A watchdog group and a nonprofit that performs inspections for the state have reported problems at Piney Ridge Treatment Center in Fayetteville, which provides care for about 100 children for sexual behavior problems and mental illness.
After two September visits to Piney Ridge, Disability Rights Arkansas emailed the Arkansas Department of Human Services about 14 areas of concern regarding conditions, including sexual contact among children.
The Arkansas Foundation for Medical Care, a Little Rock nonprofit, made an Oct. 14 visit to Piney Ridge on behalf of state regulators after they received Disability Rights' email. Its report confirmed some issues including child sexual contact, but didn't find others.
Piney Ridge's top executive disputed many of the Disability Rights claims in written responses provided to the Arkansas Democrat-Gazette.
Below are findings from Disability Rights and the Arkansas Foundation for Medical Care (AFMC) and responses from Piney Ridge Treatment Center. All are edited for clarity and brevity.
1. Disability Rights Arkansas: Lack of supervision, leading to frequent "consensual" sexual contact among children.
AFMC: Two of 20 children interviewed said other children in the facility had initiated sexual contact with them. Sixteen said they had heard of others having sexual contact at the facility. (Report did not specify whether these instances were consensual or forced contact.)
Piney Ridge Treatment Center: Residents are supervised at all times. (Did not respond directly to allegations of consensual sexual contact.)
2. Disability Rights: Forced or unwanted child-to-child sexual contact [takes place].
AFMC: Children reported sexual contact among peers (see above).
Piney Ridge: Any allegation of abuse among residents is promptly reported to law enforcement, state agencies and guardians. Allegations are investigated and corrective action is taken when needed. (Did not respond directly to whether forced sexual contact occurs.)
3. Disability Rights: Four to six children placed in the same bedroom, grouped by default instead of determinations in individual treatment plans.
AFMC: As many as six children per bedroom. State maximum is four, but Piney Ridge had a 2006 state licensing waiver to allow six.
Piney Ridge: Bedrooms contain one, three or six children consistent with state licensing requirements. Youth are grouped based on age, function, clinical needs. Facility closely monitors assignments and changes them as needed.
4. Disability Rights: Up to 24 children housed on a unit together with little structured off-unit time.
AFMC: Up to 32 kids stay on the same unit.
Piney Ridge: Residents have a structured and full daily schedule that includes school, extracurricular activities and therapy. (Didn't address numbers of children per unit.)
5. Disability Rights: Excessive use of restraints.
AFMC: Records showed 110 incidents of restraints, "seclusions" and chemical restraints during a 30-day period.
Piney Ridge: All restraint events are compliant with federal regulatory requirements, state Medicaid and licensing regulations.
6. Disability Rights: Use of chemical restraints [medication], up to 30 to 40 times per month.
AFMC: Chemical restraints comprised 12 of the 110 incidents reported in one 30-day period.
Piney Ridge: Restraints are "an unfortunate reality for treatment programs like ours." They are used only for the physical safety of children and others.
The Arkansas Democrat-Gazette would like to talk with current and former patients, their family members, and staff at Piney Ridge Treatment Center and other Acadia-owned facilities in Arkansas. The newspaper understands many of the issues are sensitive and may include personal information about minors. If you would like to talk with a reporter, contact:
Ginny Monk
(501) 378-3853
Lisa Hammersly
(501) 399-3651
7. Disability Rights: High rate of staph infections because the facility is dirty.
AFMC: Facility was "very dirty." Records showed two positive tests of throat cultures for "Staph Aureus" between July and September this year. Wound cultures included one positive for staph, five positive for Strep A and staph.
Piney Ridge: Medical personnel are available at all times with in-house medical coverage by a physician. All infections are treated.
8. Disability Rights: Children wear dirty clothing, sometimes several days in a row.
AFMC: Two children said they didn't have clean clothes to wear every day. Said laundry was done on a certain day "whether you had enough clean clothes to last that long."
Piney Ridge: Residents can do laundry multiple times per week; employees do laundry for those under age 12. Residents choose their own clothing.
9. Disability Rights: Failure to conduct psychosexual evaluations. Reviews for five children found no such evaluations; most recent psychological exam found was 2 years old.
AFMC: "All 20 charts reviewed had a psychosexual evaluation."
Piney Ridge: Clinicians complete psychosexual exams of all residents within seven days of admission.
10. Disability Rights: Housing lower-functioning kids and kids with autism "indiscriminately with all other youths" and providing all with same programs.
AFMC: "Piney Ridge staff states there is no specific policy on room assignments. Each case is evaluated by the treatment team and room placement is decided."
Piney Ridge: A resident's diagnosis, IQ, and adaptive skills are all considered as part of the admission. The center mixes "functioning levels."
11. Disability Rights: Giving children cold meals for days or weeks as a punishment.
AFMC: Fifteen of 20 children interviewed said they had received cold meals as punishment. At least one staff member said that portions "aren't big enough" and "these kids are hungry."
Piney Ridge: Cold meals are not used as punishment, but are assigned based on a child's "unwillingness or inability to follow prescribed diets or to maintain behaviors in the cafeteria" that are safe.
12. Disability Rights: Failure to properly train direct-care staff members.
AFMC: Most of 20 staff files checked contained records of orientation training. Seven had no crisis-prevention training documents or expired documents, 15 had no proof of CPR training. Other missing records: five staff members had no records for child maltreatment checks, nine had no checks for adult maltreatment, one had no criminal background check.
Piney Ridge: All direct-care staff members attend Nonviolent Crisis Intervention training upon hiring and get refresher courses every six months. They attend a four-day orientation. This training is 30 to 40 hours. Periodic required retrainings and refreshers are held.
13. Disability Rights: Taking away as punishment a computer tablet used to communicate with a child who doesn't speak English.
AFMC: The teacher at Piney Ridge denied this ever happened.
Piney Ridge: The facility has had one resident whose primary language wasn't English. The tablet or its three backups were never taken as punishment.
14. Disability Rights: Educational neglect. Providing Free Appropriate Public Education is a requirement of the federal Individuals with Disabilities Education Act.
AFMC: Saw individual education programs for students who require them and weekly progress notes. Observed quiet classrooms and students doing schoolwork.
Piney Ridge: The facility's Summit Academy program is approved through the state Department of Education, based on state standards. School reviews individual education plans every nine weeks; local school system monitors educational services.
-- Ginny Monk and Lisa Hammersly
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