*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: Springdale, AR Population Served: Adolescent girls ages 7-17
| # of residents per unit: Up to 12 | Residents per room: 2 | Capacity: 32 |
Contact with family (Calls and visit schedule): Weekly calls up to 3x/week for 10 minutes, intervention call available 1x/week for 10 minutes. Visitation available 2x/week for 30 minutes if previously scheduled. Zoom available if in person is not possible.
| Restraint utilized? Yes | Chemical Restraint utilized? Yes | Seclusion utilized? Yes |
Clinical Director: LCSW Therapists: 2 full-time therapists (1 LMSW, 1 LAC)
Treatment modalities offered: Facility declined to identify any specific modalities available.
# of individual therapy sessions/week: Varies by client, most clients receive one individual therapy session per month
# of group therapy sessions led by a licensed mental health professional/week: 3
Police Report
Assault
Officers responded to a disturbance call at facility. Upon arrival, staff advised the fire alarm had gone off, causing all the doors to unlock. Staff member stated she stepped in front of a resident attempting to escape, and the resident hit her in the forehead with the palm of her hand. The staff member stated she wanted to press charges, and a court date was issued for resident.
PRLU or OLTC
Elopement, Notice of Incident, Visit Compliance Report
Around 9:30am, a resident was upset and processing with staff when another staff member went out the back exit to go outside. The resident ran out the door before it fully closed, and once outside, she made it outside the locked area due to the back gate being open for deliveries being made. Staff were able to retrieve the resident and escorted her back to the facility. The incident lasted a total of 10 minutes.
Licensing Specialist: Jarred Parnell.
Facility visited 8/2/23 and video reviewed. The resident can be seen standing with a staff member processing and doing fitness. Another staff member walks outside from the school hallway, and the resident ran out the door before the magnetic latch could engage. The resident proceeded out the gate in the back of the building (gate was open due to a delivery truck dropping off a delivery). Facility CEO stated staff will be re-educated on exiting and entering doors and outside gates. A secondary outside gate was added in between the recreation area and the delivery area which is secured with a pad lock, and a staff person will be stationed at the gate when deliveries are being made going forward.
PRLU or OLTC
Notice of Incident, Self-Harm
Resident became dysregulated on the unit and began displaying self-injurious behaviors including pulling her hair out, punching brick, and head banging. A physical hold was initiated to maintain safety. Resident received a one-time intramuscular medication as ordered by the physician to assist in emotional regulation. Once resident was able to display safe behaviors and verbalize maintaining safe behaviors post hold, she was transitioned out of physical hold. No injuries sustained. Resident was placed on a self-harm precaution safety plan, therapist to determine duration and individualization.
PRLU or OLTC
Medical, Notice of Incident
On the evening of 7/29/23, I was asked to come in due to the nurse working floor stating she was overwhelmed. On arrival, I got a report of this patient having several complaints of pain and not feeling well. According to staff working directly with the patient, the patient’s pain seemed like it was getting worse. Upon my assessment the patient seemed to be in distress and was reporting intense pain all over. We sent the patient out with EMS to Arkansas Children’s Hospital for further evaluation. They reported vitals within normal limits and a diagnosis of syncope. We have requested lab results and are currently awaiting them.
Licensing narrative:
PRLU or OLTC
Visit Compliance Report
Program Coordinator and Licensing Specialist visited the facility to review the progress and compliance of the current Corrective Action Agreement (CAA) with CEO and Quality Assurance Director from the West Memphis facility. The Program Coordinator discussed citations the facility has received in the past six months. The expiration date for the current CAA was 7/25/2023, but due to the facility’s license still being in a probationary status and some continued concerns, the licensing unit will be continuing the CAA to October 25, 2023. The Program Coordinator explained that in October another review will be completed to determine if the facility has now met sufficient compliance with the minimum licensing standards to request a change in their license status. Licensing Specialist: Chelsea Vardell.
PRLU or OLTC
Notice of Incident, Self-Harm
Patient became upset when unable to have her hoodie and began to self-harm with thumb nail on forearm. Patient had to be restrained due to continued escalation in trying to self-harm and unable to be re-directed by staff attempts. Therapist to consult with patient to see if any safety plans are needed and the duration of them.
