Disability Rights Arkansas

Youth Home

*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: 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, Suicide Attempt

Client was extremely irritated during a problem with a peer and was set off by all of the yelling and door banging. The client, who was sobbing and rocking back and forth, declared that she was going to kill herself at least twice. She had marks on her neck, which staff observed while performing wellness checks down the hall and inquired about (as they had not previously been there). The client expressed great regret for choking herself and said she was only angry with herself for yelling at her roommate.

Nurse examined patient who had visible red markings on both sides of her neck. Patient did not require any treatment at the time. Client placed on Front of House, Eyeball, and Supportive Status precautions.

PRLU or OLTC

Accidental Injury, Notice of Incident

Staff were interacting with patients throwing around a football to patients in the big field one by one. It was the patients turn to run a route in the big open field while staff was throwing it to him and one ball in particular went through the patient’s hands and accidentally hit him in his eye while trying to catch it. MD notified with order to transport to Arkansas Children’s Hospital ER to rule out ocular/orbital injury. Resident returned from ER: “No visual deficits, no corneal abrasion. Ice to the right eye 20 minutes on then 20 minutes off as needed for right eye swelling/pain. Tylenol and Ibuprofen as needed for pain”.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice

Census: 40. Program Coordinator completed an evening visit at Rose, Mabee, Chestnut and Sturgis houses.

All houses were organized and clean. Holiday decorations were displayed. Residents appeared to be enjoying their downtime. Staff and residents reported the following activities today: eating lunch with their family, making smores, taking pictures with Santa and Mrs. Claus, and receiving candy.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice

Census: 39. Licensing Specialist completed buildings and grounds on the following houses: Chestnut, Sturgis, Rose, and Mabee. The following areas were observed: Grounds, dining rooms, milieus, bedrooms, bathrooms, gaming area/game rooms, seclusion rooms, comfort rooms, kitchen areas (staff only), group rooms/visitation rooms. There were no residents present in the following houses: Sturgis, Rose, and Mabee. The residents were at school and one resident was at an appt. with a staff member.

Licensing Specialist was escorted by Jon Pulliam, PRTF Lead Unit Manager. Chestnut House ratio was 2:1. Pulliam informed Licensing that light cover plates have been ordered to cover light fixtures in bedrooms. Chestnut and Sturgis houses were clean and had the aroma of cleaning supplies.

Rose and Mabee house female residents. Rose House ratio was 2:1. both houses have lockers near the milieu. Both houses were clean and decorated for the holiday. Licensing observed the following documentation on the walls: Residents’ rights, food menu, washing hands instructions, emergency escape plan, chore list, activity calendar, shower times and and which shower to use.

Licensing will follow up with facility regarding the light cover plates.

PRLU or OLTC

Notice of Incident, Peer Altercation

Client and peer began to argue in the milieu, then began fighting with both of them landing on the floor. Client was kicked by peer while attempting to get up off the floor and was then redirected to another part of the house. Nurse assessment: Nosebleed, bottom lip is inflamed and bleeding, client c/o tooth/jaw pain and finger pain. Nurse also noted a chip in client’s L upper lateral incisor. Client states he is unsure if this is a new or old injury. Client was transported to Ortho AR on 11/30/23 for an evaluation. Both residents were placed on freeze. Client diagnosed with Left 2nd metacarpal chip fracture at follow up appointment.

PRLU or OLTC

Complaint Survey with POC, Revisit Survey

Complaint #AR00031282 was not in compliance, all or in part, with deficiencies written at N132 and N172:

  • N 132 – Facility failed to ensure a restraint was conducted in a safe and appropriate manner to prevent potential injury for 1 (Client #1).
  • N 172 – Facility failed to ensure a resident was protected from physical harm while being placed in a locked seclusion room (Client #1).

Plan of Correction:

  • Video footage of each restraint/seclusion incident is reviewed by the Unit Manager, usually within 24 hours. By Jan. 1, 2024 this will occur on weekends also. Each video reviewed is documented and kept in a Video Review Log. Chief Clinical Officer is notified when anything is noted that is questionable or inappropriate. Action taken either leads to retraining, a hotline call, and/or disciplinary action up to and including termination. In this case, the team member involved in the inappropriate hold received dismissal. All other team members included in the incident received retraining regarding appropriate holds on 10/26/23. They also received a written personnel action. The incident was reported to the hotline on the day of the review.
  • Monitoring is completed by video review and results reported at each Performance Improvement Committee meeting quarterly.
  • Beginning Jan. 1, 2024, we will begin using a checklist to assist with predicting violent behavior. The number of seclusions and restraints prior to beginning the checklist will be compared to the number after use each month with results reported to the Performance Improvement Committee.
  • Retraining on proper use of seclusion was provided by Unit Manager. Retraining included discussion of the need to intervene when an inappropriate interaction is observed. All direct care staff were assigned a training module in our online learning system to be completed by 12/14/23. Failure to complete training will result in disciplinary action.

