(a)
Physician's Responsibility: It shall be the responsibility of each attending
physician to complete and sign the clinical record within a stipulated time
after the discharge of the resident consistent with good medical practice. The
use of rubber stamp signature is acceptable under the following strict
conditions:
(1) The physician whose signature
the rubber stamp represents is the only one who has possession of the stamp and
is the only one who uses it, and
(2) The physician places in the
administrative offices of the residential treatment facility a signed statement
to the effect that he is the only one who has the stamp and is the only one who
will use it. However, it must be emphasized that use of rubber stamp signatures
is not permissible on orders for drugs listed as "controlled substances" under
"Rules and Regulations Pertaining to Controlled Substances," R61-4 of the South
Carolina Code of Laws of 1976.
(b) Organization: The responsibility for
supervision, filing and indexing of records shall be assigned to a responsible
employee of the residential treatment facility who has had training in this
field.
(c) Indexing: Clinical
records shall be properly indexed and filed for ready access by members of the
staff.
(d) Ownership: Records of
residents are the property of the facility and must not be taken from the
residential treatment facility property except by court order.
(e) Contents: Adequate and complete clinical
records shall be written for all residents admitted to the facility. All notes
shall be legibly written or typed and signed. Although use of initials in lieu
of licensed nurses' signatures is not encouraged, initials will be accepted
provided such initials can be readily identified within the medical record. A
minimum clinical record shall include the following information:
(1) Admission Record: An admission record
must be prepared for each resident and must contain the following information,
when obtainable: name; address, including county; occupation; date of birth;
sex; marital status; race; religion; county of birth; father's name; mother's
maiden name; husband's or wife's name; health insurance number; provisional
diagnosis; case number; days of care; social security number; the name of the
person providing information; name, address and telephone number of person or
persons to be notified in the event of emergency; name and address of referral
source; name of attending physician; date and hour of admission;
(2) medical history and physical within 5
days prior or 96 hours after admission; provisional and working
diagnosis;
(3)
psychiatric/diagnostic evaluation 5 days prior or 96 hours after admission;
provisional or working diagnosis;
(4) medical treatment;
(5) dietary assessment, care plan;
(6) progress notes from all treatment
services;
(7) Medication
Administration Record or similar document for recording of medications,
treatments and other pertinent data. The staff member shall sign this record
after each medication administered or treatment rendered;
(8) final diagnosis and discharge
summary;
(9) date and hour of
discharge;
(10) in case of death,
cause and autopsy findings, if autopsy is performed;
(11) special examinations, if any, e.g.,
consultations, clinical laboratory, x-ray and other examinations;
(12) psychological testing: complete battery
within the past twelve months with repeated selected tests on admission or a
complete battery of tests within thirty days when tests have not been done
prior to admission.
(13) childhood
development history;
(14)
immunization history;
(15)
psychosocial assessment, care plan;
(16) preadmission identification of current
legal status, e.g., proof of custody;
(17) educational testing and prior
educational records;
(18) treatment
plan;
(19) activities assessment,
care plan;
(20) comprehensive
treatment plan formulated by interdisciplinary team.