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 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 

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 hit their nose with their hand, causing it to bleed. Client processed with staff and the nurse treated and cleaned client’s nose. Self-harm precautions continued.
    • Licensing follow-up: Licensing visited facility and safety plan was observed at time of visit.

PRLU or OLTC

Notice of Incident, Self-Harm

  • Self-harm
    • Throughout the day, client had been biting themselves with staff physically blocking client to prevent injury. Client was successful in biting self but did not cause injury. Client placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Licensing visited facility and safety plan was observed at time of visit. Facility continues to utilize individualized behavior management plan with client.

PRLU or OLTC

Notice of Incident, Self-Injury, Suicide Attempt

  • Suicide Attempt, Self-inflicted Injury
    • Client attempted to place her hands around her neck despite staff physically blocking her, and then began to scratch her forearm with her nails. Client processed with staff, and superficial scratches were noted to client’s forearm. Self-harm precautions continued.
    • Licensing follow-up: Licensing visited facility and safety plan was observed at time of visit.

PRLU or OLTC

Self Report Visit, Visit Compliance Report

  • Licensing Specialist: Chelsea Vardell.
  • No site visit conducted. Licensing received 3 notifications of self-harm incidents after business hours on 02/03/23 that occurred on 01/31/23.
  • Regs out of compliance –
    • 109.1.f – Facility failed to comply with the current Corrective Action Agreement, requiring all self-harm incidents be reported to Licensing by the next business day (3 incidents on 01/31/23).

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client was discovered in the bathroom using a small piece of a paint brush to injure her forearm. Staff intervened, and contraband was retrieved. Nurse cleaned and covered small laceration to client’s forearm. Client placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Licensing visited facility and safety plan was observed at time of visit. 

PRLU or OLTC

Notice of Incident, Self-Injury, Suicide Attempt

  • Suicide Attempt, Self-inflicted Injury
    • Client became dysregulated and placed her hands around her neck and began scratching her forearms with her fingernails. Client processed with staff and client’s nails were trimmed and filed. Nurse cleaned and covered superficial scratch to forearm. Self-harm precautions with constant LOS continued.
    • Licensing follow-up: Licensing visited facility and safety plan was observed at time of visit. 

PRLU or OLTC

Buildings and Grounds, Self Report Visit, Visit Compliance Report

  • Licensing Specialist: Michele Sutton.
  • Licensing completed visit and observed all units within ratio and all residents within LOS of staff. All bedrooms and dayrooms were viewed with no safety hazards noted. Tiles in room 205 and 305 have been repaired. The grounds remain out of use until the roofing project is completed.
  • Facility provided a list of new hires for January 2023 as per CAA requirements and confirmed they no longer use temporary staffing agencies.
  • Licensing followed up on recent self-harm incidents and reviewed safety plan for client who reported hiding contraband behind her bed; Contraband was removed, and facility implemented regular room searches on units. CEO is in process of training all staff on how to complete a thorough room search. Other incidents involving fingernail scratches are being addressed by staff re-training on de-escalation, ensuring residents are engaged throughout the day, and standing orders to trim/cut resident fingernails as needed.

PRLU or OLTC

Complaint Survey

Complaints #AR00029527 and #AR00029530 were in compliance.

PRLU or OLTC

Notice of Incident, Self-Harm, Suicide Attempt

  • Suicide Attempt, Self-harm 1
    • Client was discovered by staff in the bathroom with a sweatshirt tied around her neck. Once staff removed the shirt, client began hitting their head on the wall. Client was able to de-escalate, and no injuries were noted. Client placed on 3-day suicide precautions.
    • Licensing follow-up on 02/09/23: Licensing reviewed camera footage. Facility was cited for 907.2: Client was on constant LOS self-harm precautions due to a previous incident, and staff allowed her to go to the bathroom and left her in the room unsupervised for nearly 4 minutes. Facility has suspended the staff member who failed to provide adequate supervision pending internal investigation. Licensing requested all staff are trained on supervision requirements with an emphasis on safety precaution plan supervision requirements. Staff re-education has occurred and will continue to be ongoing.

PRLU or OLTC

Notice of Incident, Self-Harm, Suicide Attempt

  • Suicide Attempt, Self-harm 2
    • Client became dysregulated and began hitting themselves in the face and placed their hands around their neck to cause injury to self. Client processed with staff, and mild redness was noted to client’s neck (no first aid required). Client placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Licensing visited facility on 02/03/23. Current safety plan was observed at time of visit.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Michele Sutton.
  • Several reports of self-harm incidents from 01/26/23 – 01/27/23 were received on 01/31/23. Facility did not receive copy of signed CAA until 01/30/23, and the ADON only recently (01/27/23) became responsible for reporting incidents. Moving forward, the facility will be cited for any incidents that are not reported within 1 business day of occurrence, and facility will be cited for any incidents that are not reported within the timeframes specified in the Corrective Action Agreement.
  • TA –
    • 109.1.f – Late reporting (6 incidents).

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client began biting herself on her hand, leaving a superficial opening on the top of the skin. Area was cleaned by nurse. Client was placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Licensing cited facility on 02/06/23 for failure to comply with stipulations set forth in the Corrective Action Agreement. Facility visited on 02/09/23; Licensing reviewed client’s safety plan and observed client within LOS of staff during visit. 

