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

  • ER Visit (Abdominal Pain)
    • Client reported abdominal pain and constipation on 1/18. Laxatives were ordered to be given throughout the day with no success. The client reported continued pain on 1/19 so the client was taken to ER. No follow-up details.

PRLU or OLTC

Personnel Record Review, Visit Compliance Report

  • Specialist completed 8 personnel record reviews.
  • Regs out of compliance –
    • R105.15.c – Staff member (1) does not have verification of his qualifications in his file.
    • R105.5 – Staff member (1) does not have verification of CPR/First Aid training.
    • R105.4.c – Staff members (2) have no documentation in their charts that they have been trained on the agency’s fire and disaster plans.
    • R105.15.h – Staff member (1) only had 1 of her 3 needed personal references.
    • R105.4.a – Staff member (1) does not have verification of training on confidentiality in her chart.
  • TA –
    • R105.10 – Please ensure that training documentation for personnel records dictates what trainings are “psychiatric specific” as standard R105.10 states each child caring staff should complete ten hours of psychiatric specific training before being counted in the child/staff ratio.
  • Regs not correctable –
    • R103.8 – Seven staff members did not have their initial background checks initiated within 10 days of their hire.

PRLU or OLTC

Notice of Incident

  • Complaint
    • Licensing Specialist received a complaint called in from a client’s guardian, alleging they believe there are pictures of the child on social media accounts, the facility gave client antibiotics without guardian’s consent, and the client had what the facility reported as “spider bites” all over her (guardian believes to be staph infection).
    • Specialist attempted to call the individual who provided the information, but no call was returned. Specialist conducted a visit to facility on 12/20 to review client’s chart, which stated client complained of a single sore on her stomach. The physician was notified and reported it to be a suspected spider bite. Client was prescribed antibiotics and consent was given via telephone by client’s father. Due to no proof of the social media photo, the agency will complete re-training of the social media confidentiality policy with all staff to ensure compliance.

PRLU or OLTC

Visit Compliance Report

  • Regs out of compliance –
    • R912.4 – Trash in bathrooms, dirty floors and sinks. Please ensure shower curtains are hung up and each bathroom has a trash receptacle that is emptied daily.
    • R911.6 – Several bedrooms had excessive amounts of trash. No trash receptacles in bedrooms.
    • R913.5 – Please ensure all beds have sheets.

Medicaid Inspection of Care

Inspection of Care Report

  • Included: IOC, CAP
  • Deficiencies noted. Plan of Correction required to be completed within 30 days.

PRLU or OLTC

Notice of Incident

  • ER Visit – Intestinal Blockage
    • Resident was experiencing stomach pain for a few days when it suddenly increased on the night of 9/21/21. Client was taken to ER for further evaluation.
    • Follow-up 9/22/21: Resident is still currently in the hospital and will be kept overnight again tonight to continue monitor her condition which has been identified as an intestinal blockage.

Police Report

911 Hang Up

911 Hang up from landline; Immediate disconnect. No voices heard. On callback there is no answer at the nurses station. Accidental.

Police Report

Physical Fight in Progress

Caller reported riot was taking place and they do not have the staff to calm everyone down (7 staff members); Fighting at Nurses Station and in the unit. Caller reported there are 2 adults trying to restrain Juvenile. Unknown why they are fighting.

PRLU or OLTC

Notice of Incident

  • Arrest
    • Resident was acting out trying to hit other residents and staff, pulled down one of the lights on the unit breaking the bulbs from it, and destroyed the door on the fire extinguisher cover. The decision was made to contact the police for further assistance.
    • Specialist emailed CEO to determine additional details and staff interventions before police were called. Specialist discussed in emails with CEO details regarding the resident’s discharge and if she was arrested. No video footage of the incident was available.

Police Report

Assault

Caller reported that Juvenile assaulted 3 employees and spit in their faces. No injuries.

PRLU or OLTC

Visit Compliance Report

  • Specialist reviewed 8 children’s records and discuss the policies and procedures for the agency that were reviewed.
  • Regs out of compliance –
    • R102.4 – Agency does not currently have a policy governing the use of cameras for security or surveillance purposes. Please ensure policy includes everything outlined in section R102.4 of the Minimum Licensing Standards. Once the policy has been created/amended it will be provided to the Licensing Specialist for review.
  • TA –
    • R902.13 – Birth Certificates and social security cards were missing for 4 residents. Immunization records were missing for 4 residents.
    • R102.8 – The list of Board of Directors should also include addresses of the board members. A new list of the Board of Directors with their addresses will be provided by 9/9/21.

PRLU or OLTC

Visit Compliance Report

  • Specialist viewed full buildings and grounds; Reviewed MARs for 3 residents. Specialist requested policies and will review the documents and ask any additional questions tomorrow during an additional visit to the facility.
  • TA –
    • R907.3 – Please ensure that if staff is delayed in coming to work or calls in that additional staff are present and have correct training to be counted in the staff/child ratio.
    • R911.6 – Specialist discussed the broken or missing tiles located in the showers of some bathrooms of resident rooms. The facility reports there is no plan currently to replace them. Specialist requested the tiles to be repaired or replaced in all residents restrooms that require maintenance.

