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 [email protected]

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 presented with psychotic behaviors and symptoms that were unsafe and unstable to merit placement in an acute setting. Clinical Director made the recommendation after clinical observation to Psychiatrist and Psychiatrist ordered resident to be sent to Forrest City Medical Center to be assessed and placed in acute care due to clinical, mental health, and behavioral symptoms temporarily going beyond the scope of RTC care. Resident was discharged back to the care of Perimeter Behavioral of Forrest City on 10-17-24 after Medical Center was not able to find acute care.

PRLU or OLTC

Elopement, Notice of Incident

Two residents eloped from the premise at 1307 (1:07 pm cst) 10/12/2024. Residents were returned by Forrest City Police Department the same day at 1341 (1:41 pm CST) totaling approximately 34 minutes. Witness statements were collected and Residents are currently on elopement precautions. The Safety Team reviewed the camera footage. Staff received written corrective actions on 10/14/2024, and while ratio was 4:12, a mandatory retraining on positioning and supervision will happen this week. The fence company is out today repairing the fence. All recreation/leisure activity will only occur in the gym until repairs are fully completed.

Licensing Specialist reached out to the Facility and requested copies of the witness statements, written corrective actions, retraining roster, and before/after pictures of the fence. 10.16.24- Facility responded with: “There are only 3 forms even though four Staff were involved. The fourth Staff opted to quit. The training will occur post their Suspension which is complete 10/16/2024. Lastly, please see the attached photos of the fence. Repairs were completed today.”

PRLU or OLTC

CAP, IOC Report

Multiple deficiencies were noted during the Inspection of Care (IOC) conducted on 10/10/24. A Corrective Action Plan (CAP) was submitted and approved.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident went to Forrest City Medical Center for X-ray of left foot after complaint of pain after playing basketball. Diagnosis: “Tiny cortical defect along the superficial distal dorsal talus could represent a small impaction fracture.” Resident is on activity restriction until reassessment by Physician.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Resident went to Forrest City Medical Center ER to recheck/reclose the healing wound (see serious occurrence from 09/23/2024). Diagnosis: Unspecified open wound of R eyelid and periocular area.

Licensing Specialist: Andrea Adamson

10.8.24- Licensing Specialist and Program Manager went to the facility regarding this case and others. When discussing this incident, we were made aware that the camera in the 300-hall small dayroom does not work. The Facility has already input a service request for this, and only upper management is aware to keep everyone safe. The incident was described as another resident coming up to this child and punching him specifically in the wound. It happened quickly and the boys were separated immediately, and both put on assault precautions.

PRLU or OLTC

Medical, Notice of Incident, Visit Compliance Report

Resident went to Forrest City Medical Center ER due to complaint of shortness of breath feeling like his throat was closing. Vitals were normal and EpiPen administered at 0945 (9:45 am) with improved results. EMS arrived at 0950 (9:50 am). Diagnosis: Anaphylactic Reaction, allergy to peanuts. Prednisone prescribed. No evidence of peanuts on premises or peanut consumption based on camera review, food inspection, Resident interview and peer interview.

Licensing Specialist: Andrea Adamson

10.8.24- Program Manager and Licensing Specialist visited Facility and discussed how the child came into contact with the Peanuts. Facility states they did a thorough investigation and noted there was no explanation for how the allergy was triggered. They did update all of his information as the intake paperwork did not say he had a peanut allergy. His photo with his allergy was added to the nursing board.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Resident was sent out to Forrest City Medical Center by order of Physician for further assessment after complaint of pain in his eye after physical altercation with a peer. Diagnosis: Localized edema; Ocular pain, right eye. Residents were separated and assault precautions were initiated.

Licensing Specialist: Andrea Adamson

10.8.24- Licensing Specialist and Program manager watched video and determined no further action was needed as the Facility was in ratio and placed both children on appropriate assault precautions.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Chelsea Vardell

Licensing completed walkthrough of the 300 hall, 400 hall, dayrooms, and gym. Licensing also viewed areas of the 100 Hall that were mentioned during the visit on 8/16/24 needing repairs. Those areas were viewed and had not yet been repaired.

The following citations were issued:

910.1: Broken culvert drain, exposing sharp jagged edges was viewed near the walkway to the school/administration building.

911.15.f: Strings were found in a hoodie located in room 302.

