Observations
Based on a review of client records, the facility failed to ensure that all consents included a dated signature of witness in Client Record #1 and 3.
Client# 1 was admitted on May 17, 2019 and was still active at the time of the inspection. Consents to release information to funding sources and emergency contact were signed and dated on May 17, 2019 but failed to include witness signature.
Client #3 was admitted on June 28, 2019 and was still active at the time of the inspection. Consents to release information to the emergency contact and funding source signed and dated June 28, 2019 failed to include the witness signature.
The findings were reviewed with facility staff during the licensing inspection.
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Plan of Correction
Facility clinical supervisor retrained all facility staff on the appropriate completion of client consent to release information forms on 8/7/2019 ensuring that they had the appropriate witness signatures.
Facility clinical supervisor had all staff review all client consent to release information forms on 8/7/2019 and any incomplete consent forms were recreated appropriately at that time.
Facility clinical supervisor will review consent forms weekly during her regular clinical chart reviews beginning on 8/9/2019 to ensure ongoing compliance. |