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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Police Report

Assault

Officers were dispatched to Perimeter of the Ozarks in response to a disturbance. The caller was a staff member advising of a juvenile female who was being aggressive and hitting staff. The caller advised they were physically restraining the juvenile. Officers arrived on scene and were escorted into the facility by one of the nurses. Officers observed the juvenile female being physically restrained by a staff member. Staff was sitting on the ground against the wall with the resident in a double arm lock but released her as police entered. The resident appeared to be very agitated and upset but was no longer aggressive.

Officers spoke to the medical staff who advised that the resident had anger issues. Staff stated that the resident began attacking the medical staff. They advised she kicked one of the nurses in the stomach hard enough that the nurse was having vaginal bleeding. The nurse who was kicked did not wish to pursue any charges. The staff member restraining the resident as officers entered stated that the resident began scratching him during the restraint. The staff member showed me the left side his body, near the hip. I observed several small and long lacerations that would match scratch marks. The staff member advised he did wish to pursue charges.

The resident was cited or Battery 3rd (m).

Police Report

Disturbance

Caller stated a kid had jumped the fence at Perimeter Ozarks. White female is headed towards I49. Staff is not being very helpful. Missing juvenile walked herself back inside the facility. Staff at Ozark was not aware.

Police Report

Assault

Officers were dispatched to a battery report at Perimeter of the Ozarks. Dispatch advised that there was an employee that wanted to make a report about an incident. Upon arrival, officers made contact with a female later identified as Mia Velasquez. Mia stated that she was watching over patients and one of them got a towel. The patient started wrapping it around her neck in an attempt to harm herself. Mia and other employees tried to get the towel away from the patient. The patient punched and kicked Mia in the face. Mia was able to get the towel away from patient and restrained her. While the patient was restrained, she kicked Mia again causing her to stumble backwards. She heard a pop in her upper neck. Ambulance responded to assess the staff member.

Mia stated that she wished to press charges. Officers issued citation and JDC provided a court date for juvenile.

Police Report

Assault

Officers responded to a battery call at Perimeter of the Ozarks. The caller stated she was a nurse at the facility and had been attacked by a patient and wished to file a report. Upon my arrival I made contact with Hannah Dyer. Dyer stated she is a nurse and a resident in their care was causing issues in the main room of the ward. The resident was throwing cocktail hot dogs at one of the other residents there. She was throwing other bits of trash around the room and banging on the windows. Another staff member attempted to restrain the resident, but she fought back. Dyer joined in and staff were able to get the resident pinned on the floor on her back. Dyer stated she was holding the right arm, but the resident broke free from her grip and punched her in the throat with a closed fist. Dyer again restrained her as the resident used her finger nails to scratch at Dyer’s left hand, breaking the skin and causing injury to the outside of Dyers palm. Other staff members joined, and they were able to restrain the resident and place her back in her room.

As officers were speaking with Dyer, another nurse stated she was also injured. Rebecca Robinson stated that she responded to help Dyer and other staff members as they were struggling with the resident on the floor. Robinson stated she held down one of the resident’s hands, but the resident grabbed hold of Robinson’s middle finger and twisted it hard to one side. Robinson’s finger was swollen and starting to show bruising. Robinson stated she felt her finger was fractured.

Officers reviewed camera footage of the incident. Based on the video evidence and the statements from both Dyer and Robinson, officers have probable cause to charge with Battery 2nd Degree x2. This is enhanced from Battery 3rd Degree since Dyer and Robinson are both nurses. Officers issued citation and JDC provided a court date for juvenile.

Police Report

Assault

Officers responded to an Assault call at Perimeter of the Ozarks. The caller stated she was a nurse at the live-in facility for juvenile females. She stated she was attacked by a patient and wanted to file a report. Officers made contact with the caller (Mclellan), who stated she was assaulted by a juvenile female. Mclellan stated during time for group activity, the resident refused to exit her room. Staff spoke with her, and she initially came out, but then ran back into her room and slammed the door. Staff unlocked the door, but the resident pushed against the door to prevent it from opening. Other staff arrived to assist and eventually went into the room. Mclellan was standing outside the doorway as the resident was escorted out of the room. The resident accelerated towards Mclellan and kicked her in her chest, then grabbed Mclellan by the hair and pulled her to the ground. Other staff intervened, and the resident was placed back into her room. Mclellan stated that this was not the first time the resident has acted this way towards her or other staff.

