INITIAL COMMENTS
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This report is a result of an on-site inspection conducted for the approval to use a narcotic agent, specifically methadone, in the treatment of narcotic addiction. This inspection was conducted on June 17-20, 2013 by staff from the Division of Drug and Alcohol Program Licensure. Based on the findings of the on-site inspection, Parkside Recovery was found not to be in compliance with the applicable chapters of 4 PA Code and 28 PA Code which pertain to the facility. The following deficiencies were identified during this inspection.
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Plan of Correction
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715.21(1)(i-iv) LICENSURE Patient termination
A narcotic treatment program shall develop and implement policies and procedures regarding involuntary terminations. Involuntary terminations shall be initiated only when all other efforts to retain the patient in the program have failed.
(1) A narcotic treatment program may involuntarily terminate a patient from the narcotic treatment program if it deems that the termination would be in the best interests of the health or safety of the patient and others, or the program finds any of the following conditions to exist:
(i) The patient has committed or threatened to commit acts of physical violence in or around the narcotic treatment program premises.
(ii) The patient possessed a controlled substance without a prescription or sold or distributed a controlled substance, in or around the narcotic treatment program premises.
(iii) The patient has been absent from the narcotic treatment program for 3 consecutive days or longer without cause.
(iv) The patient has failed to follow treatment plan objectives.
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Observations
Based on the review of patient records, the facility failed to restrict the reasons for involuntary termination to those reasons allowed by regulation in two of three patient records.
The findings include:
Twenty four patient records were reviewed June 17-20, 2013. Three patient records were reviewed for involuntary, or therapeutic, discharge. One patient records contained documentation of the patient being discharged for reasons other than those listed by regulation. One patient record did not contain documentation to the patient specifying the reason(s) for the involuntary termination.
Patient # 18 was discharged as an administrative detoxification January 4, 2013. The documentation indicated the patient attempted to falsify a urine drug screen by warming a specimen in a facility staff microwave.
Patient # 19 was involuntarily terminated January 29, 2013. There was no specific documentation informing the patient of the reason for termination. Therefore, there was no ability to determine whether the facility deemed the termination would be in the best interests of the health, safety of patient or others, or if the stated conditions allowing for an involuntary termination existed.
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Plan of Correction
Parkside Recovery will follow the termination policy and restrict terminations to the approved reasons:
(1) A narcotic treatment program may involuntarily terminate a patient from the narcotic treatment program if it deems that the termination would be in the best interests of the health or safety of the patient and others, or the program finds any of the following conditions to exist: (i) The patient has committed or threatened to commit acts of physical violence in or around the narcotic treatment program premises. (ii) The patient possessed a controlled substance without a prescription or sold or distributed a controlled substance, in or around the narcotic treatment program premises. (iii) The patient has been absent from the narcotic treatment program for 3 consecutive days or longer without cause. (iv) The patient has failed to follow treatment plan
The clinical supervisors will be resonsible to review each potential termination letter given to a client to assure the policy and regulations regarding termination reasons are followed and present to ensure this deficiency does not re-occur. Additionally, each client will be encouraged to take a copy of the termination form during a meeting between the counselor and the client.
A staff training will also occur on July 29th regarding the client termination policy. |
715.23(b)(22) LICENSURE Patient records
(b) Each patient file shall include the following information:
(22) Aftercare plan, if applicable.
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Observations
Based on the review of patient records and discussion with facility staff, the facility failed to complete an aftercare plan in two of two patient records reviewed.
The findings include:
Twenty four patient records were reviewed June 17-20, 2013. Two patient records required an aftercare plan to be completed.
Patient # 15 was admitted November 28, 2008 and discharged as completed treatment March 15, 2013. There was no aftercare completed or documentation that the patient had refused aftercare.
Patient # 16 was admitted April 14, 2009 and discharged as having completed treatment January 31, 2013. There was no aftercare completed or documentation that the patient had refused aftercare.
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Plan of Correction
Clinical Superivisors will conduct a staff training on July 15, 2013 regarding the proper procedure for completing an aftercare plan with the client.
Additionally, all Clinical Supervisors will discuss with their counselors during supervision which clients are preparing to leave to assure that the aftercare plan is completed before the client actually leaves treatment. Clinical supervisors will be responsible through the supervision process to ensure this deficiency does not re-occur. |