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-Injury

  • Self-inflicted Injury
    • Client used fingernail to self-harm on their forearm. Client was placed in restraint due to not responding to staff and continued self-harm attempts. Once released, the nurse assessed client and noted a superficial wound of scratched skin; The wound was cleaned and covered with gauze.
    • Licensing follow-up: Licensing reviewed therapy notes, nursing notes, safety plans, and referrals for client and observed client within LOS of staff during visit today. Facility has requested client be discharged by 02/03/23 due to lack of progress.

PRLU or OLTC

Notice of Incident, Suicide Attempt

  • Suicide Attempt
    • Client became dysregulated and attempted to enter the kitchen and run off the unit. Client was taken off the unit for new paper scrubs due to a rip in her shirt, and while changing, attempted to tie the scrubs around her neck. Staff removed the scrubs from her neck, and the nurse noted a small bruise to her neck. Client scored high on C-SSRS assessment and will remain on suicide precautions x 7 days.
    • Licensing follow-up: Licensing reviewed safety plan and client was observed within LOS of staff during visit on 01/24/23. Client received individual therapy within 24 hours of incident.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client used tin foil wrapper she took from breakfast to create several superficial scratches to her wrist. Staff intervened and contraband was retrieved. No first aid required. Self-harm precautions extended.
    • Licensing follow-up: Client was observed within LOS of staff during visit on 02/03/23. Standing order to cut/trim fingernails as needed.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client became dysregulated and began scratching at her wrist and the side of her neck. Client then took staff keys, put the lanyard around her neck, and used keys to further scratch her neck. Staff intervened. Superficial scratches noted to wrist and neck; No first aid required. Client scored high on SSRS and was placed on suicide and self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Staff reported the client pulled a break away lanyard of off staff’s neck with key attached. CEO stated she was exploring options to replace lanyards. Client observed to be on LOS during visit on 01/24/23 and received therapy within 24 hours of incident.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 3
    • Client became upset on the unit and began to scream, scratch arms, and attempted to hit head against the wall and floor. Staff were able to process with client. Superficial scratches were observed but required no treatment.
    • Licensing follow-up: Licensing reviewed therapy notes, nursing notes, safety plans, and referrals for client and observed client within LOS of staff during visit today. Facility has requested client be discharged by 02/03/23 due to lack of progress.

PRLU or OLTC

Notice of Incident, Self-Harm

  • Self-harm 1
    • Client became dysregulated and began punching themselves in the nose, and a physical restraint was initiated. Once client was taken off the unit to process with RN, client repeated the same behavior and was placed in another restraint. No injuries were found. Self-harm precautions were extended x 7 days.
    • Licensing follow-up: Client was seen to be within close proximity of staff during licensing visit today. Client on constant LOS and received therapy within 24 hours of incident.

PRLU or OLTC

Notice of Incident, Self-Harm

  • Self-harm 2
    • Client became dysregulated and began punching themselves in the face and attempted to hit their head on the floor and bedframe. A physical restraint was initiated, during which client continued aggressive behaviors. A chemical restraint was then ordered and administered intra-muscularly to client. Client agreed to safe behaviors, and no injury was found. Client remains on self-harm precautions x 7 days.
    • Licensing follow-up: Client was seen to be within close proximity of staff during licensing visit. Client on constant LOS and received therapy within 24 hours of incident.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client found a staple and proceeded to self-harm on forearm. Client was able to process with staff and gave the staple to staff. Superficial cuts were cleaned and bandaged. Client placed on self-harm precautions x 7 days.
    • Licensing follow-up: Licensing visited facility and observed client within LOS of staff in classroom. No contraband was observed in client’s room. Client on constant LOS and received therapy within 24 hours of incident.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client self-harmed with fingernails on her forearm. Client processed with staff and affected area was cleaned. Client placed on self-harm precautions x 7 days.
    • Licensing follow-up: Licensing reviewed safety plans, therapy notes, and discharge referrals for client and confirmed she was within LOS from staff in classroom. Client has received therapy since incidents, and facility is working on discharge plan due to limited progress.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client self-harmed with fingernails on her forearm on area of skin with a scab. Nurse cleaned the affected area, and client was placed on self-harm precautions x 7 days.
    • Licensing follow-up: During visit, licensing observed resident in hallway with nurse and MHP with noiseless headphones and weighted blanket processing.

