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

Notice of Incident, Self-Harm, Visit Compliance Report

A resident lacerated his finger while pulling at the metal plate covering the outlet in his bedroom. He was taken to Washington Regional Medical Center, where he received stitches to his left index finger.

Licensing Specialist (LS): Jarred Parnell

6/5/24: Facility was visited to walk through the building and grounds and inspect outlet covers in the residential units for maintenance issues. The outlet cover from the incident was not loose or damaged at the inspection. LS Parnell spoke with the resident who stated that he was not trying to cut himself or loosen the outlet. The cut was accidental.

PRLU or OLTC

Notice of Incident, Self-Harm, Visit Compliance Report

While outside, a resident swallowed a poison ivy plant. Staff tried to take the plant away from the resident but were unsuccessful. The resident also put soap and clay in her mouth.

The resident was given Benadryl per the doctor’s orders. An x-ray was completed on the resident’s abdomen. No remarkable findings. Resident was placed on a liquid diet for 48 hours and self-harm precautions for 24 hours.

Licensing Specialist (LS): Jarred Parnell

6/5/24 – Facility was visited to inspect the outdoor area for potential hazards.

PRLU or OLTC

Notice of Incident, Self-Harm, Visit Compliance Report

Resident ate nonfood items while in the courtyard. She also made comments to staff that led to her being put on self-harm precautions. No injuries noted.

Licensing Specialist (LS): Jarred Parnell

LS Parnell visited the facility to inspect the outdoor area for hazards residents may encounter while outside.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

Residents were outside with staff around 8:00 PM, when two residents ran off the property. The Fayetteville Police Department was not notified until 9:45 PM.

One of the residents was located within 30 minutes by staff. He was placed on elopement precautions.

6/1/24: The second resident was located at a local Walmart after getting caught shoplifting. He was returned to the facility and was placed on elopement precautions.

Both residents were moved back to the main building and will process with their therapists.

Licensing Specialist (LS): Jarred Parnell

6/5/24: LS Parnell visited the facility in response to the incident. Inquiries were made to determine the amount of time elapsed between the residents eloping and the police contact. Facility administration directed staff on site to contact police approximately 36 minutes after elopement. Staff contacted police after searching for the second resident for 1.5 hours. Staff were retrained on when to contact police and response after an elopement occurs.

Police Report

Missing Person, Police Report

On May 31, 2024, at approximately 9:53 P.M., officers were dispatched to 4253 N. Crossover Rd. for a missing person. Upon arrival, officers made contact with the caller who stated that two juveniles had run away from this location at around 7:30 P.M. Officers searched the area for the juveniles but were unable to find them. Officers put out a BOLO for the juveniles and added them to the missing persons log.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident got into a fight with a peer. Resident punched peer in the jaw. Afterwards he complained of pain in his right hand. Nursing assessed his swollen hand and gave the order to take him to Physician Specialty hospital where an X-ray was completed.

Diagnosis: Right distal 5th metacarpal fracture.

Corrective action taken by the agency: Residents are not in the same room, they were both put on precautions for 24 hours. There is no viewable footage of this incident.

PRLU or OLTC

Notice of Incident, Self-Harm

Resident reported that he took an AA battery out of an audiobook and swallowed it. X-ray was ordered. Orders received to take him to Childrens Hospital for evaluation.

He was seen and orders given to repeat x-ray in one week. Return to ER if he has persistent vomiting or acute abdominal pain. Facility will not be using Audiobooks until they have came up with a solution to ensure residents are not able to access the batteries.

Police Report

Elopement, Police Report

Officers are dispatched to search for four missing residents from Piney Ridge. Residents are located and transported back to the facility.

PRLU or OLTC

Elopement, Notice of Incident

On 5/9/24 at approximately 17:33, four residents in the gym with staff members kicked the door open from the gym leading outside. They attempted to climb the fences as staff and nurses attempted to de-escalate. Twenty minutes later, they climbed the fence and went off property.

The Fayetteville Police Department was notified. Staff left the facility in an attempt to locate, however FPD located the residents and returned them to the facility within approximately 25 minutes. All residents were placed on elopement precautions. Precautions will be assessed every 24 hours until precautions removed. All residents will process with therapist.

