*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
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:
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
Police Report
Juvenile Complaint, Sex Offenses
Report received from ASP investigator: Juvenile reported the facility is a violent place, people have hit her, and someone touched her vaginal area (she did not state whether it was staff or residents). Upon being interviewed by investigator, juvenile denied anyone touching her inappropriately, but did state residents fight and staff don’t intervene.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
AV is [REDACTED], who is in DHS custody and is a patient at the Perimeter Behavioral Health of the Ozarks. AO is unknown. Client said that the facility is a violent place. She said that people at the facility have hit her, but she did not specify staff members or other patients. She was asked if she feels safe at her facility. She said she does not feel safe there, because someone at the facility has touched her vaginal area. She did not say whether the person who touched her was a patient or staff member, but she said the touching was not consensual. She did not give an age for the person who touched her or give a timeframe from when it happened. Reporter was asked if [REDACTED] seemed to be referring to an incident that has already been reported, and reporter said, “No.” Reporter said [REDACTED] seemed nervous to talk about what happened because facility chaperones were present with her as she spoke. Licensing Specialist: Rachel Carlton.
PRLU or OLTC
Notice of Incident, Peer Sexual Contact, Visit Compliance Report
A/V reported that she and the A/O were roommates, and that the A/O digitally penetrated her three times. Licensing Specialist: Chelsea Vardell. Regulations out of compliance: 109.1.f – Unprofessional conduct in the practice of child welfare activities shall include, but not limited to the following: Failing to comply with any stipulation or agreement with the Board involving probation or a settlement of any disciplinary matters. 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 the owner/operator, employee, foster parent, volunteer, child, or other person in a child welfare agency.
PRLU or OLTC
Visit Compliance Report
Blue Hall and Green Hall observed. All areas observed furnished, clean and in good repair. Bathrooms clean and sanitary with functioning sinks, toilets and showers.
PRLU or OLTC
Notice of Incident, Self-Harm
On 4/24/23 at approximately 2010, resident used a piece of plastic to rub off old scabbing on forearms. RN called to unit for support. RN processed with resident and resident gave up contraband. This event resulted in minor bleeding that was tended to by nursing. No further incident occurred. Resident has since been placed on a self-harm precaution safety plan with constant line of sight. Therapist will determine appropriate duration and individualization of safety plan.
PRLU or OLTC
Notice of Incident, Peer Altercation, Self-Harm
On 4/19/23 at approximately 1715 while on the unit, resident was involved in a verbal altercation with a peer that progressed to a brief physical altercation. Staff was able to intervene promptly to separate the residents. After this event, resident began scratching her arm with her fingernails. Staff was able to intervene and verbally de-escalate the resident. No skin was broken from scratching, and the area was noted to be slightly reddened. No nursing care was needed. Because of this event, resident was placed on a self-harm precaution safety plan with constant line of sight. Clinical will decide the appropriate amount of time for these precautions and determine if individualization of safety plan is needed.
PRLU or OLTC
Complaint Survey
Complaint #AR00029928 was in compliance.
PRLU or OLTC
Notice of Incident, Self-Harm
On 4/15/23, resident approached RN stating she needed some bandages because she “self-harmed in the shower.” Resident noted to have superficial cuts to her left forearm, per RN. When asked what she used, she reported that she used her fingernails. No first aid required. Resident placed on a self-harm precaution safety plan with constant line of sight as a result of this event.
PRLU or OLTC
Maltreatment, Notice of Incident, Visit Compliance Report
Date/Time of incident: 04/11/2023, approximately 1930. On 4/13/23, it was reported by [Redacted] that Staff 1 placed her into a physical hold in her bedroom, leaving scratch marks on right hand. Staff 2, witness, reported that no physical hold occurred. Due to the allegation, a hotline call was placed, and a report was taken and accepted (Ref #REDACTED). Staff 1 has been suspended, pending completion of state investigation. Immediate Actions Taken: Camera footage reviewed, statements provided, right hand assessed, captured, and documented by Nursing, Arkansas Child Abuse Hotline called. (Report accepted, Ref # REDACTED) Staff 1 suspended pending completion of investigation. Licensing Specialist: Clayton DeBoer.
PRLU or OLTC
Notice of Incident, Self-Harm
At approximately 1735, resident became dysregulated while on the unit. Staff attempted to verbally deescalate, but resident continued to escalate. She then obtained a calculator from a peer’s belongings, broke it, and began using a piece to attempt to self-harm with on her right wrist. Staff support was called, and the items were removed from the resident’s possession. Staff remained with resident afterwards to process event, and resident was able to regulate without further incident. There was a small superficial wound on resident’s right wrist not rendering nursing care. Because of this event, resident will be on self-harm precautions with constant line of sight.
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, and 2/6/23.
PRLU or OLTC
Notice of Incident, Suicide Attempt
It was reported to RN by therapist that resident self-reported that she had been hoarding her medication ion a cup in her bedroom and took them all together the previous night. Upon assessment of resident by RN, there were no deviations from baseline as far as mental, cognitive, or physical functionality. Residents room was searched, no contraband found. No camera footage availed upon preview. In order to prevent recurrence resident will be required not to be wearing long sleeves during medication passes. Since her current medications cannot be crushed (per APRN), thorough mouth checks will be conducted after each medication pass. Per APRN, restrict bathroom for one hour after all med pass throughout the day/night. therapist preformed c-SSRS, scoring resident high risk. As a result, resident was placed on suicide precaution safety plan with constant line of sight until further determination by therapist.