Licensing narrative:
PRLU or OLTC
Visit Compliance Report
Time of visit: 12:15 pm. Licensing Specialist completed a buildings and grounds visit and observed the following areas of Perimeter of the Ozarks: blue unit, green unit. And orange unit, the milieu, the cafeteria, seclusion rooms, and the classrooms. Licensing Specialist was escorted by Sarah Kroon and Travis Hood. The grounds around Perimeter of the Ozarks were clean. Licensing Specialist observed the landscaping around the facility. Twenty seven residents were present during the walkthrough. In the unit common areas there were chairs for the residents, a tv, coloring and drawing supplies, and a table and chairs for staff. Each unit bedroom was inspected for self-harm hazards, sleeping arrangements, and licensing concerns. Bathrooms were inspected for licensing concerns as well as hot and cold running water, and working toilets and shower drainage. The escape plan diagram was posted on the wall by the unit entrance. Licensing Specialist observed two fire extinguishers and drinking water coolers and pitchers in each unit. Resident rights and emergency diagrams, and activity schedules are posted. The facility vehicle was inspected for licensing concerns. The facility severe weather drills log was reviewed a drill was conducted on 3/2/23.
Ratios observed during the walkthrough – Blue unit: 2:1 , Orange unit: 2:8, Green unit: 1:2, Classroom ratios: 4:13 and 2:3. Licensing Specialist reviewed the mar’s on the residents listed below:[REDACTED]. All initialed and up to date.
Licensing Specialists reviewed the Corrective Action Agreement with CEO for Perimeter of the Ozarks. Licensing Specialist provided CEO a copy of the Corrective Action Agreement. CEO provided Licensing Specialist with a copy of August and September activities for the residents. The monthly calendar of activities for the residents is part of the facility’s Corrective Action Agreement. Licensing Specialist: Jarred Parnell and Kendra Rice.
Medicaid Inspection of Care
Corrective Action Plan, Inspection of Care Report
Deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted at the facility.
This IOC visit was upon request of DPSQA (Division of Provider Services and Quality Assurance) to follow up on a recent IOC inspection conducted on 10/6/22, 12/5/22, 2/6/23, and 4/3/23.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
On 7/19/23, client reported to staff that she believes she obtained injuries on her arms from a physical hold that she was placed in on 7/17/23. Due to allegation, a report was uploaded to the child abuse hotline.
Corrective action: Internal investigation opened, camera footage reviewed, statements provided. Clients arms were assessed and documented. 2 superficial, 1/4-inch scratch marks were noted on her left forearm and upper arm with no actual breaks in the skin. A pea-sized circular area of mild discoloration noted on right upper arm.
Licensing narrative:
Please ensure that staff is retrained on how to conduct appropriate restraints/escorts with residents by 8/2/2023. Please ensure staff is retrained on the facilities proper protocols when de-escalating a resident by 8/2/2023. Please ensure all staff present during the incident are re-educated on the facility’s policy regarding proper protocols for staff response to an incident by 8/4/2023. Licensing Specialist: Jarred Parnell.
Police Report
Hang Up
Open 911 line plotting at 4522 West Sunset. No sounds of distress; can hear speaking but cannot make out what is being said. Call plotting within 11 meters now at 2466 West 48th Street. 656 spoke with nurse who advised she will make contact at the front with officers.
PRLU or OLTC
Personnel Record Review, Visit Compliance Report
Licensing Specialist conducted a visit at the facility to review the policy for resident grievance reporting, and incident report log.
Licensing Specialists reviewed two (2) personnel files:
Licensing Specialist was informed that [REDACTED] transferred from Perimeter of West Memphis. She was promoted from PRN Mental Health Technician to Activities Coordinator. Both personnel files reviewed complied with the minimum licensing standards. Licensing Specialist: Jarred Parnell.
PRLU or OLTC
Visit Compliance Report
Licensing Specialists Jarred R. Parnell and Kendra Rice conducted a visit to review camera footage of nighttime visual checks during sleeping hours for blue unit, green unit, and orange unit. Licensing Specialists reviewed footage for date 6/20/2023 at 12:53 AM – 1:16 AM, and 3:30 AM – 3:32 AM.Two staff persons were observed on the camera footage in the blue unit doing routine checks. Licensing Specialists reviewed footage for date 6/19/2023 at 11:29 PM – 11:52 PM and 12:01 AM – 12:12 AM. 3 residents were on line of site precaution, staff was observed doing routine checks. Licensing Specialists reviewed footage for date 6/6/2023 at 12:01 AM – 12:11 AM. Five residents were on line of site precaution and one staff member observed doing routine checks. Licensing Specialists reviewed footage for date 6/19/2023 at 7:43 PM to review the time before sleeping hours. Licensing Specialists observed residents preparing for bed. Some residents were observed in the day area, walking in the hall way, completing hygiene. One resident was observed transferring to another unit. Licensing Specialists did not observe any minimum standard non-compliances for routine sleeping hour checks. Licensing Specialists: Jarred Parnell and Kendra Rice.
