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Location: Little Rock, AR
Population Served: Adolescents 12-17 years of age in need of mental health services on a 24 hour a day basis.
| # of residents per unit: 12 | Residents per room: 1-2 | Capacity: 54 |
Contact with family (Calls and visit schedule): Kids have daily contact with their family either via zoom, face time calls, or phone calls. In the evening they are given time to call families and their families are welcome to call anytime during the day. Outside of Covid-19 Restrictions families can visit on the weekends and once during the week.
| Restraint utilized? Yes | Chemical Restraint utilized? Yes | Seclusion utilized? Yes |
Clinical Director – LPC
Therapists: 8 full-time therapists (4 LAC, 3 LCSW, 1 LPE-1); 1 part-time/contract therapists (1 LCSW)
Treatment modalities offered: EMDR, TF-CBT, ARC, Brain Spotting, Trauma-Focused Family Therapy, Reactive Attachment Multi-Family Group
# of individual therapy sessions/week: 2-3x/week
# of group therapy sessions led by a licensed mental health professional/week: 2-4x/week
# of family therapy sessions/week: 1x/week
PRLU or OLTC
Notice of Incident, Self-Harm
Resident became upset after an altercation with her roommate and began punching a wall. Afterward, the resident was transported to Urgent Care for evaluation of her hand.
Diagnosis: Swelling and bruising to right hand. No fracture was found on the x-ray.
PRLU or OLTC
Accidental Injury, Notice of Incident
Resident complained of pain after hitting her head while doing a backbend. Resident was assessed and then transported to the emergency room for further evaluation.
PRLU or OLTC
Neglect, Notice of Incident, Visit Compliance Report
A resident was left alone and unattended in the house while her housemates went to lunch. The resident was found by a nurse entering the house.
Licensing Specialist: Kendra Rice
Program Coordinator reviewed camera footage of the incident. Per camera footage, the resident was left alone for a little more than 2 minutes. Staff members involved in the incident received written warnings. were required to review the policy and were coached verbally.
The facility was cited for 907.2
Police Report
Disturbance, Police Report
Officers responded to the facility in reference to a disturbance. A resident had an outburst and was kicking and headbutting staff members. Officers provided facility staff with a report number and left the scene.
PRLU or OLTC
Notice of Incident, Self-Harm
Resident became upset after learning she was not on the list to go on an outing and began kicking and banging her head on the wall. Afterward, the resident complained of pain in her right hand, so she was transported to the emergency room for evaluation.
Diagnosis: Right hand injury. No evidence of fracture.
Resident returned to the facility with orders to rotate Tylenol and ibuprofen and use ice packs for pain.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Kendra Rice
Program Coordinator completed buildings and grounds for Hickory House. Census: 44.
The following areas were observed: day/common area, milieu, nurse’s office, kitchen, laundry room, storage closet, staff offices, linen closet, bedrooms, bathrooms, dining area, comfort room, seclusion room, and game room.
Program Coordinator observed two water fountains and tree fire extinguishers in cases in different areas of the house, as well as, smoke detectors in each bedroom and other areas of the house. The evacuation plan was located on the wall near the milieu. Interior painting has been completed throughout the entire house.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Kendra Rice
Program Coordinator conducted an annual review of policies and procedures. All policies and procedures complied with minimum licensing standards.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client fell while on an outing to Pinnacle Mountain. After the fall, the client complained of knee pain. Swelling of the knee was noted. Client was carried down the mountain by emergency responders and transported to Arkansas Children’s Hospital.
Diagnosis: Contusion of the Left Knee. No fracture
Client was instructed to take over-the-counter pain medicines as needed and to use crutches and an Ace wrap as needed for ambulation.
PRLU or OLTC
Notice of Incident, Peer Altercation
Client was injured when he was attacked by a peer while playing basketball.
Client’s injuries included abrasions, redness, and bruising. Injuries were assessed and cleaned by staff. Client was then transported to urgent care for evaluation. No signs of a head injury were noted per Urgent Care.
The 2 clients were separated and were not allowed to interact with one another. They were also placed on freeze status.
PRLU or OLTC
Notice of Incident, Self-Harm
Client’s right hand was injured when she became upset and punched a wall several times. Client reported severe pain with limited range of motion. Purple discoloration and mild swelling were noted.
