Disability Rights Arkansas

Perimeter Behavioral of the Ozarks / Woodridge of the Ozarks

*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: 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 

Treatment Components:

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

 

DRA Monitoring/Investigations

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Police Report

Assault Simple, Battery 3rd Degree

Upon my arrival, I made contact with staff member [REDACTED]. [REDACTED], who works with Perimeter, stated that on 05/17/2023 at approximately 1930 hours, she was called to assist in restraining a female patient, who was in the process of self-harming. The patient had been there since November, and is there because of self-harm and suicidal ideations. Smith stated that had somehow gotten a piece of a pen cap, or possibly the spring from inside a click pen and was scratching herself on her forearm. As Smith and the other staff entered and attempted to restrain she bean to resist them. Smith described as manic, and in one of her regular fits. Smith took arm and put it behind her back, and as she did, the piece of the pen client had in her hand, nicked the tip of Smith’s left thumb, causing it to bleed. Client was then successfully restrained. During the struggle, had been bleeding, and Smith’s fingers intermingled with blood. Smith went to the hospital and was cleaned up and checked for contamination before being quickly released. Smith stated she wanted to press charges against because of the contamination of the blood. Smith stated that this is regular behavior for as she constantly resists any attempt to restrain her, which happens frequently. She stated she did not feel that client harmed her on purpose, or had any other intention than to harm herself and resist the staff as they attempted to gain control of her. I asked the staff if they would bring client out so I could speak with her. I called JDC and advised them of the situation and the charges. I spoke with JDC Intake Officer Munoz, who advised me to cite client and provided me with a Washington County JDC court date of 07/05/2023 at 0900 hours, with division 3. I spoke with and advised her of the court date and the charges. I changed the phone number and address information on her citation and she signed it, stating she understood and would appear on her court date. I was unable to change the court to JDC in my excite module, and I issued a paper ticket. Client was issued citation number [REDACTED] for battery 3rd degree.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/17/23, resident became upset after a verbal disagreement with peer. Resident was taken to the comfort room, but continued to escalate and began banging her head on the wall and scratching her neck. Resident was placed in a brief physical hold for safety, and released once safe behaviors were exhibited. Self-inflicted superficial scratches were noted to resident’s neck (no first aid required). Resident was placed on a self-harm precaution safety plan with constant line of sight, and her therapist will determine duration and individualization of safety plan.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/17/23, resident became dysregulated after a verbal disagreement with peer and began hitting her head on the wall and scratching her arms. Resident was placed in a physical hold to maintain safety. When resident was able to show safe behavior and verbalize ability to maintain safe behaviors, resident was transitioned out of the physical hold. No injuries obtained. Resident placed on a self-harm precaution safety plan with constant line of sight. Therapist notified for follow up to determine duration and individualization of safety plan.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/17/23, resident was seen self-harming with contraband she retrieved from a pen that she stole from a staff member. Staff support was called. RN arrived and attempted to de-escalate and retrieve contraband, but resident became aggressive while trying to retrieve contraband. Resident was placed in a physical hold to maintain safety. Resident continued to escalate while in the restraint. Provider notified and gave an order for administration of an intramuscular (IM) medication to assist in regulation. Resident received IM medication and was able to transition out of physical hold when safe behaviors were exhibited. No injuries noted on resident from restraint, but a staff member was injured with the piece of the pen while transitioning into the physical hold. She obtained a small laceration on her thumb with minor bleeding. Facility policies and procedures currently in place. Resident placed on self-harm precautions with constant line of sight and placed in paper scrubs. Therapist to follow up for duration and individualization of safety plan.

Licensing narrative:

  • 5/19/23 – Licensing emailed the facility to determine if this resident was already on a safety plan at the time she self-harmed.
  • 5/30/2023 – Licensing Specialist followed-up with facility on if a safety plan was already in place.
  • 5/31/2023 – Licensing Specialist informed that resident discharged on 5/31/2023.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/17/23, resident was seen self-harming with an object she obtained on her forearm. Additional staff and RN called to assist. Staff/RN attempts to de-escalate were unsuccessful and resident became physically aggressive towards staff while trying to retrieve contraband. Resident was placed in a physical hold to maintain safety. When resident was able to show safe behavior and verbalize ability to maintain safe behaviors, resident was transitioned out of the physical hold. No injuries obtained. Resident placed on a self-harm precaution safety plan with constant line of sight. Therapist notified for follow up to determine duration and individualization of safety plan.

