sent out for his elbow). Nurse assessed and APRN recommended resident be sent to FCMC for assessment and x-ray. FCMC Diagnosis: 1.5 mm calcification at the anterior tip of the coronoid process of the ulna is probably tiny developmental unfused apophysis, less likely would be an avulsion injury, correlate history of trauma. There is evidence of a small elbow joint effusion. Prominent soft tissue edema at the posterior and medical elbow, which could be due to trauma or cellulitis. Resident returned to facility with orders of Ibuprofen 3x daily and to see an orthopedic specialist by appointment. Resident placed on acitivity restriction.

Licensing Specialist inquired about resident’s orthopedic specialist appointment. 8/24/2023, Licensing Specialist informed that due to resident having out of state insurance the process could take one to two weeks.

PRLU or OLTC

Medical, Notice of Incident

Resident was sent out to Forrest City Medical Center for nausea and vomiting. Nurse assessed resident and consulted with APRN who recommended that [REDACTED] be sent to Forrest City Medical Center for assessment. The diagnosis at FCMC was nausea with vomiting unspecified, fever unspecified, noninfective gastroenteritis and colitis unspecified. Resident was not able to identify with nurse or hospital staff the cause of nausea and vomiting either.

PRLU or OLTC

Medical, Notice of Incident

Resident fainted in the dining room during dinner time as observed by staff and was taken to the nurse’s station. There was not a visible observation why he fainted when resident came to, and he was not able to identify why he fainted either. Resident did complain of pain in his right knee from the fall when he fainted. The nurse assessed and consulted with APRN who recommended that the resident be sent to Forrest City Medical Center for assessment and X-Ray of his knee. Diagnosis at FCMC: Syncope and collapse, contusion of right knee. The physician ordered a follow up appt for further diagnostic work up and recheck and monitoring of today’s complaints.

Licensing Specialist inquired about follow-up appointment for further diagnostic work up. Resident is scheduled to follow-up with the APRN at the end of the week.

Police Report

Threatening Behavior

Caller advised dispatch that a juvenile threatened to shank her and he had 3 shanks. Officers responded to facility. Officer advised dispatch of negative contact and if the caller calls back to notify her.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice.

Census: 58. Licensing Specialist completed buildings and grounds and observed the following areas: Classroom hall, 100 hall, 200 hall (SRU), 300 hall, 400 hall, dining room, and gym. Walking into the building, Licensing Specialist observed parked cars on the lot with no debris and flowers in flowerpots by the door. The abandoned house across has been cleaned of debris. In the quiet rooms on the classroom hall, Licensing Specialist observed that the flooring in the quiet rooms have been replaced. All bedrooms were organized, and bathrooms were cleaned. 100 Hall will be having a celebration on 8/31/2023 for having zero write ups. Licensing Specialist reviewed MAR’s for 5 residents: All initialed and up to date.

Licensing Specialist reviewed four (4) personnel files and two (2) children files: All files reviewed complied with the minimum licensing standards.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident came the nurses station reporting that he twisted his ankle on 8-15-23 while playing basketball in the gym. When asked why he didn’t come on 8-15-23 for assistance he stated that it didn’t hurt that bad and he didn’t want to go on activity restrictions. Resident had pain and swelling that was observed by the Nurse. The nurse consulted with APRN who recommended that resident be sent to Forrest City Medical Center for X-Ray and assessment; No significant findings were noted. Upon return to facility, nurse’s gave Tylenol for pain and offered an ice pack.

PRLU or OLTC

Notice of Incident, Self-Harm

During evening of 8/11/23, resident hit a wall. The next day, pain and swelling persisted and resident could not bend his wrist per his report. The resident was taken to FCMC for an x-ray and diagnosed with no acute findings after x-ray and examination.

Licensing Specialist inquired about resident hitting the wall. Licensing Specialist informed that resident hits walls at will unprovoked.

Police Report

Battery

Officers responded in reference to a physical disturbance that occurred at the facility. Staff member advised officer that juvenile became irate after staff told residents to stop playing competitive basketball (they are not allowed to do). The juvenile charged another employee, causing both staff members to fall, then struck the staff member in the nose with his fist. The staff member received 2 small lacerations and slight swelling of the nose and eye. The staff member stated she did want to press charges and filed an affidavit at the police department.

PRLU or OLTC

Notice of Incident

Resident assaulted a staff member on 8/13/23, hitting her in the face breaking her glasses and fracturing her nose/face. He also came onto the 400 hallway threatening to fight a male staff and began threatening any staff with bodily harm that attempted to process with him. Resident then broke 2 box fans, staff’s clipboard and cup, and a light fixture. The police were called and resident was placed in handcuffs, but was released back to the facility until Arkansas Detention services was able to find placement. Resident was placed on Unit Precautions and Assault Precautions and a 24-hour emergency discharge was requested. Client was denied admission to acute on 8/11/23 and 8/13/23. Resident continues violent and assaultive behaviors after several therapeutic interventions by therapist and treatment team, including medication changes. A hotline call was made on 8/14/23 and screened out. Resident was detained by the Forrest City Police on 8/14/23 with the plan to transport and process him to a Juvenile Detention Locked Facility.

There is no camera footage of this incident. Licensing Specialist informed that resident was still detained. During a buildings and grounds visit, Licensing Specialist observed where the light fixtures have been repaired on the 300 Hall near the nurse’s station that resident damaged. Licensing Specialist informed call was screened out by AR hotline. Licensing Specialist followed-up with facility to see if any allegations were made against staff. Licensing Specialist informed that resident did not make any allegations toward staff. Resident was angry because a female staff member redirected from playing rough and gave him the option of changing the game or ending the gym time. 8/22/2023- Program Coordinator completed a FOIA request for the police report to the Forrest City Police Department.

