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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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.

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.  

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client became defiant, argumentative with staff, and began kicking doors. Nurse was able to de-escalate client and cleaned superficial scratches to client’s forearm from self-harming. Client was placed on self-harm precautions with constant LOS until seen by therapist.
    • Licensing follow-up: Unannounced licensing visit conducted. No additional incidents were reported since this incident, and facility was in ratio at time of visit with no supervision concerns noted.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • During med pass, nurse noted scabs on client’s arm had been picked open. Client stated she managed to open some of them with contraband before it was taken by dayshift staff. Nurse cleaned wounds and client was placed on 1:1 observation and will continue 1:1 LOS.
    • Licensing follow-up: Unannounced licensing visit conducted. Client is off 1:1 precaution but it restricted to the unit within LOS of staff. Notice given to DCFS due to acuity of client’s behaviors.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 3
    • Client reported she had hidden and used her nail to create a small wound on her arm. Superficial wound was cleaned and covered. Client was placed on self-harm precautions x7 days with constant LOS.
    • Licensing follow-up: Unannounced licensing visit conducted. Client’s self-harm precautions expired.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client escalated and began punching walls, trying to pull sockets out of the wall, and continuing to pick open her scabs. Client was given an IM medication, and client was able to calm down in the comfort room with staff assistance. Nurse assessed and treated minor opened scabs (minimal bleeding). Client will continue 1:1 LOS.
    • Licensing follow-up: Licensing observed client programming 1:1 with staff during facility visit. Facility has made multiple acute care referrals.