Licensing narrative:

  • 6/7/2023 – Licensing Specialist inquired about the contraband that resident used to self-harm.
  • 6/8/2023 – Licensing Specialist informed that resident attempted to self-harm with a piece of a paper cut.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/16/23, resident became very dysregulated in the classroom and moved into the hallway. Once in the hallway, resident began picking at self-harm spots on her arms. Staff tried to stop the self-harming by blocking attempts and called the nurse for support. The nurse then showed up and attempted to redirect. Resident then attempted to hit her head on the wall with enough force to cause injury. Due to concerns for the resident’s safety, the nurse called for a physical hold and contacted the provider. I reviewed the current oral medication with the provider. After explaining the situation to the provider, the nurse returned to restraint. Resident appeared relaxed and calm. The restraint was ended. After the restraint, resident willingly received a one-time PRN medication to assist with continuation of emotional regulation, and this medication was well tolerated. She was compliant and seemed calm enough to rejoin the milieu. A physical assessment following the restraint found no injuries from this incident and only a minor exasperation of the existing superficial abrasion on residents’ forehead. The provider also made adjustments to resident’s current medication regimen for mood stability. Resident will be on a safety plan including constant line-of-sight monitoring for a period to be determined by the therapist.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact, Visit Compliance Report

On 5/16/23, Tennessee reported to [REDACTED], that [REDACTED] “Pulls down her pants to show her dangaling.”. She stated that [REDACTED] talks about masturbating and talks often about sex.

Corrective action: report entered in the online child abuse and neglect portal (Report, #[REDACTED]). Clients were separated by units. [REDACTED] 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 develops individualized programming to tailor each need.

Licensing narrative: Licensing requested any documentation of the accusation that made against to include, but not limited to, dates, times, and location of when these events allegedly took place. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Visit Compliance Report

Buildings & grounds conducted from 9:45 AM – 11:30 AM. Outdoor play area observed to have toys on the ground, but no trash or safety hazards. Orange unit observed to be furnished and in good repair. Client’s rights posted, bathrooms clean and sanitary with functioning sinks, toilets, and showers. Staff/client ratio 2:10.

Regulations our of compliance: 908.8 – client [REDACTED] am meds (3) were not initialed. Licensing Specialist: Clayton DeBoer.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/15/23, resident was seen picking a spot on their face with their fingernails and smearing blood around. Resident was assessed by RN, superficial wound was cleaned and covered. No further incident occurred. Resident places on self-harm precaution safety plan with constant line of sight as a result. Therapist to determine duration and individualization of safety plan.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/15/23, RN was called to blue unit where he observed the resident opening skin on left arm in attempts to cause damage by self-digging into skin with fingernails. Resident was noted to be aggressively yelling at peers and threatening staff during at this time. To maintain the safety of herself/others, and to remove from overstimulating stimuli, the resident was escorted off the unit to the comfort room. During the escort, the resident was fighting staff via kicking with intent to injure. To maintain the safety of the resident and staff, a physical hold was initiated. Resident was transitioned out of the hold when safe behaviors were exhibited and was given a PRN ordered medication per resident request. Resident continued to process 1:1 with staff in the comfort room until able to return to unit. No injuries occurred during restraint. Resident was placed on a self-harm and assault precaution safety plan with constant line of sight as a result of this event. Therapist to determine duration and individualization of safety plan.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact

On 5/12/23, reported to her therapist that [REDACTED] has been forcing to date her. Client reported that [REDACTED] “Pulled her pants down and kissed her butt, kissed her lips and other inappropriate places, and squeezed her chest.”

Corrective action: call placed to the child abuse hotline. Report accepted, #[REDACTED]. Clients were separated by units. [REDACTED] has also had a room change which will result in no roommate. This will remain in place until otherwise noted by the treatment team and therapist. [REDACTED] 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:

