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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PRLU or OLTC

Notice of Incident, Physical Maltreatment, Visit Compliance Report

A resident alleged that a staff member hit him. The staff member was suspended pending the outcome of the investigation.

Licensing Specialist: Kendra Slade

Program Coordinator visited the facility and reviewed camera footage. The resident was observed jumping up and knocking down ceiling tiles. Staff members appeared to be talking to the resident. The resident continued to knock down the ceiling tiles. A staff member was observed attempting to place the resident in a restraint. The resident was observed resisting the restraint. Another staff member entered the area to assist. The resident continued to resist the restraint.

The facility will be cited for 110.12: The agency shall notify the Licensing Unit by the next business day when a report of child maltreatment is accepted by the child abuse hotline against a person in a child welfare agency. The facility failed to notify Licensing by the next business day of the report.

The complaint has been Unfounded by Licensing. CACD case found unsubstantiated.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident complained of pain after falling while playing basketball in the gym. The resident was sent to Forrest City Medical Center for further evaluation. He returned to the facility the same day with no issue. The resident was placed on activity restriction for 72 hours, and then released to normal activities.

Licensing Specialist: Kendra Rice

Program Coordinator inquired about video footage of incident and was informed that footage would not be available due to IT working on the camera system.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident presented to the Nurse with a complaint of pain in his mouth resulting from an altercation with a peer. He was sent out to Forrest City Medical Center for further evaluation per order of the APRN. Resident returned to the milieu the same day with no issue.

Program Coordinator reviewed the provider-reported incident and inquired about camera footage. Facility reported no footage available of this incident. Program Coordinator reviewed witness statements.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident was in a physical altercation with a peer and was hit in the nose. He was sent out to Forrest City Medical Center for further evaluation.

Diagnosis: Pain to the nose. No acute fracture or dislocation.

The resident returned to the milieu the same day and was placed on activity restriction until reassessed by APRN.

Both resident and peer were separated and interviewed by Safety Team. The facility reported that the residents were placed on peer restriction.

PRLU or OLTC

Maltreatment, Notice of Incident, Redacted, Visit Compliance Report

Program Coordinator was informed of complaint during another visit: On 7/27/24, a staff member who allowed a resident to be punched by another resident, resulting in bruises. Residents referred to this as the “punching game.” Staff member did verbally address the residents and documented the issue, but did not physically intervene. Staff member suspended pending investigation.

Licensing Specialist: Kendra Slade

Licensing reviewed camera footage on 9/6/24 and confirmed the staff member did not physically intervene.

Citation issued for 110.12: Facility failed to notify Licensing by the next business day of the child maltreatment.

Citation issued for 907.2: Staff member present did not provide a level of supervision to ensure the safety and well-being of the resident being punched.

Technical Assistance was issued for 110.9.a: Notify the Child Abuse Hotline immediately of an incident. The incident was not reported to the hotline until 7/30/24.

This complaint has been founded by Licensing. Facility provided training documentation for the staff member involved. CACD case was unsubstantiated.

PRLU or OLTC

Notice of Incident, Peer Violence

Resident was in a physical altercation with a peer while playing dodge ball in the gym. This resulted in swelling to his face and head. He was sent out to Forrest City Medical Center for further evaluation.

Diagnosis: Left lateral facial soft tissue injury.

Resident returned to the milieu the same day.

PRLU or OLTC

Notice of Incident, Peer Violence

Resident was involved in a physical altercation with peers and afterward, complained of pain. After consultation between the Nurse and APRN, the resident was sent to Forrest City Medical Center for X-RAY and treatment.

Diagnosis: Abrasion. The resident was sent back to the facility for continuance of care by the facility nurses.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Chelsea Vardell

Licensing Specialist and Program Manager visited the facility and reviewed children’s records. One record did not include a treatment plan or treatment plan reviews in the chart. The facility was able to produce signed copies which were then added to the chart.

It was noted that all master treatment plans do not contain a plan to ensure the educational needs of the child are met as required in standard 903.5.d. Program Coordinator and Licensing Specialist discussed this with the facility. The facility will receive a Technical Assistance for 903.5.d.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident was in a physical altercation with a peer. The altercation resulted in an injury and he was sent out to Forrest City Medical Center for further evaluation.

Diagnosis: Laceration to left middle finger. Treatment included two sutures, a tetanus shot, and a prescription for antibiotics. Resident returned to the milieu the same day.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident engaged in self-injurious behaviors by collecting a small piece of broken glass from a clock and asking three of his peers to cut him after attempting to cut himself. The cut resulted in bleeding, and the Resident was transported to Forrest City Medical Center.

All clocks have been reviewed to ensure no residual glass is present. Resident is currently on line-of-sight supervision. Resident and peer who performed the cut have been separated.

Both Residents were assessed by their Therapist on 07/01/2024. Both Residents will undergo daily body checks by the Nursing team to assess for any self-harm injuries until further notice.

07/03/24: Facility states that clocks have been replaced. No citations given by Licensing for this incident.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident engaged in self-injurious behavior by banging his head against a door. He was sent to Forrest City Medical Center for further evaluation.

Resident returned to the milieu, same day, at 1034 (10:3 am cst).

Diagnosis: Nondisplaced fracture of the anteriormost aspect of both nasal bones

PRLU or OLTC

Maltreatment, Notice of Incident

Staff member was suspended due to an allegation from a former Resident.

7/15/24: Program Coordinator inquired for more information.

7/18/24: Facility reported the resident’s name and discharge date.

7/19/24 – Facility emailed the Program Coordinator stating the case was closed as Unfounded and inquired if the staff member could return to work.