Officer viewed the attack on the security cameras. Officer provided JDC with the necessary information and issued a citation for the charges. JDC provided a court date for the juvenile.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

During the treatment team meeting on 4/3/2024, client presented with a chief complaint of a sore arm. Client reported that 2 or 3 nights ago, she was attempting to close a door when a staff member aggressively closed the door on her arm. Client alleged that after the incident, the staff member said, “That’s what you get”. Corrective Action: Management notified. Staff member placed on suspension. The resident was taken to a walk-in clinic for an X-ray of her arm on the same day; Diagnosis: contusion of the arm. A follow-up appointment with a specialist was scheduled for 4/11/24 for further consultation. A report was made to the Child Abuse Hotline (accepted for investigation).

Licensing Specialist: Jarred Parnell

4/8/2024 – A complaint visit was conducted at the facility to review the provider reported incident. At the time of the visit there was no footage available of the alleged incident, and they were in the process of reviewing several days worth of footage. 4/12/2024 – A visit was conducted at the facility to review video footage. Video footage reviewed was 3/30/3034 19:00 – 4/1/2024 21:00. Video was reviewed for each day around bedtime which the resident stated was the time period in which the incident happened. There was one instance in which the staff person was on the unit with the resident for approximately 3 minutes and the resident and staff did not interact.

CACD investigation unsubstantiated. Complaint UNFOUNDED by Licensing.

Police Report

Battery

Officers responded to a disturbance call at Perimeter of the Ozarks. Officers made contact with staff who led them through the facility to the back courtyard. A female juvenile was being restrained on the ground by four staff members. Staff stated that the resident was trying to escape the facility by climbing the fence. Staff tried to stop her, and the resident jumped off the fence and punched staff in the left eye, breaking her glasses.

Resident was handcuffed and detained. She was moved to an isolation holding room so she could change out of her ripped clothing. Staff injuries were documented. Resident was charged with Battery 3rd and transported to Washington County JDC.

PRLU or OLTC

JDC, Notice of Incident

While outside for recreational time, resident began to try and climb fence to elope. Staff intervened and several were assaulted. Staff tried to escort resident back into the building but were unable to. Resident was restrained outside in grass area at 17:45. Staff member called Springdale Police and resident remained restrained until they arrived. Once police arrived they assisted staff in escorting resident into the building. Resident was placed in the seclusion room area for privacy due to her paper scrubs ripping and her refusing to change. At one point door had to be closed and patient was in seclusion due to trying to assault officers. Resident was escorted out of the building and taken to the local JDC at 19:35.

Resident was placed on elopement precautions (this includes paper scrubs and increased observation), assault precautions (this includes line of sight observation while awake), and has been placed temporarily in our high acuity room (this room only has one bed) due to reported feelings of feeling unsafe and also for safety.

Licensing Specialist: Jarred Parnell.

Police report was received and Licensing Specialist informed. Facility visited on 4/12/24 and video footage was reviewed for 3/28/2024 at 17:39-18:25. The video reviewed showed 5 staff persons involved with the restraint and staff can be seen struggling with the resident until police arrive. The facility utilized extra support during the restraint due to the resident being larger in stature.

  • Licensing discussed with facility staff practices for staff engaging physical restraints with residents who are larger in stature. The facility’s plan for dealing with larger residents is to initiate holds and restraints with more staff to support when needed.

Police Report

Assault

Staff reported to officer that a resident jumped on another resident and began hitting her. Officers made contact with the resident (offender) and the victim.

The resident told officer that she jumped on the victim and, with a closed fist, hit the victim in the back of the head, pulled her hair, and stomped on her. Video footage confirmed the above-mentioned statement given by the resident. Officer spoke with the victim. Asked if it hurt, the victim said yes. Officer observed slight redness on the top of her head and self-inflicted wounds on forearms. However, there was visible redness in the area of the wounds.