Client was transported to Arkansas Children’s Hospital for evaluation. Diagnosis: Hand injury with no acute fracture. Client was instructed to alternate Ibuprofen and Tylenol and apply ice as needed for pain and swelling.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Tara Norton
Licensing Specialist reviewed Children’s records. All files complied with minimum licensing standards.
PRLU or OLTC
Visit Compliance Report
Licensing Specialist: Tara Norton
LS Norton completed buildings and grounds for the following houses: Sturgis, Chestnut, Rose, and Mabee.
The following areas were obsesrved: group rooms, common areas, laundry rooms, seclusion rooms, comfort rooms, milieus, game/craft rooms, hygiene closets, storage rooms, bedrooms, and bathrooms.
The grounds around each house were clean and well maintained.
Sturgis: The house and bedrooms were mostly clean and organized. One bathroom was noted to have a black substance around the top of the walls near the ceiling. Facility cited 912.4 for the black substance on the walls.
Chestnut: House was clean and smelled of cleaning supplies. All bedrooms were clean and mostly organized. Bathrooms were clean.
Rose: House was clean and smelled of cleaning supplies. All bathrooms were clean and sanitary. All bedrooms were clean and mostly organized.
Mabee: House was clean and organized. All bathrooms were clean and sanitary. All bedrooms were mostly clean and organized.
PRLU or OLTC
Acute Placement, Notice of Incident
Resident was in the comfort room and refused to come out. Another client wanted to use the comfort room. They started arguing and exchanging words and were separated . Resident was threatening and cussing at everyone.
7:00pm: Personal Restraint: the resident became unsafe in the house, a threat to safety and herself.
7:25pm: Patient found sitting calmly in a chair at a table in the house. Patient denies pain or injury and is calm and cooperative with a depressed affect.
Client was transferred to Pinnacle Pointe for an acute stay on 05/27/24 at 1:30am. Client will return to Youth Home from acute at this time.
PRLU or OLTC
Accidental Injury, Notice of Incident
Client was actively playing volleyball with staff and peers. Client fell twice on her bottom and continued to play. Client went to sit and take a break then came to staff reporting that her wrist was hurting and that she thinks she sprained it.
Nursing Assessment: Client reports that she started to feel severe pain while tossing the ball. Left hand /wrist noted with mild swelling and limited range of motion. Tylenol PRN administered and ice pack provided. Dr Bayles notified of the findings and ordered to take client to Arkansas Children’s Hospital ER for evaluation.
05/18/24 5:25pm: Client returned from ER.
Diagnosis: Left Wrist Sprain.
PRLU or OLTC
Notice of Incident, Self-Harm
Client was prompted to put away her markers due to not being able to have them while being on eyeball. Client then began to pick at her fingers and was prompted many times to stop. Client then made her finger bleed and went onto pulling another scab and causing it to bleed as well.
Client was placed in a restraint and became very violent. Client was then taken to seclusion. Client began to scratch at staff and made several attempts to bite staff. Client began to kick at staff during this time as well and made attempts to hit her head against the floor repeatedly.
5/17/24, Licensing Specialist reviewed provider reported incident for licensing concerns. Sent email to facility to request nursing notes for resident.
5/20/24, Uploaded and reviewed nursing notes from incident. Emailed facility to inquire if resident is expected to return to the facility.
5/20/24, Facility response: At this time, she will return to our PRTF program.
Police Report
Disturbance, Police Report
Officers were dispatched to Youth Home to assist EMS with transport of resident to acute care.
Police Report
911 Hang Up, Police Report
Officers were dispatched to Youth Home regarding a 911 hang up call. Officers made contact with staff who informed them that all was well. No need for a law enforcement response.
PRLU or OLTC
Medical, Notice of Incident
Patient was eating lunch when he began choking on some potato chips. Staff performed the heimlich maneuver, dislodging the chips. Orders were given to transport patient to Arkansas Children’s Hospital ER for evaluation.
Resident returned from ER. Prescribed Maalox or other heartburn medicine for pain control if needed.
PRLU or OLTC
Elopement, Notice of Incident, Visit Compliance Report
Client became upset after witnessing a peer elope into woods. Client began picking up desks and throwing them, then charged at a door, pushing through staff. Client was placed in a personal restraint. Client was able to get out of staff hold and run toward D zone. Client escalated and threw trash can, ran out of the D zone, and began punching door, breaking the glass. Client kicked open the door and walked away from staff towards the road, hitting himself in the head.
Client was encouraged to decompress, slow his breathing, and asked what he needed. Client began to calm down and complied with staff and was released out of the restraint and escorted to the D-zone.
