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

  • ER Visit (Possible Seizure)
    • Staff reported they saw client in the hallway when she began shaking. Client’s eyes rolled back, and she fell onto the floor striking the back of her head. EMS was called and transported client to the ER.
    • Licensing follow-up on 6/3/22: Client was seen at the ER and medically cleared to return.

PRLU or OLTC

Notice of Incident

  • ER Visit (Self-inflicted Injury)
    • Client stated she inserted a piece of metal into her stitched wound on her hand. Staff then observed client insert another piece of metal quickly into the wound before staff could stop her. Client was taken to ER.
    • Licensing follow-up on 6/3/22: It was determined where the metal came from, and the object was removed from the unit. The client’s wound was cleaned and bandaged at the hospital and the client returned to the facility.

PRLU or OLTC

Notice of Incident

  • ER Visit (Sprayed by Sprinkler)
    • Client was sprayed in the face by the sprinkler system after a peer broke the sprinkler, setting off the alarm. Client reported that when she was sprayed, she passed out onto the floor. Client was taken to ER.
    • Licensing follow-up on 6/3/22: Client was seen at the ER and medically cleared to return.

Police Report

Assault

Caller advised juvenile was assaulting staff members. Upon officers arrival, juvenile was yelling as staff members were restraining her. Officer asked staff to release juvenile, and juvenile advised she became upset after smelling smoke and reporting it to staff, who would not listen. Staff reported they could not smell the smoke, and restrained juvenile after she attempted to jump into the nurse’s station. Two staff advised juvenile kicked/punched them.

PRLU or OLTC

Notice of Incident

  • ER Visit (Self-inflicted Injury)
    • Client cut herself with a piece of glass while in the shower and shoved the glass into the open wound. Client was taken to ER.
    • Licensing follow-up on 6/2/22: Specialist emailed facility to determine if client was sent to acute, and how the client was able to obtain glass to self-harm with. Facility reported the client did not go to acute care, and client stated she found the glass in the “calm down room”, but there is no window and staff were unable to locate any glass. Client received 5 stitches to the wound. On 6/3/22, Licensing viewed the buildings and grounds, but was unable to locate any loose glass.

PRLU or OLTC

Notice of Incident

  • ER Visit (Self-inflicted Injury)
    • Client was found to have cut herself with a floor tile from the bathroom. The client opened previous wounds on her arms and extended the wound. Client was taken to ER.
    • Licensing follow-up on 5/27/22: Specialist emailed the facility regarding the progress of the bathroom tile repair, since the same client cut herself with a different tile 3 weeks prior. The facility reported 1 quote has already been received and they are waiting for 2 other quotes to be completed.

PRLU or OLTC

Notice of Incident

  • Arrest
    • Client attacked 3 staff members in a classroom, beating on the walls and throwing water jugs at staff. The police were called, and the client was taken into custody and placed with JDC. No follow-up details.

PRLU or OLTC

Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Facility visited from 10:30am – 12:00pm. Census: 32. MARs checked for multiple residents.
  • Regs out of compliance –
    • R912.4 – Paper trash sacks are being used as garbage receptacles in bathrooms. Some of these trash sacks had garbage overflowing. Due date and correction date: 5/10/22. Staff stated he is researching a garbage receptacle that cannot be used to self-harm.
    • R911.6 – Shower basins have pulled up tiles (tiles approx. 2×2 inches) that have been filled with concrete. Shower tiles around the drain are cut in a way that they could be used to cut or cause harm to clients. Due date: 6/10/22. Staff stated he is researching having the shower basins replaced.

PRLU or OLTC

Notice of Incident

  • Suicidal
    • Client was found in bathroom with broken tile and large gash to left forearm. The tile was removed, and first aid administered. Client was sent to ER and received 7 stitches to her arm. Safety plan in place. Client on constant Suicide Risk for 7 days.
    • Licensing follow-up on 5/10/22: Facility visited, and shower basin observed. The tiles surrounding the drain have been removed and filled with concrete. The tiles surrounding the drains of all the showers observed today but one, are cut in such a way that they could be used for self-harm. Staff stated he is researching having the shower basins replaced.

