Q: How does Hermitage Hall determine whether someone is appropriate for its programs?

A: The facility uses specific criteria to determine whether someone is appropriate for admission. Only those males, between the ages of 9 through 17, who have exhibited sexually abusive and/or sexually reactive behaviors will be considered for admission. In addition, the adolescent must have a verbal IQ score greater than 54; must not present an immediate danger to himself or others; and, must be medically and cognitively stable; and must be compliant with his medication regimen, as prescribed by a physician. To discuss all admission criteria, please contact the Admissions Department at (615) 250-2403 or (800) 788-4771.

Q: Does Hermitage Hall serve both males and females?

A: No. Only males are treated at Hermitage Hall.

Q: Must a resident be admitted through the Court system?

A: Many of the young men who are admitted to Hermitage Hall have been adjudicated through the Court system; however, many others are referred from State agencies and some directly from families who have discovered a pattern of sexually abusive behavior.

Q: What credentials does Hermitage Hall have that allows the facility to provide services?

A: Hermitage Hall is licensed as a residential treatment facility by the Tennessee Department of Mental Health and Developmental Disabilities (TDMHDD) to provide treatment to male sex offenders. In addition, the facility is certified by The Commission on Accreditation of Rehabilitation Facilities (CARF), a nationally recognized organization that conducts in-depth reviews of facilities like Hermitage Hall. CARF maintains rigorous guidelines for service and quality, and serves as an additional third-party endorsement. Certification by CARF shows that Hermitage Hall conforms to nationally and internationally recognized service standards and is focused on delivering the most favorable treatment results.

Q: How often is Hermitage Hall inspected by the above organizations?

A: The Tennessee Department of Mental Health and Development Disabilities (TDMHDD) conducts numerous inspections each year to all residential facilities, including Hermitage Hall. Many of these visits are random and unannounced. TDMHDD also conducts scheduled inspections each year. A full inspection by TDMHDD was conducted in 2007 and 2008. Hermitage Hall remains in good-standing and had maintained licensure. CARF periodically conducts a full survey for facilities that want to maintain certification. The last CARF survey for Hermitage Hall was conducted in August of 2007, which resulted in a full three-year certification. During that survey, Hermitage Hall was commended by CARF for creative programs designed to reduce the use of restraints. The managed care organizations that handle behavioral health services for State Medicaid also periodically conduct inspections. These organizations also make referrals to the facility. In 2008, all three of Tennessee’s behavioral health organizations (BHO’s) conducted reviews. All found Hermitage Hall to be in compliance on all matters related to quality of care and safety.

Q: What sources of payment will you accept?

A: Hermitage Hall will accept private pay and private insurance, as long as the insurance carrier’s criteria for medical necessity have been met. We are also an approved Medicaid provider, so will accept Medicaid in the states of Tennessee, Kentucky, and Pennsylvania. For all other states, Single Case Agreements or Contracts are an option.

Q: How long does it take to get a child admitted into Hermitage Hall?

A: At times, Hermitage Hall receives more referrals then there are slots available. When this happens, the Director of Admissions reviews and prioritizes those who are eligible, based on current case mix, need, and other relevant factors. Average wait list time for an opening could be as short as 24 hours or up to 2 weeks.

Q: Is Hermitage Hall a secure facility?

A: Hermitage Hall is a locked-door, staff-secured facility that utilizes electronic surveillance in all resident living areas. We are staffed 24-hours a day by staff who provide line-of-sight supervision.

Q: How do you maintain line-of-sight supervision?

A: All new staff hired by Hermitage Hall are trained in how to provide “line-of-sight” supervision. In addition, the facility uses motion detectors in the bedroom areas and camera surveillance throughout the common areas of the facility.

Q: What is your staff to resident ratio?

A: On average, the ratio of direct care staff to residents is 1:8. This ratio will vary slightly from time to time, depending on the current needs of the unit and residents.

Q: Does Hermitage Hall have psychiatrists and other doctors on staff?

A: The physicians who serve residents at Hermitage Hall are not employees of the facility, but are instead contracted under a professional services agreement. This means Hermitage Hall has access to several medical professionals with a range of expertise to meet the unique needs of residents, such as psychiatrists, pediatricians, and nurse practitioners. In fact, one of the contracted psychiatrists and the nurse practitioner are also on staff at Vanderbilt University Medical Center. Members of the medical team evaluate and monitor each resident’s physical and mental health needs. If medications are determined necessary to treat any ailments or conditions, these medications are prescribed by the medical team, who also supervise the administration of medications by each program’s nursing staff. Routine early periodic screening diagnosis and treatment (EPSDT) services are provided by consulting physicians or local health care providers. When needed, all emergency medical services are obtained at local hospital emergency rooms.

Q: How do you ensure that qualified staff are hired to work with residents?

