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, Suicidal

Resident reported to staff on 9/28/23 that they have been suicidal and last night came up with a plan and had intent. Resident also told staff she had access to a length of fabric she planned on using. Staff searched room and was unable to find any length of material. Patient eventually agreed to change into paper scrubs for safety and submitted to a safety search. Nursing was able to retrieve the material that the patient had stashed in her clothes. Patient is in paper scrubs, on unit restrictions, suicide precautions, and has been referred to her therapist. Unit search to be done to check sheets, blankets, clothing, etc. for any additional contraband or ripped items.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident became upset with therapist after a session and went into a corner and began hitting her head on the wall. Staff physically blocked contact with hand, and resident physically pushed staff’s hands out of the way and became verbally aggressive. Staff was able to verbally de-escalate after some time. Patient was placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident began hitting her head on the wall and picking at her arms after becoming upset while on the unit. Staff was able to block self-injurious actions and redirect the resident without injury. Resident to remain on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff found resident trying to self-harm with a bendy pencil. Staff intervened and retrieved pencil as well as tried to redirect and process with resident. Resident reported she would self-harm again if able to. Staff were eventually able to redirect patient. Placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient began escalating due to her reporting to staff that she was being bullied on the unit by other residents. Patient began hitting window/door and then began banging her head on the wall. Staff began physically blocking her to prevent injury and tried to move her away from the wall. Patient was eventually able to calm down and process and was released from restraint. Patient placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident began picking at previous self-harm scabs in the cafeteria. Staff was able to redirect eventually and resident was sent to the nurse to get medication and minor first aid. Resident placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Jarred Parnell.

Licensing reviewed 4 personnel records. No licensing concerns noted.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff reported that resident was upset about others making rude comments and went into the hallway and began hitting themselves in the head, then began picking at their arms. Staff processed with patient and was able to redirect. Patient placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident requested to process with staff, who noticed that resident had new red marks on her arm and that she was bleeding from picking at scabs. Resident disclosed being distressed about previous cuts not being deep enough and spoke about being suicidal. Patient was placed on suicide precautions and referred to therapist.

PRLU or OLTC

Medical, Notice of Incident

Patient came to nursing window with a nosebleed and standard actions were initiated to stop nosebleed. While at the nurse’s station, her demeanor changed and the patient stated, “I feel dizzy.” Patient was instructed to have a seat and to take deep breaths, was given fluids. The nurse reports the patient’s condition started to look worse with more dizziness, staring gaze, paling skin, patient becoming diaphoretic, and patient seeming to have an altered level of consciousness but would respond to a loud voice. All vitals within normal limits. The patient was sent to hospital for further evaluation.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff redirected and processed with patient several times due to patient scratching their hand and wrist until it would bleed. Eventually, staff was able to redirect patient and no other reports were made. No signs of serious injury and no signs of infection. Patient placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Patient became escalated due to another patient talking about them and threw an item towards that patient, then acted like she was going to head butt staff. Staff put her arm up in order to block this, and patient is reporting that staff at this time hit them in their chest. Patient denies injury/pain. Staff denied this, as well as a witness, and said they were only blocking and did not touch. Patient eventually hit staff in the face and staff attempted to restrain patient, but due to aggressiveness and combativeness, they were not able to get her in to a full restraint. Once assaulted staff was out of classroom patient was allowed to sit on their own and processed with the nurse. Nurse noted abrasions behind the patient’s right ear, right side of the neck, and to jawline (appeared to be healing). Arkansas Maltreatment Hotline notified (not accepted). Staff to be re-educated on when they should allow another staff member to take over verbal de-escalating. Patient placed on assault/aggression precautions and will follow up with therapist.

Licensing Specialist: Jarred Parnell.

Licensing visited facility on 9/13/23 to review camera footage. The staff person whom the resident had an issue with can be seen leaving the residents space and re-entering their space to argue and further escalate the situation. The facility was advised the staff person be retrained on de-escalation practices and provide proof of the training to licensing before 9/29/2023.

Police Report

Assault

Officer responded to facility for an assault report. Upon arrival, a resident advised officer that another patient slapped her hand and threw a book and folders at her. She stated that this occured last Saturday, 09/09/23. The resident stated they were arguing over the the song that was playing and the movie that she decided to put on the TV. A staff member who possibly witnessed the incident was not working today. Officer advised resident a report would be filed.

