Disability Rights Arkansas

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*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 rstanford@disabilityrightsar.org

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

Treatment Components:

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

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PRLU or OLTC

Notice of Incident

  • ER Visit (Accidental Injury)
    • Client was playing sports in indoor gym and landed on right ankle, causing immediate pain/swelling. Staff provided ice, elevation, and shoe was removed. Client was transferred to ACH via ambulance at 5:58pm.
    • Specialist followed up via email on 1/21: Staff advised there was no fracture. Client resides in Rose House.

Police Report

Medical Emergency

Nurse at facility stated juvenile was playing volleyball and rolled her ankle. Officer confirmed with juvenile what had happened. Juvenile was transported to ACH by MEMS.

PRLU or OLTC

Notice of Incident

  • Suicidal/Threatening Behavior
    • Client stated to morning staff that it was going to be a bad day for everyone. Client grabbed a disinfectant wipe of staff’s desk and squeezed the excess solution into his mouth. Poison Control was called for further instructions, who stated there shouldn’t be any adverse side effects. Client then hit peer, resulting in seclusion. After punching door in seclusion, client calmed down. Upon video review, it was discovered that client was not supervised during seclusion. The seclusion room was also not free of hazards, including client’s bed. No staff noticed that client tied sheet around his neck. Client was transported to acute placement at Pinnacle Point.
    • Specialist visited facility on 1/26 and reviewed video for 1/19 from 7:30 – 8:00am. Hazardous items were in seclusion room and staff walked away for considerable amount of time after client entered. 

PRLU or OLTC

Notice of Incident

  • Suicidal/Threatening Behavior
    • Client told staff about being rude to peer the previous day, and staff gave client 30 minutes of table time for being rude. Client walked away from group (outside playing kickball) and began picking up rocks, trying to hide them. Client refused to walk back to house and began walking towards the street instead. Restraint began outside of Mabee house. Client continued to move towards street and continued to struggle while restrained in street. Help arrived and moved client out of street into house. After call with guardian, client began to scratch arms and grab the phone cord. Treatment Team felt client met criteria and need for acute placement. Client’s guardian refused to consent to acute placement and picked client up at facility. Client was discharged AMA at 7:54am. No follow-up details.

PRLU or OLTC

Notice of Incident

  • Suicidal/Threatening Behavior
    • Client’s phone call with guardian did not go well and client began to destroy property and hit a wall mirror in her room. Staff escorted client to the seclusion area. While in seclusion, client stated she would hang herself and kill herself tonight because she could not go on staying at the facility. Client put a sheet around her neck at which time a restraint was used by staff. Client debriefed afterwards with staff. Client was placed on eyeball precautions.
    • Specialist visited facility on 1/04/22 and viewed video of incident from 1/02/22 started at 1:30pm. Client had no incidents while on eyeball and client reportedly is still on eyeball.

PRLU or OLTC

Visit Compliance Report

Facility visited and incident report was reviewed, no video footage available. Clients are now in the same house but in a different hallway. Staff roster and sleep log reviewed and were in compliance with Licensing Standards. Sleep checks were conducted every 30 minutes and initialed. Staff ratio was 1:6. Interim Corrective Action reported as children being separated.

PRLU or OLTC

Notice of Incident

  • Suicidal/Threatening Behavior
    • Staff issued a high-level hold after client attempted to attack a peer. Client was taken to the seclusion room while resisting the restraint. While in seclusion, client began making suicidal comments. Staff intervened after client tried to tie a string around his neck. Client then tried to use socks to choke himself and tried to do the same with his pants. Staff intervened and took items. After client calmed down, staff processed with client.
    • Staff reported to licensing on 12/30 that client was doing well and continues to reside at facility. Video footage was observed of incident that occurred on 12/4 starting at 5pm at Chestnut House. No improper restraints or physical injuries were observed happening to client by staff. Facility is working with DCCECE Licensing to implement plan for timely reporting in the future. Plan involves nursing staff sending a brief notification when attending incident (This incident was reported on 12/30/21).

PRLU or OLTC

Visit Compliance Report

  • Hickory House viewed and MARS reviewed for 4 residents.
  • Regs out of compliance –
    • R409.6 – Outlet cover shall be replaced in room 2. Holes in wall were observed in rooms 1 and 8.
  • TA –
    • R411.5 – Bed frame had to be removed due to child using it to stand on as he broke ceiling fixtures.

Police Report

Runaway Juvenile

Caller reported Juvenile ran away from school and into the woods across the road. Several staff member conducting search. Police arrived; “Clear Alarms” on police report.

PRLU or OLTC

Notice of Incident

  • Suicidal
    • Client’s peer was having a crisis and client became anxious while inside her room. Client attempted suicide by wrapping her bed sheet around her neck and on her closet rod. Staff intervened and placed client in restraint hold. No injuries noted.
    • Client transported to Acute at Pinnacle.

PRLU or OLTC

Notice of Incident

  • Suicidal
    • Client’s peer was having a crisis and client became anxious while inside her room. Client attempted suicide by wrapping her jacket sleeve around her neck and on her closet rod. Staff intervened and placed client in restraint hold. No injuries noted.
    • Client transported to Acute at Methodist.

