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, 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.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident was separated from peer to prevent altercation. Once separated, resident began banging her head on the wall and scratching down both sides of her face with her nails. Resident was given PRN and was able to de-escalate after having to be briefly restrained. After re-escalating, resident was restrained again and given IM emergency medications. Resident was able to regain control after medication took effect.

Licensing Specialist Jarred Parnell visited facility to review resident’s safety plan. The resident was placed on constant line of sight precaution.

PRLU or OLTC

Notice of Incident, Suicide Attempt

While completing routine room checks, staff called out to resident who was in the bathroom. Resident was crying and wouldn’t produce an appropriate response when called for. Staff entered the room and observed the resident with clothing around her neck. Additional assistance was called and clothing was promptly removed from resident’s neck. No injuries were obtained. Resident was placed on suicide precautions with constant line of sight and given paper scrubs. Therapist will follow-up for individualization/duration of safety plan.

Police Report

Assault & Battery

Staff member called to file a report against a juvenile. Staff advised the juvenile was restrained after attacking another resident, then attacked the staff member after she was released from the restraint. Staff reported the juvenile bit her, pulled her hair, and hit her.

Police Report

911 Hang Up

Open line hang up call plotting in area of facility. No obvious sounds of distress.

PRLU or OLTC

Notice of Incident, Self-Harm

Staff called nurse to unit and reported patient was attempting to self-harm. Staff tried to process, de-escalate, and physically block in order to keep patient from self-harming. Patient refused to process and became assaultive towards staff. After about 30 minutes staff was able to verbally de-escalate patient. Patient was placed on self-harm precautions and will meet with therapist to determine length of time and if any other precautions are needed.

Licensing Specialist contacted facility to find out how the client was trying to self harm. 8/22/2023 – The facility contacted the Licensing Specialist to inform the client was self harming by punching a wall.

Police Report

Assault & Battery

On 8/2/23, officers responded to facility for a guardian wanting to report an assault on juvenile by a peer. Upon arrival, the guardian stated she no longer wanted to file a report after it was determined the juvenile was the primary aggressor in the altercation.

On 8/3/23, guardian called to report that there is video footage of another resident assaulting her daughter. Guardian wants to know options of why someone is lying. Officers responded.

Police Report

Elopement

Staff advised dispatch they had a resident get out of the facility. Approximately 10 minutes later, staff reported that they had the resident in their car and were taking her back to the facility. Upon officers arrival, staff had the resident under their supervision and did not need further assistance.

Police Report

Assault

Officers responded to a disturbance call at facility. Upon arrival, staff advised the fire alarm had gone off, causing all the doors to unlock. Staff member stated she stepped in front of a resident attempting to escape, and the resident hit her in the forehead with the palm of her hand. The staff member stated she wanted to press charges, and a court date was issued for resident.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

Around 9:30am, a resident was upset and processing with staff when another staff member went out the back exit to go outside. The resident ran out the door before it fully closed, and once outside, she made it outside the locked area due to the back gate being open for deliveries being made. Staff were able to retrieve the resident and escorted her back to the facility. The incident lasted a total of 10 minutes.

Licensing Specialist: Jarred Parnell.

Facility visited 8/2/23 and video reviewed. The resident can be seen standing with a staff member processing and doing fitness. Another staff member walks outside from the school hallway, and the resident ran out the door before the magnetic latch could engage. The resident proceeded out the gate in the back of the building (gate was open due to a delivery truck dropping off a delivery). Facility CEO stated staff will be re-educated on exiting and entering doors and outside gates. A secondary outside gate was added in between the recreation area and the delivery area which is secured with a pad lock, and a staff person will be stationed at the gate when deliveries are being made going forward.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident became dysregulated on the unit and began displaying self-injurious behaviors including pulling her hair out, punching brick, and head banging. A physical hold was initiated to maintain safety. Resident received a one-time intramuscular medication as ordered by the physician to assist in emotional regulation. Once resident was able to display safe behaviors and verbalize maintaining safe behaviors post hold, she was transitioned out of physical hold. No injuries sustained. Resident was placed on a self-harm precaution safety plan, therapist to determine duration and individualization.

