INITIAL COMMENTS
|
This report is a result of an on-site licensure renewal inspection conducted on June 25, 2018 by staff from the Department of Drug and Alcohol Programs, Bureau of Quality Assurance for Prevention and Treatment, Program Licensure Division. Based on the findings of the on-site inspection, Gaudenzia Montgomery County Outpatient, was found not to be in compliance with the applicable chapters of 28 PA Code which pertain to the facility. The following deficiencies were identified during this inspection:
|
Plan of Correction
|
709.92(a)(2) LICENSURE Treatment and rehabilitation services
709.92. Treatment and rehabilitation services.
(a) An individual treatment and rehabilitation plan shall be developed with a client. This plan shall include, but not be limited to, written documentation of:
(2) Type and frequency of treatment and rehabilitation services.
|
Observations
Based on a review of 14 client records, the facility failed to properly document the frequency of services on the comprehensive treatment plan in 3 records.
Client #12 was admitted on 3/5/18, and was active at the time of inspection. The client's individualized treatment plan was dated 6/14/18 and does not indicate the frequency of counseling services to be provided.
Client #13 was admitted on 3/15/18, and was active at the time of inspection. The client's individualized treatment plan was dated 5/25/18 and does not indicate the frequency of counseling services to be provided.
Client #14 was admitted on 12/22/15, and was active at the time of inspection. The client's individualized treatment plan was dated 6/19/18 and does not indicate the frequency of counseling services to be provided.
These findings were reviewed with facility staff as part of the inspection process.
|
Plan of Correction
The electronic treatment plan form is currently undergoing revision to provide space to specify both type and frequency of interventions as well as prompts to remind the clinician to address this area. These revisions will be completed and fully implemented by 7/31/18. Program management will ensure that treatment plans are properly utilized through ongoing regular chart audits.
|