Hang up at Ozark Guidance. Upon call back, they said it was an accident and were probably trying to dial another number.
Police Report
Hang Up
PRLU or OLTC
Notice of Incident, Self-Harm
Resident presented to RN with a 1.5-inch laceration on left forearm with no active bleeding. When RN inquired about the cause of the injury, resident stated that they used contraband to self-harm in the shower. Resident was reluctant to give up the contraband, but RN was successful in retrieving the item used. The area was cleansed with antibacterial soap and bandaged accordingly. Will monitor laceration and will notify MD if there are any deviations from baseline while healing. In relation to this, resident will continue to be on self-harm precautions with 1:1 observation, and in addition, resident’s person will be searched each shift to ensure that resident is not carrying any contraband that they can utilize to harm themselves or others.
PRLU or OLTC
Notice of Incident, Self-Harm
Resident became dysregulated on the unit after a verbal altercation with a peer. Resident began picking at old scabs from previous self-harm incidents causing mild bleeding. Staff intervened by blocking self-harm acts and verbal de-escalation. Resident was able to regulate emotions after processing with staff 1:1. Affected arm cleaned with soap and water, left open to air. Resident to remain on current self-harm precaution safety plan with constant line of sight until safe behaviors are displayed. Therapist notified for evaluation.
PRLU or OLTC
Notice of Incident, Self-Harm
Resident became dysregulated on the unit and began picking at old scabs from previous self-harm incidents causing mild bleeding. Staff intervened by blocking self-harm acts and verbal de-escalation. Resident was able to regulate emotions after processing with staff 1:1. Affected arm cleaned with soap and water, left open to air. Resident to remain on current self-harm precaution safety plan with constant line of sight until safe behaviors are displayed. Therapist notified for evaluation.
PRLU or OLTC
Notice of Incident, Self-Harm
Resident became dysregulated while on the milieu and began hitting herself in the face with her hand. Staff was able to intervene by physically blocking self-harm acts and verbal de-escalation until residents’ emotions were regulated and safe behavior was displayed. Resident taken to nurses station where nose was cleaned with soap and water. No injury apparent. Therapist informed of event for follow up. Resident to remain on current self-harm precaution safety plan with constant line of sight.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 1
- Client became dysregulated and began hitting themselves in the face with a closed fist. A physical hold was initiated after de-escalation attempts were unsuccessful. Once client exhibited safe behaviors, client was released and dried blood on her face was cleaned. Client will continue self-harm precautions with constant LOS.
- Licensing follow-up: Unannounced licensing visit conducted. Facility was in ratio with no supervision concerns. Client is currently on safety plan to address behaviors and therapist continues to monitor client.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 2
- Client began to hit herself in the nose with her fist and had to be placed in a physical restraint after de-escalation attempts were unsuccessful. Due to client’s aggression, a one-time dose of IM emergency medication was administered. Once safe behaviors were exhibited, client was released and minimal dry blood on client’s face was cleaned. Client will remain on her current self-harm precaution safety plan with constant LOS.
- Licensing follow-up: Unannounced licensing visit conducted. Facility was in ratio with no supervision concerns. Client is currently on safety plan to address behaviors and therapist continues to monitor client.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 3
- Nurse was called to assist due to client standing in a chair with glass in hand from the ceiling lightbulb. A physical hold was initiated to retrieve the glass from client, and client was able to regulate emotions. Nurse cleaned/covered 2 small lacerations on client’s hand. Client to remain in comfort room with a staff member present at all times, maintaining strict 1:1 observation.
- Licensing follow-up: Unannounced licensing visit conducted. The unit lights were in good repair, and client was observed in the comfort room programming 1:1 with staff. Facility is working on acute placement for client. Licensing inquired if light covers could be screwed in place, and CEO advised that the lightbulb she has been getting into has been secured.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 4
- Client picked existing scabs from previous self-harm attempts on her arm. Nurse cleaned superficial wound (minimal bleeding). Client will remain on current self-harm safety plan with constant LOS.
- Licensing follow-up: Facility visited, and client was observed within LOS of staff (no longer on 1:1 precautions). Facility has given client’s caseworker notice due to severity of her behaviors and lack of progress with treatment. No alternate placement has been located.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 5
- Client picked existing scabs from previous self-harm attempts on her arm. Nurse cleaned area (minimal bleeding). Client was placed on self-harm precaution safety plan with constant LOS.
- Licensing follow-up: Client has discharged due to disruptive behaviors and acuity. Client will not return to the facility.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury
- Client began to hit herself in the nose with her fist and had to be placed in a physical restraint after de-escalation attempts were unsuccessful. Due to client’s aggression, a one-time dose of IM emergency medication was administered. Once safe behaviors were exhibited, client was released and minimal dry blood on client’s face was cleaned. Client will remain on her current self-harm precaution safety plan with constant LOS.
- Licensing follow-up: Unannounced licensing visit conducted. Facility was in ratio, safety precautions were noted in daily census, and no supervision concerns were noted. Therapist continues to monitor client.
PRLU or OLTC
Notice of Incident, Suicide Attempt
- Suicide Attempt
- Client became upset related to a disagreement with peers and attempted to tie her paper scrubs around her neck. Staff removed the paper scrubs and had to physically block client from hitting herself in the head. Client was able to regulate emotions, and no injuries were sustained. Client will remain on suicide and self-harm precautions with constant LOS.
- Licensing follow-up:Unannounced licensing visit conducted. Client is currently restricted to unit and was observed completing schoolwork within LOS of 2 staff members and wearing paper scrubs.
Police Report
Hang Up
Hang up from landline at Ozark Guidance. No sounds of distress.