PRLU or OLTC

Medical, Notice of Incident

On the evening of 7/29/23, I was asked to come in due to the nurse working floor stating she was overwhelmed. On arrival, I got a report of this patient having several complaints of pain and not feeling well. According to staff working directly with the patient, the patient’s pain seemed like it was getting worse. Upon my assessment the patient seemed to be in distress and was reporting intense pain all over. We sent the patient out with EMS to Arkansas Children’s Hospital for further evaluation. They reported vitals within normal limits and a diagnosis of syncope. We have requested lab results and are currently awaiting them.

Licensing narrative:

  • 8/4/2023 – the provider reported incident was reviewed by Licensing Specialist. More information was requested from the facility about the incident.
  • 8/8/2023 – [REDACTED] responded stating the patient was referred to the doctor to get her birth control checked. The resident has had no other issues like the one described in the incident.

PRLU or OLTC

Visit Compliance Report

Program Coordinator and Licensing Specialist visited the facility to review the progress and compliance of the current Corrective Action Agreement (CAA) with CEO and Quality Assurance Director from the West Memphis facility. The Program Coordinator discussed citations the facility has received in the past six months. The expiration date for the current CAA was 7/25/2023, but due to the facility’s license still being in a probationary status and some continued concerns, the licensing unit will be continuing the CAA to October 25, 2023. The Program Coordinator explained that in October another review will be completed to determine if the facility has now met sufficient compliance with the minimum licensing standards to request a change in their license status. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient became upset when unable to have her hoodie and began to self-harm with thumb nail on forearm. Patient had to be restrained due to continued escalation in trying to self-harm and unable to be re-directed by staff attempts. Therapist to consult with patient to see if any safety plans are needed and the duration of them.

Licensing narrative:

  • 7/25/2023 – The provider reported incident was reviewed by Licensing Specialist.
  • 7/31/2023 – Licensing Specialist contacted the facility to get more information about the incident:
    • Why was the resident unable to have a hoodie?
    • What kind of restraint was used?
    • How long was the restraint used?
    • How many staff were involved in the restraint?
    • How many staff were involved in the incident?
  • 7/31/2023 – Licensing Specialist received information from the facility regarding the incident. The resident was not able to have a hoodie because hoods are contraband. The restraint used was handle with care. The incident took place around 10:58 AM – 11:06 AM. There were 8 staff present during the incident and 2 participated in the hold.

PRLU or OLTC

Visit Compliance Report

Time of visit: 12:15 pm. Licensing Specialist completed a buildings and grounds visit and observed the following areas of Perimeter of the Ozarks: blue unit, green unit. And orange unit, the milieu, the cafeteria, seclusion rooms, and the classrooms. Licensing Specialist was escorted by Sarah Kroon and Travis Hood. The grounds around Perimeter of the Ozarks were clean. Licensing Specialist observed the landscaping around the facility. Twenty seven residents were present during the walkthrough. In the unit common areas there were chairs for the residents, a tv, coloring and drawing supplies, and a table and chairs for staff. Each unit bedroom was inspected for self-harm hazards, sleeping arrangements, and licensing concerns. Bathrooms were inspected for licensing concerns as well as hot and cold running water, and working toilets and shower drainage. The escape plan diagram was posted on the wall by the unit entrance. Licensing Specialist observed two fire extinguishers and drinking water coolers and pitchers in each unit. Resident rights and emergency diagrams, and activity schedules are posted. The facility vehicle was inspected for licensing concerns. The facility severe weather drills log was reviewed a drill was conducted on 3/2/23.

Ratios observed during the walkthrough – Blue unit: 2:1 , Orange unit: 2:8, Green unit: 1:2, Classroom ratios: 4:13 and 2:3. Licensing Specialist reviewed the mar’s on the residents listed below:[REDACTED]. All initialed and up to date.

Licensing Specialists reviewed the Corrective Action Agreement with CEO for Perimeter of the Ozarks. Licensing Specialist provided CEO a copy of the Corrective Action Agreement. CEO provided Licensing Specialist with a copy of August and September activities for the residents. The monthly calendar of activities for the residents is part of the facility’s Corrective Action Agreement. Licensing Specialist: Jarred Parnell and Kendra Rice.

Medicaid Inspection of Care

Corrective Action Plan, Inspection of Care Report

Deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted at the facility.

