Disability Rights Arkansas

Piney Ridge Treatment Center

*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: Fayetteville, AR                   Population Served: Children and adolescents ages 7-17 with sexually maladaptive behaviors and other co-occurring psychiatric conditions.

# of residents per unit: Up to 32 Residents per room: 1, 3 or 4 Capacity: 102

Contact with family (Calls and visit schedule): Typically, bi-weekly phone calls. Visits with family are scheduled (frequency or schedule not provided).

Restraint utilized? Yes Chemical Restraint utilized? Yes Seclusion utilized? Yes

Treatment Modalities:

Clinical Director: LPC's                    Therapists: 8 full-time therapists (2 LMSW, 1 LPC, 3 LAC, 2 LPC); 1 part-time/contract therapist (LAC)

Treatment modalities offered: TF-CBT, CBT and other modalities individualized for resident and needs.

# of individual therapy sessions/week: 1-2

# of group therapy sessions led by a licensed mental health professional/week: 3

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PRLU or OLTC

Visit Compliance Report

  • Completed walkthrough and reviewed 4 MARs.
  • Specialist discussed complaint alleging staff were not in ratio on 10/16/21. Staff provided a list of staff who worked that night. A staff member was late to work causing the ratio to be 31/3 for approximately 30 minutes. The CEO stated they had 2 extra direct care staff in the building, but that they would make sure extra staff are always assigned to prevent shortages.
  • Regs not correctable –
    • R1007.4 – Licensing determined complaint to be founded; The North Unit was out of ratio with the residents 31/3 for approximately 30 minutes.
    • R1008.4.d – Medications were not documented as given to 3 residents.
  • Regs out of compliance –
    • R1013.8 – Several bedsheets had stains or debris on them (The CEO stated bedsheets are changed weekly and residents can change their sheets as needed. A training will be conducted to ensure everyone is aware they can have clean linens as needed).

PRLU or OLTC

Notice of Incident

  • ER Visit (Overdose)
    • Peers reported to staff that resident had taken an unknown amount or type of medications that she had been “cheeking” during medication administration by staff. Resident taken to ER; No follow-up details.

PRLU or OLTC

Notice of Incident

  • ER Visit (Self-Harm)
    • Resident was self-harming by biting the inside of her lip so she could “see the blood”. The biting left several deep cuts to the interior portion of her bottom lip that continued to bleed. Resident was taken to ER. No follow-up details.

PRLU or OLTC

Notice of Incident

  • ER Visit (Foot Pain)
    • Resident reported pain/swelling to his right foot. Resident was sent for X-ray at ER. No follow-up details.

PRLU or OLTC

Notice of Incident

  • Complaint
    • Complaint received that staff were out of ratio with the residents on the North unit this past Saturday (10/16/21).
    • Specialist visited the facility and staff provided a print out of staff who were working on 10/16/21. The report shows there were 4 staff with 31 residents, and then 1 staff clocked out at 22:00 leaving 3 staff to 31 residents. The relief worker was late to work and did not clock in until 22:30 which brought the ratio back up to 31 residents to 4 staff.

PRLU or OLTC

Notice of Incident

  • Sexual Abuse
    • A former resident reported sexual abuse by an unknown peer between 2018 and 2019 while at the facility. No further information can be provided.
    • Child Abuse Hotline was called and accepted, unsubstantiated. The resident is no longer in the care of the facility so the Specialist cannot interview him. The A/O is an unknown peer and the time frame of the alleged abuse is sometime in 2018 or 2019 making video review impossible.

PRLU or OLTC

Notice of Incident

  • Elopement
    • Residents eloped through the door of the cafeteria and climbed over the fence leaving the facility grounds. Facility notified the police department. No follow-up details.

PRLU or OLTC

Visit Compliance Report

  • Specialist reviewed 2 MARs and completed walkthrough. Agency has purchased several new items to be updated including soap dispensers, exit signs, water racks, doorknobs, etc.
  • Regs out of compliance –
    • R1011.7 – Rooms 400 & 403 have damaged drywall on wall & ceiling from residents hitting/picking at it. Profanity written on a wall of the hall in the South Unit in 2 locations. Agency will have rooms and walls repaired. Room 406 smelled of wet clothes/body odor; Housekeeping was called to clean the room.

PRLU or OLTC

Notice of Incident

  • ER Visit (Foreign Object)
    • Resident reported she had stuck a rock in her vaginal cavity and it had not come out. Resident reported pain 8/10 so she was taken to ER. No follow-up details.

PRLU or OLTC

Notice of Incident

  • Maltreatment (1)
    • During interview about a separate matter, Specialist was informed that staff member used inappropriate language and threatened a resident. Additionally, staff did not intervene as the resident was being beat up by his peers.
    • Agency stated they are currently doing their own investigation into this matter and conducting interviews with the staff and residents involved. Specialist interviewed 6 residents involved in the altercation that took place; 2 residents reported they did not hear inappropriate comments/language from staff and the other 4 reported that staff “asked nicely”.

PRLU or OLTC

Notice of Incident

  • Injury (Self-Inflicted)
    • Resident was taken to ER for X-ray of his finger due to punching the wall and window of the seclusion room he was placed into on 9/11/21.
    • Specialist received an addendum reporting that both the residents hands were X-rayed at the time of the ER visit and it was determined that he had fractured both pinky fingers.

