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, Suicide Attempt, Visit Compliance Report

Client was not responding to staff while she was in the restroom. The nurse opened the door to find her in the shower floor with pants tied around her neck. Nurse was able to get the pants off from her neck, respiratory rate and pulse within normal limits. Resident originally reported she was playing the choking game, but then started crying because she missed her mom. Complete assessment was done, she scored low on suicide risk assessment, and however she was placed on self-harm precautions and monitored closely. Upon re-assessment the resident was no longer upset, no injuries from having the pants around her neck.

Licensing narrative: licensing requested the facility to retain any video footage of this incident for review and send all nursing/staff notes to the program coordinator. 5/17/23- licensing received a copy of the nursing notes. 5/25/23- licensing visited the facility and was informed there is no video footage available for review. The resident was in her own bathroom that is inside her own bedroom when the incident occurred. Licensing Specialist: Chelsea Vardell.

Police Report

Battery, Disturbance

Caller reported patient has injured other patients, broken cameras, stabbed a staff member with a pencil, attempted to set off the sprinkler system, and is currently punching a wall in the dayroom. Patient has received emergency medication but none are working. Patient has been separated from other patients and is with staff, and currently has a screw and is threatening to stab someone with it.
Upon officers arrival, 3 staff members reported they were assaulted by juvenile after he became increasingly angry. Staff attempted to restraint juvenile but were unsuccessful. Staff stated they were able to get the juvenile in a central room and locked the doors, keeping him from wandering the facility and causing more damage. Once inside that room, juvenile began destroying property totaling approximately $1200 in damages. Staff member stated this behavior started the night before after juvenile destroyed some property and was “not allowed to play and have fun after last night’s incident so he became upset.” Officers made contact with juvenile who was acting calm and was arrested and transported to JDC without issue.

PRLU or OLTC

Notice of Incident, Visit Compliance Report

Client was in the North Dayroom and found out that his level was dropped. He became escalated and threw items, kicked the door and staff attempted to de-escalate. He then started hitting his shoe against the video camera on the unit and ripped it off the ceiling. He was restrained for safety as he continued to be escalated and during the restraint he kicked and hit at staff and received emergency medication. Client was released per protocol, and he continued the physical aggression toward staff and was placed in a supine hold for additional intervention, but was not able to be safely held. He then tore down additional cameras and pulled bolted down row of seats up on the unit, apparently obtaining a screw. He punctured a staff member’s arm with the screw (No apparent serious injury) and pushed and hit other staff members. The LPN called the administration and asked for intervention by the Fayetteville Police Department (FPD). The FPD were contacted, and they came to the facility and took the resident to the local Juvenile Detention Center where he is charged with criminal mischief and 3 charges of battery. At this time, a final decision has not been made of whether or not he will return to the facility.

Licensing narrative: Licensing visited facility, but was informed that there is no video footage of the incident because the resident broke the cameras during the incident. Resident has since returned and is no longer having major violent outbursts, but the facility reports he is making minimal progress with the treatment. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Medical, Notice of Incident

Resident came to nurses’ station crying, reporting stomach pain. She was assessed, APRN was notified, and orders were given to send to ER to rule out appendicitis. Resident was transported via EMS to AR Children’s Hospital. Resident left via EMS at 2340, and a staff went with her as well. She returned via Piney Transportation approximately 07:00 05/09/2023. She had a CT scan, lab work and an ultrasound. She was discharged with diagnosis ovarian cyst. She will be treated with anti-Inflammatory for the pain as directed.

PRLU or OLTC

Accidental Injury, Notice of Incident

On 5/8/2023 reported that while playing kickball in the gym he slid into a wall. RN on duty notified APRN, K. Reynolds. APRN ordered an x-ray of the right ankle and foot. X-ray report shows normal x-ray examination of the foot. No follow up required at this time.

PRLU or OLTC

Medical, Notice of Incident

On 5/3/23 it was reported by staff member that resident was non-responsive while in the cafeteria. The nurse did sternal rub and resident was responsive for a moment, and then went back to non-responsive state, breathing even and unlabored, vs bp 156/95, pulse 118, r 16, t 98. APRN Karen Reynolds was notified and gave order to send patient to Physician Specialty Hospital for evaluation and treatment. Staff transported by van. He was taken via staff and a nurse. He returned from the hospital. No new diagnosis or change in medication. The ER was able to pull old records and show that he did have a history of irregular heart rate.