  • 5/15/2023 – Licensing contacted the agency for guardianship information and the staff report that was completed at the time of the call.
  • 5/31/2023 – Licensing Specialist followed-up with the facility on safety precautions. Licensing Specialist informed that resident was still on precautions and residents are still separated.
  • 6/29/2023 – Licensing was made aware that this report was called back into the and has now been accepted for investigation referral the assigned investigator is [REDACTED] with [REDACTED] and he has granted licensing permission to contact the agency.
  • 7/5/2023 – Licensing Specialist contacted the facility for information regarding a safety plan for the residents, and inquire about the which unit they are staying in.
  • 7/7/2023 – Licensing Specialist contacted the facility for information regarding a safety plan for the residents, and inquire about which unit they are staying in because a response was not received.
  • 7/7/2023 – The facility responded the residents are on different units, one is on orange and one is on blue, and their safety plan is expired, but they are on a strict peer restriction which means they are not aloud to be around each other. The facility was instructed the residents need a new safety plan because they are involved in an active maltreatment case and the safety plan will need to run the duration of the investigation.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff called nurse to unit and reported patient has been self- harming. Patient has been picking at previous wound on leg and making it bleed again. Patient initially non-communicative but after trying to process, nurse was able to get the patient to talk and quit picking at area. Patient stated that the unit had gotten too loud because of two other residents arguing. They were also able to be de-Escalated. Patient requested PRN medication, and it was given by nurse as ordered. Leg was also assessed, cleaned, and bandaged. Self-harm precautions in place, and therapist notified to discuss with patient if any other precautions are needed and the duration of it.

Police Report

Missing Juvenile, Runaway Juvenile, Suicidal

At 1735 hours, caller advised juvenile ran away from facility. At 1748 hours, caller advised the juvenile was at 2710 S 48th with a nurse; Officer responded to location and juvenile was transported to NWMC for suicidal ideations. Juvenile was returned to facility at approx. 1930 hours.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/10/23, resident became upset and began hitting their head on the wall and scratching their skin with intent to injure themselves. Verbal de-Escalation and blocking techniques were unsuccessful, and resident had to be placed in a brief physical hold. Resident was transitioned out of hold when safety criteria was met. Superficial scratches noted on the skin, no nursing care required. Resident placed on a self-Harm precaution safety plan with constant line of sight, and will meet with therapist to determine duration/Individualization of safety plan.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

The Springdale Police Department called to report they are concerned about Perimeter of the Ozarks. Licensing was informed that last weekend during an elopement, the resident was located and staff refused to come to the hospital to pick up the resident. After threatening the staff with a citation, 2 to 3 hours later, the staff from Perimeter of the Ozarks showed up at the hospital. The Police Captain stated his officers were told by Perimeter staff that once a resident runs away, they are no longer responsible for them. The Captain was also concerned about the length of time it takes Perimeter staff to let them into the facility when they respond to a call.

Licensing narrative: 5/18/2023- Licensing requested the facility policy regarding what steps the facility takes when a resident elopes. The facility reports that the CEO has reached out to the Springdale Police Department and resolved the issues. The CEO has provided the Police Captain with her direct phone number in the event the department cannot reach staff when calling the facility’s main phone line. The CEO has also stated that the staff will be retrained on the facility’s procedures on bringing a resident who has eloped from the facility back to the building once they have been deemed safe to do so by either the police department or hospital physician. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/10/23 at around 20:00 patient creates a superficial self-harm wound on her left forearm. Nurse cleaned the wound and bandages it. Patient reported she did it due to the unit being loud and her recent court appearance. Patient was placed on self-harm precautions. Therapist to consult with resident to determine if any other precautions are needed and to discuss length of them.

Licensing narrative: 5/11/2023- email sent to the facility requested further information including resident guardianship and the cause of the unit being “Loud”.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/10/23 at 20:00, patient self-harmed by scratching self with a piece of plastic on forearms. Staff processed with patient. Contraband was retrieved by staff. RN cleaned wound and assessed patient. Placed on self-harm precautions. Therapist to consult with patient to see duration of precautions and if anymore are needed.

Licensing narrative:

  • 5/11/2023 – Licensing emailed the facility to determine what the plastic was that the resident used to self-harm.
  • 5/30/2023 – Licensing Specialist followed-up with facility on the plastic that the resident obtained.
  • 6/7/2023 – Licensing Specialist inquired about the piece of plastic that resident self-harmed with.
  • 6/8/2023 – Licensing Specialist informed it is unknown how the resident obtained the piece of plastic. It was reported that the piece of plastic was small in size.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident created a superficial self harm wound on her left forearm with her fingernails. Reported that she did it because the unit got too loud. Assessed, cleaned, and bandaged by RN. Resident placed on self-harm precautions. Therapist to consult with resident to determine if additional precautions are needed and the length of time they will stay in place.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