PRLU or OLTC

Visit Compliance Report

  • Specialist received a complaint that staff was out of ratio on 8/30/21. Specialist completed building and grounds walkthrough; All units were currently in ratio, but after shift change between 20:00-20:30 tonight, North and East Units will be out of compliance due to lack of staff availability. (10 staff to 92 residents)
  • Regs out of compliance –
    • R1012.4 – Bathrooms on South and West Units had paper towels and toilet paper in the floor. Staff stated residents just used restrooms before going to bed. Staff will clean once residents are asleep.
  • Regs not correctable –
    • R1007.4 – Staff/child ratio was not met on the night of 8/30/21; North Unit was 31 residents to 3 staff, East Unit had 21 residents to 2 staff. Specialist met with CEO who stated the facility was actively trying to fill available positions. Facility has had a high number of call ins and lack of staff availability.

PRLU or OLTC

Visit Compliance Report

No site visit conducted on this day. The specialist spoke with staff to inform them that the complaint received on 7/18/21 has now been completed. Licensing Complaint unfounded.

PRLU or OLTC

Notice of Incident

  • Complaint
    • Licensing Unit received complaint (from unknown source) stating that the facility is severely understaffed. “On August 30, 2021 one unit had 31 kids and 3 staff during the day. Yesterday there were only 8 staff for 94 kids. The DON and a nurse had to staff the annex building.”
    • Specialist visited the facility on 9/7/21 for unannounced visit to conduct walkthrough. The facility was currently in ratio, but the reports from 8/30/21 did show that two units were out of ratio that night as the complaint stated. Additionally, due to call ins, ratio will be out of compliance again tonight (9/7/21).

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • Client reported to staff that during his first restraint hold at the facility on 8/26/21, staff choked and hit him after the resident spit in his face.
    • Staff was placed on suspension on 10/21/21 pending the results of the investigation. Child Abuse Hotline was called and accepted, unsubstantiated. Facility reports there is no video footage of the incident and incident packet has been reviewed. The restraint report shows that resident reported he felt safe with no pain/injuries noted to him by the nurse. Due to no injuries/complaints from resident at the time of the incident, the agency did not have reasonable cause to believe maltreatment occurred so it was not reported.

PRLU or OLTC

Visit Compliance Report

  • Facility reported a total of 10 residents and 1 staff member tested positive for Covid-19 this morning. An additional staff member is currently off work with Covid-19. Due to the outbreak, specialist viewed rooms on East and South Units, but not North and West Units as these were where residents were being held on isolation for positive Covid-19. Specialist reviewed 4 residents MARs.
  • Regs not correctable –
    • R908.8 – After reviewing MARs for 4 residents on West Unit, it was discovered that all medications for today were labeled as administered to the patients for the full day including night medications. Nurse reports she has a “bad habit” of pre-filling medication logs when she knows she will be the one to administering them in the evening. Additionally, two medications were not initiated or marked as administered to resident on 8/18/21.

PRLU or OLTC

Notice of Incident

  • Suicidal Statement
    • Resident reported to staff that he wanted to kill himself.
    • Physician was notified and ordered the resident to be assessed for acute placement. He was assessed late afternoon/evening and was admitted late in the evening to Vantage Point for acute care.

PRLU or OLTC

Notice of Incident

  • Injury (Accidental)
    • Resident attempted to do a back flip during recreation and landed on his hand. Nurse noted swelling/bruising. Resident was taken to ER. No follow-up details.

PRLU or OLTC

Notice of Incident

  • Injury (Peer Altercation)
    • Two residents were in an altercation in the cafeteria.
    • Both residents were placed on precautions and assessed by the nurse. Resident 1 stated his pinky finger hurt and was swollen. He received an X-ray that showed an acute oblique nondisplaced fracture of the base of the distal phalanx of the fifth finger. Staff emailed the specialist to report that the staff/child ratio at the time of the incident was 3/17 and there is no video footage of the incident.

Police Report

Assist Agency

Smoke coming from room; Smoke coming from mechanical room, no fire. CEMS and PD canceled.

PRLU or OLTC

Notice of Incident

  • Maltreatment – Sexual Abuse
    • A former resident made a report that during his stay in 2018/2019 that an unknown staff member pulled him from class and took him to the nurse’s station. While at the nurse’s station the unknown female staff fingered his private parts. The former resident reported that this only happened one time.
    • Due to their not being a staff member named in the investigation and the alleged abuse happened 2-3 years ago, there is not enough information for an interim corrective action. Child Abuse Hotline was called and accepted.

PRLU or OLTC

Notice of Incident

  • Other – Restraint
    • Resident was refusing to go inside the facility after it began to rain/lightning. Resident was placed in a restraint hold for kicking/hitting staff by two nursing staff. Resident claimed nurse bent her thumb backwards during the restraint but does not believe it was done on purpose.
    • Facility interviewed both nurses on the incident/restraint hold.

PRLU or OLTC

Visit Compliance Report

  • Regs out of compliance –
    • R911.15.f – Cords found on shorts in rooms of 201 and 408. Strings were removed from shorts on site. Correction date 7/9/21.
    • R907.3 – Staff was out of ratio with residents in Sprout Day Room 1:12. Additional staff were called to the day room to ensure ratio compliance before walkthrough continued. Correction date 7/9/21.

Medicaid Inspection of Care

On-Site Inspection

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

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • Resident reported that staff member pushed him. Resident states he first pushed staff several times and was upset at staff member for taking his ball and dice. Staff member then pushed resident about 6ft towards the nurse’s station.
    • Staff member was immediately taken off his shift and sent home. Staff member was placed on suspension. Child Abuse Hotline was called and accepted.