PRLU or OLTC

Visit Compliance Report

  • Specialist discuss incident in which staff pushed resident during an altercation. Specialist reviewed camera footage which shows staff grabbing the resident by the arms and throwing her into a wall forcibly. The resident falls to the ground after hitting her face on the wall. Additional staff can be seen coming into the hallway and standing in the hallway while the resident and staff continued to argue.
  • The additional staff member did not report the incident and no other staff were made aware until staff member notified his supervisor. Staff member was placed on administrative leave pending an internal investigation. After video was reviewed, it was decided staff would be terminated.

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • Staff allegedly pushed resident in the hallway of her unit the night of 8/11/21. Child Abuse Hotline was called, accepted, but unsubstantiated.
    • Staff member was placed on administrative leave on 8/12/21 once staff were made aware of the incident. Specialist reviewed the camera footage on 8/20/21 in which staff can be seen grabbing the resident by both arms in the hallway of her unit and throwing her into a wall. The resident hits her face on the wall and falls to the ground. Specialist called to report the incident again and it was accepted for investigation.

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • During a verbal altercation, staff allegedly stated to resident “If you were my child, I would spank you”. Additionally, the resident claims the staff spanked her. Child Abuse Hotline was called, not accepted.
    • Staff was placed on suspension 8/13/21 and 8/14/21. Specialist visited facility to discuss incident with staff; The staff member has been retrained on the agency’s trauma informed behavior management policy, SAMA, and a copy of her corrective action has been placed in her personnel file. Video footage does not show the staff member ever spanking resident and staff denies hitting the resident. Staff does admit to making the statement that she would spank her.

PRLU or OLTC

Visit Compliance Report

  • Completed facility walkthrough and reviewed 2 MARs; Specialist discussed incident between staff and resident and reviewed camera footage.
  • Regs out of compliance –
    • R912.4 – Ensure restrooms are kept clean; Correction date 7/9/21.
    • R911.6 – Inappropriate language wrote on the bathroom doors for Blue Unit, Orange Unit, and Green Unit.
  • Regs not correctable –
    • R905.9 – Staff did not use minimal force necessary when initiating a restraint hold on resident.
    • R905.12 – Staff placed resident in seclusion without orders by a physician.

PRLU or OLTC

Complaint Survey with POC, Revisit Survey, Workload Report

  • Complaint #AR00026825 substantiated.
  • Regs out of compliance –
    • N 126 – Facility failed to ensure seclusion was not used as a form of retaliation and/or discipline for 1 resident.
    • N 216 – Facility failed to ensure all staff were trained not to use restraint and/or seclusion for disciplines, retaliation, coercion or convenience after an incident with 1 client who was forcefully placed in seclusion.
  • Plan of Correction: Employee involved in restraint was terminated; Changes to policy for reviewing restraints, retraining for staff on restraint, seclusion, and de-escalation.
  • 08.16.21 Revisit, Facility in compliance with program requirements.
  • Survey Team Composition and Workload Report –
    • Surveyor 1 onsite 11 hours 8am – 6pm; 6.5 travel hours, 0.5 off-site report prep hours (07/07/21 – 07/08/21).
    • Surveyor 2 onsite 0.5 hours 8am – 6pm; 6 travel hours, 0.5 off-site report prep hours (07/08/21).
    • Surveyor 1 onsite 3.5 hours 8am – 6pm; 4 travel hours, 0.5 off-site report prep hours (08/16/21).
    • Surveyor 2 onsite 3.5 hours 8am – 6pm; 4.5 travel hours (08/16/21).

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • Resident was grabbed from behind by staff member, picked up off the ground and swung into the seclusion room. Staff released the resident with excessive force and the resident hit the floor and slid into the wall. Staff then kicked the resident’s shoe into the room and closed the door.
    • Staff member was placed on immediate leave in which his keys and fob were obtained pending the results of the investigation. Resident was assessed by staff RN and found to have a wound to her forehead. RN stopped the bleeding, applied band-aid, and performed neuro checks with no negative outcomes. Child Abuse Hotline was called and accepted.

Police Report

911 Hang Up

No sounds of distress; Called back and spoke with individual at facility, who stated she was working and had to hang up.

Police Report

Citizen Assist

Caller stated no one would let her know if Juvenile made it to Perimeter where he was transferred. Officer spoke with employee at Perimeter, who stated Juvenile was there, safe, asleep, and in good health. Employee stated they had procedures to follow and not violate HIPAA laws.

PRLU or OLTC

Visit Compliance Report

  • Regs out of compliance (2 personnel and 2 children’s records reviewed, walkthrough) –
    • P105.5.g – No functional job description was observed in employee’s file. Due date 5.12.21
    • R910.1 – A line of tiles was missing from the bathroom in Green Hall and a loose detached shower head with a sharp edge was observed in Daisy Hall.

PRLU or OLTC

Visit Compliance Report

  • Regs out of compliance –
    • R913.5 – Mattress in room 304 has a gash in vinyl measuring approx. 5 inches. (Staff stated they had brand new mattresses in storage, and he left to go get one)
  • TA –
    • R911.6 – Tile in shower floor of one room is missing. Edges are not sharp, but area should be patched with cement or retiled to prevent further deterioration.

PRLU or OLTC

Survey Composition and Workload Report

One surveyor onsite 1.5 hours 8am – 6pm; 4.5 travel hours, 1.5 off-sight report prep hours.