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

Maltreatment, Notice of Incident, Visit Compliance Report

Resident alleged a staff member slapped him after attempting an ESI. Resident, witness, and staff statements collected. Camera footage and nursing notes reviewed.

Licensing Specialist: Eleanor White

Facility visited to review video footage. Restraint hold not captured on camera, however, restraint was documented in Facility notes. Statements from resident, witnesses, and staff are conflicting. No abuse was seen. No injuries reported.

Case is UNFOUNDED. Staff received retraining and was returned to normal job duties.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident stated to Nurses that a staff member had choked him. The staff member was immediately placed on suspension. The Resident and witnesses were interviewed by a member of the Safety Team and their written statements were collected. Additionally, camera footage was reviewed by the Safety Team.

Based on our internal findings, the staff member will be terminated 05/09/2024.

Licensing Specialist: Eleanor White

LS White and LS Norton reviewed camera footage. No cameras in bedroom, but other residents and staff corroborate Resident statement.

Facility will be cited for 109.1.g: Unprofessional conduct in the practice of child welfare activities. Licensing finds this complaint as FOUNDED.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent by order of APRN to Forrest City Medical Center (FCMC) for further assessment to his right foot after complaint of pain after playing basketball. Resident returned to the milieu at 1415 hours with no issues and no new complaints of pain.

Diagnosis: Nondisplaced fracture through base of fifth metatarsal. Resident is on activity restriction until released by APRN. Orthopedic appointment pending.

Agency reported that resident is doing fine, no more complaints of pain, and has been released from activity restrictions. No citations as agency acted within the MLS.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident hurt right hand while playing in the gym. Pain and swelling noted. After consultation with APRN, resident was sent to Forrest City Medical Center for assessment and x-ray. Resident was diagnosed with an unspecified sprain of the right wrist and contusion of the right hand. Treatment included elastic bandage and RICE therapy. Resident was sent back to the facility with orders for Ibuprofen 600mg oral tablet every six hours as needed.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident stated that on 4/27/24, he was in the dining room and a staff member came up to him and squeezed him hard from behind like a bear hug until his face turned red. The resident did not mention if his breathing was affected. The resident said staff did this because he wouldn’t sit down. The resident has several areas of petechiae on his chest due to this and starting to form bruises. A report was made to the Child Abuse Hotline (accepted for investigation).

Licensing Specialist: Eleanor White

5/7/24 – Program Manager and Licensing Specialist visited the facility to review camera footage, nursing notes, and witness statements. Video footage confirmed allegation occurred. Per the staff member’s own statement: “that’s when I start squeeze him to make sure he don’t get up out his seat.” A second staff member can be seen on video eating lunch with other residents and not offering assistance during the hold.

  • Facility cited 905.10: The staff picked up the child from the lunchroom and physically carried him back to the resident’s dorm when he refused to follow instructions.
  • Facility cited 905.4.g: The staff used a form of hug containment as a form of behavior management then proceeded to squeeze the resident across the chest to gain his compliance. This resulted in the resident sustaining marks across his chest that were visible by nursing staff approx. 3 hours later.
  • Facility cited 109.1.g: The staff reported that he squeezed the resident around his chest to prevent him from getting up from a lunchroom table.
  • Facility cited 907.2: The other staff in the lunchroom failed to intervene, assist, or call for nursing during the incident in the lunchroom.

CACD investigation found TRUE. Licensing complaint founded. Staff was terminated from the facility and witnessing staff will be retrained.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident reported swelling and pain of the right index finger. He reports that it has been swollen for a week and he does not know the origin of the pain and swelling. No bruising was noted. After consultation with the APRN from Nurse resident was sent to the Forrest City Medical Center. Findings from X-Ray was normal, soft tissues are normal, no acute findings from the Medical Center.

PRLU or OLTC

Notice of Incident, Staff Neglect, Visit Compliance Report

On 04/25/24, resident hid from staff behind his bedroom door as they were transitioning the hall residents to the cafeteria for breakfast. Resident was left unattended for approximately 19 minutes in his room. There are no cameras in the bedrooms, therefore no camera footage to review. Corrective Action: All staff involved were written up due to this safety and supervision issue. In addition, all staff involved were retrained in safety and supervision of residents.

