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, 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.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 3
    • A physical hold was initiated after client began using fingernails to self-harm on forearm and began hitting themselves in the head. Reopened scab on client’s forearm was cleaned and covered. Client was placed on self-harm precautions with constant LOS x 7 days.
    • Licensing follow-up: Client was observed within LOS of staff during facility visit on 02/03/23. Client processed with therapist, and standing order is in place to cut/trim fingernails as needed. CEO stated facility is educating staff about different de-escalation interventions and working on programmatic changes to keep residents engaged during the day. 

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 4
    • Client used a small piece of rubber they had ripped off their notebook to rub on their arm. Staff retrieved the item, and reopened scabs on forearm were cleaned and covered. Client placed on self-harm precautions with constant LOS x 7 days.
    • 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.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client was placed in a physical hold after biting themselves and using fingernails to self-harm. Upon assessment, nurse noted scabs were reopened and the area was cleaned and covered. Self-harm precautions with constant LOS extended.
    •  Licensing follow-up: Client has been discharged from facility to a more appropriate setting due to severity of behaviors.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 2
    • Client used fingernails to re-open scab on their forearm. 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 facility visit on 02/03/23. Client processed with therapist about incident, and standing order is in place to cut/trim fingernails as needed. CEO stated facility is educating staff about different de-escalation interventions and working on programmatic changes to keep residents engaged during the day.

PRLU or OLTC

Corrective Action Agreement

  • Update: Additional support is needed, therefore, CAA agreed upon on 06/09/22 will be extended for a minimum of 6 months (07/25/23) up to 1 year.
  • The additional non-compliance areas have been cited during the past 6 months:
    • Section 103 (Central Registry and Criminal Record Checks) – Facility cited on 10/03/22.
    • Section 910 (Grounds) – Facility cited on 12/29/22.
    • Section 911 (Buildings) – Facility cited on 07/20/22, 11/17/22, 12/29/22, 01/19/23.
    • Section 912 (Bathrooms) – Facility cited on 07/20/22.
    • Section 907 (Ratio and Supervision) – Facility cited on 06/22/22, 10/03/22, 11/03/22, 11/23/22, 12/29/22, 12/29/22, 01/19/23.
    • R109.1.f (Unprofessional Conduct) – Facility cited on 12/27/22.
    • R109.1.g (Unprofessional Conduct) – Facility cited on 06/20/22, 09/01/22, 09/16/22, 10/03/22, 10/17/22.
    • R110.9 (Inspections, Investigations, & Corrective Action) – Facility cited on 10/03/22.
    • R110.12 (Inspections, Investigations, & Corrective Action) – Facility cited on 08/12/22, 08/16/22, 10/05/22.
    • R110.14 (Inspections, Investigations, & Corrective Action) – Facility cited on 06/20/22.
    • R110.17 (Inspections, Investigations, & Corrective Action) – Facility cited on 08/12/22, 10/07/22.
  • Facility is required to complete the revised corrective actions provided.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury 1
    • Client began hitting herself in the nose repeatedly, then began to pick at a scab on her arm. Client was able to process with staff, and no first aid was required. Self-harm precautions extended.
    • Licensing follow-up: Facility visited on 02/03/23, and client was observed within LOS of staff during visit. 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 using their fingernails to scratch their hand, then began biting their knees. Client was restrained; Once released, nurse assessed client and noted scratch to wrist and several bite marks on knees (no first aid required). Self-harm precautions extended.
    • Licensing follow-up: Client has been 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 was placed in a physical hold after banging her head against the wall. Client will continue self-harm precautions with constant LOS.
    • Licensing follow-up: Client is on individualized behavior management plan, and licensing observed staff using treatment modalities in plan during visit on 01/24/23. No further incidents have been reported since 01/26/23, and client was observed within LOS of staff during 02/03/23 visit.

PRLU or OLTC

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

  • Licensing Specialist: Michele Sutton.
  • Licensing viewed blue, orange, and green units, classrooms, cafeteria, and grounds. Grounds are not in use due to roof replacement with the presence of sharp metal, nails, and screws on the grounds. Bathrooms in 305 and 205 have tiles needing replaced, but they were secured and did not present a safety hazard. Going forward, non-safety issues will not be cited as long as the furnishings and materials are functional and do not pose a risk to the physical and psychological comfort or safety of children.
  • Licensing viewed safety plans for 4 residents with more than 1 self-harm attempt over the last 5 days. Safety plans were in place and each resident was within LOS/proximity of staff during visit. Each resident had documentation of an individual therapy visit within 24 hours of incident(s), and 1 resident has been referred for discharge due to lack of progress.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client used fingernails to self-harm on their forearm; Staff used blocking techniques to prevent further self-harm. Nurse noted client had reopened wounds from previous self-harm incidents; First aid provided. Client will continue self-harm precautions x 7 days.
    • Licensing follow-up: Licensing reviewed safety plan and client was observed within LOS of staff during licensing visit. Client has received therapy since the incident and the facility is working with MT DHS on a discharge plan for client due to limited progress.

PRLU or OLTC

Notice of Incident, Suicide Attempt

  • Suicide Attempt
    • Client reported to staff that while in the bathroom, she tied an article of clothing around her neck. Slightly reddened marks were noted around client’s neck that quickly dissipated. Client was placed on suicide precautions with constant LOS x 7 days.
    • Licensing follow-up: Facility visited, and all residents were within LOS of staff during visit. No additional self-harm incidents have been reported for this client.

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.