A revisit was conducted on February 21, 2024, for all deficiencies cited on November 28, 2023. All deficiencies have been corrected, and no new noncompliance was found.

PRLU or OLTC

Notice of Incident, Self-Harm

Client became upset due to a family session and began banging on the front walls of the seclusion room. Client banged head on the unlocked seclusion room door and was placed in a restraint to prevent self-harm. Client was released once she calmed down, but went down the hallway and hit her hand on the wall. Client was placed in another restraint to prevent further injury. Chemical restraint was administered per nursing.

Client complained of right hand pain and was given an icepack and Ibuprofen. Area was reddened, no swelling noted. Nursing will continue to monitor. Client was transported to Rivendell for an acute stay on 11/07/23 during the evening shift. She remains at Rivendell at this time. Licensing Specialist informed that it is unknown at this time if resident will be returning to the facility.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient was putting a snake like fidget toy around her neck and a peer stated that she could get in trouble for playing around in that manner. She stated that she did not care as she was already on consequence. Staff informed her that unsafe behaviors would land her on other consequences. She was not pleased to hear this and threw the things down and ran out the door fleeing.

Patient was restrained to prevent elopement and escorted towards seclusion. Client was released from restraint after agreeing to remain calm. Patient voluntarily entered seclusion and began kicking and punching the wall. Client was restrained again to prevent self-harm. Additional staff arrived. Client began to process with staff but became annoyed that she was still at the school and not on her way to the house and she began digging her nails into her left arm leaving marks. Staff restrained her to further prevent this.

Patient was placed on Freeze, eyeball and FOH. Nurse noted fingernail marks to client’s left forearm where she dug her nails into arm in attempt to self harm (did not break the skin, superficial indentions noted to skin).

PRLU or OLTC

Accidental Injury, Maltreatment, Notice of Incident, Self-Harm, Visit Compliance Report

Client was upset after receiving a pause for being rude to staff, refused to take meds and started flipping over furniture. Client was placed in a personal restraint and taken to seclusion. While in locked seclusion, client broke a peers cup that was left inside and exposed sharp plastic edges around the cup that could be used to self-harm with. Staff entered to remove the item, and client threw the bottle at staff. Client was placed in another restraint and began kicking and scratching staff. Client was trying to bang her head on the floor and spit on staff as well. Once calm, client agreed to talk with nurse once released from restraint.

Nurse assessment: Client reported that her head was pulsating and 2 scratches were noted on client’s thumb from the personal restraint. Client also complained of knee pain, stating she hurt her knee earlier while outside.

On 10/26/23, client stated she was restrained improperly on 10/25/23 and that a staff member was digging his nails into her hand (stating abrasion on thumb was from this). She also reported that she was grabbed by the collar of her shirt and that it was tight on her neck and it was “choking her.” Patient stated that she tried to tell them that she was being choked but they wouldn’t listen. Patient had no marks on her neck/throat but is noted to have some petechiae around her eyes and cheeks that wasn’t there yesterday. Client was transported to Arkansas Children’s Hospital ER to assess petechiae rash on face and headache that has not responded to treatment. Diagnosis: Concussion. Client placed on activity restrictions and the allegation was reported to the Child Abuse Hotline and accepted.

Licensing Specialist: Kendra Rice.

Licensing viewed video footage of incident. Facility reported that the staff member was terminated on 10/26/23.

Facility cited 109.1.g: Staff member was observed grabbing the resident’s arm and it appeared that he pushed the resident.

Facility cited 905.15: A water bottle was left in seclusion room that resident destroyed into pieces.

This complaint was founded by Licensing. CACD investigation was unsubstantiated.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient reported to nurse that two days ago she hit her arm against the wall and bruised it. Patient was assessed initially yesterday and today it showed continued discomfort and discoloration, orders received to be evaluated at urgent care. Ortho Arkansas had the following results: Right wrist is not fractured, some swelling noted to Ulnar side of right wrist.