There is not enough in this narrative to warrant follow up. No injuries and no report of any fear. No witness statement, and sounds like it should be handled at the facility.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient began scratching at her arms in an attempt to self-harm. Patient refused to process with staff and continued scratching and would only respond by shrugging her shoulders. Eventually, staff were able to redirect patient, and she was placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff prevented a physical altercation between resident and peer before class. Once class began, resident asked for a pencil which she then started using to self-harm with by scratching her wrist. Staff retrieved pencil, and resident was placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was in the cafeteria refusing to eat, and began self-harming with her nails. She was scratching long lines on her wrist with her nails. Patient was verbally re-directed after multiple attempts, and placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient refused to return to her unit and managed to get on top of the milieu desk. Patient jumped down behind the desk and grabbed items in an attempt to get something to self-harm with. Staff where able to remove all objects before that was possible. Patient was restrained and had to be transitioned into a three person restraint due to repeated attempts of trying to bite herself and being combative with staff. Once calm, patient was released and allowed to go to her unit. She was placed on self-harm precautions and referred to therapist.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Jarred Parnell.

A corrective action visit was conducted to discuss implantations and updates in regards to the corrective action agreement. Staff provided an updated employee list on 8/2/23 for staff receiving regulatory checks and EOC walkthrough checks conducted for maintenance concerns. Self-harm practices and prevention were discussed, including adding a layer of padding to the seclusion room. Staff trainings and orientation process was discussed, and the facility has implemented a staff to peer support group twice a month to voice concerns.

A facility walkthrough was conducted in regards to shower maintenance and to inspect resident units. Facility cited 911.15: A pair of pants with drawstrings was found in the Blue Unit.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff saw that therapist had a resident in her office and needed help. The resident started grabbing things off the therapist’s desk and grabbed a coffee cup and threw it on the ground. When staff attempted to escort the resident out of the office, she dropped to the ground and began reaching for items off the floor. She grabbed a piece of the broken coffee cup which staff removed. During this, the coffee cup scratched her right hand in between her thumb and first finger. The resident was placed in a restraint for safety. When the resident was released, her hand was cleaned and examined, and the patient was returned to the unit.

Facility informed Licensing on 9/11/23 that the resident is no longer at the facility and has been discharged.

PRLU or OLTC

Notice of Incident, Self-Harm

Nurse was notified that patient had previously used a crayon to self-harm with. Nurse noted there were two superficial wounds on forearm. The area was cleaned and examined. Nurse reported the area was scabbed over and seemed to be clear of any infection. Resident reported when asked that they had done this on impulse. Patient is on self-harm precautions. Therapist to consult with resident to see what the duration of precautions will be and also if any other precautions are needed.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was seen self-harming on her unit by staff. Staff intervened, and resident was removed from the unit and redirected due to self-harm behaviors. No injuries obtained from event. Self-harm precaution safety plan initiated and sent to therapist for individualization/duration determination.

8/25/2023 – Licensing Specialist reached out to the facility for ratio and how the resident was self harming. The facility responded there were two staff and then a lead also came onto the unit to assist. The patient was removed from the unit to prevent escalating peers. A nurse also came out to process with her. She was reported to have been head banging but that is not verifiable due to her being in a corner out of view of the camera.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident became dysregulated after an argument with a peer and began punching herself in the face. Resident was placed in a brief physical hold to prevent continued self-harm. Once resident was able to display calm behaviors, she was transitioned out of hold. No injuries sustained from self-injurious behaviors/restraint. Resident placed on a self-harm precaution safety plan as a result of this event. Therapist notified of incident for individualization/duration of safety plan.

PRLU or OLTC

Notice of Incident, Self-Harm, Suicide Attempt

Patient has been trying to get her dad to transfer facilities and has been escalated due to that not happening. Nurse was called to unit and upon arrival she discovered patient had torn paper scrubs and was trying to wrap them around her neck. Once paper scrubs pieces were retrieved she began to bang her head on the wall and started to yell at peers she wanted to die and that someone should do it for her. Patient was placed in restraint for safety, and emergency medications administered after patient was unable to de-escalate. Patient was able to calm down once medication took effect. Patient is on suicide precautions until determined to be safe by clinical team. Therapist to continue to follow-up to determine if any additional precautions are needed.

Police Report

Welfare Check

Guardian requested a welfare check on juvenile at facility. The guardian reported juvenile had called him and told him she keeps getting assaulted and no one will help her. Officer responded to facility to check on juvenile.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient became upset when told by staff she would not be able to transfer to a different facility that day. She ran into the seclusion room and began to bang her head on the wall and stated that she wanted to kill herself. She was verbally de-escalated by nurse and staff. Once she returned to the unit, she got a marker and started self-harming with them resulting in a brief restraint. Patient was placed on suicide precautions and on line of sight. Therapist to consult with her to see if any additional precautions are needed and the duration.

Licensing Specialist: Jarred Parnell.

Facility visited 8/22/23 and video reviewed. No issues noted by licensing.