Police Report
Alarm
Alarm is showing motion detector sensor. Confirmed accidental.
PRLU or OLTC
Theft of Vehicle
Christopher stated that on 06/21/2023 he parked his black 2021 Bintelli Beast Moped outside of the Perimeter of the Ozarks, facing S 48th St, 5 parking spots from the entrance, at 4:10 PM and when he walked outside at 4:34 PM it was no longer there. Christopher stated he is still in procession of the keys. He stated he did not witness any suspicious activity and he stated there were no cameras in the parking lot of the facility, only inside of the building. On 06/24/2023 the victim from incident 23-40008 found his stolen scooter. Officers went and confirmed.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist observed all units (Green, blue, and orange) to ensure that residents are participating in scheduled activities. Licensing Specialist arrived during a new work shift and staff were preparing for activities.
PRLU or OLTC
Complaint Survey
Complaint #Ar00030227 was in compliance. The facility was in compliance with §483, subpart g – conditions of participation for psychiatric residential treatment center.
PRLU or OLTC
Visit Compliance Report
Program Coordinator and Specialist Jarred Parnell completed a full buildings and grounds walkthrough of the facility. Bedroom 103 on the blue unit was not viewed as a resident was in the bed resting. Child/Staff ratios were as follows: 3:1 blue unit. 9:2 orange unit. 8:1 classroom 1. 5:4 classroom 2.
Both classrooms were next door to each other, and one staff had gone to the second class, so to return to the correct ratio one staff was immediately asked to leave classroom 2 and rejoin classroom 1. The shower basin in room 305 was seen to be in poor condition with a mildew smelling emitting from it. The licensing staff discussed this with the maintenance staff and regional CEO who reported that they will begin addressing it immediately. Please ensure that the shower basin is repaired by 7/14/2023.
Regulations out of compliance: 911.6 – the shower basin in room 305 was seen to be in poor condition with a mildew smell emitting from it.
Regulations needing technical assistance: 907.3 – staff was seen out of ratio – 8:1 in classroom 1, but over ratio in classroom 2, 5:4. The teacher of classroom 1 reported that the additional staff had stepped out of the room. Licensing Specialist: Chelsea Vardell.
Police Report
Sex Offenses
Alleged victim (AV) is client who resides with her mother. Alleged offender (AO) is AV’S roommate at Perimeter Behavioral of the Ozark. AV was getting ready to take a shower when she began to act anxious. AV did not want to go in the same room as her roommate. AV disclosed later that AO had raped her the night before. AV did not go into details of the rape, as AV stated she wanted to speak with her counselor. AV and AO have been separated. No other information was provided.
Client was interviewed by Inv. Logan Woynaroski at Perimeter Behavioral Health in Springdale. Detective Hunter Helms and ASP Intern Allison Atkins observed. After building rapport, client advised Woynaroski she was in foster care. Client advised Woynaroski that something had happened with her former roommate [REDACTED] and her former roommate [REDACTED]. Client refused to tell Woynaroski any details aside from what happened with roommate occurred more than once, but less than five (5) times, and what happened with roommate occurred one time. Client advised these incidents occurred in the “back rooms” of the units. Client would only say “They raped me,” and when asked what “Rape” meant, client said “Sexual things.” Client refused to acknowledge the body safety diagrams. The victim did not disclose anything illegal during the forensic interview. This case can be closed, no charges.
PRLU or OLTC
Notice of Incident, Self-Harm
Patient had to be restrained at 08:19 in the morning. Nurse reported upon arrival patient was banging her head on the wall while staff were physically blocking to reduce the impact. It was reported that the patient would not respond to verbal de-escalation and behaviors continued to increase. Patient began attempting to self-harm by scratching at legs. Patient did not report to staff what led to this escalation. Staff did report at the beginning of the escalation the patient said that she hated herself and wanted to be free. Patient placed on precautions, self-harm safety plan initiated. Therapist to consult with resident to see if any additional precautions are needed and to determine length of time.
Licensing narrative: Licensing Specialist will follow-up with facility on what precautions were implemented. Licensing Specialist confirmed that resident was placed on a self-harm precaution safety plan.