PRLU or OLTC

Notice of Incident, Self-Harm

At approximately 0850 client was observed to be irate by staff. He stated that he was angry and then punched the wall with his closed fist. Swelling was noted on his right hand, and he received an x-ray in house. There were not significant findings on the x-ray.

PRLU or OLTC

Accidental Injury, Notice of Incident

Client reportedly called for help after slipping and falling as she got into the shower. She stated that she felt like her ankle twisted and it was in pain. The medical provider was contacted, and an x-ray was ordered of the right ankle. The x-ray came back negative for fracture or soft tissue swelling.

PRLU or OLTC

Accidental Injury, Notice of Incident

Client was outside playing basketball with peers from his unit. The resident fell down and twisted his ankle and stated he heard a loud popping sound. He was provided first aid; the medical provider was contacted, and an x-ray was performed. In addition, [REDACTED] went to Ozark Orthopaedics and he did not have a fracture. He has a follow up appointment on 5/1/23.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 1:45pm – 3pm. Census: 91. Areas observed: gym, units (East, West, North, & South), computer lab, classrooms, cafeteria, dining room area, game room, garden area, and courtyards. Residents must display safety to participate in gardening, and the garden is behind a locked fence. CEO reported the facility has been seclusion free as of 03/01/23 and seclusion rooms are being used as storage closets. MARs reviewed for 5 residents.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Chelsea Vardell.
  • Review of the agency’s current mandated reporter policy determined it does not comply with A.C.A. 12-18-402 nor the Minimum Licensing Standards. Please ensure facility policy is updated to reflect the need of all staff to report directly to the child abuse hotline without delay. The updated policy shall be submitted to the Licensing Unit by 04/14/23 and all applicable staff shall be retrained on the updated policy within 2 weeks of the enactment of the updated policy.
  • TA –
    • 110.9 – Any owner/operator, employee, foster parent, or volunteer in a child welfare agency shall immediately notify the Child Abuse Hotline if he or she has reasonable cause to suspect that a child has been subjected to child maltreatment, died as a result of child maltreatment or if they observe a child being subjected to conditions or circumstances that would reasonably result in child maltreatment.
    • 102.3.h -Child Maltreatment/Mandated Reporter policy; according to Arkansas law, including, procedures to ensure that alleged, suspected, or witnessed incidents of maltreatment are reported to the Child Maltreatment Hotline, and documented as required by these or other applicable rule or laws.

PRLU or OLTC

Altercation, Notice of Incident, Peer Altercation, Visit Compliance Report

At approximately 1005, the North unit was lining up after community group to go to class. Client 1 pushed and then quickly hit client 2. Staff intervened on the situation. Client 2 was assessed by nursing; order was received to take him to Arkansas Children’s hospital due to possible fractured nose. He was having trouble breathing out his nose and reported numbness. Client 1 reported pain to his right hand. He was assessed and order received for x-ray to be completed in house. Resident was taken to Children’s hospital where he had a CT scan that confirmed a [REDACTED] . He returned to facility with ibuprofen every 6 hours for pain, and a follow-up with ENT on 04/03/2023. Client 1 had x-ray completed in house of his hand and shows no fracture or dislocation. He will be treated for pain as needed and also follow-up with APRN as needed. Client 1 was placed on precautions for the behavior and was on increased observation. Licensing Specialist: Kendra Rice

PRLU or OLTC

Notice of Incident, Peer Altercation

Client was pushed in the cafeteria by another resident, [REDACTED], during horseplay. She hit her left temple are on the floor. Nursing assessment shows pupil equal and reactive, no issues noted. Nursing informed the APRN who ordered the resident to go to the emergency room for assessment. She was taken to Arkansas Childrens ER. She returned at 2250 with an order for ice and ibuprofen. No new injuries were found.