PRLU or OLTC

Notice of Incident

  • ER Visit (Sputum Blood)
    • Client was coughing for 2 days when staff noted blood in her sputum and no improvement of symptoms. Client was taken to ER. No follow-up details.

PRLU or OLTC

Visit Compliance Report

  • Licensing Specialist: Chelsea Vardell.
  • Census: 31. Specialist conducted facility visit from 1240 – 1525. MARs reviewed for 3 residents. Residents on the blue unit mentioned concerns about rats, spiders, mold, and lack of hot water. Residents also complained of a staff member who they reported makes them feel uncomfortable. One resident reported “[staff member] always stares at our butts.” Residents reported they do file grievances, but no one ever comes and talks to them about it. Licensing spoke to staff about residents’ concerns: Concerns about pest control are being addressed by the pest control company that visits the facility a minimum of 2x/month. Concerns of mold were checked, and one room was found to have mold in the shower. Concerns of staff and grievances were discussed, and staff stated he receives the grievances and will follow up with the residents. Specialist discussed with staff how to ensure residents have access to file concerns.
  • Regs out of compliance –
    • R911.6 – Outlet cover was broken off in the hallway of the blue unit. Mold was visible in the ceiling of the shower in room 303. Due date 4/15/22.
  • Regs not correctable –
    • R907.3 – Ratio on blue unit was 10 residents to 1 staff. Staff reported that no other staff was scheduled to the unit and only 1 staff is “always” assigned to the unit. Ratio on green unit was 9 residents to 1 staff. Staff reported that no other staff was scheduled to the unit and due to the facility being short staff there has been only 1 staff assigned to the unit in recent weeks.
    • R908.8 – MARs for client had medication documented as administered at 16:00 even though it is currently 14:10.

PRLU or OLTC

Revisit Survey, Validation Survey with POC

  • A validation survey was conducted 4/4/22 to 4/7/22.
  • Regs out of compliance –
    • N 131 – Facility failed to ensure chemical restraint and seclusion were not used simultaneously for 1 resident.
    • N 143 – Facility failed to ensure a physicians order for a physical restraint was signed by the physician for 1 resident.
    • N 207 – Facility failed to ensure serious occurrences were reported to the Office of Long Term Care and Disability Rights Arkansas were notified after suicidal attempts taken by 2 residents.
  • Plan of Correction – Retraining on restraints/seclusion, review of policies, operational rule for review of all ESIs, review of serious occurrence incidents for compliance with reporting with goal of 100% compliance monthly for 4 months.
  • A revisit was conducted on 5/9/22 for all deficiencies cited on 4/7/22. All deficiencies have been corrected, and no new noncompliance was found.

Police Report

Hang Up

911 open line from landline, in the background could hear someone yelling “help” a few times and then phone disconnected. No answer on call back. Officer arrived on scene; Juveniles had got a hold of the telephone, no emergency here.

PRLU or OLTC

Children's Records Review, Visit Compliance Report

  • Licensing Specialist: Chelsea Vardell.
  • Specialist conducted facility visit from 1220 – 1515. Facility CEO reported that repairs to the facility are proceeding, and the floors are being resurfaced today. Specialist completed record review for 5 clients.
  • Regs out of compliance –
    • R902.13 – Three clients missing immunization record, birth certificate & social security card. Two clients missing birth certificate & immunization record. Due date: 4/29/22.
  • TA –
    • R902.10 – Specialist provided education to staff on what information is required at the time of admission.
    • R902.12 – Specialist provided education to staff on what intake information should be gathered within ten days of admission.
  • Regs not correctable –
    • R903.4 – Client did not have a Master Treatment Plan in her chart. Client has been admitted for more than 30 days.
    • R905.17 – Restraint justification packet for client that was conducted on 11/20/21 would not be located.

PRLU or OLTC

Notice of Incident

  • Elopement
    • Client began to wake up peers and was able to set off a fire alarm in room 302 causing the magnetic locks to disengage and doors on the unit to open. Client then eloped from facility out the main unit door, and 2 peers eloped off green and orange units. Law enforcement was contacted to assist in finding the 3 residents.
    • On 3/25, Specialist discussed the incident with the facility and staff reported they will be discharging client who has encouraged elopements by residents at the facility.