Officers placed the resident under arrest for purposely causing physical injury to another person, and because the victim is under the age of twelve, this is upgraded from a battery third to a battery 2nd degree which is a felony. Resident was issued a citation (24-17163) for Battery 2nd Degree which was turned over along with her property to Juvenile intake.

PRLU or OLTC

Notice of Incident, Peer Altercation

For background, the perpetrator was involved in an incident on 3/16/24 where she physically assaulted several staff and residents leading to her first arrest from the facility. She was returned to the facility on 3/18/24 with a court order to notify law enforcement of any further act of violence while at the facility moving forward.* On 3/21/24 at approximately 2003, resident physically assaulted another resident after a brief verbal altercation. She was placed in a physical hold to maintain safety. Once was deemed safe, she was transitioned out of hold. Both residents were assessed by nursing and no injuries were reported.

Because of the standing court order, law enforcement was notified of the physical assault, and the resident was transferred to JDC and will not be returning to the facility.

Police Report

Assault

3/16/24 – Officers arrived on scene of an Assault/Battery call at Perimeter of the Ozarks. Caller advised a 12 yo resident was assaulting staff and had to be physically restrained. Upon arrival, officers made contact with lead nurse who advised that the resident had attacked another resident and several staff members. Officers were escorted inside where the resident was being restrained by four staff members. Resident stated she was attacked by another resident. She said once she was attacked, she began fighting other residents and hit a male staff member, because she does not like the male gender.

Staff member who had been attacked completed witness statements. Photos of injuries were taken, emailed, and uploaded to Evidence.com. Resident was arrested and transported to the jail, then Washington County JDC were she was charged with four counts of Assault 2nd, and one count of Battery 3rd.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Resident became escalated on the unit and began physically assaulting various staff members and destroying property. The resident attempted to run off the unit but was blocked by staff. Resident’s behaviors continued, and a physical restraint was initiated. When staff attempted the restraint, another resident stepped in and began physically assaulting the resident. Staff intervened and separated the residents. Moments later, the resident physically assaulted a different peer that was a bystander. Staff intervened and separated the residents. The resident was taken off unit and physically restrained but continued to physically assault staff despite interventions. Springdale Police Department was called and the resident was transported to Washington County JDC where she was booked over the weekend and released back to the facility.

Licensing Specialist: Jarred Parnell.

Facility visited 3/20/24 and video footage was reviewed. Safety plan for the facility is to train staff and strategize regarding situations handling larger residents and resident separation de-escalation. Program Coordinator requested police report on 4/1/24.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Jarred Parnell.

Review of personnel files was completed. MARS log was reviewed.

Police Report

Assault

Officers responded to Perimeter of the Ozarks regarding a disturbance. Officer requested additional units due to the physical fight between at least 4 juvenile females. Two female juveniles were detained for attacking another resident, 11yo female.

Officers interviewed victim who stated she had been upset and broke some crayons, and another resident took her notebook and was kicking it. She went to a staff member in the room and stated that she felt unsafe. The staff member instructed her to stand behind him. Two residents began attacking the 11yo resident, grabbing her by the hair, punching her in the face, and throwing her to the ground. Staff manage to separate the residents, but a third resident kicks the 11 yo resident. Visible purple/blue bruises can be seen on her leg. She also had red marks on her arms and legs. Her face was red and discolored where she had been punched. The 11yo resident did not make physical contact or hit anyone during the altercation.

Two of the offending residents were transported to ACH for suicidal ideations. Staff had informed officers that going to the hospital had been a premeditated plan of the residents. The third offending resident was arrested and transported to the juvenile section of the Springdale jail. Jail staff transported all three residents after discharge to the Washington County Juvenile Detention Center.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Resident physically assaulted her peer by punching her in the face after a verbal altercation. Within a few seconds, another resident became involved and began physically assaulting the peer. During the altercation, a third resident ran up and kicked the peer. The altercation was ceased in under a minute by staff intervention. Upon separation, the peer exited the unit with staff while the residents remained on the unit.