PRLU or OLTC

Accidental Injury

Client was playing basketball in the gym and went to catch the basketball and hit the ball with his pinky. He complained of pain 5/10 and was given ice and analgesic. APRN notified and x-ray was ordered to be obtained in house. The result of x-ray was obtained on 3-17-23 and he was diagnosed with a fracture to his pinky finger. He was taken to Ozark Orthopedics on 3-17-23 and a splint was placed. He was discharged on 3-17-23 to the care of his father and his father was aware of follow up needed. Interim Action Narrative: Resident was assessed and provided with ice and analgesic. APRN notified and x-ray ordered. Diagnosis: . Resident evaluated at Ozark Orthopedics and splint provided.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client was playing basketball in the gym when he rolled his ankle, and stated he heard a pop when he landed. Ice and Ibuprofen were provided and an in-house x-ray showed an oblique fracture. Client was taken to the ER where a soft cast was applied. Client has a follow-up appointment with an orthopedic clinic scheduled.
    • Licensing follow-up: Licensing received report late due to staff illness and staff who sent notification did not have the correct email for the Licensing Specialist. No licensing concerns noted.

Police Report

Welfare Concern

Caller with CPS in Florida needing a welfare check on juvenile. Juvenile is listed in an investigation in Florida and they need an officer to make sure he is not injured and has no bruises. Officer spoke with juvenile and did not observe any marks, injuries, or bruises on juvenile. Juvenile informed officer of a scar on his leg from a dog bite.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Michele Sutton.
  • Unannounced bimonthly visit. All classrooms, gym, East Unit, North Unit, West Unit, and South Unit viewed. A door in Room 106 (West Unit) had wooden lining that was partially peeled off; Facility reported a new door has been ordered and maintenance will sand door while waiting for the new door to prevent residents from peeling pieces off the door. MARS viewed for 5 residents. Licensing discussed activity schedule for the residents. Licensing reviewed records for 5 personnel and 4 children. No licensing concerns noted.

Police Report

Assault & Battery

Caller reported her son is currently a patient at the facility and was assaulted last night by another resident. The patient informed his mother that he thought his nose was broken. The officer spoke with staff about the incident, who stated both patients were playing a game where they were chasing each other and the patient was hit in the nose; His nose was not broken.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client became upset and hit a wall. X-ray completed in-house: No fracture.
    • Licensing follow-up: Medical treatment provided. No further follow-up required.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client complained of left-hand pain after attempting to catch a basketball. X-ray completed in-house: Dislocated fifth digit. Splint was placed and client will follow-up with Ozark Orthopedic this week.
    • Licensing follow-up: Medical treatment provided. No further follow-up required.

PRLU or OLTC

Notice of Incident, Peer Altercation

  • Peer Altercation, Self-inflicted Injury
    • Client was seen by the APRN on 02/01/23 after complaining of pain to his right hand. Earlier in the week, client became upset at a peer and engaged in a brief altercation, then hit a wall.
    • Licensing follow-up: Facility provided medical care to address resident complaint. No further follow-up required.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client complained of pain from recreation to his left pinkie and left ankle. X-ray completed on 02/02/23 with no significant findings.
    • Licensing follow-up: Facility provided medical care to address resident complaint. No further follow-up required

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client mis-stepped while walking down the hall and rolled his right ankle. APRN ordered an x-ray and ankle brace. X-ray results revealed no fracture. Client will be treated for pain as needed.
    • Licensing follow-up: Client received medical treatment and follow-up for his injuries.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client became upset and hit a wall; Ice was provided, and client voiced no other complaints. On 01/03/23, client complained of pain in her left hand and an x-ray showed a fracture to the fifth metacarpal. Client will follow-up with orthopedic clinic.
    • Licensing follow-up: Facility provided appropriate medical treatment and follow-up for resident injury. No additional follow-up required at this time.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury (1)
    • Client reported having an injury prior to admission, but thinks he re-injured it with a basketball. X-ray was ordered and showed a nondisplaced oblique fracture to base of the middle phalanx of the second digit. Client will follow-up with orthopedic clinic.
    • Licensing follow-up: Client went to orthopedic clinic on 12/20/22 and a splint was placed on his finger. Client placed on no sports and will follow-up with a hand specialist (specialist is booked and will call facility with an appointment date). No licensing concerns noted.