Current through Register Vol. 30, No. 38, September 20, 2024
A. An
administrator shall ensure that:
1. A medical
record is established and maintained for each resident according to A.R.S.
Title 12, Chapter 13, Article 7.1;
2. An entry in a resident's medical record
is:
a. Recorded only by a personnel member
authorized by policies and procedures to make the entry;
b. Dated, legible, and authenticated;
and
c. Not changed to make the
initial entry illegible;
3. An order is:
a. Dated when the order is entered in the
resident's medical record and includes the time of the order;
b. Authenticated by a medical practitioner or
behavioral health professional according to policies and procedures;
and
c. If the order is a verbal
order, authenticated by the medical practitioner or behavioral health
professional issuing the order;
4. If a rubber-stamp signature or an
electronic signature is used to authenticate an order, the individual whose
signature the rubber-stamp signature or electronic signature represents is
accountable for the use of the rubber-stamp signature or electronic
signature;
5. A resident's medical
record is available to an individual:
a.
Authorized according to policies and procedures to access the resident's
medical record;
b. If the
individual is not authorized according to policies and procedures, with the
written consent of the resident or the resident's representative; or
c. As permitted by law;
6. Policies and procedures include the
maximum time-frame to retrieve a resident's medical record at the request of a
medical practitioner, behavioral health professional, or authorized personnel
member; and
7. A resident's medical
record is protected from loss, damage, or unauthorized use.
B. If a behavioral health
residential facility maintains residents' medical records electronically, an
administrator shall ensure that:
1. Safeguards
exist to prevent unauthorized access, and
2. The date and time of an entry in a
resident's medical record is recorded by the computer's internal
clock.
C. An
administrator shall ensure that a resident's medical record contains:
1. Resident information that includes:
a. The resident's name;
b. The resident's address;
c. The resident's date of birth;
and
d. Any known allergies,
including medication allergies;
2. The name of the admitting medical
practitioner or behavioral health professional;
3. An admitting diagnosis or presenting
behavioral health issues;
4. The
date of admission and, if applicable, date of discharge;
5. If applicable, the name and contact
information of the resident's representative and:
a. If the resident is 18 years of age or
older or an emancipated minor, the document signed by the resident consenting
for the resident's representative to act on the resident's behalf; or
b. If the resident's representative:
i. Has a health care power of attorney
established under A.R.S. §
36-3221
or a mental health care power of attorney executed under A.R.S. §
36-3282, a
copy of the health care power of attorney or mental health care power of
attorney; or
ii. Is a legal
guardian, a copy of the court order establishing
guardianship;
6. If applicable, documented general consent
and informed consent for treatment by the resident or the resident's
representative;
7. Documentation of
medical history and results of a physical examination;
8. A copy of resident's health care
directive, if applicable;
9.
Orders;
10. If applicable,
documentation that evaluation or treatment was ordered by a court according to
A.R.S. Title 36, Chapter 5 or A.R.S. §
8-341.01;
11.
Assessment;
12. Treatment
plans;
13. Interval
notes;
14. Progress
notes;
15. Documentation of
behavioral health services and physical health services provided to the
resident;
16. If applicable,
documentation of the use of an emergency safety response;
17. If
applicable, documentation of time-out required in
R9-10-714(6);
18.
Except as allowed in
R9-10-707(E)(1)(d),
documentation of freedom from infectious tuberculosis required in
R9-10-707(A)(13);
19.
The disposition of the resident after discharge;
20. The discharge plan;
21. The discharge
summary, if applicable;
22. If applicable:
a. Laboratory reports,
b. Radiologic reports,
c. Diagnostic reports, and
d. Consultation reports;
and
23. Documentation of medication administered to the
resident that includes:
a. The date and time
of administration;
b. The name,
strength, dosage, and route of administration;
c. For a medication administered for pain,
when administered initially or on a PRN basis:
i. An assessment of the resident's pain
before administering the medication, and
ii. The effect of the medication
administered;
d. For a
psychotropic medication, when administered initially or on a PRN basis:
i. An assessment of the resident's behavior
before administering the psychotropic medication, and
ii. The effect of the psychotropic medication
administered;
e. The
identification, signature, and professional designation of the individual
administering or providing assistance in the self-administration of the
medication; and
f. Any adverse
reaction a resident has to the medication.
The following Section was adopted under an exemption from
the provisions of the Administrative Procedure Act which means these rules were
not reviewed by the Governor's Regulatory Review Council; the Department did
not submit notice of proposed rulemaking to the Secretary of State for
publication in the Arizona Administrative Register; and the Department was not
required to hold public hearings on these rules (Supp.
98-4).