Licensing followed up with the facility, requesting any video footage of the incident. Facility stated no video footage of the incident exists.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was on an outing when he reported swallowing a plastic bottle cap on accident. He was assessed on site and then brought back to the facility. X-ray revealed no foreign bodies. Will follow up with APRN on 5/8/24.

PRLU or OLTC

Notice of Incident, Peer Altercation

On 05/03/2024, two resident got into an altercation in the gym. One resident shoved another, who in return hit the resident in the face. Staff was able to quickly separate the two residents. They were taken to the nurses station to be assessed. One had no injuries. One reported pain and had swelling to the left side of his jaw. He was taken to the ER where they did an x-ray.

Diagnosis: Fracture to jaw. Resident is on protein shakes and crushed meds for 6 weeks. The two residents were put on assault precautions and had a 6 foot no interaction.

5/6/2024- The provider reported incident was reviewed by the licensing specialist. Licensing Specialist contacted the facility in order to review the video footage of this incident.

5/8/2024 – Licensing Specialist received a response from the facility which stated you could not see the incident. Therefore the video was not saved. The residents were supervised by two staff for 12 residents in addition to the Certified Recreational Therapist and Activities Coordinator.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident was in the floor playing with Lincoln Logs, when he and a peer got into an altercation. During the altercation the resident was bitten and kicked in the face. Resident reported pain in the right side of his jaw. An X-ray was done in-house and showed no acute findings, but recommended CT for follow-up. On 4/21/2024, the resident was taken to Washington Regional Medical Center. CT was completed, and no fractures or dislocations were found. Resident was sent home with a muscle relaxer to take BID for 15 days and follow-up as needed by Primary Care Physician.

4/25/2024 – Licensing Specialist received a response from the facility for the safety plan “So, [the resident] was placed on assault precautions to be reviewed daily, [the peer] was placed on assault precautions to be reviewed daily for kicking the resident.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident reported pain to his left hand due to hitting a ball with the end of his finger. X-ray was ordered by APRN and shows small chip fracture to the base of the 4th middle phalanx. The fingers were buddy-taped together and an order was given to follow-up with Ozark Orthopedics early next week.

PRLU or OLTC

Notice of Incident, Self-Harm

On 4/17/24, Resident complained of hand pain due to punching a wall 2-3 days prior. X-ray was completed in house and shows fracture to the 5th metacarpal. Resident was taken to Ozark Orthopedics on Thursday 04/18/2024. A splint was placed for one week. Resident will follow-up with Ozark Orthopedics (will likely transition to cast at that time). Tylenol and Ibuprofen is given as needed for pain.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Jarred Parnell

A visit was conducted for the facility’s annual policy review. Policies reviewed: Personnel, Volunteer, Student Intern, Admission, Intake, Behavior Management, Crisis Management, Child Maltreatment/Mandated Reporter, Child Exploitation, Visitation, Family Therapy or Therapeutic Pass, Admission Health Assessments, Target Population and Admission, Exclusion, and Discharge Criteria.

PRLU or OLTC

Accidental Injury, Notice of Incident

A resident reported to the nursing department that on April 5th or April 6th, he was playing basketball and ‘rolled’ his ankle two or three times. APRN ordered an X-ray of the resident’s right ankle. Resident was diagnosed with a small acute nondisplaced fracture of the distal fibular metaphysis. On 4/13/24 the resident was taken to Washington Regional Medical Center and received a walking boot and was referred to an orthopedist specialist.

PRLU or OLTC

Accidental Injury, Notice of Incident

A resident reported to the nursing department that he had injured his right hand earlier in the week playing football. APRN ordered an x-ray of the right hand. X-ray found a type II non-displaced fracture of distal fifth phalanx. Findings suggest that the fracture is healing at this time. Resident was sent to Washington Regional Medical Care in Fayetteville, AR on 4/13/24 and received a splint. He is to follow up with an orthopedic specialist.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident got into a verbal argument with a peer about the line order while getting lunch, which soon escalated into a physical altercation. Staff was able to intervene and stepped between the resident and peer. The resident attempted to punch the peer multiple times, but a staff member was using her body to shield the peer and she was hit multiple times. Another peer struck the resident on the left side of the head while the resident was focused on attempting to hit his peer. A second staff member was able to get the resident away from the altercation.

