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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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.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was taken to the emergency room due to concerns of injury to her right hand. Resident had become escalated on several occasions leading to her punching the wall multiple times. While at the ER, resident was diagnosed with no fractures or breakage. The resident returned to the facility around 1800 with no new orders. Resident placed on self-harm precautions.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact

On 1/18/24, resident told her caseworker that she had been sexually assaulted two Fridays ago by her roommate at the time. Resident refused to write a statement about the situation and also refused to give any more details when asked. Resident does have a history of making allegations and then recanting shortly after. Caseworker is the one who reported the information to us. Roommate when spoken to adamantly denies the allegation with the resident. There is no camera footage in the room so we cannot confirm or dismiss the allegation. Corrective Action: Residents separated and now on different units. Internal investigation being done. Residents placed on sexual misconduct precautions.

Licensing Specialist Jarred Parnell contacted the facility to follow-up with the provider reported incident. The report was not accepted by DCFS and there is no video footage of the incident. Facility staff stated the resident who made the allegation has a history of making false accusations and was not willing to write a statement regarding the incident.

This was not a complaint case, so there is no licensing complaint finding.

Police Report

Assault & Battery

Caller advised she would like to make a report for an assault that happened to her daughter yesterday at this address. Caller advised they are both patients inside the facility.

Officer spoke to mother of child. Some of the staff that was here last night reviewed the video for the officer. The mother and child will not file charges at this time, but officer will be filing an incident report.

PRLU or OLTC

Medical, Notice of Incident

Resident was taken to the ER due to continued complaints of sore throat, nausea, and cramping. Medications had been ordered as nursing already tested for flu, strep, and COVID -19 but the patient was refusing them. Staff was concerned due to the extremeness of patient’s behaviors (crying and yelling) that she was extremely ill. Multiple tests, x-rays, and exams were conducted at the ER and resident was discharged and returned to the facility on 12/27/23 at 2:00 am. She was sent back with a diagnosis of constipation and positive Coronavirus OC43 (this strain is associated with the common cold). Medications were ordered.

Police Report

Citizen Assist

Caller would like to speak to an officer concerning a patient making false allegations of child abuse. Caller was given his options.

Police Report

Disturbance

Officer responded to facility and spoke with the caller and the victim (Resident1), who stated that she and another resident were in a verbal argument when Resident2 grabbed Resident1 by the back of the head and hit her several times. There was no apparent injury and staff separated the two.

The incident is being handled internally.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident reported they had hit their elbow and was in pain. The nurse assessed and wrapped the arm and gave prn Tylenol as ordered without any further interventions needed at the time. It was reported that other residents on the unit started saying this resident was faking which triggered the resident who then banged their arm again on purpose due to this. The nurse was concerned upon assessment that the area was dislocated and wanted to make sure there was no further injury. Resident was taken to the ER and diagnosed with a bruised elbow.

Police Report

Assault

Officer Samuelson responded to Perimeter of the Ozarks to speak with 16 year old patient. Resident1 said there was an incident in which she was assaulted on Dec 4 (23-78333) and on Dec 10 (23-78341). On 12/4/23, Resident1 was in the Day Room Green Unit. Resident2 and Resident3 walked up to Resident1 and pulled her hair. They began hitting her in the back of the head and scratching her. Officer observed a scratch on her arm and took a photo. Resident1 said she was placed in a restraint by staff for fighting, but she was just trying to fight back to get the girls off of her.

Resident1 said she requested to press charges. At the time of incident, staff would not allow her to contact police and said they do not need to get involved. She still lives in the same wing as the other girls and sees them on a regular basis. Resident1 also said she feels like she is being denied her rights to access to contact CPS or her advocate.

Officer Samuelson received an e-mail from Sara Whorton (staff) on December 18 with the following statements: “Results regarding reported incidents: The first incident actually took place on 12/3/23 not 12/4. We do not have audio, but it can be seen on camera that the two other reported residents did walk up and start hitting Resident1 from behind. Staff intervened immediately but both reported residents did get several hits before they were able to be broken up. This took place at 18:28.”

Officer forwarded this case to Washington County Juvenile Prosecutors office for review of the charges of Battery 3rd Degree for Resident2 AND Resident3.

Police Report

Assault

Officer Samuelson responded to Perimeter of the Ozarks to speak with 16 year old patient. Resident1 said there was an incident in which she was assaulted on Dec 4 (23-78333) and on Dec 10 (23-78341). On 12/10/23, Resident1 was in the Day Room Green Unit. Resident2 had assaulted her by going for her hair, and hitting her across the face. She received a black eye, swelling, and a busted lip. Staff came in and both girls fell to the ground. As one resident was being restrained, she kicked the other resident in the mouth.

Resident1 said she requested to press charges. At the time of incident, staff would not allow her to contact police and said they do not need to get involved. She still lives in the same wing as Resident2 and sees her on a regular basis. Resident1 also said she feels like she is being denied her rights to access to contact CPS or her advocate.

Officer Samuelson received an e-mail from Sara Whorton (staff) on December 18 with the following statements: “The second incident took place on 12/9/23 at 15:47 not on 12/10. Resident1 antagonized several residents one after the other for about 10 minutes. The other four did not respond as staff were able to intervene. The reported resident did fight with Resident1 after verbal exchange was seen being made on camera. Again, we do not have audio, but the reported resident got up from her chair and hit Resident1 which began the fight. Staff were there and broke it up immediately.”

Officer forwarded this case to Washington County Juvenile Prosecutors office for review of the charges of Battery 3rd Degree.