Disability Rights Arkansas

Perimeter Behavioral of Forrest City / Woodridge of Forrest City

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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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Police Report

Fire Alarm

Smoke alarm was noted to be going off in room 104. Alarm was cleared within the hour, no damage or other issues noted.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

Caller stated that the air conditioner in the classroom is broken. Caller stated management is aware and they have not repaired it. Licensing Specialist: Sharra Singleton-Litzsey.

Regulations out of compliance: 911.15.F – room 104 had shorts with a drawstring in them.

Regulations needing technical assistance: 911.10 – the air conditioning was not working properly in 2 classrooms. Store services repair company has been called out to address the concerns. Visit by store services were on 5/15 and 5/17 to fix the problem. This complaint is unfounded based on the fact that the agency was aware and had contacted a repair company.

PRLU or OLTC

Accidental Injury, Notice of Incident

Per staff report the resident fell while in the gym playing basketball and complained of head pains

Actions taken: The resident was taken to the nurse’s station and assessed. The resident was then assessed by the APRN. The APRN referred the resident to Forrest City Medical Center for further evaluation. The resident was diagnosed with: Encounter for screening, unspecified.

PRLU or OLTC

Accidental Injury, Notice of Incident

Per staff report the resident reported to the nurse that he jammed his fingers while playing basketball in the gym.

Actions taken: The resident was taken to the nurse’s station and assessed. The resident was then assessed by the APRN. The APRN referred the resident to Forrest City Medical Center for further evaluation. The resident was diagnosed with: no acute fracture or dislocation. The proximal and distal carpal rows are adequately aligned. The soft tissues are grossly unremarkable.

PRLU or OLTC

Notice of Incident, Peer Altercation

Per staff report, the resident was in a physical altercation with a peer. The resident complained of pain in the right fifth digit with swelling from hitting his peer. The resident was taken to the nurse’s station and assessed. The resident was then assessed by the APRN. The APRN referred the resident to Forrest City Medical Center for further evaluation.

The resident was diagnosed with: no acute fracture or dislocation. The proximal and distal carpal rows are adequately aligned. The soft tissues are grossly unremarkable. The resident was placed on peer restriction and assault precautions for safety. No licensing concerns noted.

PRLU or OLTC

Revisit Survey with POC

On December 14, 2022, a compliant survey was conducted at the facility by the Office of Long Term Care to determine compliance with federal requirements for Psychiatric Residential Treatment Facilities participating in Medicaid Program(s). This survey found this facility was not in substantial compliance.

A revisit was conducted on April 25, 2023, and your facility was still not in substantial compliance with the following participation requirement(s): N142 Order For Use Of Restraints Or Seclusion.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Per staff report the resident was in a physical altercation where he obtained a busted upper lip on the inside of mouth

Actions Taken: The resident was taken to the nurse’s station and assessed. The resident was then assessed by the APRN. The APRN referred the resident to FCMC for further evaluation. The resident was diagnosed with: . The resident has been restricted from his peer. The resident was also placed on assault precautions which will be re-evaluated within 72 hours (about 3 days) for safety. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Per staff report the resident was in a physical altercation with multiple peers.

Actions Taken: The resident was taken to the nurse’s station and assessed. The resident obtained multiple direct blows to the face. The resident was then assessed by the APRN. The APRN referred the resident to FCMC for further evaluation.

The resident was diagnosed with: The resident is not to participate in any physical activities until further notice. The resident has been peer restricted from all peers involved in the physical altercation. The resident was also placed on assault precautions which will be re-evaluated within 72 hours (about 3 days) for safety. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Accidental Injury, Notice of Incident

Per staff report the resident injured their left thumb playing basketball. The resident was taken to the nurse’s station and was assessed. There was no fracture or dislocation.

PRLU or OLTC

Accidental Injury, Notice of Incident

Per staff report the resident rolled his Lt ankle while in the gym.

Actions Taken: The resident was taken to the nurse’s station and assessed. The resident was then assessed by the APRN. The APRN referred the resident to FCMC for further evaluation. The resident was diagnosed with: No acute fracture or dislocation. The ankle mortise is intact. Soft tissues are unremarkable. No other interventions necessary.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Per staff report the resident alleged to the nurse that around 8pm [REDACTED] walked into his room and choked him.

