Observations
The facility failed to obtain an informed and voluntary consent from the client prior to disclosure in three of seven client records reviewed on November 2, 3, and 13, 2017.
Client #1 had a signed release of information form for a funding source, but the purpose of the disclosure did not indicate funding as the reason.
Client #2 did not document a release of information form for the funding source.
Client #5 had a signed release of information form for a funding source and another provider, but the purpose of the disclosure indicated all of the options (i.e. Ongoing Care, Management, and Treatment, Aftercare planning and Referral, Service Coordination, and Insurance Claim Processing).
These findings were reviewed with the facility staff during the licensing process.
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Plan of Correction
The Program Director and Clinical Supervisor met with all clinical staff from the Oil City, Titusville and Franklin offices on November 6,2017 at our bi-monthly staff meeting. It was discussed for the individual counselors to ensure all proper boxes on the release of information forms are checked. The releases of information forms will also be checked during the initial intake chart checks and any other subsequent chart During the chart checks by staff they will ensure the boxes are checked and when warranted the box for insurance processing. It will be discussed with the clinical staff during their weekly supervision and randomly checked by the clinical supervisor and/or Program Director. |