Due to the nature of the attack, the age difference between initial perpetrator and victim, and the recent increase in assaultive behavior with the original resident, Springdale Police Department was contacted. Residents were detained and transported to Washington County Juvenile Detention Center by Springdale PD. All 3 perpetrators were seen by the judge at JDC and were charged with Battery 2nd degree. Two residents were transferred back to the facility after their hearing. One resident remained in custody at Washington County JDC after her hearing. Facility provider was notified of the incident and will be seeing resident for a medical assessment today to ensure there was no significant injury.

Licensing Specialist: Jarred Parnell.

The facility requested a copy of the police report to provide to Licensing. Licensing inquired of safety plans in place prior to the incident. Facility visited and video footage was reviewed.

  • Technical Assistance provided regarding escalation and altercations in the future: When residents are exhibiting assaultive behavior and deregulation as a group, the facility will remove the target of the aggression and assaultive behavior to the milieu to process and diffuse the situation as a preventative measure. If there is only one deregulated resident exhibiting assaultive behavior, that resident will be removed to the milieu for processing to diffuse the situation.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

Licensing was included on a complaint to the Office of Long Term Care on 4/23/24 regarding an allegation that the facility was not properly documenting physical and chemical restraints.

Licensing Specialist: Jarred Parnell

An internal staffing was completed regarding the information and visit scheduled for 4/30/24 to review children’s records, restraint logs, incident logs, and personnel files. During facility visit on 4/30/24, the DON informed Licensing that during the timeframe of 2/22/24 and 3/29/24, not all restraints were logged by the former Director of Quality and Risk Management (recently resigned). The DON also reported that they use nurses from the Clip Board agency and that they are trained in Handle with Care before working on the floor.

Licensing visited the facility on 5/7/24 to review restraint logs and files for residents to ensure they are updated with restraint packets and doctor’s orders for restraints conducted on 5/2, 5/3, and 5/4. All were updated.

While the agency is aware that all documentation for restraints were not kept well organized by the former Director of Quality and Risk Management, all documents have been accounted for to the best of the facility’s knowledge.

Licensing investigation unfounded.

PRLU or OLTC

Notice of Incident, Suicide Attempt

Resident reported to staff that she had taken approximately 2 weeks worth of medication all at once after “cheeking” her medication at med pass for the last 2 weeks. The resident was transported to Arkansas Children’s Hospital for further evaluation. Per discharge report, there were no findings indicative of an overdose during her stay overnight, and she was released back to the facility 3/6/24. Resident was placed on suicide precautions with observation level to be constant line of sight of staff at all times. Medications will be placed in applesauce/pudding at med pass to better ensure adequate ingestion of medication. Resident will participate in thorough mouth checks by nursing department at med pass and remain at nurses’ station for 10 minutes after administration of medication for closer observation under RN supervision.

Facility staff stated there was no evidence in the medical report or physical evidence showing the resident had “cheeked” her medicines. Staff believe she was lying about the incident. A copy of the residents vitals documentation completed by facility nursing staff when the resident returned to the facility will be provided to Licensing. Vitals showed normal.

Police Report

Assault

2/26/24 – Officer responded to Perimeter Ozarks regarding an Assault/Battery. A staff member advised she was attacked by one of the juveniles that was a resident of Perimeter. Staff advised she was tending to another juvenile and making sure she was in her room when resident punched her in the face two times, grabbed her by her hair, and pulled her to the ground. Other employees had to separate the two and had to restrain the resident . The staff member had a scratch mark on the left side of her cheek. Staff advised she wanted to press charges for the Battery.

3/22/24 – The staff member called and left a voicemail stating that she wanted to drop charges and did not want the incident investigated further.

Police Report

Assault

2/27/24 – A staff member advised officer that she responded to two juvenile females fighting at Perimeter of the Ozarks. As she attempted to separate the fight, a resident intentionally punched her in the face and left her lip swollen. Staff stated that she had video of the incident. She was advised to write a statement for what had occurred and turn it in as soon as possible.