10/18/2023 – Licensing Specialist informed there was no fracture but resident was placed in a cast for two weeks due to bruising and swelling. Resident has a follow-up appointment scheduled for 10/8/2023 at 3:40pm.

PRLU or OLTC

Notice of Incident, Self-Harm

The patient entered the seclusion room because she was unhappy and disobeyed staff directives, according to the staff. After being observed hitting her head while in seclusion, the patient was put in a personal restraint. The patient was eventually quiet enough to be taken out of the personal restraint after ten minutes. Nurse noted three self-harm marks: one bite mark just above the left wrist, one bite mark that penetrated the flesh on the wrist, and a superficial scar on the left lower arm. Patient rejected all medical attention and did not allow nurse to take vital signs. Patient placed on freeze, FOH, and eyeball. Patient received orders for transfer to acute facility.

Licensing Specialist informed that resident returned to the facility on 10/23/2023.

PRLU or OLTC

Medical, Notice of Incident

Patient was at OBGYN appt during snack BG (blood glucose) check. Upon returning to the facility, nurse did dinner Accu-Chek. Patient told nurse she had eaten ‘two rice krispies, original size’ and ‘two packets of cheese peanut butter crackers’. Carb count was estimated at 86 carbs, BG was 441. Patient was given 14 units Novolog (6 units per s/s 6 units per carb count, 2 units for additional BG correction). Patient was told to wait to eat dinner until BG could be rechecked. Pt refused and began to curse at this nurse and threatened to ‘fuck things up’. Patient then grabbed dinner and began eating it. BG rechecked a half hour after dinner was eaten. Patient told nurse that she was feeling ‘dizzy’ and ‘not well’. BG was 540. Ketones trace. Patient told nurse ‘I need to go to children’s.

Due to patient’s increasing BG and presenting symptoms, patient was taken to Arkansas Children’s Hospital ER. Upon patient’s return, no signs of distress noted. LPN recorded vital signs and blood sugar levels upon return. Will follow physicians orders for continued plan of care.

PRLU or OLTC

Notice of Incident, Self-Harm

Nurse informed that patient had punched the wall while she was agitated last night (10/7/23). Nurse noted swelling and purple discoloration at #5 proximal aspect of digit, with abrasions on prone aspect of right hand. Orders received to have her evaluated at urgent care. Diagnosis: Sprain of R fifth finger.

PRLU or OLTC

Accidental Injury, Notice of Incident

Patient was returning to house from outside activity and twisted her right ankle. Nurse noted swelling/bruising to area. Patient unable to stand and bear weight or perform active or passive range of motion. Orders received to transport to ACH for evaluation. ER findings: No fracture on x-ray, likely sprain/strain. Diagnosis: Acute R ankle pain.

Police Report

Caller reported his granddaughter went on a visitation with her father over the weekend and upon returning to the facility, the juvenile tested positive for THC. Caller complained there was no report of the drug screen completed by Youth Home staff. Officer provided details of report to DHS Hotline.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice.

Licensing reviewed 12 children files from 10:30am – 2:00pm. All complied with the minimum licensing standards.

PRLU or OLTC

Elopement, Notice of Incident, Peer Altercation

Peer (1) gave client a threatening quote on whiteboard saying “If you don’t stop you will not enjoy the consequences”. Staff encouraged client to allow them to de-escalate the situation. Client seemed accepting to the information. While staff was helping de-escalate another peer (2), the client went behind staff’s back and immediately started fighting peer (1). Additional staff were called due to the increased aggressiveness. Staff had to remove pt’s arms from peer’s neck. After staff was standing between client and peer, he quickly calmed down and walked out of the class with staff.

Staff discussed patient going to Chestnut House for the afternoon to separate the residents, and patient refused and stated they would have to restrain him to get him there. As staff went to get help, patient ran out of the D-Zone and out the side door and eloped. Staff pursued patient but lost sight of him. Run protocol was initiated and the Pulaski County Sheriff’s Office was notified. At approximately 10:20 am, patient arrived back to campus via the police.

