Adopted adolescent that came from group home prior to presenting to the Emergency Department on 4/27/2026 with Law Enforcement due to increased aggression and agitation at group home. 4/26/26 had aggressive behavior at his group home physically assaulting two staff members. One staff sprained a wrist and the other staff required facial surgery following the incident. Earlier in the day he had made threats to stab teachers and staff at school. He reported he meant to strike is housemates but struck the staff instead. A few years ago patient had a previous episode of physical aggression toward caregivers and was hospitalized at that time.
Psychiatric Diagnosis: ADHD
ADHD is a psychiatric diagnosis characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly affect a person’s daily functioning, especially in academic and occupational settings.
PH-F15-6783
Recommendation is for level 5 QRTP
15-year-old female presenting to inpatient as a step up from PrairieCare Residential after experiencing increased mood dysregulation and suicidal ideation. This is her 4th hospitalization with PrairieCare and has been hospitalized at two other facilities. Guardians are currently hoping for a QRTP closer to home and not out of state.
Discharge Plan as of 5/7/26:
-PCR, declined for return
-Avanti, declined, not accepting BCBS at this time
-Gerard, in process of reviewing
-North Homes, declined due to current milieu
-Newport MN, declined due to functional impairment limiting ability to engage effectively in programming
-Newport CT, in process of reviewing
-Rogers Behavioral Health, referral sent
-Acadia Healthcare, referral sent
Continue with established outpatient providers following RTC:
– Individual Therapy
– Medication Management
– CTSS
– Primary Care Provider
MHF-M16-6777
Youth came to our ED 5/5 via parent after discovery of past sexual abuse toward sibling. Parent is refusing to take pt home. CPS doesn’t have jurisdiction to remove pt from home as his safety is not at risk. Current CMH worker is contracted, many steps would be needed if RTC were to be pursued/recommended. No waiver.
MHF-F11-6771
Youth came to our ED in a smaller town on 4/27/26. Was in a pre-adoptive home who is refusing to allow her to return, was at RTC prior to that. Struggling to identify placement options due to age, IQ, and history of behaviors. County is currently exploring all options for her- PRTF, QRTP, Group Homes, DD waiver placements- Crisis and CRS, shelters, and fosters.
CH8SCH-M12-6473
Patient presented to the ER 1/21. Patient is familiar to us. Patient has a complex psychosocial history with prior CPS involvement and a chaotic home environment. Patient typically does well in the ER & hospital setting but struggles at home with severe aggression and behavioral dysregulation in relation to conflict with parents. Patient does not appear to comprehend the severity of his actions and feels like his actions are justified (which appears to be related to his level of functioning). Patient likely needs a crisis respite placement/group home placement, but his CADI waiver and insurance are on hold while transferring to Benton County.
Doing very well for the most part at CentraCare.
CH8SCH-M10-6691
Patient presented from foster care due to concerns of aggression and dysregulation in the context of trauma history and out of home placement. Unable to return to previous foster care. Being referred for residential treatment though needs a safe location while awaiting residential.
PH-M15-6144
Recommending PRTF/RTC/ CADI placement with supports
15 year old male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at Gerard
Funding is in place for RTC with Polk County, has waiver
MHF-F12-6723
Youth came to our ED on 4/16. She was on the run from 4/11-4/15 and returned to adoptive parent 4/15 who brought her to the ED 4/16. SEY concerns while she was on the run. Adoptive parent does not want her returning home. Youth was only open with contracted CMH CM when arriving at the ED. County is working on transitioning her to operated CMH CM. DA was completed 4/22/26 and recommends QRTP/Group Home, need transfer to operated CMH and County JST approval before moving forward there. No waiver currently and no access to County paid shelters due to parent having custody. Have explored parent referred shelters, but so far they have denied. Once operated CM is assigned a referral can be made to Hennepin County YSC. Has history of physical aggression toward siblings, elopement behaviors and SEY concerns.
PH-M10-6705
Recommending PRTF/RTC
10-year-old male who presents to PrairieCare Inpatient Hospital after an episode of behavioral escalation at home.
This is his 2nd psychiatric inpatient hospitalization and had been engaging in outpatient therapy services.
Funding is in place for QRTP with Mower County
Discharge Plan as of 04/20/2026:
RTC/QRTP: (Funding approved 2/17)
– Gerard (Declined due to safety concerns, recommending Bar None Haven or PRTF level of care)
– PrairieCare Residential (Declined due to acuity)
– Northwoods (one year WL, not viable immediate option)
– Bar None Haven (Declined due to safety concerns)
– Nexus Mille Lacs (Declined due to safety concerns)
-Avanti (unable to refer d/t gender criteria)
-North Homes (unable to refer d/t age)
-Newport (unable to refer d/t insurance)
PRTF:
– Grafton (Declined due to request for further diagnostic clarity)
– Nexus East Bethel (reviewing)
-Leo Hoffman (unable to refer d/t age)
-Northwoods (one year WL, not viable immediate option)
Interim Plan:
Establish Psychological Testing
-Sagent Behavioral Health in Rochester
-Southern MN Psychological Services
Establish Occupational Therapy with School
Establish CTSS
-Fernbrook
-Independent Management Services
-Cedar House
Continue with following outpatient providers:
– Medication Management at Olmstead County Medical Center
– CMHCM with Mower County
EH-F16-6694
Patient is a 16-year-old female presenting to the emergency department with concerns for psychiatric evaluation. Patient states that she is here because she has had suicidal thoughts. She states that she “acted out” at home today. She reports that she was recently hospitalized at Prairie care for a month and 1 week. She states that she was “kicked out of residential” because of frequent outburst. Patient states that she did not feel as though she was getting the help that she needed. She reports that she felt as though the workers there were talking about her. She states that today she again felt more suicidal. She states that she cut her arm with the top of a container. Denies any recreational drug or alcohol use. She denies other concerns at this time.
Previous psychiatric diagnoses include PTSD, RAD, Dysthymia, GAD and ADHD. She has had 2 previous psychiatric hospitalization(s). Most recent psychiatric hospitalization was 3/22/26 at Prairie Care, Altru health 2/12/26 for 13 days. Prairie Care in December 2025 due to behavioral escalation and SI crisis. . She admits current or past partial programs or residential programs. She was at Prairie Care Residential for one month. She had to leave due to her behaviors like hitting, screaming, biting and trying to kill herself. She denies psych testing. She admits to 1 previous suicide attempt(s): In December jumped in front of a car. She admits to engaging in self-injurious behavior. Last SIB Today cut her left inside forearm.
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