PRLU or OLTC

Buildings and Grounds, Monitor Visit, Self Report Visit, Visit Compliance Report

  • Licensing Specialist: Michele Sutton.
  • Licensing visited facility and discussed plans to renovate the milieu area with CEO. MARS reviewed with no deficiencies noted. Licensing viewed units, isolation rooms, and grounds. Sharp metal was found on facility grounds, but staff reported residents have not been allowed to use the courtyard, grounds, or gym due to roof being replaced.
  • Follow-up on self-reported incidents: CEO reported individualized behavior plans are being created for residents who exhibit frequent self-harm behaviors. CEO also plans to increase therapy and educational groups on the unit. Staff are receiving training on supervision requirements (1:1, constant LOS).
  • Licensing interviewed 4 residents. Resident reported they don’t have anything to do since not being able to use the grounds or gym. Resident reported facility has locked residents’ puzzles/books in their closets, only allowing 1 item out at a time to prevent clutter; Resident stated they mostly watch TV or listen to music and “the only thing we have to do is fight, so there are a lot of fights.” Another resident stated she was upset that she was moved to a different unit instead of the peer who allegedly touched her, and stated there is “nothing different” about being on suicide and line of sight precautions and stated she is not in LOS of staff at all times.
  • TA –
    • 909.8 – Ensure each child is provided with opportunities for regular recreational activities and exercise; Ensure residents have group recreational activities indoors while grounds are inaccessible. CEO stated they will re-visit policy of locking recreational materials in closets.
    • 901.1 – Ensure the grounds have been examined thoroughly for self-harm implements when construction is completed.

Police Report

Sex Offenses

It was reported Juvenile 1 was tickling Juvenile 2 and then began touching her inappropriately. J1 moved her hand to J2s vagina on top of her clothes. J2 continuously told J1 to stop but J1 did not listen. J2 stated J1 has a crush on her. Child Abuse Hotline was called.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client was found by staff on unit self-harming with object. Staff intervened and noted dry blood and superficial cuts to client’s arms. Client turned in 2 pieces of material from her fidget she was hiding under her bra, and her cuts were cleaned.
    • Licensing follow-up: Licensing visited facility and viewed client’s treatment plan, that included receiving crisis therapy following self-harm incidents. Client’s room was viewed, and no visible contraband was observed.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client became agitated and began punching herself in the face/head. A physical restraint was initiated to prevent further injury. Client was placed on self-harm precautions x 7 days.
    • Licensing follow-up: During unannounced licensing visit, CEO reported staff have been educated on supervision requirements including that true LOS includes proximity to resident.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client became agitated and began punching herself in the nose. A physical restraint was initiated to prevent further injury. Client was placed on self-harm precautions x 7 days.
    • Licensing follow-up: CEO stated individualized behavior plan for resident will be created to address frequency of self-harm behaviors. In the meantime, client is on constant LOS and increased supervision.

Police Report

Sex Offenses

Juvenile 1 indicated that during a hug, Juvenile 2 grabbed her butt. The contact was not wanted by J1. A date for the incident is unknown. Both juveniles were moved to separate units after facility was made aware of the incident. In a separate incident on 1/14/23, J2 licked and sucked on a peers’ (J3) neck. The contact was not wanted by J3. The Child Abuse Hotline was called.

