Pennsylvania Code
Title 28 - HEALTH AND SAFETY
Part V - Department of Drug and Alcohol Programs
Chapter 709 - STANDARDS FOR LICENSURE OF FREESTANDING TREATMENT FACILITIES
Subchapter F - STANDARDS FOR INPATIENT NONHOSPITAL ACTIVITIES-SHORT-TERM DETOXIFICATION
Section 709.63 - Client records
Universal Citation: 28 PA Code ยง 709.63
Current through Register Vol. 54, No. 44, November 2, 2024
(a) There shall be a complete client record on an individual which includes information relative to the client's involvement with the project. This shall include, but not be limited to the following:
(1) Consent
forms.
(2) Drug and alcohol support
plan.
(3) Progress notes.
(4) Medication records.
(5) Record of services provided.
(6) Aftercare plans, if applicable.
(7) Discharge summary.
(8) Follow-up information.
(9) Verification that work done by the client
at the project is an integral part of the client's drug and alcohol support
plan.
(10) Documentation of special
dietetic needs, if applicable.
(b) The project shall develop and maintain client records on standardized project client record forms.
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