Police Report
Hang Up
Hangup plotting at Ozark guidance center, no sounds of distress.
PRLU or OLTC
Notice of Incident, Peer Sexual Contact, Visit Compliance Report
On the evening of 6/12/23, the patient reported to staff that she was feeling anxious and scared about sleeping in her room. Staff asked her about it and the patient pulled the staff to the side of the hall. Patient told staff that she did not want to sleep in her room because of her roommate and for safety reasons. Staff reported about 45 minutes later the same patient approached her and told her the reason she was scared was because the night before (6/11/23) her roommate had raped her.
Corrective action: report entered in the online child abuse and neglect portal and accepted. Clients were separated by units. Client was placed on a sexual misconduct precaution safety plan with constant line of sight until she is asleep for 15 mins. Therapist to further process events with both residents and develop individualized programming to tailor each need.
Licensing narrative:
Police Report
Assault Simple
On 06/07/2023 at approximately 20:51 hours, I, Officer Crites 385, was dispatched to a call of an assault/battery report at Perimeter of the Ozarks. While I was in route, I was advised through Springdale dispatch that the caller needed to file a report for an assault on an employee. The suspect was described as a 13-year-old female. The caller stated that while the staff was attempting to get the child into a unit, the child was kicking an employee and was punching the employee in the face. The caller stated that this altercation happened around 5:00 PM today. When I arrived on scene, I spoke with the caller. She identified as [REDACTED]. She stated that one of their residents was refusing to go back to her unit and was trying to break out of the facility. The nursed called for the staff to try and help her back into the unit. This is when caller and another staff member were trying to escort to her unit and she was kicking them. When they arrived at the room, client wrapped her legs around staff’s legs. Staff then raises her arms to disengage with client. When staff let go of client, she got up and charged at her. The staff then eventually were able to get client in a restraint. Client threated to kill staff during this altercation. Client was given a shot of some kind of medication and she calmed down.
I contacted WCJDC, and they advised that they would not be detaining due to her medical situation. They advised that they thought it would be unsafe to keep because they don’t have any medical trained staff in the Juvenile Detention Center. Client was given the intake date at 11:00Am at 123 N college.
PRLU or OLTC
Personnel Record Review, Visit Compliance Report
Licensing Specialist reviewed one (1) personnel file: [REDACTED] clinical director. Personnel file reviewed complies with the minimum licensing standards. Licensing Specialist: Kendra Rice.
PRLU or OLTC
Notice of Incident, Self-Harm
On 7/5/23 at approximately 1820, client became angry and punched a wall twice with her right hand. Upon initial assessment, the RN noted the onstage swelling and bruising with range of motion present. The physician was notified of the event after the initial assessment. The plan of action moving forward included to continue to monitor affected area and update physician with status changes, as well as offer comfort measures including ice packs and prn pain medications for relief. Upon assessment of client’s hand today, 7/6/23, the RN noted that their right knuckle appeared moderately swollen with complaints of tenderness and lessened range of motion compared to yesterday evening’s assessment. The physician was notified of the assessment and recommended to have client sent out for x-rays to rule out a possible fracture. Client is currently at Northwest Arkansas Children’s Hospital awaiting x-ray results.
Corrective action: Work in collaboration with the treatment team to help find ways to better assist when she has anger impulses without risking self-injurious behavior. Licensing narrative: 7/13/2023 Licensing Specialist reviewed the provider reported incident. X-ray results have been requested from the facility.
PRLU or OLTC
Notice of Incident, Suicide Attempt, Visit Compliance Report
On 6/5/23 at approximately 1853, she was observed in her room with a sweatshirt she had placed around her neck. Staff intervened and removed the sweatshirt from around her neck. At this time, RN assessed, and no visible injuries were sustained from the sweatshirt placement around her neck. After this, client began processing with staff about her feelings at the time. She expressed hopeless feelings in the beginning but by conclusion of verbal processing, she felt “better” and verbalized the willingness to communicate with staff further about her feelings and to use her coping skills. Client continued to sit in her bedroom. Resident contracted for safety; increased line of sight discussed with staff.
Licensing narrative: Licensing Specialist reviewed provider reported incident. Licensing Specialist will inquire about if resident was alone in her room.
Regulations out of compliance: 907.2 – staff member left resident unsupervised while providing 1:1 supervision. Licensing Specialist: Kendra Rice.