PRLU or OLTC

Notice of Incident, Sexual Contact

  • Peer Sexual Contact
    • Client reported peer “grabbed her breasts” but could not remember specific day it occurred. Facility Corrective Action Plan: Therapeutic group to be conducted by therapists on peer-to-peer boundaries, implement no touching by residents to each other on unit, evaluate room assignments, re-educate staff on appropriate supervision, and impacted residents will process with their therapist. Child Abuse Hotline called, screened out.
    • Licensing follow-up: Licensing spoke with client, who stated it happened while she was in line for dinner. Client stated she was moved to a different unit but would have preferred for her peer to be moved instead. Client confirmed the interventions listed have been implemented.

PRLU or OLTC

Notice of Incident, Self-Injury, Visit Compliance Report

  • Self-inflicted Injury 2
    • Client entered peer’s room and ripped pieces of the sinks wooden liner off, using it to create superficial cuts on arm. Client’s wounds were cleaned by RN.
    • Licensing follow-up: TA was provided during licensing visit on 01/09/23 to ensure this area was repaired with note that repairs were pending. During visit on 01/19/23, the sink area was repaired and the lining was secured.
  • Regs out of compliance –
    • 911.6 – Ensure repairs are completed timely and ensure the safety of the area while repairs are pending.
    • 907.2 – Ensure there is increased supervision in any area with identified safety hazards.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client began hitting their head against the wall, reopening an existing wound. Client’s therapist removed them from the unit and processed with client. The injury was cleaned, and client will continue self-harm precautions x 7 days.
    • Licensing follow-up: Client has been placed on individualized behavior plan.

PRLU or OLTC

Notice of Incident, Sexual Contact

  • Peer Sexual Contact 1
    • Client reported a peer had grabbed her buttocks while hugging goodnight. Facility Corrective Action Plan: Therapeutic group to be conducted by therapists on peer-to-peer boundaries, implement no touching by residents to each other on unit, evaluate room assignments, re-educate staff on appropriate supervision, and impacted residents will process with their therapist. Child Abuse Hotline called, screened out.
    • Licensing follow-up: Licensing attempted to talk to resident, who stated she didn’t want to talk about it and that “way worse things happen here.” Client abruptly exited the room, so licensing was not able to obtain more specific information regarding her concerns.

PRLU or OLTC

Notice of Incident, Sexual Contact

  • Peer Sexual Contact 2
    • Client reported that while side hugging peer goodnight, peer “Sucked, bit” her neck. Facility Corrective Action Plan: Therapeutic group to be conducted by therapists on peer-to-peer boundaries, implement no touching by residents to each other on unit, evaluate room assignments, re-educate staff on appropriate supervision, and impacted residents will process with their therapist. Child Abuse Hotline called, screened out. 
    • Licensing follow-up: Licensing spoke to resident during visit on 01/19/23. She confirmed the incident occurred and stated, “staff do their job and help us and stuff.” No additional follow-up needed at this time.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client used a small piece of wood to make superficial scratches to her forearm. Staff confiscated the wood and client agreed to leave her room. Client then returned to her room and found another piece of wood but was intercepted by staff. Superficial scrapes noted to forearm (nurse care not required). Client placed on self-harm precautions x 7 days.
    • Licensing follow-up: Licensing completed unannounced visit this day and viewed the client’s bedroom and the entire unit, including baseboards and door frames; No problem areas were identified. DON stated the wood was possibly obtained from bathroom in 201 which has since been repaired.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client became overstimulated due to increased sound on the unit and began to hit her forehead against the wall, causing a disruption to an existing wound. RN provided client with noise canceling headphones and took her off the unit to clean her forehead. Client later repeated the same behavior and was deescalated by staff. Client placed on self-harm precautions x 7 days.
    • Licensing follow-up: Facility has developed and individualized behavior plan for this client that includes recognizing signs and symptoms of escalation and responding with specific interventions. Only staff who have signed off on her behavior plan are to work 1:1 with her during escalation.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 3
    • Client became escalated and used her fingernails to open existing wounds on her forearms and create new abrasions; Client refused first aid. Client was placed on self-harm precautions x 7 days.
    • Licensing follow-up: Per CEO, client will received individualized behavior plan to address self-harm behaviors and is currently on safety plan that includes LOS.