Licensing Specialist: Eleanor White

  • Facility cited MLS 907.2 (Childcare staff shall be responsible for providing the level of supervision, care, and treatment necessary to ensure the safety and well-bein of each child at the facility, taking into the child’s age, individual differences and abilities, surround circumstances, hazards, and risks).

PRLU or OLTC

Maltreatment, Notice of Incident

A resident reported an allegation of abuse that took place during an ESI (that a staff member hit him in his eye). Corrective Actions Taken: Staff have been suspended pending investigation. Internal investigation of the incident has taken place.

During licensing visit on 05/20/24, the agency reported this staff member was terminated on 04/29/24 as she violated the agency’s restraint hold policy. Agency stated that the staff initiated a restraint hold due to resident’s repeated attempts to break into the nurses station and attempting to damage property. The facility reports that no witness statements were gathered regarding the incident.

PRLU or OLTC

Acute Placement, Notice of Incident

Client was sent to Forrest City ER due to psychosis with suicidal/homicidal ideations with intent. Client was assessed and was transported to Rivendell Acute for further evaluation and treatment. Resident returned back to the facility on 05/02/24 and has not presented these symptoms since.

Police Report

Assault

Officer was dispatched to Forrest City Police Dept. for a walk in report. Upon arrival, officer made contact with a staff member from Perimeter of Forrest City who explained that he was at work breaking up a fight between two residents. After getting the residents separated, the staff member asked one of the juveniles if he would like to play spades to calm him down. The other juvenile then walked up to the staff member, pushing him. The staff member was eventually backed into a corner. The staff member stated that the resident began to swing at him, so the staff member began to swing back, hitting the resident “a couple of times” before he stopped and grabbed the resident to prevent him from swinging again.

Officer gathered information for the report and notified the Child Abuse Hotline because the staff member stated that he had hit the juvenile.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident was sent to Forrest City Medical Center for further assessment to his face. Resident and peers were in a physical altercation that resulted in a nose injury. Diagnosis: Comminuted bilateral nasal bone fractures. The Resident and peers are peer restricted. Room changes and assault precautions have been implemented. Resident is on activity restriction until released by ENT. ENT appointment is 04/29/2024

Agency reported as follows: “It is not known what caused the fight, but they have been on peer restriction.” 05/15/24 – Licensing conducted a final follow up and agency reported resident is recovered and is doing fine.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

Licensing was included in a complaint to the Office of Long Term Care on 4/18/2024. The complaint states that during the review of three restraint holds at the facility by SAMA founder Larry Hampton and Executive Vice President Lisa Hampton comments were made about the inappropriate use of SAMA techniques by Perimeter staff.

Licensing Specialist: Chelsea Vardell

Licensing visited the facility and met with management. The responses quoted by SAMA founder and Executive Vice President were read aloud to the management team and discussed. Video of each restraint hold was reviewed with them. Two of the three incidents were previously addressed with the facility. The third incident was not reportable to licensing, as it did not result in emergency medical care or an arrest, therefore it was not received by licensing until this complaint was filed.

The facility is currently moving away from SAMA as their form of behavior management and restraint. Approximately 85% of staff have already been trained on Handle with Care, and the remaining 15% should be trained by 7/1/24. Licensing will continue to monitor the facility’s progress in transitioning to Handle with Care.

During the video review of the third incident, it was determined that the staff initiating the restraint did not use the minimal force necessary during the hold. The facility reports that this staff member was already terminated due to another incident.

  • Facility cited 905.9 (Physical restraints shall be performed using minimal force and time necessary).

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center for an X-ray after complaint of pain. Resident describes pain from sports related injury while playing basketball as “rolling ankle in gym.” Diagnosis: Right foot pain/swelling. No acute fracture or dislocation. Resident is on activity restriction for minimum three days until reassessment by Physician.