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client began picking and opening old scabs on arms. Nurse cleaned area. Self-harm precautions with constant LOS continued.
    • Licensing follow-up: Licensing cited facility on 02/06/23 for failure to comply with stipulations set forth in the Corrective Action Agreement. Facility visited on 02/09/23; Licensing reviewed/observed client’s safety plan during visit.

PRLU or OLTC

Notice of Incident, Suicide Attempt

  • Suicide Attempt
    • Client became dysregulated after arguing with peers and placed their hands around their neck. Client processed with staff and was placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Licensing cited facility on 02/06/23 for failure to comply with stipulations set forth in the Corrective Action Agreement. Facility visited on 02/09/23; Licensing reviewed client’s safety plan and observed client within LOS of staff during visit. 

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client retrieved a metal piece from a clipboard and used it to scratch herself on the forearm. Client was placed in a physical hold to retrieve the contraband. Once released, client handed staff a second piece of contraband. Body and room search was performed, and paper scrubs provided. Nurse cleaned/covered superficial scratch to wrist and reopened scabs on arms. Self-harm precautions extended.
    • Licensing follow-up: Client was observed within LOS of staff during facility visit. Client reported to staff that she had been collecting and hiding contraband in the gap between her bedframe and the wall; Staff removed the contraband from this area, and client was placed on an individualized safety contract.

CWARB, CWARB Actions

Notice of Adverse Action

  • The decision was made by the Child Welfare Agency Review Board to change the facility’s license status from a Regular License type to a Probationary License on 01/25/23, which will remain in effect until 10/25/23.
  • The change of license was based on continued failure to comply with the Minimum Licensing Requirements as well as a formal Corrective Action Agreement dated 06/09/22, in the following areas: Central Registry and Criminal Record Checks, Unprofessional Conduct, Inspections, Investigations, Corrective Action, Behavior Management, and Ratio & Supervision. The Corrective Action Agreement has been extended until 07/25/23.

PRLU or OLTC

Notice of Incident, Sexual Contact

  • Peer Sexual Contact
    • Client reported peer made an unwelcome romantic advance towards her as evidenced by kissing. Child Abuse Hotline was called, not accepted. Corrective Action Plan: Peer processed with therapist on peer-to-peer boundaries, reiterate no touching by residents to each other on the unit, residents room assignment changed for safety.
    • Licensing follow-up: Hotline call screened out. There have been no other reported incidents since intervention has been in place. 05/03/23 update: Call was not screened out but overturned and accepted for investigation. CACD case was unsubstantiated.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client used fingernails to create scratch on forearm. Nurse cleaned and covered the abrasion. Client placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: TA issued on 02/01/23 for all 6 incidents reported on 01/31/23 (late reporting due to nurse quitting). Client was observed within LOS of staff during facility visit and standing order in place to cut/trim nails as needed. 

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client used their fingernails to reopen scabs on their arms and hands. Client processed with staff and nurse cleaned and covered client’s wounds. Client remains on self-harm precautions with constant LOS.
    • Licensing follow-up: TA issued on 02/01/23 for all 6 incidents reported on 01/31/23 (late reporting due to nurse quitting). Facility visited on 02/03/23; Client was discharged from facility to a more appropriate setting due to severity of behaviors.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 3
    • Client created abrasion on her forearm using her fingernails. Nurse cleaned and covered the area, and client was placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: TA issued on 02/01/23 for all 6 incidents reported on 01/31/23 (late reporting due to nurse quitting). During facility visit on 02/03/23, client was within LOS of staff and standing order in place to cut/trim fingernails as needed.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 5
    • Client began using fingernails to scratch scab on forearm. After staff attempted blocking techniques, client became agitated and began punching themselves in the head and face. A physical hold was initiated. Afterwards, nurse noted abrasion to client’s arm that client refused to have cleaned/covered. Self-harm precautions with constant LOS continued.
    • Licensing follow-up: TA issued on 02/01/23 for all 6 incidents reported on 01/31/23 (late reporting due to nurse quitting). During facility visit on 02/03/23, client was within LOS of staff and standing order in place to cut/trim fingernails as needed.

Police Report

Notice of Incident, Self-Injury

  • Self-inflicted Injury 4
    • Client was placed in a physical hold due to using their fingernails to self-harm on their hands and forearms. A new abrasion was noted on client’s forearm, and the area was cleaned and covered. Self-harm precautions with constant LOS continued.
    • Licensing follow-up: TA issued on 02/01/23 for all 6 incidents reported on 01/31/23 (late reporting due to nurse quitting). Facility visited on 02/03/23; Client was discharged from facility to a more appropriate setting due to severity of behaviors.

PRLU or OLTC

Special Visit, Visit Compliance Report

  • Licensing Specialist: Michele Sutton
  • Licensing met with staff to review the corrective action agreement. After review, staff were provided instruction on reporting requirements for incidents. A copy of the CAA will be sent to the facility on 01/30/23 for signature.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client used fingernails to pick at their hand and wrist. Nurse cleaned and covered area. Client placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Client was observed within LOS of staff during licensing visit. Standing order in place to cut/trim fingernails as needed.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client told staff “I found a new way to self-harm” and explained when they snap their fingers close to their forearm, their fingernail will cause a scratch. Nurse cleaned and covered 2 superficial scratches to client’s arm. Client was placed on self-harm precautions with increased LOS x 7 days.
    • Licensing follow-up: TA issued on 02/01/23 for all 6 incidents reported on 01/31/23 (late reporting due to nurse quitting). Client was observed within LOS of staff during facility visit and standing order in place to cut/trim fingernails as needed.