Actions Taken: The resident was taken to the nurse’s station and assessed. The resident did not have any visible injuries. A written statement was collected from the resident and the employee. The was called by the nurse and accepted here is the referral number [REDACTED]. Camera observation was conducted on 4/24/2023 at 10:28am. [REDACTED] is observed walking onto the 300-Hall at 8:25pm, [REDACTED] is then observed walking into multiple resident’s rooms conducting quality checks. [REDACTED] is then observed walking to the end of the hall to room 302. He is observed walking into the room at 8:26pm with (2) witnesses [REDACTED] and [REDACTED]. He then exits the room at 8:27pm. The employee has been suspended pending further investigations. The resident will be seen by his therapist to address any additional issues of concerns. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Chelsea Vardell.
  • Facility visited from 12:30pm – 3:15pm. Census: 51. Licensing reviewed educational records for 3 residents, including records showing the update to IEPs occurring every 9 weeks.
  • Licensing and the Education Director discussed the facility’s process to ensure each child’s IEPs are met and how they provide these documents after the child is discharged. Licensing and staff also discussed the current license and capacity for their programs: Facility currently accepts 52 PRTF children (15 out of state only), and they can admit up to 14 children in the SRU program. The CEO will discuss the desired capacity for each program with upper management and respond to licensing by 04/19/23.

PRLU or OLTC

Accidental Injury, Notice of Incident

Per staff report the resident was outside playing football when he slipped and fell. The resident was taken to the nurse’s station and assessed. The resident was then assessed by the APRN. The APRN referred the resident to FCMC for further evaluation. The resident was diagnosed with a [REDACTED]. The resident returned with one new medication. The resident will not be permitted to engage in any physical activities until further notice. Nursing and staff will continue to monitor the residents progress while in school and the milieu.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

Per staff report the resident tampered with the smoke detector triggering the fire alarm and eloped from the facility.

Actions Taken: The resident tampered with the smoke detector in the hallway. Once tampered with the smoke detector it triggered the fire alarm unlocking the facility doors. The resident ran down 300-Hall towards the cafeteria and out of the residential lobby. Staff tried to stop the resident and pursed him while on campus grounds. The resident successfully eloped from the facility grounds. FCPD was notified and continued to search for the residents while in the community. The resident was found by FCPD and brought back to campus at 3:55pm. The resident was assessed by the nursing department and appeared to be alert and oriented. The resident did not have any complaints of pain or injury. The resident was placed on elopement precautions and unit restriction. The precautions will be re-evaluated in 72 hours (about 3 days) for safety. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Review of the agency’s current mandated reporter policy revealed a concern with the Licensing Unit. 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 04/13/23 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

Notice of Incident, Peer Altercation, Visit Compliance Report

Per staff report the resident while in the gym the resident was in physical altercation with a peer.

Actions Taken: The resident was taken to the nurse’s station and assessed. The resident presented with a small knot on the left side of his head. The resident presented with steady gain, skin intact, and denied any pain or discomfort. The resident was also assessed by the APRN. A referral was made to transport the resident to FCMC for further evaluation. The resident returned with no new order and was diagnosed with . The resident and his peer were both placed on assault precautions and peer restriction to limit contact. Precautions will be re-evaluated in 72 hours (about 3 days) for safety. Licensing Specialist: Chelsea Vardell.

Police Report

Runaway

Staff reported 3 juveniles ran from property. Officer entered all juveniles into ACIC.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

Date/Time of incident: 3/25/2023/ 8:28am Please describe the incident: Per staff report the resident’s eloped from the facility grounds after tampering with a smoke detector in his room causing all the facility doors to unlock.

Actions Taken: Camera review was conducted on 3/27/2023 at 11:00am. Two residents are observed going into room 104. The resident exited the room and a peer entered. As the peer entered about 30 seconds later the fire alarm was triggered. Staff are observed lining the resident up and exiting the building to the courtyard. While waiting in the courtyard for the building the be cleared. Two residents ( and are observed getting out of line and walking towards the building. A third resident ( is also observed getting out of line from the far right and running towards his two peers. All three residents ran inside of the building down 100-Hall to the exit. Staff are observed following the residents from the courtyard to the building and to 100-hall out of the exit. FCPD was called and gave the residents description. The residents were found by the FCPD on 3/276/2023 around 9:30am. At the first point of contact all three residents had knives on them, the residents procured the knives after eloping from the facility. 2 of them (and dropped their knives and the police were able to obtain them. The third resident, who is took off running in the middle of an open field. The resident then held the knife to his throat threatening to kill himself. The police were able to subdue the resident and retrieve the weapon. was taken to Forrest City ED for further evaluation. The resident has now been transferred to Perimeter West Memphis Acute for homicidal ideation and suicide gesture. and were both sent out to the FCMC on 3/26/2023 for further evaluation. Both residents returned with no new orders. Both residents have been placed on a safety plan and elopement precautions. Licensing Specialist: Kendra Rice.

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

Children's Records Review, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 2:15pm – 2:30pm. Census: 56. Licensing reviewed 2 resident files.
  • Regs out of compliance –
    • 902.3 – No copy of social security card or documentation of request for 1 resident.