PRLU or OLTC

Medical, Notice of Incident

Resident was sent to Forrest City Medical Center to have sutures removed (related to previous injury received). Resident returned to the milieu at 1515 (3:15 pm cst) with no issues. Resident is on activity restriction for the next seven days by order of Physician.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Eleanor White

Census: 54. Licensing Specialist reviewed children’s records per MLS 904. All records reviewed comply. Required documentation and verifications were present. Case files are well organized and easy to navigate through. The agency’s documentation and notations are nicely detailed and up to date. No concerns or violations.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Resident ran out of area into the laundry room where a Mental Health Technician (MHT) followed attempting to redirect him back into the proper area. The resident reported alleged physical abuse by staff (allegation was that staff hit him). Resident was assessed by Nursing team. No bruises, marks, scratches, or injuries noted and resident denies pain. Staff was sent home for the rest of the day pending further investigation by Safety Team. A report was made to the Child Abuse Hotline (not accepted for investigation).

Licensing Specialist: Eleanor White

04/12/24 – LS White reviewed 15 minutes of camera footage related to the incident on 04/07/24. Footage showed resident going into the laundry room and a female staff member following him into the laundry room. A moment later additional staff entered the laundry room and the original staff member exited. A nurse then enters the laundry room. There are no cameras in the laundry room to verify what occurred there.

Although LS White was unable to substantiate the allegation, since the incident occurred in the laundry room area where there are no cameras, the female staff member was terminated for violating company policy 04/09/24.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was sent to Forrest City Medical Center for X-ray to right hand, after complaint of pain to Nurses and swelling noted. Resident describes pain/swelling comes from punching a door the previous day. No acute fracture or dislocation.

PRLU or OLTC

Accidental Injury, Notice of Incident

Client was playing basketball in the gym and was accidently hit by the ball. This re-opened the injury to his right eye from 3/27/2024. APRN was notified and an order was obtained to send client to Forrest City Medical Center for further evaluation and treatment. Laceration without foreign body of right eyelid and periocular area (received sutures to the affected area). Resident will see Primary Care Physician in 7 to 10 days for suture removal.

04/09/24 agency reports: Resident has presented no new issues since his return. Resident is currently on activity restriction until further evaluation.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center for continuance of care to receive a splint to left hand after complaint of pain to Nurses. Resident jammed his finger while playing basketball.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was sent to Forrest City Medical Center for further assessment to right hand after complaint of pain to Nurses. Resident describes the complaint of pain coming from punching walls. Resident describes “too much was going on” around him. He shares this is what he typically does when he feels overwhelmed. This behavior has been reported to his Therapist and he also shares that he has his “coping toy” which has been helping him.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent to Forrest City Medical Center for further assessment to left hand, pinky finger after complaint of pain to Nurses. Resident describes the pain as coming from jamming his finger while playing basketball. Diagnosis: Small avulsion off the proximal palmar surface of the middle phalanx of the fifth finger. Resident is on activity restriction until Orthopedic consult 04/08/2024.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent out by order of Physician to Forrest City Medical Center for further assessment of right knee. Resident describes the complaint of pain coming from “moving wrong and had to see the nurses” while playing basketball. Resident is on activity restriction until 4/5/24. Diagnosis: No acute fracture or dislocation. Mild prepatellar soft tissue swelling.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was sent out by order of Physician to Forrest City Medical Center for further assessment of left knee. Resident complained of pain after falling while playing outside. Resident is on activity restriction until 04/04/2024. Diagnosis: L knee pain/swelling. No acute fracture or dislocation. Two cannulated screws through the tibial tuberosity are in place and intact, mild prepatellar soft tissue swelling.

PRLU or OLTC

Medical, Notice of Incident

Resident presented to nurse’s station and informed the nurse he had breathing and congestion, a rash between his buttocks, a laceration behind his right ear, and that his urine was brown. APRN was notified and an order obtained to send resident to FCMC for further evaluation and treatment for shortness of breath.

Chest x-ray conducted with no abnormal findings. EKG results: “Sinus rhythm with occasional premature ventricular complexes. Possible Inferior infarct.” Cardiac consult pending at Le Bonheur. Lab (urinalysis with C&S) was ordered for the discoloration of the urine. Hydrocortisone 1% apply topically between buttock twice daily for 7 days for skin irritation of the buttock. Order to clean right ear with antibacterial soap daily times 5 days and apply TAO daily topically for 7 days (laceration to ear due to “poor hygiene, lack of cleanliness”).