Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.106 - HEALTH CARE FACILITIES
Subchapter 37.106.30 - Eating Disorder Centers
Rule 37.106.3025 - EATING DISORDER CENTERS (EDC): CLINICAL RECORDS
Universal Citation: MT Admin Rules 37.106.3025
Current through Register Vol. 18, September 20, 2024
(1) An EDC's clinical records must contain the following:
(a) the name, address, date of
birth, and gender of the client;
(b) the name and contact information for the
client's family and any legally authorized representative;
(c) be in the preferred language and include
any special communication needs of the client;
(d) a reason of admission for care,
treatment, or services;
(e) an
initial screening assessment;
(f) a
clinical intake assessment;
(g)
medical information including results of physical exam and laboratory testing;
(h) an initial plan of care and
plan of care reviews;
(i)
documentation of individual, family, and group therapy;
(j) documentation of family involvement or
reason why involvement is contraindicated;
(k) documentation of consultations with a
registered dietitian;
(l)
documentation of monitoring the client's weight and food related behaviors as
outlined in the plan of care; and
(m) a discharge summary.
AUTH: 50-5-247, MCA; IMP: 50-5-247, MCA
Disclaimer: These regulations may not be the most recent version. Montana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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