At approximately 5:27 PM, the CEO was notified by AOC via phone that while residents were in the gym, which has 2 unlocked outside doors (Leading to the fenced/Locked area). While in there, 2 residents escalated and staff walkied for support. At this time, a resident exited the gym in attempts to leave the property. One staff member followed. At this time, a staff member intercepted and was able to get to the gate opening before exited. Staff stated the gate was ajar with no chain. As the staff attempted to keep her inside the fenced area, resident saw a 2nd staff coming in for assistance and as result, escaped the staff. That was when the staff notified and he notified the CEO. CEO informed to have police called. At this time, [Recated] Director of Nurse (DON) also called CEO at 5:31 PM as she was driving home and noticed the resident. CEO informed [REDACTED] police were notified and that her number would be provided to the police if she is able to keep vision on the resident and communicate with police resulting in a hopeful quick pick up. Regional CEO was notified at 5:35 PM. At approximately 6:20 PM CEO was notified the police had located resident and DON was heading back to property and complete notification process of incident. At 6:27 PM DON was notified by police they were taking to the hospital as she stated she would “kill everyone in the building” and “suffocate all of the kids.”. CEO began communicating with sargent [REDACTED] police about next steps. It was agreed we would take the resident back for stabilization if they could transport her back to us. It was agreed police would remain present until she was safely in a locked area and a person search was conducted.

Licensing narrative: 5/11/2023- licensing emailed the facility for further information. Facility visited 5/15/23 in response to self-Report elopement of client. Gate outside of gym doors observed to be chained/Locked. Per staff report, this gate is to remain chained/locked at all times when not in use. Kitchen staff left gate unlocked when client eloped.

Regulations out of compliance: 907.2 – gate outside of gym doors observed to be chained/Locked. Per staff report, this gate is to remain chained/locked at all times when not in use. Kitchen staff left gate unlocked when client eloped. Licensing Specialist: Clayton DeBoer.

PRLU or OLTC

Notice of Incident, Self-Harm

On 5/9/23 it was reported to RN that resident had scratched their arms in response to residents yelling in the dayroom at one another and the unit being to noisy. RN assessed arm. Superficial scratched noted to the lower forearm. Scratches cleaned with soap and water. Resident placed on a self-harm precaution safety plan with constant line of sight. Therapist notified, resident to be seen by them the following day to discuss duration or individualization of safety plan.

PRLU or OLTC

Notice of Incident, Suicidal

On 5/3/23, staff received a note from resident that stated that they were suicidal. C-SSRS screening performed by RN. Resident scored high risk. She was placed on a suicide precaution safety plan with constant line of sight and placed in paper scrubs for safety. Therapy was notified of screening results for follow up with resident the next day.

Police Report

Assault

On 4/27/23 a report was received from Arkansas State Police Investigator Deidre Uselton in regards to a new report. The DHS snapshot was reviewed and the following is a summary of the report. AV is who is in DHS custody. AO is Employee . AV has large red marks, bruises, & scratches on her left shoulder all the way down her left arm. said that a staff member named had put her in “a hold, scratched her, hit her and grabbed her arm too tightly. hair is extremely oily (appearing almost wet), full of dandruff and with spots of dried blood along her scalp. The victim was interviewed by Karen at the Children’s Safety Center. Below is a narrative of that interview. The interview was recorded and placed in the case file. Karen conducted a digitally recorded forensic interview with   told Karen she goes by   said she likes to draw and color and then told Karen she was brought here by Perimeter where she is at right now.  said she does not really feel safe at Perimeter. Karen asked to talk about this and she stated that “she” grabbed her thumb and fingers and twisted and squeezed her arm and it left a bruise on her right arm.  said this was from the hold she was put in.  said that they put her arms behind her and then put her on the ground and then they get on top of you and hold you down.  said this happened last Monday at Perimeter. She said that the staff is not very nice to the kids.  said that they snatch papers out of their hands and say that’s what you get.  said that the staff will say if you want to get in a fight, I can’t hold you back.  said she has never been in a hold before.  was asked who put her in the hold and she said short and and .  said she was getting into a fight with someone and they were pulling her hair out.  said it was because this resident was trying to take all her stuff because the staff told this resident to throw all her stuff out.  said the resident hit her and then she hit her back. She said that the resident hit her on the elbow and head and then pulled her hair.  said she hit her on the back in self-defense.  said she had to get her down so she would not hurt her and make her go to the hospital.  said at this time the staff to her in a hold.  said the other resident got to stay in the unit.  said after the hold she became calm.  made a statement that hurts other people in holds and that she has seen a big fat bruise on another resident but did not give a name. Karen asked how the hold happened.  said that she was on the ground on her back and had her feet, had her left arm, and had her right arm.  said that she was moving her arms or trying.  said she got calm and was put on another unit and she other unit is really good.  said she does take medicine and made a comment that her dosage goes up ever da.  said when she breaks a rule at Perimeter her comfort stuff gets taken away. Karen went over the other forms of maltreatment and did make a disclosure of Sexual abuse that has been reported to the hotline (re). Karen asked some clarifying questions at this time.  was asked if she said anything or what she heard when this happened and she said she heard her name but did not remember anything else. She was asked about bathing at Perimeter and she said she takes a shower every night and washes her hair once a week. She said her caseworker is who brings her shampoo and conditioner.  said if something happened, she would tell Abigail (adoption specialist) and she said she did not have anyone else she trusted. The victim stated that she was fighting with another juvenile and that the staff separated them and put her in a “hold”. The bruising is from her being put in that hold, which is by the way she explained it, the way the staff pins the juveniles down on the ground until they calm down during a physical altercation with other juveniles. There is no probable cause for charges at this time, this case can be closed.