This IOC visit was upon request of DPSQA (Division of Provider Services and Quality Assurance) to follow up on a recent IOC inspection conducted on 10/6/22, 12/5/22, 2/6/23, and 4/3/23.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

On 7/19/23, client reported to staff that she believes she obtained injuries on her arms from a physical hold that she was placed in on 7/17/23. Due to allegation, a report was uploaded to the child abuse hotline.

Corrective action: Internal investigation opened, camera footage reviewed, statements provided. Clients arms were assessed and documented. 2 superficial, 1/4-inch scratch marks were noted on her left forearm and upper arm with no actual breaks in the skin. A pea-sized circular area of mild discoloration noted on right upper arm.

Licensing narrative:

  • 7/21/2023 – Program Coordinator emailed the facility to find out more information regarding the allegations and why there appears to be a delay in reporting.
  • 7/24/2023- Licensing Specialist Jarred Parnell reviewed the complaint.
  • 7/26/223 – Program Coordinator and Licensing Specialist visited the facility to discuss the incident. The camera footage was reviewed. Witness statements, training verification, and regulatory check information was obtained. Licensing requested re-training of staff and a copy of the video footage. Licensing received a copy of the retraining.
  • 7/26/2023 – Licensing Specialist visited the facility to review camera footage and discuss the reported incident. The video footage was reviewed with handle with care instructor. Camera footage from 7/17/23 was reviewed beginning at 5: 32 PM to 5:53 PM. Questions during review of the video footage concerning handle with care practices and restraint holds used during the incident were answered by handle with care trainer. When the resident was taken to the floor on the unit for a restraint hold, staff participated in holding the resident’s legs after again being told to leave the room by the handle with care instructor observing the restraint.

Please ensure that staff is retrained on how to conduct appropriate restraints/escorts with residents by 8/2/2023. Please ensure staff is retrained on the facilities proper protocols when de-escalating a resident by 8/2/2023. Please ensure all staff present during the incident are re-educated on the facility’s policy regarding proper protocols for staff response to an incident by 8/4/2023. Licensing Specialist: Jarred Parnell.

Police Report

Hang Up

Open 911 line plotting at 4522 West Sunset. No sounds of distress; can hear speaking but cannot make out what is being said. Call plotting within 11 meters now at 2466 West 48th Street. 656 spoke with nurse who advised she will make contact at the front with officers.

PRLU or OLTC

Personnel Record Review, Visit Compliance Report

Licensing Specialist conducted a visit at the facility to review the policy for resident grievance reporting, and incident report log.

Licensing Specialists reviewed two (2) personnel files:

  • Director or quality & risk management – 6/22/2023
  • Activities coordinator – 7/9/2023

Licensing Specialist was informed that [REDACTED] transferred from Perimeter of West Memphis. She was promoted from PRN Mental Health Technician to Activities Coordinator. Both personnel files reviewed complied with the minimum licensing standards. Licensing Specialist: Jarred Parnell.

PRLU or OLTC

Visit Compliance Report

Licensing Specialists Jarred R. Parnell and Kendra Rice conducted a visit to review camera footage of nighttime visual checks during sleeping hours for blue unit, green unit, and orange unit. Licensing Specialists reviewed footage for date 6/20/2023 at 12:53 AM – 1:16 AM, and 3:30 AM – 3:32 AM.Two staff persons were observed on the camera footage in the blue unit doing routine checks. Licensing Specialists reviewed footage for date 6/19/2023 at 11:29 PM – 11:52 PM and 12:01 AM – 12:12 AM. 3 residents were on line of site precaution, staff was observed doing routine checks. Licensing Specialists reviewed footage for date 6/6/2023 at 12:01 AM – 12:11 AM. Five residents were on line of site precaution and one staff member observed doing routine checks. Licensing Specialists reviewed footage for date 6/19/2023 at 7:43 PM to review the time before sleeping hours. Licensing Specialists observed residents preparing for bed. Some residents were observed in the day area, walking in the hall way, completing hygiene. One resident was observed transferring to another unit. Licensing Specialists did not observe any minimum standard non-compliances for routine sleeping hour checks. Licensing Specialists: Jarred Parnell and Kendra Rice.