Observations
The facility failed to document an informed and voluntary consent from the client prior to the disclosure of information contained in the client record in one of seven client records reviewed on October 17, 2018.
Client # 1 was admitted June 20, 2018.
The client's name and diagnosis was disclosed to the funding entity for counseling authorization on June 25, 2018.
The client's name and progress report was disclosed to a treatment provider on August 16, 2018.
The findings were reviewed with the facility staff during the licensing process.
|
Plan of Correction
For aa records that are currently open the Clinician will obtain necessary written releases. The Program Director will review the policy on confidentiality. Clinicians will obtain written informed consent for the disclosure of information for all necessary parties. This will be monitored during monthly chart reviews and discussed in the quality improvement meetings. |