The resident was assessed by nursing and was found to have a laceration on the pinna of left ear. The wound was cleaned, and a sterile dressing was applied. Ibuprofen was given for comfort and APRN was notified. Orders were received to take the resident to the Washington Regional Medical Center ER for evaluation and treatment, where he received 3 sutures.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact, Visit Compliance Report

Resident was sitting in the classroom beside his peer. Resident reported that his peer started to talk sexually, showed the resident his penis, briefly placed his hand on the resident’s clothed crotch area, and then “made” the resident touch his penis (which was outside his pants). Staff sitting in front of the residents turned around and saw the peer buttoning up his pants. Residents were separated. A meeting is scheduled with the peer’s team to discuss removal, referrals will be sent out to Acute facilities and the peer will not be sleeping in patient bedrooms. He is on additional observation that will be assessed every 24 hours. Re-education will occur with staff. A report was made to the Child Abuse Hotline and accepted for investigation.

Licensing Specialist: Jarred Parnell

Licensing Specialist conducted a visit at the facility to review video footage of the incident. Staff at the front of the classroom was seen going to the door to speak with someone, and during this time, the peer was seen reaching over to resident under the desk. It is unclear what he was doing with his hand under the desk. Peer can be seen looking around the room and then leans his head towards resident’s pelvic region. After the incident the staff person seated directly in front of the boys turned to see what was going on and then the boys were separated due to peer messing with his pants.

The facility is trying to find treatment more suited to the peer’s needs, as he has had other difficulties and behaviors unrelated to this incident which were not conducive to success at the facility. The peer currently sleeps in the hallway or NPR room with doctor’s orders until he is discharged from the facility. Re-education and training was conducted for staff concerning classroom supervision and expectations.

CACD investigation was unsubstantiated. Complaint UNFOUNDED by Licensing.

PRLU or OLTC

Notice of Incident, Peer Altercation

Resident started to antagonize other peers and he and two other residents started a physical altercation with one another. Resident was hit by one of the residents in the face. Staff body blocked and defused the situation. Resident complained of pain in face and an x-ray was ordered by APRN which he received on 3/11/2024. He had no acute fracture and additional medical care was not ordered.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident reported that he ran into the wall during recreational therapy on Saturday and today his left wrist is hurting. X-ray done in house with results showing possible buckle fracture. Resident was taken to Ozark Orthopedics and fracture was confirmed to left wrist. He has a soft splint on and will follow-up in 1-2 weeks.

PRLU or OLTC

Medical, Notice of Incident

Resident reported shaking or tremors and falling outside. She was assessed and had no injuries. APRN was called and gave order to send resident to Physician Specialty Hospital. She came back with new order to discontinue Cogentin and to follow up next week with Psychiatrist. Guardian called and she stated that her daughter used to do that to get attention from others. She followed up with APRN on 2/23/24.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident notified staff and nurses that while playing basketball on 02.22.2024 he ‘jammed’ his right thumb. APRN notified and an x-ray was ordered of the right hand. The results of the x-ray were a fracture of the right thumb. APRN ordered to refer the resident to orthopedics for further treatment.

PRLU or OLTC

Accidental Injury, Notice of Incident

Resident was in the gym and reported that he hurt his ankle while reaching for a frisbee and tripping. X-ray was performed in house showing fracture to right ankle. He was seen by Ozark Orthopedics 02/22/24 and confirmed diagnosis of fracture to ankle. He was placed in a soft cast with crutches and will return on 02/28/2024 to see specialist.

PRLU or OLTC

Medical, Notice of Incident

Staff reported that resident was having an allergic reaction in the gym. Nurse found resident laying down, face up, she was breathing but not responding to verbal stimuli. EPI pen was administered, and EMS was called. Patient was taken via EMS to Arkansas Children’s Hospital. She was assessed at the hospital and given IV fluids. The physician did not think it was an allergic reaction. She returned to facility and will follow-up with APRN here on 02/21/2024. Diagnosis: Syncope.

The following correspondence was received from the facility in regards to the incident: She saw APRN on 2/21 Subjective Pt reported a food allergy to berries on admit. She had an episode in the cafeteria on 2-20-24 with syncopal episodes and was sent to ER. ACH declined an “allergic reaction response” but no documentation to support. Mother and DHS declined a history of food allergies.