Client was placed on house restriction and “freeze” for aggression. Nurse assessment: Erythema noted to posterior neck and (L) ear. He endorsed some soreness of bottom tooth, #24 as he reported hitting his head on the wall while striking his peer. He reports 6/10 pain and requested orajel. Orajel administered. This tooth appears pushed back and not aligned with others. Client reports this is WNL for him except the sensitivity.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

Licensing received complaint: Reporter stated resident returned home from a weekend pass with her non-custodial parent and was reportedly acting “strange”. RN reportedly drug tested the resident and she came back positive for marijuana. The reporter suspected that the non-custodial parent provided the resident with the marijuana as he has a known history of substance abuse. The reporter states that the facility failed to call the Child Abuse Hotline and instead stated that they will be doing their own investigation internally. The family has filed a police report with the Pulaski Co. Sheriff’s Office. The incident occurred on 10/1/23 and it is reported that no call to the hotline has been made by the facility as of 10/6/23.

Licensing Specialist: Kendra Rice.

Licensing requested nursing notes for 10/1/23 and inquired of lab results. Lab results received. Resident tested negative for marijuana and positive for nicotine.

This complaint has been unfounded by Licensing.

PRLU or OLTC

Medical, Notice of Incident

Resident was transported by staff to Baptist Urgent Care for them to examine her bruised tailbone as she was experiencing leaking from the area, which was also producing an odor. Baptist Urgent Care advised staff that resident needed to be taken to the ER to ensure proper drainage and further assessment. Resident was then taken to Arkansas Children’s Hospital ER and diagnosed with Pilonidal Cyst.

Orders: Dressing applied to tailbone to collect drainage (will need to be changed frequently), [REDACTED] by mouth 3x a day for 10 days, and follow-up with Surgery Clinic.
Licensing Specialist inquired about follow-up appointment for resident. Licensing Specialist informed resident is scheduled to discharge on 8/5/23. A call was made to expedite the resident’s surgery appointment. No call had been returned to the nurse charge.

Police Report

Welfare Check

Officer responded to the facility in reference to a welfare concern. Caller advised he wants to know his son is alive (resident at the facility).

Upon arrival, staff informed officer that resident’s father had been calling to speak with his son for his birthday, but that his parental rights were taken away and he can receive no information regarding his son and his well-being. Officer informed caller that he can no longer call the group home demanding to talk to his son.

Police Report

Assist Ambulance

Officer was dispatched to facility in reference to an ​assist MEMS with a juvenile. ​Prior to arrival,​ I was advised that the juvenile was actively being restrained. ​Upon arrival,​ juvenile was located asleep in his bed unrestrained. Officer was advised he was restrained several hours ago and had since been unrestrained. ​MEMS responded to the scene and transported the juvenile without incident.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice.

Licensing completed building and grounds at Chestnut House from 9:30am – 10:15am. Areas observed: Comfort room, seclusion room, staff bathroom, bedrooms, bathrooms, storage closet, game room, visitation/therapy room, laundry room, library, and dining area.

The Chestnut House flooring had been repaired, baseboards replaced, and walls were painted. A date has not been determined when residents will move back into the house.

Police Report

Elopement

Officer was dispatched to facility in regards to a runaway juvenile. Officer canvassed the area and located the missing juvenile walking through a field. ​Upon making contact with the juvenile, she stated she ran away from the youth home because she has felt trapped and just needed to get away. Staff arrived on scene and transported the juvenile back to the facility.

PRLU or OLTC

Elopement, Notice of Incident

Resident returned to the house with staff after dinner, and once staff attempted to open the door, client sprinted into the woods. Staff attempted to pursue resident but was unsuccessful. Pulaski County Sheriff’s Office was contacted and located the resident. Resident stated she ran b/c she has been having ‘unwanted thoughts to harm self’ and ‘impulsive thoughts’, but denies plan to harm self at this time. Resident was assessed and the nurse noted superficial cuts on R shoulder and on L shin. Resident stated these are from running through the woods. Denies any other pain/injuries.

Licensing Specialist informed resident was placed on close observation, run risk, freeze, and house restriction.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact, Visit Compliance Report

Two residents accused peer of going into their room and touching them inappropriately. A hotline report was filed and residents were placed on 6 ft. peer limit from the accused. On 9/7/23, facility was informed the call was accepted for investigation.

Facility informed licensing that 1 resident attempted to tell staff but staff did not understand that it was touching. This staff member received disciplinary action. It was reported that there were no witness statements. Licensing inquired about late reporting, and received an email with correspondence on when the hotline was submitted and accepted.
This complaint was unsubstantiated by Crimes Against Children Division (CACD) and Licensing.