Police Report

Sex Offenses

AV is currently residing in Perimeter Behavioral Health facility with AO. It was reported that disclosed when was residing in the same facility as her, they decided to date, would inappropriately touch and penetrate her vagina. would often get into bed and touch her thigh, neck, hair, and under her clothes on the vagina making her uncomfortable 3 different times. once told that she didn’t want this and to stop but she didn’t and pinned her wrist above her head. would often brag to other people around the facility about them being together which also made uncomfortable leading to her self-harming. It is said that never wanted to do this and always felt uncomfortable. It is unknown where staff was while this was happening, they are supposed to check in every 15 minutes. It is unknown when this happened or if they still have contact with one another. On 04/26/23 was interviewed by Arkansas State Police Investigator Christina Duncan. I have attached Duncan’s notes on the interview to the case file. The following is a summary of the interview. Client stated that the touching was unwanted but, in her statement, did not tell the suspect to stop or that the contact was not wanted. also stated that when the suspect had asked her if she wanted to “Do it” she did not say no but instead laughed and said, “No we will get caught”. The last contact that mentioned in her statement was that the suspect told that it was her turn to be on top and the suspect told to put her fingers inside the suspects vagina, so did what she was told. never mentioned any force used by the suspect. After several weeks of not being able to contact the suspect in this case I was contacted by Investigator Duncan who told me that she had spoken to the suspects care giver in Texas. Duncan told me that the suspect was in Foster Care and the would not allow her to be interviewed. Duncan told me that State Police would be closing this case unfounded. This case will be closed there is no evidence that a crime was committed and in the victim’s statement she did not disclose that she had told the victim to stop, or the touching was unwanted.

PRLU or OLTC

Notice of Incident, Self-Harm

Notified 4/26/23 at 6:09p RN was called to the unit and found resident self harming with what appeared to be cardboard from an ear plug package. Staff gave the RN a piece of a croc shoe charm (plastic/rubber) the resident used to make the original laceration. It was observed the wound was no longer bleeding but the cardboard was being rubbed vigorously in attempt to prolong the bleeding. RN and staff attempted to physically block resident and verbally de-escalate her with deep breathing exercises. When this was not successful, a staff with a great rapport with the resident came in attempts to de-escalate and was successful. The area on her left arm was opened and dried blood was present. Area was cleaned and bandaged. Self harm precautions were initiated by nursing for safety. The assigned clinical therapist will further assess to determine further self harm protocols.

PRLU or OLTC

Maltreatment, Notice of Incident, Self-Harm

On assessment from nursing today, there is a moderate amount of petechia on resident’s left arm. It was reported by the resident to staff that her arm was “smashed” while in restraint on 4/25/23 when she attempted to assault staff and engaged in a fight with a peer. After reviewing camera footage of the 4/25/23 event, it was found to be no inappropriate restraint and the physical hold was brief. Nursing assessed after the physical hold and observed no apparent injuries at that time. After this, resident was removed from the area. Approximately 18:52 resident began vigorously scratching her left arm with her own fingernails. Per camera footage, there was not a staff member in the immediate area when resident engage in self harm. Resident has been placed on self harm precautions