Police Report

Assault

Officer responded after a juvenile pulled the fire alarm, allowing 3 juveniles to escape. Upon arrival, officers observed all doors unlocked, multiple juveniles yelling, and staff members running around attempting to restore order. Staff were eventually able to get the remaining juveniles into their rooms. A juvenile advised officer that J1 (who ran away) threatened to kill her, so she barricaded a door out of fear. Officers located the 3 juveniles, and J1 was transported to JDC.

PRLU or OLTC

Notice of Incident

  • ER Visit (Strep Symptoms)
    • Client taken to ER after exhibiting strep-like symptoms.
    • Follow-up pending; Facility will follow-up with further information after discharge.

PRLU or OLTC

Notice of Incident

  • ER Visit (Vomiting)
    • Client taken to ER due to vomiting multiple times. Client could not hold any fluids or medications down.
    • Specialist was at the facility on 3/23 for licensing visit and was notified of the incident by the Director of Nursing. Specialist did not receive detailed incident report until 3/26.

PRLU or OLTC

Visit Compliance Report

  • A visit was conducted to check facility issues that were discussed the week before. All halls were cleaner than before, and no issues were found with toilets. Overall, the rooms and facility were in much better shape than last time.
  • Regs out of compliance –
    • R912.4 – Room 103 bathroom had some trash on the floor. (Due Date: 3/17/22)
    • R911.6 – Blue Hall had a dirty pile of towels on the floor walkway when walking in. A laundry bag was next to the pile. It was discussed that staff should be making sure clients put towels in bag (Due Date 3/17/22). Outlet on wall of hall was missing a cover (replaced on the spot).

PRLU or OLTC

Notice of Incident

  • Acute Care Placement
    • Client was placed in acute care after becoming upset during an attempted elopement on 3/12/22.
    • Specialist followed up on 3/15 regarding the elopement: Staff informed specialist they were attempting to placement for client.

PRLU or OLTC

Notice of Incident

  • Attempted Elopement
    • Client set off the fire alarm in her restroom to disable the locked doors on the unit. Client, along with peer on the orange unit, ran out the exit doors to elope.
    • Staff pursued the residents and were able to reach them while still on facility grounds. Clients returned to the facility willingly. Specialist followed up on 3/15 to determine if client was ever placed in acute care.

Police Report

Disorderly Conduct

Juvenile pulled fire alarm and attempted to elope; Staff brought juvenile back, no assistance needed.

PRLU or OLTC

Notice of Incident

  • ER Visit (Ingested Plastic)
    • Client taken to ER after reporting she had swallowed 7 pieces of plastic and placed 4 pieces of plastic in her vagina. No follow-up details.

PRLU or OLTC

Visit Compliance Report

  • Buildings and grounds walkthrough conducted. The agency reported they have now hired a full-time housekeeper who is currently in orientation. Facility reported they will ensure the issues found are repaired immediately themselves instead of waiting for the owner of the building to repair them.
  • Regs out of compliance –
    • R912.4 – Restrooms were seen in poor condition with toilet paper on the floor, a used tampon on the back of the toilet, and hair all over the sinks. The toilet in Room 105 was clogged. Visible mold seen in the bottom of the shower in room 305. (Due Date: 3/9/22)
    • R911.6 – Dayroom and bedrooms in blue unit were messy with debris and used food wrappers on the floor. Dayroom and bedrooms on orange unit also in disarray. Amazon boxes seen in several rooms, and staff stated they were used by the girls for personal storage or as a trash can for their rooms. Profanity seen on the ceiling of bedroom (derogatory remarks about facility). The green unit had baseboard trim peeling from the wall in the dayroom. Water damage from a previous roof leak on the ceiling of the dayroom is currently being covered by a board (staff reported there is an order to fix the drywall). A shower still had several missing tiles (staff reported the tile replacement is the responsibility of the owner of the building they lease from; There has been an order to fix this for almost 1 year now without repair). The dining room area had baseboard trim falling off the wall (wall behind trim is rotted). (Due Date: 3/9/22)