A: The facility employs a wide range of professionals to work with residents – professionals who are already educated in working with behavioral issues and who hold degrees as psychologists, social workers, professional counselors, and educators. Most of these professionals already hold a Masters degree in their discipline. When anyone is considered for employment, a complete application containing work history is obtained, fingerprints are taken, copies of legal identification, diplomas, degrees, and licenses are obtained, and references are checked. An independent firm conducts a complete background check that includes a search of sex offender and abuse registries. Before an employment offer is extended, the new hire must pass a drug test, TB skin test, and a physical exam.

Q: Does the facility provide any special training to employees on working with sex offenders or those with behavioral problems?

A: Every new employee receives 40 hours of classroom training and 40 hours of mentoring. Training includes practical application of the Hermitage Hall treatment program, including: Handle with Care; CPR/First Aid/Blood-borne Pathogens; Offender Dynamics; Cultural Diversity, Boundaries; Verbal De-escalation; Rights of Residents Served; Service Excellence; Line of Sight; Ounce of Prevention; HIPAA Compliance, and more. These training sessions are offered every month, in case employees need to repeat certain sessions. Annually, every staff person is required to be re-trained on the above topics.

Q: How are the educational needs of residents met while they are living at Hermitage Hall?

A: Hermitage Hall operates an on-site school for K-12 that is approved by the State of Tennessee Department of Education for general and special education. When applicable, an Individual Education Plan (IEP) is developed for students with special educational needs. The school program integrates therapeutic activities with daily instruction. All credits earned while attending school at the facility are transferrable when the resident leaves and returns to his permanent residence. Residents may also choose to participate in vocational training classes that teach marketable skills and include practical experience in on-campus jobs. Structured activities are provided daily to assist the resident in developing socially appropriate leisure interests and skills.

Q: If a resident completes his education while at Hermitage Hall, can he graduate?

A: Yes. In fact, a graduation ceremony is held at the end of the school year for those who complete their high school educational requirements while at Hermitage Hall. This ceremony involves everyone – residents, their families (if available) and staff – and acknowledges each resident who has met all criteria to receive a high school diploma.

Q: Do residents receive therapy to address issues about their sexual offending behavior?

A: Every resident who enters Hermitage Hall is assigned to a therapist and a therapy group. The therapist manages the case and serves as liaison with probation officers, social workers, family members, and others who are involved with the resident. The therapist works with a team of facility professionals, including physicians, nurses, educators, recreational therapists to develop a treatment plan that documents goals and recommends treatment interventions. This plan is designed to help residents with behavioral adjustments, which include teaching them ways to avoid sexual re-offending. The multi-disciplinary team meets regularly to discuss each case and to address issues and concerns. Families/legal guardians and caseworkers may also be involved in treatment team meetings, as appropriate. Each month, the treatment plan is updated and adjustments made to ensure the resident continues to make progress. From the outset, the treatment plan also serves as the planning document for discharge and aftercare.

Q: How often are clinical services provided by therapists?

A: Therapists conduct individual sessions with each resident weekly and meet with residents in group sessions for at least four hours a week. Family sessions are also provided, based on State or contract requirements.

Q: Does Hermitage Hall use seclusions and/or chemical restraints in treating residents?

A: If determined appropriate by the clinical team, a non-locked seclusion room is used when residents need “time out” that removes them from peer interaction for a limited period of time. When placed in the “quiet room,” residents are always supervised by staff. When behavioral outbursts must be addressed, various crisis management techniques of de-escalation are utilized, tailored to the needs of the resident and the situation. Staff is trained in appropriate ways to handle such crises. The “Handle with Care Management System” trains all staff on protective hold procedures. Chemical restraints are not authorized or utilized at Hermitage Hall.

Q: How long is the typical treatment program for a sexual offender who is admitted to Hermitage Hall?

A: The estimated length of stay to complete a full treatment program for rehabilitation as a sexual offender is one year; however, length of stay will vary by each resident’s situation and clinical prognosis.

Q: When can residents be visited by family or those involved in the case?

A: Standard visitation is available Saturdays and Sundays 9:00 am to 11:00 am. Other times and dates may be scheduled with the therapist.

Q: How will discharge planning be conducted and who will be involved in the process?

A: The discharge planning process begins on the day of admission. The admissions department, clinical team, educational staff, medical and nursing resources, as well as the utilization review department work together to plan discharge, placement and aftercare options. Parents, local caseworkers and probation officers receive copies of the Master Treatment Plan reviews, which includes the discharge plan. Contingency plans are made to account for changes in the original discharge destination. Creating a successful transition to permanent placement permeates Hermitage Hall’s practice. When the treatment team and workers agree that a resident is approaching eligibility for discharge, every effort is made to coordinate the logistics of the discharge with families and case workers, according to the requirements of the contract.