3/18/24 – Officer closed the case due to not being able to get back in contact with the staff member involved. Report was submitted to supervisor for review pending victim contact.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident was involved in a physical altercation with a peer. Staff were able to intervene and separate the residents, but resident was able to make direct physical contact with a closed fist towards her peer and staff. Resident was placed in a brief physical hold and was transitioned out of hold when stable. On the initial post restraint medical evaluation, resident reported no complaints of an injury.

On 2/28/24, resident started complaining of pain in her right hand. Mild redness and swelling were noted upon nursing assessment. The facility medical provider was consulted, and resident was transferred to Ozark Orthopedic Urgent Care 2/29/24 for evaluation. Results were negative for a fracture, and injury was ruled a mild sprain. Her follow up plan of care includes wearing a wrist brace for 2 weeks as needed with continued interventions including ice, rest, and elevation of wrist. The residents involved are now on different units.

Police Report

Assault

A staff member advised officer that she was attacked by one of the residents. The staff stated she was tending to other residents when resident became uncooperative and aggressive towards her while she was trying to get them in their secured rooms. She said resident attacked her by pulling her hair and hitting her in the face several times. Other employees assisted in separating from her.

The staff member said she did not have any marks or injuries from the attack. She said she was advised by her employer she could file a police report for the incident to have documentation. Officer provided her with the report number and advised her to call if she had any questions or further information.

PRLU or OLTC

Notice of Incident, Self-Harm, Suicide Attempt

Around 7:40am, resident was removed from the unit due to self-harming and sat with the nurse, who treated her scratches and gave her medication before returning resident to the unit. Back on the unit, the resident entered the bathroom with a sweater. Staff found her with the material wrapped around her neck two minutes later. Material was removed and no injury was noted. Resident placed on precautions and redirected to dayroom. Resident changed into scrubs (part of suicide precautions). Resident was moved to green unit at 13:10. At 13:26 staff support was called and resident was found wrapping material around her neck again. Material was removed and nurse assessed and found no injury. When asked why staff did not enter the room with resident, he stated he did not want to be put in the position of having allegations due to their being no cameras in the room. Staff arrived in less than one minute after support was called. Resident was removed from unit and taken to the sensory room to process with staff. Resident continued to have behavior issues for several more hours but was able to be redirected and no other attempts were made.

  • Corrective Action: Coaching of leads and supervisor on shift. Initiating 1:1 supervision with DON to discuss job descriptions and responsibilities of this position. Facility leadership will follow-up on safety precautions and will review suicide precautions. Facility is developing a corrective action plan including re-organization and re-structuring of milieu leadership and responsibilities.

Licensing Specialist inquired with the facility as to how they will handle line-of-sight residents going forward, and suggested use of the sensory room bathroom which is more open and situated near the milieu. 2/7/2024 – Licensing Specialist received correspondence from the facility stating they are in the process of coming up with a plan regarding this. “We are going to re-do our SI precautions and look at adding that with the bathroom as well.”

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Jarred Parnell

All resident units were inspected for maintenance regarding bathroom areas, sleeping areas, and resident clothing storage. Floors and common spaces were inspected for cleanliness. Resident unit areas were inspected for furniture appropriate for the facility. Water faucets, toilets, and shower faucets were inspected. The cafeteria hall was inspected and all fire extinguishers were inspected and up to date inspection tag. Outside recreational areas were inspected as well as all exits from the recreational yard.

PRLU or OLTC

Notice of Incident, Suicide Attempt

Staff reported that the resident was in the bathroom while staff was making rounds. Staff requested a response from resident and after several attempts staff entered bathroom. When staff entered bathroom they found resident had ripped their sweatshirt and used a piece of the material to tie it around their neck. Material was removed and nurse was called to unit to assess resident. It was reported resident had slight redness around neck but no further injury. Resident refused to process with staff. Corrective Action: Resident placed on suicide precautions. Unit search done for contraband. Nurses will continue monitoring to make sure no adverse effects.

Licensing Specialist Jarred Parnell received a response to the inquiry from facility staff which said the resident was not on a current safety plan. She went into the bathroom to do evening hygiene and was in there for 4 mins before the next rounding time when staff went in there.