7/29/24: Program Coordinator discussed staff suspension with Program Manager. Suspension was lifted and facility was informed that staff member could return to work. Case complete.

PRLU or OLTC

Elopement, Notice of Incident

Resident eloped fromthe facility for approximately one hour and forty-three minutes before being returned by Forrest City Police Department. Resident eloped under a fence, held up by a peer.

Camera review was conducted by the Safety Team. Bars for the fence have been ordered, and the Safety team is evaluating all fencing to ensure no other parts need to be re-bared. No outdoor recreation will commence until fencing is completed (all recreation and physical activity will be in the gym).

Supervising staff will be retrained this week. A refresher on supervision will also be completed this week for all Staff.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist (LS): Eleanor White

LS White reviewed personnel records. Records contained the required verifications, certifications, and documentation. Staff training is up to date.

Technical Assistance (T/A) was given for 2 new staff members whose background check paperwork was not submitted correctly to the central registry. The facility will follow up with the Placement & Residential Licensing Unit (PRLU) to have checks run and completed within 10 days.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center by order of the APRN for further evaluation to his nose. Resident reported the pain after he was hit in the nose while horseplaying with a peer.

Resident returned to the milieu the same day at 1332 (1:32 pm cst) with no other issues presented.

Diagnosis: Contusion to the nose

PRLU or OLTC

Complaint, Recertification, Recertification Survey, Revisit Survey with POC

A 5-year Validation survey was conducted from 06/03/2024 through 06/07/2024. Complaint #AR00033421, was not in compliance, all or in part, with deficiencies cited at N0142 and N0156.

-N142: Based on record review and interview, the facility failed to ensure an order for a physical and chemical restraint that was not received at the same time for 5 case mix clients.

-N156: Based on interview and record review, the facility failed to ensure physician’s orders were signed and in the clients’ record for 4 case mix clients.

The facility submitted a plan of correction and this was approved. A revisit was conducted on July 8, 2024, for all deficiencies cited on June 7, 2024. All deficiencies have been corrected, and no new noncompliance was found.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was sent to Forrest City Medical Center by order of the APRN for further evaluation to his right hand due to pain and swelling, originating from the Resident punching a wall.

Resident returned to the milieu the same day at 1440 (2:40 pm cst) with no other issues presented.

X-ray findings: No acute fracture or dislocation

PRLU or OLTC

Medical, Notice of Incident

Resident was sent to Forrest City Medical Center by order of APRN due to a complaint of back and leg pain. The resident and his mother were involved in a car accident while on pass.

Resident returned to the milieu same day at 1700 (5:00 pm cst) with bandages and RICE instructions. No other issues presented.

Diagnosis: Sprain of unspecified site of Right knee; Low back pain

PRLU or OLTC

Notice of Incident, Suicide Attempt

Resident was sent to Forrest City Medical Center (FCMC) by order of Physician for a psych evaluation due to self-harm behaviors, which included wrapping a cable cord around his throat and stating, “I want to die.” for approximately one minute.

Red discoloration and one scratch were noted with no other injuries. Columbia Suicide Screening was completed with a score of four.

The maintenance team has since put the cord further into the ceiling and blocked off access to it. The cord’s necessity is being evaluated to determine if it can be removed.

Resident refused transportation to FCMC but was transported via ambulance. Resident was accepted into Acute care and transport is expected today at 0800 (8:00 am cst) from FCMC.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center (FCMC) by order of the APRN for further evaluation and an X-Ray of his right hand.

Resident accidentally injured his right hand while playing basketball.

Resident returned to the milieu the same day at 1545 (3:45 pm cst) with no issues. No acute fracture or dislocation were found.

PRLU or OLTC

Medical, Notice of Incident

Resident was sent to Forrest City Medical Center by order of APRN for further assessment after labs run at admission showed some low levels.

Resident returned to the milieu same day at 1717 (5:17 pm cst) with no issues.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center (FCMC) by order of APRN for further evaluation of his right ankle.

Resident accidentally rolled his ankle while playing basketball in the gym. Swelling and pain were noted.

Resident returned from FCMC at approximately 1600 (4:00 pm) with no new issues.

No acute fracture or dislocation. Resident is on activity restriction until 06/01/24 pending further evaluation by APRN.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center (FCMC) by order APRN for further evaluation of his right ankle.

Resident accidentally tripped and fell, hurting his ankle while playing basketball in the gym. Swelling and pain were noted.

Resident returned from FCMC at approximately 1600 (4:00 pm) with no new issues. Diagnosis: Sprain of right foot. Resident is on activity restriction until further evaluation by APRN.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was sent to Forrest City Medical Center (FCMC) by order APRN for further evaluation to his left arm.

Resident injured himself with a pencil from his pocket after being upset with a peer, escalating to self-harm behavior. The pencil was confiscated, and sweeps were conducted.

Resident is on self-harm precautions until further evaluation. The second Resident is on assault precautions. Both Residents are currently on line-of-sight supervision, as well as peer restriction until further evaluation.

Camera footage was reviewed and both Residents were interviewed by the Safety Team.

Resident returned from Forrest City Medical Center at approximately 1950 (7:50 pm) with no new issues. The Nursing department bandaged the wound upon return. Wound care ongoing by Nursing department.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center for further evaluation to his right ring finger after complaining of pain. Slight swelling was noted. Resident describes playing basketball, and the basketball hit his right ring finger.

Resident returned from Forrest City Medical Center at approximately 1746 (5:46 pm) with no new issues.

No acute fracture or dislocation. Resident on activity restriction until further assessment by Nursing/APRN.