PRLU or OLTC

Notice of Incident

  • Suicidal
    • Client’s peer was having a crisis and client became anxious while inside her room. Client attempted self-harm by using plastic hangers to cut her wrist repeatedly. Client then attempted suicide by wrapping her bed sheet around her neck and on her closet rod. Staff intervened and placed client in restraint hold. No injuries noted.
    • Client transported to acute care hospital.

PRLU or OLTC

Notice of Incident

  • Suicidal/Threatening Behavior
    • Client self-harmed by scratching abrasions into her wrists and breaking scabs from previous self-harm areas. Shortly after, client picked up telephone receiver and wrapped the cord around her neck. Staff placed client in restraint for safety and removed telephone cord.
    • Specialist made call to facility staff who stated that prior to the phone call, staff had recently had to remove phone cord from client’s neck again today (11/24/21). Staff stated they were actively seeking placement for client in acute facility and if unsuccessful, ACH ER. Staff indicated when alternative placement was found, client would not be allowed to return to facility.

PRLU or OLTC

Notice of Incident

  • Suicidal Behavior
    • In his therapy session, client reported attempting to electrocute himself by touching wires in the electrical outlet in his room. Client notified staff after receiving a small shock and nurse evaluated and found no injury. Client was placed on increased monitoring and moved to increased viewing room. Client indicated that he wanted to die but had no plan, but the following day stated he did not. No follow-up details.

PRLU or OLTC

Notice of Incident

  • Suicidal/Threatening Behavior
    • Client became combative, threw a basket, kicked and attempted to punch staff and was then placed in a restraint and locked seclusion. Client started to choke himself with his shirt and staff intervened. Client screamed he wanted to kill himself and banged head on door. Client refused PRN, but eventually calmed down and was allowed to come out of seclusion. No concerns noted by nurse. Specialist left voicemail with facility.

PRLU or OLTC

Complaint Survey

Complaint #AR00027400 and #AR00027434 were unsubstantiated.

PRLU or OLTC

Notice of Incident

  • Accidental Injury
    • Client injured her knee during game of kickball when a peer slipped and fell on client’s leg. Client was sent to ER and was found to have a sprain of the right knee. Client was given knee immobilizer and will be using crutches. No follow-up details.

Police Report

Medical Emergency

Caller reports subject possibly tore his ACL in field behind admin building. No further info.

PRLU or OLTC

Visit Compliance Report

Visit completed to review video footage of incident. Specialist viewed video of client being escorted into the building by several staff and to the seclusion room. Holds were done appropriately, viewed orders for seclusion and hold. Client was placed on run risk and eyeball precaution status. Staff did everything according to policy and procedures to ensure client safety.

PRLU or OLTC

Notice of Incident

  • Accidental Injury
    • Client was playing basketball when he fell and heard a pop sound from his leg. Client was taken to ER; No broken bones were found.
    • Client should rest and use ice and no physical activity until healed.

PRLU or OLTC

Notice of Incident

  • Aggression/Fighting
    • Client became escalated after meeting with the nurse, started screaming, and ran out the front door. Client was placed in hold and escorted back to house from school in van by staff. Client was placed in seclusion after continuing to threaten staff/peers. While in seclusion, client wrapped shirt around neck. After shirt was removed, client calmed down and was assessed by nurse. Client had imprint of concrete on forehead, but no laceration. No follow-up details.

PRLU or OLTC

Notice of Incident

  • Accidental Injury
    • Client was playing football when he collided with another peer and his foot was kicked on accident. Client was advised to get X-ray.
    • Specialist emailed facility to find out outcome of ER visit; Facility will get back with specialist after checking with Nursing team.

PRLU or OLTC

Notice of Incident

  • Suicide Attempt
    • Client was observed with hoodie wrapped around his neck; After staff removed hoodie, client began destroying property and was put in physical hold and placed in seclusion. While in seclusion, client took off his shirt and tried to put it around his neck; Staff removed shirt and administered chemical restraint after client became more calm and stated that he was hungry and wanted to come out to eat dinner.

PRLU or OLTC

Complaint Survey with POC, Revisit Survey

  • Complaint #AR00027557 substantiated.
  • Regs out of compliance –
    • N 132 – Facility failed to ensure a personal restraint was performed in a safe and appropriate manner for 1 client.
    • N 189 – Facility failed to ensure a staff debriefing was conducted after the use of a restraint for 1 client.
    • N 124 – Facility failed to ensure staff were retrained in the appropriate application of a personal restraint for 1 client who were subject to the inappropriate application of a personal restraint.
  • Plan of Correction – A training video was developed to demonstrate appropriate and inappropriate holds; The proper use of a post intervention debriefing is described in a training video that must be completed by staff; All ESIs will be reviewed by the Unit Managers for appropriate use of CPI techniques. All retraining will be reported to the Chief Clinical Officer on a monthly basis. An update to the Ethical Standards Policy #1405 was approved that added duty to intervene for all staff if they observe misconduct.
  • During the Revisit Survey conducted on 11/30/21, facility was found to be in compliance with program requirements.

PRLU or OLTC

Notice of Incident

  • Medical
    • Client was sent to Urgent Care due to eye pain and blurred vision. Client was not able to be seen and was taken to ER.
    • Specialist emailed to find out outcome of ER visit; Facility will get back with specialist after checking with Nursing team.