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Minnesota Statutes Public Welfare and Related Activities (Ch. 245-267) § 245F.19. Patient records

Current as of January 01, 2025 | Updated by Findlaw Staff

Subdivision 1.Patient records required. A license holder must maintain a file of current patient records on the program premises where the treatment is provided. Each entry in each patient record must be signed and dated by the staff member making the entry. Patient records must be protected against loss, tampering, or unauthorized disclosure in compliance with chapter 13 andsection 254A.09; Code of Federal Regulations, title 42, sections 2.1to2.67; and title 45, parts 160 to 164.

Subd. 2.Records retention. A license holder must retain and store records as required bysection 245A.041, subdivisions 3and4.

Subd. 3.Contents of records. Patient records must include the following:

(1) documentation of the patient's presenting problem, any substance use screening, the most recent assessment, and any updates;

(2) a stabilization plan and progress notes as required bysection 245F.07, subdivisions 1and2;

(3) a discharge summary as required bysection 245F.07, subdivision 3;

(4) an individual abuse prevention plan that complies withsection 245A.65and related rules;

(5) documentation of referrals made; and

(6) documentation of the monitoring and observations of the patient's medical needs.

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Cite this article: FindLaw.com - Minnesota Statutes Public Welfare and Related Activities (Ch. 245-267) § 245F.19. Patient records - last updated January 01, 2025 | https://codes.findlaw.com/mn/public-welfare-and-related-activities-ch-245-267/mn-st-sect-245f-19/

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