Observations
Based on a review of client records, the facility failed to ensure that client information was not released after the informed and voluntary consent to release client information forms expired in four of eight client records reviewed.
The findings include:
Eight client records requiring informed and voluntary consent to release client information forms were reviewed on May 14-15, 2014. Documentation contained in client records #1, 5, 6 and 7 confirmed that information was released from the client records after consent forms in the client records expired.
Client #1 was admitted on October 30, 2013. The informed and voluntary consent to release client information forms contained in the record were signed on October 30, 2013 and expired on April 30, 2014. The record included a PCPC form that was completed and released to the insurance company on May 2, 2014 for the purposes of re-authorization for continued stay.
Client #5 was admitted on August 28, 2013 and discharged on March 7, 2014. The informed and voluntary consent to release client information forms contained in the record were signed on August 29, 2013 and expired on February 29, 2014. Information contained in the client record was released to a judge, probation officer and insurance company on March 4 & 7, 2014, after the consent form expired.
Client #6 was admitted on July 22, 2013 and discharged on February 21, 2014. The informed and voluntary consent to release client information forms contained in the record were signed on July 22, 2013 and expired on January 22, 2014. A PCPC form was completed and released to the insurance company on January 31, February 7, 17, and 21, 2014. A letter to the probation officer was released on February 24, 2014.
Client #7 was admitted on July 18, 2013 and discharged February 17, 2014. The informed and voluntary consent to release client information forms contained in the record were signed on July 18, 2013 and expired on January 18, 2014. The record included a PCPC form that was completed and released to the insurance company on January 22 & 31 and February 6 & 17, 2014.
The aforementioned information was discussed with the clinical supervisor and was not disputed.
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Plan of Correction
On May 22, 2014 the Consent for release of Confidential Information was revised, to revoke the consent of information to read "(unless expressly revoked earlier)expires upon discharge from treatment". This consent is in place and was discussed, and distributed in the Staff meeting on May 22, 2014 to the counseling staff. The Residential Director is responsible for supervising the execution of the consent under the direction of the Executive Director. |