Client was assess by the nurse. Upon examination, no physical markings were noted, and the patient reported no injuries from the restraint, declining medication. Staff informed the nurse that the patient began hitting himself in the head while walking away. Another face-to-face assessment, along with a neuro exam, occurred at 1448, revealing the patient to be conscious, alert, aware, and oriented x4 with a steady gait.
Orders given: Freeze, HR, RR, and hydroxyzine 25 mg PRN BID
Licensing Specialist: Tara Norton
LS Norton visited the facility to review video footage. No citations given.
PRLU or OLTC
Notice of Incident, Self-Harm
Client complained to staff of a sore hand. Client stated that after a bad phone call w/ mother she went to her room and punched the wall.
Upon assessment, the right knuckles are swollen and beginning to turn purple. Client tells this nurse that she has trouble feeling ends of fingers. Client sent to urgent care per provider on call.
Diagnosis: Contusion to hand. No fracture. Ice/compression recommended for at least 20 min per day, rest recommended. Splint given. Ibuprofen as needed for pain.
PRLU or OLTC
Acute Placement, Elopement, Notice of Incident
Resident left the dinner line and exited the front of the administration building, walking toward a neighbor’s home. As staff looked for the resident, they were waved down by a neighbor. The resident stood in the neighbor’s foyer, stating that she could not go back to the facility.
Staff processed with her, and they returned to the facility. Resident was placed on house restriction and transported to acute care.
Licensing contacted facility to obtain a copy of the nursing notes, to inquire about video footage and ratio.
PRLU or OLTC
Notice of Incident, Self-Harm, Visit Compliance Report
Client had a bad phone call with her parents and was upset because of her conversations with peers. Client began to pace back and forth and started to kick the door down to plan an escape. Client was redirected to stop kicking the door. Client then charged as though to strike another client. Staff stepped between clients to avoid this conflict. Becoming more angry, Client grabbed electronic cords, and tried to wrap them around her neck. Staff grabbed the cords and prevented client from wrapping them around her neck. Client was redirected to sit in the milieu and offered to have a talk away from others in the recreation room.
Licensing Specialist: Tara Norton
5/2/24 – Facility visited in response to incident. Camera footage reviewed. Resident was observed grabbing some loose wires from a computer and attempting to place the wires around her neck. Staff were observed removing the wires from the resident’s hands and trying to verbally de-escalate.
PRLU or OLTC
Acute Placement, Notice of Incident, Visit Compliance Report
Client was exhibiting aggressive behavior after he returned from school. After ramming a chair into staff’s desk, client was placed in a personal restraint. Once released, he began beating on the door of his room. Client left his room, but was advised to return to his room. When he refused, he was placed into another personal restraint. During this restraint, client began struggling, cursing, and kicking staff. Clients shoes were removed. Client was released from restraint and taken to locked seclusion. Client began screaming and stated that staff had scratched him. Client began banging on the window, then tried to put his bracelet around his neck. Client was placed in another restraint, so the bracelet could be removed. Client was placed back into locked seclusion but was unable to calm down. He continued to yell, hit the door, and hit himself, growing more unstable. Client was sent for acute placement. Per facility, client will not be returning upon his discharge from acute care.
Licensing Specialist: Tara Norton
4/25/24 – Facility visited in response to incident. Camera footage was reviewed, which showed personal restraints used and resident being placed in the seclusion room due to aggressive behavior toward staff. No citations issued as a result of this incident.
PRLU or OLTC
Accidental Injury, Notice of Incident
Patient was playing football and tripped and fell while running, injuring his leg. Nurse assessed patient and determined he should be seen by an Urgent Care physician. Urgent Care staff examined patient and advised Youth Home staff to take patient to the ER due to the severity of his injury. Staff transported patient to the ER. Patient diagnosed with contusion of Left knee. X-ray of knee was normal. Care instructions included RICE therapy for 48 hours (Rest, ice, compression, and elevate) and PRN pain medication as needed.
PRLU or OLTC
Accidental Injury, Notice of Incident
While playing a recreational activity, the patient threw a football, irritating his left hand leaving it unable to move. After seeing the nurse and being advised by the doctor, staff were advised to transport patient to Urgent Care at around 2:45 pm. Patient returned from UC visit with left hand/wrist wrapped with ace wrap. UC advised to put patient on activity limit/ice/ibuprofen/ace wrap. No fracture was found on X-ray.