911.6: Facility walls throughout the building appeared dirty with smudges on them and peeling paint. Dayroom 1B had silicone caulking that had drained down the wall for another repair and was left, peeling back the paint. The baseboard trim was hanging off with debris built up around it in Dayroom 1B. Room 306 had broken concrete along the bottom wall and was missing trim. Room 407 exposed wire behind the sprinkler head that is protruding from the wall and the tile was broken by the resident bed. Bathroom in the gym had torn linoleum around the toilet and a makeshift wooden toilet back cover anchored to the wall. The shower and bathroom door on the 100 hall were seen to be in disrepair and need replacing. The sprinklers in rooms 302 & 303 were protruding from the wall and could not be pushed back into place during the visit.

PRLU or OLTC

Accidental Injury, Notice of Incident, Visit Compliance Report

Resident was sent out to Forrest City Medical Center by order of Physician for further assessment to his head after accidentally bumping heads with a peer while horseplaying. Diagnosis: Laceration to head with sutures/adhesive wound closure. By order of Physician: Neuro checks every 48 hours and Resident is on activity restriction for seven days.

Licensing Specialist: Chelsea Vardell

9/25/24- Licensing visited facility to review camera footage. The facility was unable to locate exactly when and where the resident was injured in the video review. Camera footage was reviewed of the gym and courtyard on 9/22/2024 from 16:40-16:52. Video showed the gym was non-compliant with ratio regulations 2:17. The facility is being cited for 907.3 for failing to maintain a ratio of 1:6 in the gym on 9/22/2024.

The facility reports they will speak with the staff to determine the correct time frame of when the resident was injured so that licensing can review the correct video at a later date. 10/8/24- Licensing Specialist and Program Manager went to facility and determined that no further action was needed. Facility put in a discharge request for resident as he has failed to make any progress in treatment and and continues to engage in aggressive behaviors with peers.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Resident was sent to Cross Ridge Community Hospital for an assessment of his nose after being involved in a physical altercation with his peer. Diagnosis: Closed fracture to nose. Both were separated and resident was moved to another hall. Resident is on activity restriction and an ENT appointment is pending.

Licensing Specialist: Chelsea Vardell

9/25/24 – Licensing visited the facility to review camera footage. The resident and other boys were seen entering a bedroom, and staff could be seen entering and then exiting a short time later with the injured resident. No concerns noted.

PRLU or OLTC

Medical, Notice of Incident

Resident was sent out to Forrest City Medical Center ER by order of Physician due to shaking and tremors. All vitals normal. Resident returned to facility without further complaint, no new issues, or new diagnosis. Diagnosis: Unspecified.

Police Report

Police Report, Redacted, Sexual Harassment

Officer was dispatched to the facility for a sexual misconduct report. Upon arrival, a staff member explained that she and one of the kids had been in the hallway by themselves the previous evening, and the resident tried to pull her into a room and said “let’s have sex.” The staff member also said that the resident told her if she told someone, he would punch her in the face. Officer let the resident sign a Juvenile Affidavit and completed the report.

PRLU or OLTC

Medical, Notice of Incident

Resident was sent out to Forrest City Medical Center ER by order of Physician due to complaint of back pain. Diagnosis: Joint pain; Musculoskeletal Pain. Facility reported the resident’s back pain was a result of a flare from a diagnosis of scoliosis. Resident was placed on activity restriction until flare subsided.

PRLU or OLTC

Complaint, Notice of Incident, Redacted, Visit Compliance Report

Facility received an outside complaint and forwarded it to Licensing. The complaint stated that a resident was being slammed into walls and having his head slapped and pushed into the wall. Additionally, the complaint stated a staff member is threatening to harm the resident’s family and extend his treatment stay for non-therapeutic reasons. A report was made to the AR Child Abuse Hotline and accepted.

Licensing Specialist: Kendra Slade

During resident’s interview with the assigned investigator, resident reported he was just mad at the time of the report and that nothing had happened to him while at the facility.

9/6/24 – Licensing spoke with staff regarding complaints and any restraints the resident was placed in that the staff member participated in. Licensing requested nursing notes and written statements from staff member. Per nursing note, resident was placed in a restraint due to displaying aggression toward peers and his bottom lip was injured. The staff member was moved to another unit for now.