PRLU or OLTC

Notice of Incident, Peer Altercation, Property Damage

The resident reported to the nurse that he had hand pain and swelling to his right hand with pain 7/10. This pain and swelling has most likely come from frequent past incidents of property destruction and physical altercation where the resident has been advised by staff not to use or further injure his hand. The resident was assessed and checked by APRN who recommended going to FCMC for a medical examination and X-Ray. The resident was diagnosed with a Hand Contusion and was given Ibuprofen as needed. Resident continues to be on activity restrictions until able to stop injuring his hand/body.

PRLU or OLTC

Medical, Notice of Incident

Resident reported to the nurse that he had stomach pain and discomfort; Origin of the pain was not known and the resident said he did not know why he waited so long to ask for help. The resident reported to the nurse that his stomach has been hurting for the past four days. After nurse assessment and consultation with the staff APRN, the resident was taken to Forrest City Medical Center for examination. The resident was diagnosed with Dysuria and prescribed medications.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

After a physical altercation between 2 residents, both complained of injuries. A bite to Resident 1’s thumb was observed with broken skin and bleeding to wound; Nurse applied First Aid to thumb and Resident 1 was taken to FCMC for an x-ray. No broken bones were observed on the x-ray and antibiotic was prescribed to Resident 1. Resident 2 complained of pain/swelling to foot and was taken to FCMC for an x-ray. RICE Therapy prescribed and bandage was given to Resident 2. Upon return to the facility bandage was taken for safety, continued monitoring, and RICE Therapy. Resident placed on Activities Restriction for safety.

Licensing Specialist: Kendra Rice.

Licensing Specialist reviewed camera footage on 8/9/2023 for the provider reported incident. Licensing Specialist observed the two residents begin to fight and staff separating the residents. Licensing observed a peer jump in the altercation, and peer was then escorted out of the room. Due to staff members and residents around the physical altercation, Licensing Specialist was unable to see the resident being bitten and peer hurting his foot. Licensing Specialist did observe peer limping away from the area of the physical altercation. Licensing Specialist informed that both resident and peer were placed on assaultive precautions.

PRLU or OLTC

Medical, Notice of Incident

Resident came out of the shower with a nosebleed. Within the next three hours after that nosebleed was brought under control by the nurse, he had three additional nose bleeds in addition to vomiting. After nurse assessment and consultation with the staff APRN, the resident was taken to Forrest City Medical Center for examination. The resident was given an X-ray, and general assault edema was diagnosed. Received oxymetazoline intranasal drops (0.05%) in spray and Norco P) 5/325 1 tablet oral during visit and assessment at ER. The resident did not complain of pain, swelling, or further complications. Symptoms appeared to reduce and go away after the ER visit.

Licensing Specialist inquired about incident due to the resident’s diagnosis. 8/9/2023, Licensing Specialist informed that resident caused trauma to his nose by picking in his nose.

PRLU or OLTC

Medical, Notice of Incident

Resident came to the nurse’s station with his eyes open (they appeared to be cross) stating to the nurse that he could not open his eyes. When nurses asked him what made his eyes get to the point where he could not open them, he stated that he did not know but asked to come to the nurses’ station when he realized that he could not close his eyes while staring at the ceiling. Resident was also experiencing anxiety as well that may have induced his eyes to feel like they were stuck.

The resident was assessed and checked by the nurse for eye discomfort and injury. After consultation with the staff APRN, the resident was taken to Forrest City Medical Center for examination. After the medical screening exam at the ER, it was determined that the encounter for screening was unspecified. The resident returned from ER and was able to respond to eye commands given by the nurse.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident was left on hall unattended for approximately 1 hour. While staff were redirecting other residents from horseplaying, resident slipped into his room and closed the door. During this time another staff member left the hall, and upon returning, both staff transitioned residents to the dayroom and then outside. Another staff member observed resident in the hall and he returned to his group. The infraction was called into the maltreatment hotline and accepted. Both staff members were suspended and terminated on 8/8/23. Safety and Supervision training is to be given to direct care staff within the next 14 days.

Licensing Specialist: Kendra Rice.

Facility visited and video reviewed on 8/9/2023. Licensing Specialist observed resident enter his room while staff member was distracted by other residents. Shortly after, staff members began checking and locking bedrooms, but neither staff checked or locked resident’s bedroom. Staff and residents then left the area, and resident was observed about an hour later standing at the entrance door of the hall. A peer alerted a staff member, who then opened the door allowing resident to enter other area.

This complaint was founded by Licensing. Facility cited 907.2: Staff members left resident on hall in his bedroom unsupervised.

Licensing Specialist was informed by CACD investigator that the case was found unsubstantiated.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was sent to Forrest City Medical Center (FCMC) to get an object that he lodged in his ear out. The object was removed from resident’s ear at the ER and no further treatment was needed.

Licensing Specialist inquired about guardianship and lodged object. Clinical Director informed Licensing Specialist that the object was a piece of paper.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center (FCMC) for x-ray due to lower back pain from recreational activity.

Licensing Specialist inquired about guardianship and more details on reported incident. 8/9/2023, Licensing Specialist informed that upon admission it was disclosed that resident has back issues that flare up from time to time.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to FCMC for x-ray and exam due to neck pain from recreational activity.

Licensing Specialist inquired about guardianship and more details on reported incident. 8/9/2023, Licensing Specialist informed that on admission it was disclosed that resident has a nodule in his neck.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident injured his right finger from playing basketball and was sent to Forrest City Medical City (FCMC) for an exam and X-ray.

X-ray results: No injury or remarkable findings.