Police Report
Hang Up
Another hang up from Ozark Guidance. No signs of emergency.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 1
- Client was triggered by a peer and began using her fingernail to reopen superficial abrasions that caused minimal bleeding. Nurse cleaned abrasions and processed with client. Client will continue self-harm precautions with constant LOS.
- Licensing follow-up: Licensing visited facility and observed client within LOS of staff in classroom. Classroom was in ratio.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 2
- Client became dysregulated and began hitting themselves in the face. Client was placed in a physical hold after de-escalation attempts were unsuccessful. Once safe behaviors were exhibited, client was released and minimal dry blood on client’s face was cleaned. Client processed with staff and self-harm precautions with constant LOS was initiated.
- Licensing follow-up: Unannounced licensing visit conducted. Facility was in ratio and no supervision concerns were observed. Client is currently on safety plan and therapist continues to monitor client.
PRLU or OLTC
Complaint, Notice of Incident, Visit Compliance Report
On 3/10/23 the current CEO of the facility had participated, in part, of a restraint hold with a resident although she does not have the proper training and/or certification to do so. The reporter stated that the CEO was using her hand to shield a resident that was in a restraint hold from headbutting staff. The reporter states that the CEO was asked multiple times to allow another staff to assist as she does not have her restraint training. The CEO reportedly refused. The reporter also mentioned concerns about the CEOs comments about the residents. The reporter states that the CEO said, in front of approximately six staff, that she would “love to put her in paper scrubs to humiliate her”. Licensing Specialist: Rachel Carlton.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury 1
- Client was placed in a physical hold after she began scratching herself and attempting to hit her head on the wall. Client was able to regulate emotions and process with staff. Nurse cleaned superficial scratches (minimal bleeding) on client’s forearms, and client was placed on self-harm precautions x7 days with constant LOS.
- Licensing follow-up: Unannounced licensing visit conducted. Client’s current safety precautions were observed at time of visit, and therapist continues to monitor client.
PRLU or OLTC
Notice of Incident, Self-Injury, Visit Compliance Report
- Self-inflicted Injury 2
- Nurse was called to assist due to client standing in a chair with glass in hand from the ceiling lightbulb, and ceiling tiles hanging above her. A physical hold was initiated to retrieve the glass from client, and client also released an object from her mouth. Due to extreme self-injurious behaviors, a one-time IM emergency medication was administered to help de-escalate client. Nurse cleaned 2 new ½-inch superficial cuts on client’s hand. Client will remain on 1:1 observation.
- Licensing follow-up: Facility visited on 03/15/23 and camera footage reviewed (view was limited due to a resident breaking a camera). The facility was in ratio at time of incident, and no supervision failures were observed. Client was observed wearing paper scrubs and programming 1:1 with staff in the comfort room during visit. Facility has made referrals to acute care.
Police Report
Hang Up
911 hang up, no sounds of distress. Upon call back, staff stated there was no emergency.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury
- Client became escalated and began picking on her arms. Client responded to verbal de-escalation after some time, and nurse noted a reopened scab on her wrist and arm with minimal bleeding (area cleaned). Client will remain on 1:1 observation and 1:1 LOS.
- Licensing follow-up: Unannounced licensing visit conducted. DCFS given notice regarding client due to acuity of her behaviors. Client is currently off 1:1 supervision but is restricted to her unit with several peers; Client was observed within LOS of staff.
PRLU or OLTC
Notice of Incident, Suicide Attempt
- Suicide Attempt
- Client pulled the extension cord through the plexiglass around the TV and wrapped it around her hands. After staff removed the cords, client re-escalated and attempted to tie a shirt around her neck. Client was placed in a physical restraint, during which she scratched multiple staff members. Once calm, client was released and no injuries were noted. Client will continue assault and property destruction precautions x7 days and was placed on self-harm precautions with constant LOS x7 days.
- Licensing follow-up: ADON and CEO reported client pulled the extension cord that is secured behind the TV box. Staff are being trained on “imminent risk” to make better decisions about when restraints are appropriate to ensure residents are prevented from self-harming.
PRLU or OLTC
Monitor Visit, Visit Compliance Report
- Licensing Specialist: Michele Sutton.
- Facility in ratio at time of visit. Follow-up on self-reports received prior to visit: 1:1s were being observed per constant LOS self-harm precautions. Facility has started filling gaps between the anti-ligature box and toilets in the bathroom (cited previous week) and will have completed by 03/15/23. Licensing viewed bathrooms and bedrooms with no concerns noted. Staff were interacting calmly with residents and no supervision/safety concerns were noted.
PRLU or OLTC
Notice of Incident, Self-Injury
- Self-inflicted Injury
- In relation to escalated noise on the unit, client used her nails to open old scabs and create a new laceration on her arm. Superficial scratches were cleaned and covered. Client was placed on self-harm precautions with constant LOS x7 days.
- Licensing follow-up: Unannounced licensing visit conducted. Client’s safety plan ended on 03/13/23.
PRLU or OLTC
Notice of Incident, Peer Altercation, Suicide Attempt
- Suicide Attempt, Peer Altercation
- Client became agitated related to not feeling well and attempted to use her shirt as a ligature but was intercepted by staff. Client was placed in a physical hold after multiple attempts by staff to block her from self-harming. Client was able to self-regulate, and no injuries were noted. Approximately 1 hour later, client was involved in an altercation with peers and sustained superficial scratch marks on the side of her neck. The scratches were cleaned, and client was taken to the comfort room. Client was placed in another physical hold after attempting to tie paper scrubs around her neck. Once calm, client was released. Client was placed on assault precautions x7 days and suicide precautions with constant LOS.
- Licensing follow-up: Unannounced licensing visit conducted. Client was restricted to unit within LOS of 2 staff and wearing paper scrubs.