10/1/24 – CACD case was closed unsubstantiated. The facility requested the staff member be removed from the ICA in place, and Licensing requested any precautionary retraining records the facility performed with staff. The facility reports that they believe this case was a misunderstanding and did not require any re-training as no wrongdoing was discovered.

Complaint was unfounded by Licensing. Staff member approved to return to normal job duties.

PRLU or OLTC

Medical, Notice of Incident

Resident was sent out to Forrest City Medical Center ER by order of Physician due to tremors and unstable vitals. Diagnosis: Tardive Dyskinesia, Bradycardia. Resident was interviewed by Safety team morning of 09/03/2024 and he shared he refused his medication for two days but resumed taking them today. He also verbalized the importance of taking his medications daily as symptoms were from abrupt stop in medications.

PRLU or OLTC

Acute Care, Notice of Incident, Suicidal Ideation

A resident was sent out to Forrest City Medical Center Emergency Room by order of the Psychiatrist due to suicidal gestures and verbalizing a suicide plan. The resident was evaluated and then admitted to Perimeter Acute, West Memphis AR. The facility expects the resident to return after completing acute care. A safety plan will be implemented, along with additional precautions.

PRLU or OLTC

Notice of Incident, Peer Altercation

A resident was sent out to Forrest City Medical Center for an x-ray of his right hand due to a complaint of pain. The resident states the hand pain is a result of a fight last week. The resident returned to the facility the same day with no issues.

PRLU or OLTC

Notice of Incident, Peer Altercation

A resident was sent out to Forrest City Medical Center for an x-ray of his right hand due to complaint of pain. The pain started after a brief fight with another resident. The resident returned to the facility the same day with no issues and a bandage wrap.

PRLU or OLTC

Notice of Incident, Peer Altercation

A resident was sent out to Forrest City Medical Center for an x-ray of his left hand due to a complaint of pain. The resident states the hand pain started last week during a fight with another resident. The resident returned to the facility the same day with no issues.

PRLU or OLTC

Medical, Notice of Incident

A resident was sent out to Forrest City Medical Center for further evaluation to his inner thigh due to redness, swelling, and irritation per order of the APRN. Resident returned to the facility the same day with no issue.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Chelsea Vardell

Licensing completed a buildings and grounds walkthrough of the Psychiatric Residential Treatment Facility (PRTF) 100 unit, the Sexual Rehabilitation Program (SRP) 200 unit, the 100 A/B dayrooms, and the gymnasium.

The buildings have obvious signs of wear and tear, including: paint missing beside a resident’s bed, doors with damage, and chipped tiles in showers. All areas viewed were clean and sanitary.

Licensing encouraged the facility to make updates to the buildings to improve their appearance. Licensing will return within three months to complete another walkthrough to view any improvements that have been made.

MARs were reviewed at Nurses Station 1. All were initialed and up to date.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident continued to complain of pain and appeared to have further discomfort in his right foot. After assessment from Nurse, the resident was taken to Forrest City Medical Center for further physical care and examination, and his foot was stabilized. The resident returned to facility for continued care and monitoring of right foot.

PRLU or OLTC

Notice of Incident, Physical Maltreatment, Visit Compliance Report

Resident reported that a staff member choked him in his room. The staff member was suspended pending the outcome of the investigation.

Licensing Specialist: Chelsea Vardell

Licensing visited the facility to discuss the incident and review camera footage for the date of the incident. In the video, the accused staff member is observed entering the bedroom at 21:28, then quickly exits and re-enters the room at 21:29. The facility reports that staff entered the room because the resident was becoming upset with his roommate, and the staff member entered to keep distance between the two residents. The staff member is seen exiting the room at 21:30 with the resident. they appear to be calmly talking with one another. One staff member had a clear view of the bedroom and witnessed the interaction between resident and staff.

Licensing obtained witness statments from the two residents, the accused staff, and the staff in the hallway.

This complaint has been Unfounded by Licensing. Staff members will be retrained on de-escalation techniques. Facility provided documentation of the retraining.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident complained of pain to his right foot and difficulty walking after tripping while playing basketball. After evaluation by the nurse, the resident was sent to Forrest City Medical Center for an x-ray and further assessment. Findings showed no acute fracture or dislocation. Resident was sent back to the facility, where he was given pain medication as needed and placed on activity restriction for two days to allow his ankle to rest and heal.